ABSTRACT
Multiple endocrine neoplasia type 1 (MEN1) is a rare hereditary syndrome known to predispose subjects to endocrine neoplasms in a variety of tissues such as the parathyroid glands, pituitary gland, pancreas and gastrointestinal tract. We herein report a patient with a past history of pituitary adenoma, presenting with symptoms of chronic diarrhea for nearly one year and a sudden upper gastrointestinal hemorrhage as well as perforation without signs. Nodules in the duodenum and in the uncinate process and tail of pancreas and enlargement of the parathyroid glands were detected on preoperative imaging. Gastroscopy revealed significant ulceration and esophageal reflux diseases. The patient underwent subtotal parathyroidectomy and autotransplantation, pylorus-preserving pancreaticoduodenectomy and pancreatic tail resection and recovered well. The results observed in our patient suggest that perforation and bleeding of intestine might be symptoms of Zollinger-Ellison Syndrome in patients with MEN1.
Subject(s)
Duodenal Diseases/etiology , Gastrointestinal Hemorrhage/etiology , Intestinal Perforation/etiology , Multiple Endocrine Neoplasia Type 1/complications , Zollinger-Ellison Syndrome/etiology , Adult , Biopsy , Duodenal Diseases/diagnosis , Duodenal Diseases/surgery , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/surgery , Gastroscopy , Humans , Intestinal Perforation/diagnosis , Intestinal Perforation/surgery , Magnetic Resonance Imaging , Male , Multiple Endocrine Neoplasia Type 1/diagnosis , Pancreatectomy , Pancreaticoduodenectomy , Parathyroidectomy , Predictive Value of Tests , Tomography, X-Ray Computed , Treatment Outcome , Zollinger-Ellison Syndrome/diagnosis , Zollinger-Ellison Syndrome/surgeryABSTRACT
OBJECTIVE: Viral hepatitis B is a worldwide public health problem; in China, chronic hepatitis B patients account for 30-40 million people and chronic hepatitis C accounts for 16% of all chronic hepatitis patients. Interferon-alpha (IFNalpha) is rather expensive and has many serious side-effects, which makes practitioners prudent in its use. METHOD/RESULTS: A multicenter study held in China showed that the negative seroconversion of HBV DNA by oxymatrine and IFNalpha-1b was 42.3% and 40.7%, respectively, and that of HBeAg was 36.5% and 38.9%, respectively, after 3 months treatment with each in patients with chronic hepatitis. CONCLUSIONS: Oxymatrine has a similar efficacy to IFNalpha, but with no adverse effects apart from slight injection pain, and it is much less expensive.
Subject(s)
Alkaloids/therapeutic use , Antiviral Agents/therapeutic use , Hepatitis B/drug therapy , Hepatitis C/drug therapy , Alkaloids/pharmacology , Animals , Antiviral Agents/pharmacology , Humans , Interferon-alpha/pharmacology , Interferon-alpha/therapeutic use , QuinolizinesABSTRACT
Severe acute pancreatitis is a disease of rapid onset and progression with high mortality and morbidity. A new concept suggests that it is multifactorially induced and involves multi-links and that therapy must be directed to several more important links at the same time. The regimen of integrated traditional Chinese and western medicine acts on the same or different sites and links to inhibit or block the inflammatory cascades. Concomitantly, preventive measures were taken at the start of the treatment for preventing the progression of the disease, protecting the function of vital organs, and avoiding the occurrence of complications. No mortality or serious complications occurred in a series of 38 patients with Balthazar's CT grading of D and E. The treatment regimen and the mechanisms of actions of these drugs were delineated in detail in the tables and figure; the regimen is highly recommended for clinical use.
