[High altitude illness and related diseases - a review].

Upon reaching a height over 2500 m above seal level symptoms of altitude illness can develop over 1 - 5 days. The risk is mainly -determined by the altitude and rate of ascent and the symptoms vary. Most common are symptoms of acute mountain illness (AMS) but more dangerous high altitude cerebral edema (HACE) and high altitude pulmonary edema (HAPE) can also develop. The causes of AMS, HACE and HAPE are lack of oxygen and insufficient acclimatization, but the presenting form is determined by the responses of the body to the lack of oxygen. The most common symptoms of AMS include headache, fatique and nausea, but insomnia and nausea are also common. The most common symptoms of HAPE are breathlessness and lassitude whereas the cardinal sign of HACE is ataxia, but confusion and loss of consciousness can also develop. In this article all three main forms of altitude illness are reviewed. The emphasis is on preventive measures and treatment but new knowledge on pathogenesis is also addressed.

Evidence-based pathogenesis and treatment of ulcerative colitis: A causal role for colonic epithelial hydrogen peroxide.

In this comprehensive evidence-based analysis of ulcerative colitis (UC), a causal role is identified for colonic epithelial hydrogen peroxide (H2O2) in both the pathogenesis and relapse of this debilitating inflammatory bowel disease. Studies have shown that H2O2 production is significantly increased in the non-inflamed colonic epithelium of individuals with UC. H2O2 is a powerful neutrophilic chemotactic agent that can diffuse through colonic epithelial cell membranes creating an interstitial chemotactic molecular "trail" that attracts adjacent intravascular neutrophils into the colonic epithelium leading to mucosal inflammation and UC. A novel therapy aimed at removing the inappropriate H2O2 mediated chemotactic signal has been highly effective in achieving complete histologic resolution of colitis in patients experiencing refractory disease with at least one (biopsy-proven) histologic remission lasting 14 years to date. The evidence implies that therapeutic intervention to prevent the re-establishment of a pathologic H2O2 mediated chemotactic signaling gradient will indefinitely preclude neutrophilic migration into the colonic epithelium constituting a functional cure for this disease. Cumulative data indicate that individuals with UC have normal immune systems and current treatment guidelines calling for the suppression of the immune response based on the belief that UC is caused by an underlying immune dysfunction are not supported by the evidence and may cause serious adverse effects. It is the aim of this paper to present experimental and clinical evidence that identifies H2O2 produced by the colonic epithelium as the causal agent in the pathogenesis of UC. A detailed explanation of a novel therapeutic intervention to normalize colonic H2O2, its rationale, components, and formulation is also provided.

Maculopatía por inmunoganmapatía / Maculopathy due to Immunoganmopathy

La maculopatía por inmunoganmapatía es una enfermedad macular inusual caracterizada por la presencia de fluido intra y subretinal en asociación con ganmapatías monoclonales. Puede constituir la primera manifestación de enfermedad sistémica en un número considerable de pacientes. La infiltración de la retina neurosensorial y del espacio subretiniano por las inmunoglobulinas provoca un aumento de la presión osmótica lo cual genera acumulación del fluido intra y subretinal. El "silencio angiográfico" la distingue de otras maculopatías con desprendimientos serosos. La plasmaféresis combinada con quimioterapia constituye la primera línea del tratamiento. Aunque el líquido intrarretinal mejora considerablemente, el subretinal persiste en la mayoría de los ojos. La agudeza visual mejor corregida final muestra una ganancia de 0,3 décimas como promedio después del tratamiento. Con el objetivo de exponer contenido actualizado sobre maculopatía por inmunoganmapatía, se realizó una revisión de las publicaciones más relevantes relacionadas con el tema durante los últimos ocho años(AU)

Immunoganmapathy maculopathy is an unusual macular disease characterized by the presence of intra- and subretinal fluid in association with monoclonal ganmapathies. It may constitute the first manifestation of systemic disease in a considerable number of patients. Infiltration of the neurosensory retina and the subretinal space by immunoglobulins causes an increase in osmotic pressure which leads to accumulation of intra- and subretinal fluid. The "angiographic silence" distinguishes it from other maculopathies with serous detachment. Plasmapheresis combined with chemotherapy is the first line of treatment. Although intraretinal fluid improves considerably, subretinal fluid persists in most eyes. The final best-corrected visual acuity shows a gain of 0.3 tenths on average after treatment. In order to expose updated content on immunoganmopathy maculopathy, a review of the most relevant publications related to the subject during the last eight years was performed(AU)

Simple Analysis to The Similarities and Differences of Ancient and Modern Doctors in Diagnosing and Treating the Bone Atrophy Based on TCM / 浙江中医药大学学报

[Objective] To explore the similarities and differences between ancient and modern physicians in treating "bone atrophy"so as to provide reference for clinical treatment of renal osteodystrophy, bone tuberculosis and osteoporosis. [Method] Summarizing the similarities and differences between ancient and modern physicians in etiology and pathogenesis and treatment of syndrome differentiation of bone atrophy by consulting the literatures. [Results] Ancient and modern physicians have connections and differences in treatment based on syndrome differentiation of bone atrophy.Ancient physicians who treated bone atrophy whose syndrome was evil invading XiGu, deficiency of spleen and kidney with coordinating meridian of Yangming, getting rid of evil obtained better effects and the syndrome of Qi deficiency and blood stasis, damage of Yin and Yang that treated with enriching Qi and activating blood, nourishing yin and tonifying yang as well. Modern physicians who treated bone atrophy whose syndrome was deficiency of spleen and kidney, dampness and blood stasis with nourishing kidney and spleen, activating blood and draining turbidity obtained certain effects and the syndrome of kidney and essence deficiency, blood and Qi stasis that treated with strengthening bones and essence, promoting flow of qi and blood as well. So as the syndrome of Yang deficiency of kidney, phlegm and blood stasis resisting meridian. [Conclusion] Ancient and modern physicians have certain effects in the treatment of bone atrophy.They both believe that Qi and blood stasis are the factors which lead to bone atrophy, therefore, activating Qi and blood as treatment of bone atrophy are both agreed.The difference is that the ancient physicians believed that the spleen and stomach deficiency was the key to the formation of bone atrophy.Coordinating Yangming meridian as treatment.Modern physicians believe that kidney deficiency and blood stasis is the key to the formation of bone atrophy.Nourishing kidney and activating blood as treatment mainly.

Autonomic Dysreflexia (review) / 中国康复理论与实践

@#Autonomic dysreflexia (AD) is a condition of abnormal sympathetic response,which generally occurs in patients with the spinal cord injury (SCI) at levels of T6 and above.AD usually occurs owing to the excessive reaction of the sympathetic nervous system to the adverse stimulus.Since AD can result in fatal complications,such as epilepsy,apnea,heart infarction,acute intracranial hypertension and cerebral hemorrhage,the diagnosis and treatment of AD is very important.This article simply introduces the morbidity,pathogenesis,causative factor,clinical manifestation and treatment of AD by reviewing recent literatures.