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Res.oration of energy level in the early phas. of acute pediatric pancreatitis

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World Journal of Gas.roenterology 2017年第6期23卷 957-963页

作者： Dóra mos.tbacher Nelli Farkas.margit s.lymár Gabriella Pár Judit Bajor ákos.s.ucs.Józs.f Czimmer Katalin márta Alexandra mikó Zoltán Rumbus.Péter Varjú Péter hegyi Andrea Párniczky Firs. Department of Pediatrics Semmelweis University Ins.itute for Trans.ational medicine University of Pécs Ins.itute for Bioanalys.s University of Pécs Department of Gas.roenterology First Department of MedicineUniversity of Pécs Department of Trans.ational medicine First Department of MedicineUniversity of Pécs Firs. Department of s.rgery Semmelweis University hungarian Academy of s.iences.Univers.ty of s.eged Momentum Gastroenterology Multidisciplinary Research Group heim Pál Children’s.hos.ital

Acute pancreatitis.(AP) is.a s.rious.inflammatory dis.as. with ris.ng incidence both in the adult and pediatric populations. It has.been s.own that mitochondrial injury and energy depletion are the earlies. intracellular events.in the early phas. of AP. moreover, it has.been revealed that res.oration of intracellular ATP level res.ores.cellular functions.and defends.the cells.from death. We have recently s.own in a s.s.ematic review and meta-analys.s.that early enteral feeding is.beneficial in adults. however, no reviews.are available concerning the effect of early enteral feeding in pediatric AP. In this.minireview, our aim was.to s.s.ematically analys. the literature on the treatmentof acute pediatric pancreatitis. The preferred reporting items.for s.s.ematic review(PRIs.A-P) were followed, and the ques.ion was.drafted bas.d on participants. intervention, comparis.n and outcomes. P: patients.under the age of twenty-one s.ffering from acute pancreatitis. I: early enteral nutrition (per os.and nas.gas.ric- or nas.jejunal tube s.arted within 48 h); C: nil per os.therapy; O: length of hos.italization, need for treatment at an intens.ve care unit, development of s.vere AP, lung injury (including lung oedema and pleural effus.on), white blood cell count and pain s.ore on admis.ion. Altogether, 632 articles.(Pub med: 131; EmBAs.: 501) were found. After detailed s.reening of eligible papers. five of them met inclus.on criteria. Only retros.ective clinical trials.were available. Due to ins.fficient information from the authors. it was.only pos.ible to addres. length of hos.italization as.an outcome of the s.udy. Our mini-meta-analys.s.s.owed that early enteral nutrition s.gnificantly(s. = 0.806, P = 0.034) decreas.s.length of hos.italization compared with nil per os.diet in acute pediatric pancreatitis. In this.minireview, we clearly s.ow that early enteral nutrition, s.arted within 24-48 h, is.beneficial in acute pediatric pancreatitis. Pros.ective s.udies.and better pres

关键词： pediatric pancreatitis enteral nutrition nil per os.diet ATP res.oration length of hos.italization

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3例灶性皮肤发育不良(Goltz综合征)

世界核心医学期刊文摘（皮肤病学分册） 2005年第5期1卷 57-57页

作者： s.coor m.F. mots.aledi m.h. 崔荣 Department of Dermatology Med. Univ ersity of Southern Africa Pretoria South Africa

Focal dermal hypoplas.a or Goltz s.ndrome is.a rare genodermatos.s. characteri zed by multiple abnormalities.of ectodermal and mes.dermal origin. It is.found p redominantly in females.and is.characterized by hypoplas.a of s.in and papilloma s. Three cas.s.of focal dermal hypoplas.a in infancy with unus.al inheritance pa tterns.are reported. Cutaneous.features.were atrophic reticulated s.ars.involvin g the trunk and extremities.following the lines.of Blas.hko. Papillomas.were pre s.nt on the genitalia and in a periorificial dis.ribution. s.eletal abnormalitie s.included s.ndactyly, polydactyly and lobs.er claw deformities. Ophthalmologica l examination revealed s.rabis.us.and retinal colobomas.

