Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologica...Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologically. Risk factors determining independently the outcome of SAP are early multi-organ failure, infection of necrosis and extended necrosis (> 50%). Up to one third of patients with necrotizing pancreatitis develop in the late course infection of necroses. Morbidity of SAP is biphasic, in the first week strongly related to early and persistence of organ or multi-organ dysfunction. Clinical sepsis caused by infected necrosis leading to multi-organ failure syndrome (MOFS) occurs in the later course after the first week. To predict sepsis, MOFS or deaths in the first 48-72 h, the highest predictive accuracy has been objectified for procalcitonin and IL-8; the Sepsis- Related Organ Failure Assessment (SOFA)-score predicts the outcome in the first 48 h, and provides a daily assessment of treatment response with a high positive predictive value. Contrast-enhanced CT provides the highest diagnostic accuracy for necrotizing pancreatitis when performed after the first week of disease. Patients who suffer early organ dysfunctions or at risk of developing a severe disease require early intensive care treatment. Early vigorous intravenous fluid replacement is of foremost importance. The goal is to decrease the hematocrit or restore normal cardiocirculatory functions. Antibiotic prophylaxis has not been shown as an effective preventive treatment. Early enteral feeding is based on a high level of evidence, resulting in a reduction of local and systemic infection. Patients suffering infected necrosis causing clinical sepsis, pancreatic abscess or surgical acute abdomen are candidates for early intervention. Hospital mortality of SAP after interventional or surgical debridement has decreased in high volume centers to below 20%.展开更多
INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis （ALE） is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generall...INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis （ALE） is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generally include two major categories： classic paraneoplastic limbic encephalitis （LE） associated with the so-called well-characterized onconeural autoantibodies against intracellular neuronal antigens （e.g., Hu, Ma2, etc.） and new-type AIE associated with autoantibodies to the neuronal surface or synaptic antigens.展开更多
Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (...Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (ACh) in the case of vascular dementia (VD) The purpose of this study was to explore the levels of ACh and choline (Ch) in the cerebrospinal fluid (CSF) of patients with AD and VD, and their possible relationship with cognitive impairment KH*2/5DMethods Twenty-two AD patients, twenty-two VD patients, and twenty normal controls were recruited and scored with a Mini-Mental State Examination (MMSE) CSF concentrations of ACh and Ch were measured using high-performance liquid chromatography with an electrochemical detector (HPLC-ECD) and the results were then compared to cognitive status Results ACh concentrations in CSF of AD patients [(10 7±5 1) nmol/L] and VD patients [(16 8±7 4) nmol/L] were both significantly lower than in controls [(34 5±9 0) nmol/L, t =10 67, P <0 001; t =6 91, P <0 001] Both results correlated positively with MMSE scores ( r s =0 88 and r s =0 85, respectively, P <0 01) The CSF concentration of Ch was significantly higher in VD patients [(887 4±187 4) nmol/L] compared to AD patients [(627 6±145 1) nmol/L, t =6 4, P <0 001] and controls [(716 0±159 4) nmol/L, t =4 2, P =0 002] CSF Ch concentration showed no difference between AD patients and normal controls, nor did it correlate with MMSE score in any of the three groups Conclusions The positive correlation between ACh deficit and cognitive impairment suggests that ACh is an important neurotransmitter for memory The similar decrease in ACh concentration in AD and VD patients may imply a similar pathogenesis for the process of cognitive impairment involved in these two disorders The elevated CSF levels of Ch in VD patients compared to AD patients may be useful diagnostically Cholinesterase inhibitors may be helpful not only for AD patients, but als展开更多
The emergence and development of constructal theory,which has been a new discipline branch to research sorts of structures in nature and engineering,are reviewed.The core of the constructal theory is that various shap...The emergence and development of constructal theory,which has been a new discipline branch to research sorts of structures in nature and engineering,are reviewed.The core of the constructal theory is that various shapes and structures of the matters in nature are generated from the tendency to obtain optimal performance.Constructal theory and its application are summarized,from disciplines such as heat,mechanism,fluid flow,electricity,magnetism and chemistry,to life and non-life systems in nature.展开更多
