系统性红斑狼疮伴发急腹症的诊治思考 一附18 例临床分析

目的：提高对系统性红疯狼疮（SLE）伴发急腹症临床表现的认识,总结诊断和治疗此类病例的经验。方法：对18例SLE伴发急腹症的病例进行回顾性分析。结果：SLE并发急腹症临床表现多样化,可以表现为消化道出血,肠梗阻。肠穿孔,急性胃肠炎,急性胰腺炎,急性腹膜炎等。治疗后16例病情得到控制,2例死亡。结论：SLE伴发急腹症预示病情危重,对此应提高认识,尽早诊断;应用大剂量肾上腺皮质激素和免疫抑制剂有良好的疗效。     

缩唇腹式呼吸训练联合弹力带抗阻运动对慢性心力衰竭患者运动耐力、心肺功能及生活质量的影响

摘要 目的：观察缩唇腹式呼吸训练对联合弹力带抗阻运动对慢性心力衰竭（CHF）患者运动耐力、心肺功能及生活质量的影响。方法：选取2020年4月~2021年7月期间我院收治的CHF患者83例。按照双色球法将患者分为对照组（n=41）和观察组（n=42）,对照组接受弹力带抗阻运动,观察组接受缩唇腹式呼吸训练联合弹力带抗阻运动。观察两组运动耐力、心肺功能、生活质量及1年内再住院率和1年内死亡率情况。结果：两组干预4周后躯体领域评分、情绪领域评分、其他领域评分和总分均下降,且观察组低于对照组（P<0.05）。两组干预4周后用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）、最大自主分钟通气量（MVV）、左室射血分数（LVEF）升高,且观察组高于对照组（P<0.05）,而左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）下降,且观察组低于对照组（P<0.05）。两组干预4周后6 min步行距离试验（6MWT）、峰值摄氧量（VO_2peak ）及无氧阈值（AT）升高,且观察组高于对照组（P<0.05）。观察组的1年内再住院率、1年内死亡率均低于对照组（P<0.05）。结论：弹力带抗阻运动联合缩唇腹式呼吸训练可促进CHF患者心肺功能改善,提高运动耐力,促进生活质量提升,同时还可降低1年内再住院率、1年内死亡率,疗效较好。     

Diabetes in Urban African Americans. XII. Anthropometry for Assessing Municipal Hospital Outpatients Recently Diagnosed with Type 2 Diabetes

Objective : Abdominal obesity is associated with insulin resistance and cardiovascular risk factors, but there has been little information published to advance the use of abdominal anthropometry in the care of diabetic patients. Research Methods and Procedures : A cross-sectional survey of municipal hospital outpatients recently diagnosed with type 2 diabetes (73 men and 142 women of whom 89% were African Americans). Age-adjusted linear regression was used to compare the supine sagittal abdominal diameter (SAD), supine waist circumference, four anthropometric ratios, and the body mass index (kg/m²) for their ability to predict serum fasting C-peptide and lipid levels. Results : The best predictor of log-transformed C-peptide was SAD/height (p<0.0001 for men; p = 0.0003 for women). SAD/thigh circumference was the best predictor of log-transformed triglycerides for men (p = 0.002) and of total cholesterol/HDL cholesterol for women (p = 0.043). The body mass index was less able to predict C-peptide, HDL cholesterol and total cholesterol/HDL cholesterol than was SAD/height or SAD/thigh circumference or waist circumference/height. Discussion : Anthropometric indices of abdominal obesity appear to be correlated with insulin production and lipid risk factors among municipal-hospital, type 2 diabetic patients much as they are in other studied populations. Since anthropometric data are inexpensively obtained and immediately available to the practitioner, their utility for preliminary clinical assessment deserves to be tested in prospective outcome studies.     

The abdomen of a free-living female of Strepsiptera and the evolution of the birth organs

Mengenillidae is a small, basal family of Strepsiptera, mainly characterized by free-living females in contrast to the endoparasitic females of Stylopidia. Here, we describe external and internal structures of the female abdomen of Eoxenos laboulbenei (Mengenillidae). The external morphology was examined and documented using microphotography. Internal structures were reconstructed three-dimensionally using a μCT-data set. The morphologically simplified abdomen comprises 10 segments. The integument is weakly sclerotized and flexible. Spiracles are present dorsolaterally on segments I–VII. Segment VII bears the posteroventral birth opening and the small abdominal segment X carries the anus at its apex. Numerous eggs float freely in the hemolymph. The musculature of segments I–IV is composed of ventral and dorsal longitudinal muscle bundles, strongly developed paramedial dorsoventral muscles and a complex meshwork of small pleural muscles, with minimal differences between the segments. Segments V–X contain more than 50 individual muscles, even though the musculature as a whole is weakly developed. Even though it is not involved in processing food, the digestive tract is well-developed. Its postabdominal section comprises a part of the midgut and the short hindgut. The midgut fills a large part of the postabdominal lumen. The lumina of the midgut and hindgut are not connected. Five or six nodular Malpighian tubules open into the digestive tract at the border region between the midgut and hindgut. The birth organ below the midgut releases the primary larvae after hatching via the birth opening at segment VII. It is likely derived from primary female genital ducts. The presence of six additional birth organs of segments I–VI are de novo formations and a groundplan apomorphy of Stylopidia, the large strepsipteran subgroup with endoparasitic females. The loss of the primary birth organ of segment VII is an apomorphy of Stylopiformia (Stylopidia excl. Corioxenidae).     