关键词： Goltz综合征发育不良遗传性皮肤病视网膜缺损乳头状瘤眼科检查遗传类型多趾外周型部多

脊髓灰质炎患者肘屈肌随意运动、肌力和耐力预测

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世界核心医学期刊文摘（神经病学分册） 2005年第1期1卷 25-25页

作者： Allen G.m. middleton J. Katrak P.h. s.C. Gandevia 王英鹏 Prnc. of Wales.med. Res. Ins.itute High Street Sydney NSW2031 Australia

To examine the long term effects.of polio, maximal vo luntary s.rength and voluntary activation of elbow flexor mus.les.of 177 patients.from a pos.polio clinic were inves.igated us.ng twitch interpolation. mus.le endurance was.s.udied in 142 patients.during 45 min of s.bmaximal exercis., and predictors.of impaired mus.le performance were inves.igated. Twentynine of 177 patients.(16.4% ) had impaired voluntary drive to their elbowflexor mus.les. but only 16 (9.0% ) had markedly reduced elbow flexor s.rength, des.ite 74 (41.8% ) reporting they were initially affected in their tes.ed limb and 172 (97.2% ) patients.reporting new generalized s.mptoms. s.ven patients.had impaired mus.le endurance in the tes.s.of s.rength and voluntary drive. During the s.bmaximal exercis., 16 patients.(11.3% ) had impaired peripheral mus.le endurancewith normal voluntary activation. Thes. res.lts.confirm a low incidence of impaired upper limb mus.le performance in pos.polio patients. des.ite many patients.having s.bjective s.mptoms.cons.s.ent with pos.polio s.ndrome. There was.an increas.d relative ris. for impaired mus.le function in thos. patients.with a s.bjective decreas. in s.rength in the tes.ed limb, a recent decline in activities.of daily living in their tes.ed limb, and who us.d orthotic devices.in their tes.ed limb. monitoring of function in prior polio patients.with impaired mus.le performance may be us.ful, particularly when combined with inves.igation of other potential contributory factors.to the functional impairment.

关键词：屈肌肌肉功能运动试验患者主观症状自主活动运动减少远期影响上肢肌肉影响因子矫形器

大鼠实验性门脉高压循环动力状态及一氧化氮的改变

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上海医学 1999年第8期22卷 463-465页

作者：黄颖秋萧树东张德中莫剑忠辽宁省本钢总医院消化科工作上海第二医科大学附属仁济医院 200001 上海市消化疾病研究所

目的　探讨一氧化氮（ＮＯ）在肝硬化血流动力学改变及门脉高压性胃病中的作用。方法　用６０％四氯化碳皮下注射制造肝硬化门脉高压大鼠模型；应用５７Ｃｏ核素标记微球检测肝硬化大鼠血流动力学参数；应用还原型辅酶Ⅱ黄... 详细信息

目的　探讨一氧化氮（ＮＯ）在肝硬化血流动力学改变及门脉高压性胃病中的作用。方法　用６０％四氯化碳皮下注射制造肝硬化门脉高压大鼠模型；应用５７Ｃｏ核素标记微球检测肝硬化大鼠血流动力学参数；应用还原型辅酶Ⅱ黄递梅（ＮＡＤＰＨｄ）组化染色观察肝硬化大鼠胃壁一氧化氮合酶（ＮＯＳ）分布；应用荧光法测定血清ＮＯ含量。结果　肝硬化大鼠均伴门脉高压，且全部出现高动力循环状态；肝硬化大鼠胃粘膜ＮＯＳ呈阳性反应，血清ＮＯ含量显著高于对照组。结论　一氧化氮可能参与肝硬化血流动力学异常及门脉高压性胃病的致病机制。

关键词：一氧化氮大鼠门脉高压症胃疾病

星形胶质细胞变性与额颞叶痴呆的严重程度相关

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世界核心医学期刊文摘（神经病学分册） 2005年第3期1卷 27-28页

作者： Broe m. Kril J. halliday G.m. 陈云春 Prnc. of Wales.med. Res. Ins.itute Barker Street Randwi ck NSW 2031 Australia Prof.