The Tieluping silver deposit, which is sited along NE-trending faults within the high-grade metamorphic basement of the Xiong'er terrane, is part of an important Mesozoic orogenic-type Ag-Pb and Au belt recently d...The Tieluping silver deposit, which is sited along NE-trending faults within the high-grade metamorphic basement of the Xiong'er terrane, is part of an important Mesozoic orogenic-type Ag-Pb and Au belt recently discovered. Ore formation includes three stages: Early (E), Middle (M) and Late (L), which include quartz-pyrite (E), polymetallic sulfides (M) and carbonates (L), respectively. The E-stage fluids are characterized by δD=-90‰, and δ 18 O=9‰ at 373°C, and are deeply sourced; the L-stage fluids, with δD=-70‰, and δ 18 O=-2‰, are shallow-sourced meteoric water; whereas the M-stage fluids, with δD=-109‰, and δ 18 O=2‰, are a mix of deep-sourced and shallow-sourced fluids. Comparisons of the D-O-C isotopic systematics of the E- stage ore-forming fluids with the fluids derived from Mesozoic granites, Archean-Paleoproterozoic metamorphic basement and Paleo-Mesoproterozoic Xiong'er Group, show that these units cannot generate fluids with the measured isotopic composition (highδ 18 O and δ 13 C ratios and lowδD ratios) characteristic of the ore-forming fluids. This suggests that the E-stage ore-forming fluids originated from metamorphic devolatilization of a carbonate-shale-chert lithological association, locally rich in organic matter, which could correspond to the Meso-Neoproterozoic Guandaokou and Luanchuan Groups, rather than to geologic units in the Xiong'er terrane, the lower crust and the mantle. This supports the view that the rocks of the Guandaokou and Luanchuan Groups south of the Machaoying fault might be the favorable sources. A tectonic model that combines collisional orogeny, metallogeny and hydrothermal fluid flow is proposed to explain the formation of the Tieluping silver deposit. During the Mesozoic collision between the South and North China paleocontinents, a crustal slab containing a lithological association consisting of carbonate-shale-chert, locally rich in organic matter (carbonaceous shale) was thrust northwards beneath the Xiong'er terrane along the Machaoying faul展开更多
文摘Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologically. Risk factors determining independently the outcome of SAP are early multi-organ failure, infection of necrosis and extended necrosis (> 50%). Up to one third of patients with necrotizing pancreatitis develop in the late course infection of necroses. Morbidity of SAP is biphasic, in the first week strongly related to early and persistence of organ or multi-organ dysfunction. Clinical sepsis caused by infected necrosis leading to multi-organ failure syndrome (MOFS) occurs in the later course after the first week. To predict sepsis, MOFS or deaths in the first 48-72 h, the highest predictive accuracy has been objectified for procalcitonin and IL-8; the Sepsis- Related Organ Failure Assessment (SOFA)-score predicts the outcome in the first 48 h, and provides a daily assessment of treatment response with a high positive predictive value. Contrast-enhanced CT provides the highest diagnostic accuracy for necrotizing pancreatitis when performed after the first week of disease. Patients who suffer early organ dysfunctions or at risk of developing a severe disease require early intensive care treatment. Early vigorous intravenous fluid replacement is of foremost importance. The goal is to decrease the hematocrit or restore normal cardiocirculatory functions. Antibiotic prophylaxis has not been shown as an effective preventive treatment. Early enteral feeding is based on a high level of evidence, resulting in a reduction of local and systemic infection. Patients suffering infected necrosis causing clinical sepsis, pancreatic abscess or surgical acute abdomen are candidates for early intervention. Hospital mortality of SAP after interventional or surgical debridement has decreased in high volume centers to below 20%.
文摘INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis （ALE） is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generally include two major categories： classic paraneoplastic limbic encephalitis （LE） associated with the so-called well-characterized onconeural autoantibodies against intracellular neuronal antigens （e.g., Hu, Ma2, etc.） and new-type AIE associated with autoantibodies to the neuronal surface or synaptic antigens.
