Objective To study the etiology， pathogenesis， and diagnosis of small bowel volvulus in adults. Method The clinical data of 43 cases of small bowel volvulus admitted to HassanⅡHospital of Settat from October 2009 to October 2012 were analyzed retrospectively. Results There were 11 cases of spontaneous small bowel volvulus.There were 32 cases of secondary small bowel volvulus， of which 19 cases due to postoperative abdominal adhesions. Clinical manifestation：early persistent severe abdominal pain was in 40 cases， frequent vomiting was in 29 cases， intestinalpattern or abdominal mass was in 28 cases. All 43 patients were received surgery， 22 （51.2%） cases were diagnosed by preoperative ultrasonography， small bowel necrosis was found in 16 cases during operation， 37 （86.0%） patients were cured and 6 （14.0%） patients died. Conclusions Secondary small bowel volvulus is main small bowel volvulus， post-operative abdominal adhesion is major causes of small bowel volvulus， the value of abdominal X-ray in diagnosing is limited. However， ultrasonography and CT are helpful in diagnosing these diseases. Small bowel volvulus and intestinal obstruction can reinforce each other. Early small bowel volvulus is characterized by clinical conditions such as severe abdominal pain， early vomiting signs， and signs not matching the symptoms. Acute onset and rapid progression are the features of small bowel volvulus， surgery should be intervened in early stage.
Objective To study the preventive measure of the subambient temperature burn by analysing the pathogenesis feature. Methods The cl inical data were analysed from 351 cases of subambient temperature burn between February 2004 and February 2009, including age, sex, burn season, burn factors, burn position, burn area, burn degree, treatment way, and wound heal ing. Results Subambient temperature burn occurred in every age stage. The susceptible age stages included infant, children, and the elderly. Female patients were more than male patients. The common burn reasons werehot-water bottle burn, honey warm keeper burn, and heating device burn. The peak season was winter. Lower l imb was the most common site of the subambient temperature burn. The deep II degree to III degree were the most common level, and the burn area was always small, often 1% of total body surface area. Most of patients were treated with changing dressings at cl inic and few patients needed hospital ization. Though the surface of wound could heal finally, and the wound healed well with no obvious scar in patients who received operation. Conclusion Subambient temperature burn is the frequently encountered disease in winter. Use of the warming articles should be cautious, at the same time safety awareness should be strengthened so as to decrease the incidence rate of subambient temperature burn and the injury degree.
Objective To summarize the recent pathogenetic researches on the acute pancreatitis. Methods Relevant references about the pathogenesis of acute pancreatitis, which were published recently domestic and abroad were collected and reviewed. Results Recent experimental data indicated that the synthesis and release of pro-inflammatory cytokines and chemotactic factors were responsible for local injury and systemic dissemination of the inflammatory mediators. Experimental studies also provided evidences implying that the immune system might play a role in the development of pancreatitis, such as the activation of lymphocyte and neutrophil. Additionally, the pancreas may completely recover or become fibrotic after an attack of acute pancreatitis and the presence of pancreatic stellate cell was known as a crucial factor in the fibrogenesis. Conclusion The pathogenesis of acute pancreatitis is very complicated, the factors that determine the ultimate severity of the attack are still unknown.
Diabetic retinopathy (DR) is one of common and specific microvascular complications caused by diabetic mellitus, and remains a serious and common ocular complication leading preventable blindness. At present, the specific pathogenesis of DR is not completely clear, and many factors are involved in its occurrence and development. Adiponectin (APN) is an endogenous cytokine secreted by adipocytes. It is expressed in all layers of retina, especially in the outer layer (rods and cones). It is involved in regulating fatty acid oxidation and glucose metabolism by binding with specific receptors. In recent years, a lot of studies have found that APN can be involved in regulating blood glucose, inhibiting neovascularization, reducing inflammation, dilating blood vessels and improving vascular endothelial function. At present, the specific mechanism of APN in the occurrence and development of DR Remains to be determined. Further research on the level changes and the specific mechanism of action of APN in DR may help to identify the characteristic metabolic changes of DR, thus providing new biomarkers for the diagnosis of DR, while helping to promote the innovation of the treatment of DR.