Double abdomen induction by UV in Bradysia tritici (syn. Sciara ocellaris,Sciaridae): sensitive stages and conditions for photoreversal

Summary The pattern anomaly double abdomen was induced in embryos of Bradysia tritici (syn. Sciara ocellaris) by irradiation of the anterior egg pole with far UV (254 or 285 nm) using low UV fluences. The maximum yield of 18% of double abdomens was obtained when 2.5 h embryos were irradiated (late intravitelline cleavage stage); earlier irradiation failed to yield double abdomens, as did irradiations after the early syncytial blastoderm stage. Exposing irradiated embryos to photoreverting light (366 nm) reduced the yield of malformations. Most double abdomens were symmetrical and the number of segments ranged from 3 to 8 in each set, with the mean value at 6.4 segments.     

The ventral nerve cord in Cephalocarida (Crustacea): New insights into the ground pattern of Tetraconata

Cephalocarida are Crustacea with many anatomical features that have been interpreted as plesiomorphic with respect to crustaceans or Tetraconata. While the ventral nerve cord (VNC) has been investigated in many other arthropods to address phylogenetic and evolutionary questions, the few studies that exist on the cephalocarid VNC date back 20 years, and data pertaining to neuroactive substances in particular are too sparse for comparison. We reinvestigated the VNC of adult Hutchinsoniella macracantha in detail, combining immunolabeling (tubulin, serotonin, RFamide, histamine) and nuclear stains with confocal laser microscopy, complemented by 3D‐reconstructions based on serial semithin sections. The subesophageal ganglion in Cephalocarida comprises three segmental neuromeres (Md, Mx1, Mx2), while a separate ganglion occurs in all thoracic segments and abdominal segments 1–8. Abdominal segments 9 and 10 and the telson are free of ganglia. The maxillar neuromere and the thoracic ganglia correspond closely in their limb innervation pattern, their pattern of mostly four segmental commissures and in displaying up to six individually identified serotonin‐like immunoreactive neurons per body side, which exceeds the number found in most other tetraconates. Only two commissures and two serotonin‐like immunoreactive neurons per side are present in abdominal ganglia. The stomatogastric nervous system in H. macracantha corresponds to that in other crustaceans and includes, among other structures, a pair of lateral neurite bundles. These innervate the gut as well as various trunk muscles and are, uniquely, linked to the unpaired median neurite bundle. We propose that most features of the cephalocarid ventral nerve cord (VNC) are plesiomorphic with respect to the tetraconate ground pattern. Further, we suggest that this ground pattern includes more serotonin‐like neurons than hitherto assumed, and argue that a sister‐group relationship between Cephalocarida and Remipedia, as favored by recent molecular analyses, finds no neuroanatomical support. J. Morphol. 275:269–294, 2014. © 2013 Wiley Periodicals, Inc.     

The Accumulation of Visceral Adipose Tissue may be Influenced by Intra-Abdominal Temperature

Despite the established link between visceral obesity and major chronic diseases, little is known about physiologic factors that directly and specifically lead to the accumulation of visceral fat. I hypothesize that reduced intra-abdominal temperature might be a physical factor underlying the partitioning of adipose tissue to the intra-abdominal region rather than the periphery. The hypothesis is supported by biochemical reports that rat and bovine lipoprotein lipase have increased activity when incubated at lower temperatures. Persons exercising in cool water have been found to preserve subcutaneous fat whereas comparable exercise without local cooling results in subcutaneous fat loss. Pima Indians, a group that commonly acquires extreme levels of visceral fat, have been found to have lower intraabdominal temperatures during sleep than weight-matched European-Americans. In a study of four young men and four young women, I have noted that mean intra-abdominal basal temperatures were higher for women than men (36.51 ± 0.18°C vs. 35.91 ± 0.11°C; p = .0014). Since the men are more likely to acquire visceral obesity at later age, this also provides support for my hypothesis. Investigators might wish to examine further the temperature dependence of adipose-tissue lipoprotein lipase, the temperature variation between sites of adipose tissue, and the effects of foods, physical activities, smoking and drugs on localized body temperature.