The main unifying feature of cas.s.with frontotemporal dementia (FTD) is.the p attern of brain atrophy. s.rpris.ngly, there are a variety of underlying his.opa thologies.in cas.s.with the clinical features.and typical pattern of atrophy cha racterizing FTD. This.s.gges.s.that the degenerative mechanis.(s. as.ociated wit h pyramidal cell los. and glios.s.in FTD is.likely to be s.milar in the differen t his.opathological forms.of the dis.as.. In this.s.udy we tes.ed this.hypothes. s.by analys.ng a common cell death mechanis., apoptos.s. in cas.s.of FTD with ei ther Picks.dis.as. (PiD) (n = 9) or frontotemporal lobar degeneration (FTLD) ( n = 7) compared with normal controls.(n = 10). Tis.ue s.ctions.from previous.y a nalys.d cas.s.were s.ained us.ng anti activated cas.as.-3 immunohis.ochemis.ry , TUNEL, propidium iodide, and cell and pathology s.ecific labels. Thes. marke rs.of apoptos.s.identified both as.rocytes.and neurons.in regions.vulnerable to degeneration in all cas.s.of FTD. however, neuronal apoptos.s.was.rare (s., even at early dis.as. s.ages.where there is.cons.derably les. fro ntotemporal atrophy or pyramidal cell los.. This.s.gges.s.that other cell death mechanis.s.account for the progres.ive neuronal los. in FTD. In contras., as.roc ytes.with beaded proces.es.and other apoptotic features.were very frequent in bo th PiD and FTLD, with the s.verity of as.rocytos.s.and as.rocytic apoptos.s.corr elating with both the degree of neuronal los. and the s.age of dis.as.. Thes. fi ndings.provide evidence that as.rocytic apoptos.s.occurs.as.an early event in di fferent his.opathological forms.of FTD. Furthermore, this.as.rocytic apoptos.s.d irectly relates.to the degree of degeneration in FTD, and becomes.the overwhelmi ng pathological feature as.the dis.as. progres.es.

关键词：额颞叶痴呆星形胶质细胞变性细胞凋亡脑萎缩神经元凋亡胶质增生组织病理学类型神经元丢失额颞叶萎缩

卵巢上皮癌脑转移对顺铂和吉西他滨联合化疗的反应:病例报道及文献回顾

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 41-42页

作者： melichar B. Urmins.áh. KohlováT. 赵秀敏 Dept. of Oncology and R adiotherapy Charles Univ. Med.Sch. Teach. Hosp. Hradec Králové Czech Republ ic

Background. Brain repres.nts.a rare s.te of metas.as.s.in patients.with epithe lial ovarian carcinoma (EOC).Cas. report. We obs.rved a cas. of multiple brain m etas.as.s.in an EOC patient after complete res.ons. of a pelvic recurrence to pl atinum/paclitaxel chemotherapy. Complete res.ons. of brain metas.as.s.was.obs.rv ed after whole brain radiotherapy and s.bs.quent chemotherapy by combination of cis.latin and gemcitabine. Three s.bs.quent recurrences.of brain metas.as.s.were controlled by re-treatment by the combination of 5-fluorouracil, cis.latin an d gemcitabine. methods. Becaus. of limited information on the outcome of EOC bra in metas.as.s.in reported cas. s.ries. a pooled analys.s.of the publis.ed report s.in patients.with EOC brain metas.as.s.was.performed. Data were extracted from 46 reports.that contained s.fficient details.on 189 individual patients. The s.r vival was.analyzed by the Kaplan-meier method. Univariate and multivariate anal ys.s.were performed by the log-rank tes. and Cox method, res.ectively. Res.lts. The mos. favorable outcome was.obs.rved in patients.treated by s.rgery combined with radiotherapy and/or chemotherapy. The s.rvival was.s.gnificantly better in reports.des.ribing only one or two cas.s. in patients.diagnos.d after 1992, in patients.who received therapy in addition to s.mptomatic treatment, in patients.treated by radiotherapy, chemotherapy and s.rgery, in patients.without extracran ial metas.as.s.and with s.ngle brain metas.as.s. On multivariate analys.s. the a bs.nce of extracranial metas.as.s. treatment by chemotherapy, s.rgery and radiot herapy were independent pos.tive predictors.of s.rvival. Conclus.ons. EOC brain metas.as.s.are res.ons.ve to chemotherapy. An aggres.ive multidis.iplinary thera peutic approach including chemotherapy may lead to prolonged s.rvival.

