1.Clinical management of acute superior mesenteric vein thrombosis
Ji WANG ; Xi WANG ; Guojing ZHANG ; Li LU ; Yongjia YAN ; Weihua FU
Chinese Journal of General Surgery 2018;33(12):1034-1037
Objective To evaluate the diagnosis and treatment of acute superior mesenteric venous thrombosis (ASMVT).Methods Clinical data of 36 ASMVT patients admitted to our department from Jan 2014 to Oct 2017 were retrospectively analyzed,the differences of the clinical data and prognosis of nonsurgical group and surgical group were studied.Results All patients received anticoagulation therapy immediately after diagnosis,and recanalization rate was 42%.Surgical group included 21 cases,of which 9 cases received emergency surgery,12 cases received delayed bowel resection.There was significant difference between non-surgical group and surgical group (P > 0.05) in hemoglobin level at admission (124 ±29)g/L vs.(93 ± 13) g/L,t =3.880,P =0.006.Compared with delayed bowel resection group emergency surgery group had longer bowel resection (65 ± 58) cm vs.(13 ± 6) cm,t =2.700,P =0.035,more loop ileostomy (6 vs.1,x2 =7.875,P =0.016),more postoperative complication rate (56% vs.8%,x2 =5.619,P =0.046),but there was no significant difference in hospitalization time,hospitalization cost,postoperative recurrence and mortality rate (P > 0.05).Conclusions Early anticoagulantion therapy is advised for ASMVT patients to avoid bowel resection or reduce the length of intestinal resection.It is advisable for those who can be tided over to delayed bowel resection with intestinal obstruction.
2.Advances of immunological pathogenesis research in HIV related neurocognitive disorder.
Journal of Zhejiang University. Medical sciences 2016;45(3):249-255
With extended life of HIV-infected patients due to highly active anti-retroviral therapy (HAART), the rate of HIV associated neurocognitive disorder (HAND) remains high and attracts much attention. The evidence is clear that cytokines are elevated in the blood of patients with HIV infection, which contribute to elevating the permeability of blood-brain barrier. Benefiting from that, cells in the brain are infected with HIV that has accelerated through the blood-brain barrier both as cell-free virus and infected immune cells including monocytes and T cells. Upon migration into the central nervous system, HIV-infected monocytes and T cells not only infect brain resident cells but also produce proinflammatory cytokines such as TNF and IL-1ß, which further activate microglia and astrocytes. These activated brain glial cells and perivascular macrophages, which release inflammatory mediators, are the main contributors to neuroinflammation resulting in neuronal dysfunction. The pathogenesis of HAND is multifaceted, however, mounting evidence indicates that HIV related neuroinflammation plays a major role, which should be the focus of therapeutic research for HAND in future.
Astrocytes
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Blood-Brain Barrier
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Brain
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Cell Movement
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Central Nervous System
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Cytokines
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HIV Infections
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immunology
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HIV-1
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Humans
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Macrophages
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Microglia
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Monocytes
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Neurocognitive Disorders
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immunology
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Neurons
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T-Lymphocytes