基金ThisworkwassupportedbyBeijingMedicalDevelopmentFunds (No .ZD199812 )
文摘Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (ACh) in the case of vascular dementia (VD) The purpose of this study was to explore the levels of ACh and choline (Ch) in the cerebrospinal fluid (CSF) of patients with AD and VD, and their possible relationship with cognitive impairment KH*2/5DMethods Twenty-two AD patients, twenty-two VD patients, and twenty normal controls were recruited and scored with a Mini-Mental State Examination (MMSE) CSF concentrations of ACh and Ch were measured using high-performance liquid chromatography with an electrochemical detector (HPLC-ECD) and the results were then compared to cognitive status Results ACh concentrations in CSF of AD patients [(10 7±5 1) nmol/L] and VD patients [(16 8±7 4) nmol/L] were both significantly lower than in controls [(34 5±9 0) nmol/L, t =10 67, P <0 001; t =6 91, P <0 001] Both results correlated positively with MMSE scores ( r s =0 88 and r s =0 85, respectively, P <0 01) The CSF concentration of Ch was significantly higher in VD patients [(887 4±187 4) nmol/L] compared to AD patients [(627 6±145 1) nmol/L, t =6 4, P <0 001] and controls [(716 0±159 4) nmol/L, t =4 2, P =0 002] CSF Ch concentration showed no difference between AD patients and normal controls, nor did it correlate with MMSE score in any of the three groups Conclusions The positive correlation between ACh deficit and cognitive impairment suggests that ACh is an important neurotransmitter for memory The similar decrease in ACh concentration in AD and VD patients may imply a similar pathogenesis for the process of cognitive impairment involved in these two disorders The elevated CSF levels of Ch in VD patients compared to AD patients may be useful diagnostically Cholinesterase inhibitors may be helpful not only for AD patients, but als
基金supported by the National Natural Science Foundation of China (Grant No. 51176203)the Natural Science Foundation of Naval University of Engineering (Grant No. HGDYDJJ10011)
文摘The emergence and development of constructal theory,which has been a new discipline branch to research sorts of structures in nature and engineering,are reviewed.The core of the constructal theory is that various shapes and structures of the matters in nature are generated from the tendency to obtain optimal performance.Constructal theory and its application are summarized,from disciplines such as heat,mechanism,fluid flow,electricity,magnetism and chemistry,to life and non-life systems in nature.
基金the Ministry ofScience and Technology of China(Grant No.95-Pre-39-04)National Natural Science Foundation of China(Grant Nos.40425006,49972035,40352003)+1 种基金the Hundred YoungScientists Program of the Chinese Academy of Sciences(CAS) the Trans-Century Teacher Program of theEducation Ministry of China.
文摘The Tieluping silver deposit, which is sited along NE-trending faults within the high-grade metamorphic basement of the Xiong'er terrane, is part of an important Mesozoic orogenic-type Ag-Pb and Au belt recently discovered. Ore formation includes three stages: Early (E), Middle (M) and Late (L), which include quartz-pyrite (E), polymetallic sulfides (M) and carbonates (L), respectively. The E-stage fluids are characterized by δD=-90‰, and δ 18 O=9‰ at 373°C, and are deeply sourced; the L-stage fluids, with δD=-70‰, and δ 18 O=-2‰, are shallow-sourced meteoric water; whereas the M-stage fluids, with δD=-109‰, and δ 18 O=2‰, are a mix of deep-sourced and shallow-sourced fluids. Comparisons of the D-O-C isotopic systematics of the E- stage ore-forming fluids with the fluids derived from Mesozoic granites, Archean-Paleoproterozoic metamorphic basement and Paleo-Mesoproterozoic Xiong'er Group, show that these units cannot generate fluids with the measured isotopic composition (highδ 18 O and δ 13 C ratios and lowδD ratios) characteristic of the ore-forming fluids. This suggests that the E-stage ore-forming fluids originated from metamorphic devolatilization of a carbonate-shale-chert lithological association, locally rich in organic matter, which could correspond to the Meso-Neoproterozoic Guandaokou and Luanchuan Groups, rather than to geologic units in the Xiong'er terrane, the lower crust and the mantle. This supports the view that the rocks of the Guandaokou and Luanchuan Groups south of the Machaoying fault might be the favorable sources. A tectonic model that combines collisional orogeny, metallogeny and hydrothermal fluid flow is proposed to explain the formation of the Tieluping silver deposit. During the Mesozoic collision between the South and North China paleocontinents, a crustal slab containing a lithological association consisting of carbonate-shale-chert, locally rich in organic matter (carbonaceous shale) was thrust northwards beneath the Xiong'er terrane along the Machaoying faul