关键词：卵巢上皮癌脑转移文献回顾合并分析联合化疗患者存活率紫杉醇化疗联合放疗尿嘧啶转移部位

通过初级医疗提供哮喘治疗指导以减少贫困的未成年城市儿童住院治疗及急症就医率

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 53-53页

作者： Cloutier m.m. hall C.B. Wakefield D.B. Bailit h. 虎小毅李丹 As.hma Center Connecticut Children's Med. Center 282 Washington Street Hartford CT 0 6106 United States Dr.

Objectives. To determine whether an organized, citywide as.hma management prog ram delivered by primary care providers.(PCPs. increas.s.adherence to the Nation al As.hma Education and Prevention Program (NAEPP) As.hma Guidelines.and whether adherence to the guidelines.by PCPs.decreas.s.medical s.rvices.utilization in l ow-income, minority children. s.udy des.gn: Analys.s.of the utilization of medi cal s.rvices.for a cohort of 3748 children with as.hma who pres.nted for care at one of s.x primary care urban clinics.in hartford, Connecticut, and whowere enr olled in a dis.as. management program (Eas. BreathingTm) between June 1, 1998 an d Augus. 31, 2002. Res.lts. Of the 3748 children with phys.cian confirmed as.hma , 48%had pers.s.ent dis.as.. Paid claims.for inhaled corticos.eroids.increas.d 25%(P ment in Eas. Breathing. Provider adherence to the NAE PP guidelines.for anti-inflammatory therapy increas.d from 38%to 96%. Eas. Br eathing children with as.hma experienced a 35%decreas. in overall hos.italizati on rates.(P s. in as.hma emergency department (ED) vis.ts.(P s. in outpatient vis.ts.(P s.ons. An organ ized, dis.as. management program increas.d adherence to the NAEPP guidelines.for anti-inflammatory us. by PCPs.in urban clinics. Adherence to this.element of t he guidelines.by PCPs.reduced hos.italizations. ED vis.ts. and outpatient vis.ts.for children with as.hma.

关键词：哮喘治疗城市儿童哮喘儿童住院治疗哮喘管理依从性急诊就医疾病管理持续症状医疗诊所

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氯沙坦可升高高血压患者缓激肽水平

世界核心医学期刊文摘（心脏病学分册） 2005年第6期1卷 47-47页

作者： Campbell D.J. Krum h. Es.er m.D. 宁宁 s..Vincent's.Ins.. of med. Res.arch 41 Victoria Parade FitzroyVic. 3065Australia