ObjectiveTo summarize basic research progress and current status of clinical diagnosis and therapy for gastroesophageal reflux disease.
MethodRelated literatures were collected to review the pathogenesis, clinical manifestations, diagnosis and therapy of gastroesophageal reflux disease.
ResultsGastroesophageal reflux disease was caused by many factors, such as hiatus hernia, hypotensive lower esophageal sphincter pressure, acid pocket, prolonged esophageal clearance, and delayed gastric emptying. Extra-esophageal symptoms was a common clinical presentation to gastroesophageal reflux disease. The diagnosis methods for gastroesophageal reflux disease included the symptom observation, gastroscopy examination, 24 h pH monitoring of esophageal, proton pump inhibitor test, questionnaire of gastroesophageal reflux disease and so on. The laparoscopic fundoplication could essentially treat the pathophysiologic abnormalities of gastroesophageal reflux disease, which had an obvious curative effect and wide application prospect.
ConclusionPathogenesis, diagnosis, and therapy of gastroesophageal reflux disease are associated with multiple factors, which is still controversial and remains to be further studied.
Objective?To explore the difference between bone marrow edema syndrome (BMES) and avascular necrosis of femoral head (ANFH).?Methods?Recent original articles about BMES and ANFH were extensively reviewed, and were comprehensively analysed.?Results?The pathology, pathogenesis, clinical features, treatment selection, and prognosis are different between these two diseases.?Conclusion?BMES and ANFH are two different diseases. Micro-fracture may be the cause of bone marrow edema.
【Abstract】ObjectiveTo review the research advance of intestinal barrier changes and its pathogenesis in stress conditions.MethodsThe literatures in recent years on the changes of the intestinal barrier,and its pathogenesis in stress conditions were reviewed.Results In some severe stress conditions, such as trauma, severe inflammation and acute severe pancreatitis, etc, a series of pathophysiologic disorders of intestinal barrier， even systemic inflammatory response syndrome and multiple organ dysfunction syndrome or multiple organ failure were induced. The pathogenesis was a result of a series of neurologic, immunologic and endocrine factors making one another. ConclusionRecognizing the changes and pathogenesis have an important clinical significance for treating and preventing the intestinal barrier dysfunction induced by stress.
Bacterial biofilm is the key problem of chronic wound infection and difficult healing. How to prevent and control bacterial biofilm and improve the prognosis of chronic wound has become a research hotspot in the field of wound care. This paper will summarize from the following aspects: four major stages in the process of chronic wound bacteria biofilm formation (surface adhesion, formation of small colonies, biofilm maturation, and dispersion and separation); characteristics of host immune response in the presence of biofilms; morphological, microbiological, and molecular detection methods for biofilms; and progress in in vitro trials, animal trials, clinical trials, and new therapeutic methods of biofilm. The purpose of this review is to provide evidence for the treatment of biofilms for chronic wounds.
Non-alcoholic fatty liver disease (NAFLD) is one of the major chronic liver diseases that endanger human health. It is characterized by hepatic steatosis and absence of other causes of hepatic fat accumulation, such as alcohol abuse. The incidence of NAFLD is increasing year by year. However, the pathogenesis is still undefined. Porphyromonas gingivalis is a major periodontal pathogen of various periodontal disease. Apart from affecting periodontal health, Porphyromonas gingivalis is also related to the incidence of many systemic diseases. In recent years, Porphyromonas gingivalis is considered to be a risk factor of NAFLD. In this paper, the relationship between NAFLD and Porphyromonas gingivalis, as well as the possible pathogenesis are discussed.
Immune-mediated necrotizing myopathy (IMNM) is a type of autoimmune myopathy characterized by relatively severe proximal weakness with high serum muscle enzyme levels, myofiber necrosis with minimal inflammatory cell infiltrate on muscle biopsy, and infrequent extra-muscular involvement. The mechanism of necrotizing myopathy remains unclear. The new European Neuromuscular Centre criteria divides IMNM into three distinct subtypes according to different autoantibodies, which reminds us antibodies may be involved in the pathogenesis of IMNM and different subtypes may have different pathogenesis. This review summarizes the current understanding of the pathogenesis of IMNM.
