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Journal of the Royal College of Physicians of London最新文献

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Cloning, clones and clonal disease. 克隆、克隆和克隆性疾病。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
L Luzzatto

In the past, cloning has been familiar to plant breeders because many plants can be easily reproduced in this way, bypassing the lengthy process of cross-fertilisation. Recently, the concept of cloning has become popular in human biology and medicine on two accounts. First, individual genes can be cloned from the enormous complexity of the DNA that makes up the human genetic material. It is expected that, within a few years, all the estimated 100,000 human genes will be isolated by this approach. This should make it possible to identify all the genes that determine the individual characteristics of human beings, including those responsible for causing human diseases or for making people more or less susceptible to pick up diseases from the environment. Cloned genes made into pharmaceutical products are already in use for treating a variety of diseases, from hormonal deficiencies to certain types of anaemia.

在过去，植物育种家对克隆已经很熟悉了，因为许多植物可以很容易地通过这种方式繁殖，绕过了漫长的交叉受精过程。最近，克隆的概念在人类生物学和医学中变得流行，原因有二。首先，个体基因可以从构成人类遗传物质的极其复杂的DNA中克隆出来。预计在几年内，所有估计的10万个人类基因将通过这种方法被分离出来。这样就有可能确定决定人类个体特征的所有基因，包括那些导致人类疾病或使人们或多或少容易从环境中感染疾病的基因。制成药品的克隆基因已经用于治疗多种疾病，从激素缺乏到某些类型的贫血。
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引用次数: 0
The prospects for specialist registrars. 专业注册商的前景。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
N Dudley
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引用次数: 0
Physician, govern thyself? 医生，你能控制自己吗?
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
O Segal
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引用次数: 0
Presentation and clinical features of severe sepsis. 严重脓毒症的临床表现及特点。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
J Green, W A Lynn
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引用次数: 0
Bile acid malabsorption in persistent diarrhoea. 持续腹泻引起胆汁酸吸收不良。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
M J Smith, P Cherian, G S Raju, B F Dawson, S Mahon, K D Bardhan

Unlabelled: We have investigated bile acid malabsorption (BAM), and its response to treatment, in patients seen in this district general hospital with chronic continuous or recurrent diarrhoea.

Methods: Seven-day retention of 75-SeHCAT was measured (normal: > 10%).

Treatment: Patients were initially given conventional therapy (prednisolone +/- ASA drugs in Crohn's disease, and antidiarrhoeals in the others). If this therapy failed, bile acid sequestrants (BAS) were prescribed. The definition of successful response was based on the patient's perception of sustained improvement.

Patients: The 304 patients were categorised as follows: Group 1: Crohn's disease patients with ileal resection, in clinical remission (n = 37). Group 2: Crohn's disease, unoperated and in clinical remission (n = 44). Group 3: vagotomy and pyloroplasty, with/without cholecystectomy (n = 26). Group 4: diarrhoea predominant 'irritable bowel syndrome' (IBS) (n = 197).

Results: BAM was found in 97% (36/37), 54% (24/44) and 58% (15/26) of patients in groups 1, 2 and 3 respectively. One third (65/197) of patients with IBS had BAM. The outcome of treatment was available in 96 patients with BAM: of the patients with ileal resection 32% responded to antidiarrhoeals, 60% to BAS. Of the unoperated Crohn's patients 55% responded to disease-specific therapy, 40% to BAS. Of the gastric surgery patients 18% responded to conventional treatment, 64% to BAS. Of the IBS patients 15% of responded to conventional therapy, 70% to BAS.

Conclusions: This observational study indicates that BAM is common in patients with chronic diarrhoea, and is frequently found in IBS. The results of open treatment suggest that, where antidiarrhoeal drugs fail in such patients, BAS are often effective.

未标记:我们调查了胆汁酸吸收不良(BAM)及其对治疗的反应，在该地区综合医院看到的慢性持续或复发性腹泻患者。方法:测定75-SeHCAT的7 d保留率(正常:> 10%)。治疗:患者最初给予常规治疗(克罗恩病患者给予强的松龙+/- ASA药物，其他患者给予抗腹泻药)。如果这种治疗失败，则开胆汁酸隔离剂(BAS)。成功反应的定义是基于患者对持续改善的感知。患者:304例患者分为以下两组:第一组:行回肠切除术的克罗恩病患者，临床缓解(n = 37)。第二组:克罗恩病，未手术且临床缓解(n = 44)。第三组:迷走神经切开术和幽门成形术，合并/不合并胆囊切除术(n = 26)。第4组:腹泻为主的“肠易激综合征”(IBS) (n = 197)。结果:1组97%(36/37)、2组54%(24/44)、3组58%(15/26)的患者出现BAM。三分之一(65/197)的IBS患者有BAM。96例BAM患者的治疗结果:回肠切除术患者中32%对抗腹泻药有反应，60%对BAS有反应。在未手术的克罗恩病患者中，55%对疾病特异性治疗有反应，40%对BAS有反应。在胃手术患者中，18%对常规治疗有反应，64%对BAS有反应。在IBS患者中，15%对常规治疗有反应，70%对BAS有反应。结论:这项观察性研究表明，BAM在慢性腹泻患者中很常见，并且经常在IBS中发现。开放治疗的结果表明，在抗腹泻药物对这类患者无效的情况下，BAS通常是有效的。
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引用次数: 0
Over-the-counter medicines and the elderly. 非处方药和老年人。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
N L Barnett, M J Denham, S A Francis

Sales of over-the-counter (OTC) medicines are rising, and will continue to rise as more products are reclassified from prescription-only status to OTC medicines (either pharmacy-only or general sales list). Patients and doctors often omit discussion of OTC medicines when giving or taking a medication history. This has serious potential for identifying adverse drug reactions and drug-drug interactions, which are more common in older people. Therefore, medication histories should include documentation of any OTC medicines taken.

非处方药(OTC)的销量正在上升，并且随着越来越多的产品被重新分类，从仅限处方状态变为OTC(仅限药店或一般销售清单)，这种销量将继续上升。患者和医生在提供或服用药物时经常忽略讨论非处方药。这对于识别在老年人中更为常见的药物不良反应和药物-药物相互作用具有重要的潜力。因此，用药史应包括所服用的任何非处方药的记录。
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引用次数: 0
Current concepts in viral hepatitis. 病毒性肝炎的最新概念。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
J M Hoare, D M Forton
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引用次数: 0
The prospects for specialist registrars. 专业注册商的前景。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
A S Mcintyre
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引用次数: 0
The emperor's new clothes. 皇帝的新衣。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
W F Cunningham
{"title":"The emperor's new clothes.","authors":"W F Cunningham","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76057,"journal":{"name":"Journal of the Royal College of Physicians of London","volume":"34 5","pages":"501-2"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/e6/jrcollphyslond146954-0093b.PMC9665498.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21902973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Controversy in thyroid disease. 甲状腺疾病的争议。
Journal of the Royal College of Physicians of London
Pub Date : 2000-09-01
A J Krentz
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引用次数: 0
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