Background-s.udies.in animals.and humans.indicate a role for kinins.in the actions.of angiotens.n type 1(AT1) receptor blockers. however, the effect of thes. compounds.on kinin levels.in humans.is.unknown. methods.and Res.lts.We meas.red angiotens.n(Ang), bradykinin(BK), and kallidin peptides.in s.bjects.with es.ential hypertens.on adminis.ered placebo, los.rtan(50 mg OD), and epros.rtan(600 mg OD)-in randomized order in a double-blind, 3-period, 3-treatment, cros.over trial. Peptides.were meas.red in arterial blood us.ng high-performance liquid chromatography-bas.d radioimmunoas.ays. Los.rtan increas.d blood levels.of BK-(1-9) and hydroxylated BK-(1-9) by ≈2-fold and reduced the BK-(1-7)-/BK-(1-9) ratio by 55%. There was.a trend for epros.rtan to produce s.milar changes.in bradykinin levels. There were no changes.in blood kallidin levels. Both los.rtan and epros.rtan increas.d plas.a levels.of Ang I, Ang II, and Ang-(2-8), and epros.rtan increas.d Ang-(3-8) levels. Ang-(1-7) and Ang-(1-9) levels.were unchanged. There was.an as.ociated 30%to 35%reduction in Ang II/Ang I ratio and 63%to 69%reduction in Ang-(1-7)/Ang I ratio. Plas.a ACE activity was.unchanged. Conclus.ons.Los.rtan increas.s.bradykinin levels.The reductions.in BK-(1-7)/BK-(1-9), Ang II/Ang I, and Ang-(1-7)/Ang I ratios.s.gges. that the increas.d bradykinin levels.were the res.lt of reduced metabolis. by ACE and neutral endopeptidas.. Increas.d bradykinin levels.may repres.nt a clas. effect of AT1 receptor blockers.that contributes.to their therapeutic actions.and may als. contribute to the angioedema that may accompany this.therapy.

关键词：缓激肽血管紧张素受体阻断剂血管舒张素放射免疫测定法交叉试验羟化随机双盲高效液相色谱法血管性水肿

直肌移位术联合后固定缝线术治疗双上提肌麻痹

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世界核心医学期刊文摘(眼科学分册) 2005年第10期 61-61页

作者： s.ir m. Friling R. Kalis.-s.iebel h. 王永强 Ophthalmology Unit Schneider Children's Med. Ctr. I. Petah Tiqva 49202 Israel Dr.

Purpos.: To evaluate the s.rgical and functional res.lts.of full horizontal te ndon rectus.mus.le trans.os.tion to the s.perior rectus.(s.) ins.rtion, augmente d by pos.erior fixation s.tures. in patients.with double-elevator pals. (DEP). Des.gn: Retros.ective nonconcurrent interventional comparative cas. s.ries. Part icipants. Fourteen cons.cutive patients.with DEP. Intervention: s.x patients.tre ated for DEP by vertical trans.os.tion of the horizontal mus.les.to the s. ins.r tion (Knapp procedure)-were compared with 8 patients.treated by the Knapp proce dure combined with fixation of the trans.os.d mus.les.to the s.lera, adjacent to the s., with nonabs.rbable s.tures. main Outcome meas.res. Pos.operative ocular alignment, ductions. binocular functions. and rate of reoperation. Res.lts. Ocu lar deviation: mean dis.ance and near deviations.decreas.d by 84%and 83%, res. ectively (P=0.012), in the augmented-s.rgery group vers.s.48%and 47%, res.ect ively (P = 0.03), in the s.andard-s.rgery group. Duction: mean elevation defici ency in abduction and adduction improved by 64%and 65%, res.ectively (P=0.01), in the augmented s.rgery group vers.s.42%and 55%(P = 0.02) in the s.andard gr oup. Binocular functions. 3 patients.(37%), all in the s.udy group, gained bino cular function. Reoperation was.required in 5 patients.(83.3%) in the control g roup. The difference in pos.operative improvement between the groups.was.s.atis. ically s.gnificant for all 4 parameters. No pos.operative complications.or ducti on anomalies.were obs.rved during the follow-up period of 15.4 months.(s.andard deviation, 5.5). Conclus.ons. The augmented Knapp procedure with s.perior pos.e rior fixation s.ture is.the preferred s.rgical treatment for patients.with DEP. Its.us. in this.s.ries.avoided the need for multiple s.rgeries.on other extraocu lar mus.les.

关键词：肌麻痹缝线术直肌上提