RESUMEN
Abdominal pain is an alarming signal indicating that either tissue or organ in the abdominal cavity is in trouble.The etiology of abdominal pain is often obscure.The underlying diseases are multidisciplinary,and the disease process varies with time.Often,an acute abdominal pain (including acute abdomen) requires urgent diagnosis and treatment.Chronic abdominal pain involves many difficult cases.Having fifty years of clinical experiences,the author concludes that a scientific decision making process is essential in the diagnosis of all types of abdominal pain.It involves the following:(1)Data collection through history taking,physical examamination,and laboratory diagnosis.(2)Analysis and synthesis of data are important to gain insight into the disease process for the establishment of a logical diagnosis.(3)Close observation is required for acute abdominal pain of unknown origin.Even after a diagnosis is made,the patient should still be followed up to check if the diagnosis and treatment are correct.
RESUMEN
Objective To probe the mechanism of metronidazole resistance to Helicobacter pylori (Hp). Methods (1) The selective pressure test of metronidazole. (2) SDSPAGE electrophoresis. (3) Nitrate reduction test. (4) Test for detecting the enzyme activities associated with 95 substrates of gram negative. Results After the mutation of Hp from sensitive to resistant strains, the activities of enzymes associated with monomethyl succinate, succinic acid and Dalanine is decreased, and those associated with Lfucose 6phosphate glucose is increased. Conclusions The metronidazole resistance of Hp is associated with the metabolism and the change of enzyme activities.
RESUMEN
Objective To explore the potential role of activation of the colonic mucosal mast cells in the pathogenesis of irritable bowel syndrome (IBS). Methods The activation of colonic mucosal mast cells was evaluated by double immunohistochemical staining with c-Fos and tryptase in restraining stress and conditioned restraining stress rats and in 56 refractory IBS patients(by Rome Ⅱ criteria), 2 free-symptom more than 6 months patients and 20 healthy controls. It was also evaluated that the effect of mast cell stabilizer sodium cromoglycate 20 mg/kg given intraperitoneally (i.p.) 30 min before stress or conditioned stress on electromyographic activity (EMG) in abdominal striated muscle as the marker of visceral sensitization. The relationship between the severity index of symptom and the percentage of activation of sigmoid-rectal mucosal mast cells in IBS was analyzed by Spearman rank correlation. Results The percentage of activating mast cells instead of the total number increased significantly in stress (2.5 ?0.8 vs. 8.0?0.9) and conditioned stress (2.5? 0.8 vs. 7.8?0.8) rats compared with that in controls ( P