Ernest Hemingway, one of the brightest stars on the literary stage of both American and the whole world literature in the twentieth century, had gained an everlasting reputation by the image of"the tough man"...Ernest Hemingway, one of the brightest stars on the literary stage of both American and the whole world literature in the twentieth century, had gained an everlasting reputation by the image of"the tough man"he created in lots of his works.Hence, to readers, Hemingway must be a strong man both physically and mentally. Though Hemingway had passed away, he left us an inestimable literary treasure, and we can draw some lessons from his suicide tragedy. To modern people who are展开更多
Helicobacter pylori(H. pylori) is one of the most widespread infections in humans worldwide that chronically infects up to 50% of the world's population. The infection is involved in the pathogenesis of chronic ac...Helicobacter pylori(H. pylori) is one of the most widespread infections in humans worldwide that chronically infects up to 50% of the world's population. The infection is involved in the pathogenesis of chronic active gastritis, peptic ulcer, mucosa-associated lymphoid tissue lymphoma and gastric cancer, therefore, it has been classified as class Ⅰ definite carcinogen by the World Health Organization. Despite the established etiological role of H. pylori, its actual distribution and association with related diseases is controversial and there is a large intercountry variation especially among Asian countries. H. pylori infection is more frequent in developing countries like India, Pakistan, and Bangladesh as compared to developed Asian countries like Japan, China and South Korea. However, the frequency of gastric cancer is comparatively lower in India, Pakistan, and Bangladesh with that of Japan, China and South Korea. Such phenomenon of clinical diversity, defined as enigma, is judged by genetic variability of the infecting H. pylori strains, differences in the host genetic background in various ethnic groups, and environmental factors such as dietary habits. Most of the studies have so far focused on the bacterial factor while environmental issues, including dietary components, were not given due attention as one of the factors related with H. pylori associated gastric carcinogenesis. The dietary factor has been suggested to play an important role in H. pylori related carcinogenesis, and in this respect several studies have corroborated the intake of various dietary components as modulatory factors for gastric cancer risk. In this review, such studies, from in vitro experiments to clinical trials, are being focused in detail with respect to enigma associated with H. pylori. It may be conceivably concluded from the available evidence that dietary factor can be a game changer in the scenario of Asian enigma, particularly in high risk population infected with virulent H. pylori strains, however further affirmation studies are desperately needed to achieve conclusive outcomes.展开更多
Intrduction: Edema, Hypertension and Hypokalemia occur with inhibition of 11 B-Hydroxysteroid Dehydrogenase Type 2 (11B-HSD2) by chronic Licorice ingestion. However, a similar presentation following a chronic use of a...Intrduction: Edema, Hypertension and Hypokalemia occur with inhibition of 11 B-Hydroxysteroid Dehydrogenase Type 2 (11B-HSD2) by chronic Licorice ingestion. However, a similar presentation following a chronic use of another commonly used sweetener “Stevia” is not reported. Objective: To document a first case report of a subject presenting with Edema, Prehypertension and Hypokalemia induced by 11B-HSD2 inhibition induced by chronic ingestion of sweetener stevia. Case Report: 32 year old Caucasian woman presented with generalized edema (feet, hands and face) of over 6 months. She was noted to also manifest Prehypertension (138/88 mmHg) and Hypokalemia (3.4 mM/l). Laboratory tests revealed decline in serum aldosterone and plasma renin activity, an increase in plasma cortisol/cortisone ratio. On persistent interrogation, patient admitted to daily consumption of sweetener stevia for over 9 months. All the presenting manifestations resolved with normalization of the laboratory tests on withdrawal of stevia. Conclusion: This case report indicates that chronic ingestion of sweetener stevia may induce edema, hypertension and hypokalemia via reduced conversion of cortisol into cortisone by inhibition of 11 B-Hydroxysteroid Dehydrogenase Type 2.展开更多
The main line of John Fowles' short story The Enigma is the missing of John Marcus Fielding. It mainly narrates people's views on Mr. Fielding, attitudes to him and attempts to clear the mystery up. Fowles inh...The main line of John Fowles' short story The Enigma is the missing of John Marcus Fielding. It mainly narrates people's views on Mr. Fielding, attitudes to him and attempts to clear the mystery up. Fowles inherits the concept of postmodernism in terms of themes, narration and other aspects, which gives a further and deeper expression of his views on freedom, mystery and the relationship between author, characters and readers. In particular, this short story of John Fowles, who was influenced by existentialism, carries out a profound literary interpretation of existentialism in many aspects. Focusing on the themes, the paper will look at the existentialist articulation in The Enigma.展开更多
It was more than 40 years ago, as a first-year Urology resident, that I performed my first varicocele ligation （a palomo procedure under the watchful eye and able hands of my staff physician. I dutifully read all I c...It was more than 40 years ago, as a first-year Urology resident, that I performed my first varicocele ligation （a palomo procedure under the watchful eye and able hands of my staff physician. I dutifully read all I could the night before the procedure and became familiar with the names of Barfield, Macomber and Sanders, Tulloch, MacLeod, Ivanissevich, Palomo, Amelar and Dubin and others who had written about varicoceles being associated with abnormal semen parameters and a potentially surgically correctable cause of male infertility.展开更多
在接触Enigma之前,你需要一点New age music的背景。New age源自于上世纪七十年代,德国的一些音乐家将电子合成音响的概念融入到人的原声和即兴演奏中。后来,这种音乐渐渐发展成以冥思和心灵为创作的出发点,它的素材也汲取于原始部落土...在接触Enigma之前,你需要一点New age music的背景。New age源自于上世纪七十年代,德国的一些音乐家将电子合成音响的概念融入到人的原声和即兴演奏中。后来,这种音乐渐渐发展成以冥思和心灵为创作的出发点,它的素材也汲取于原始部落土著、少数民族、宗教、图腾、外太空等能够拓展精神感染力的领域。Newage音乐在几十年的发展演变中。展开更多
American writer Emily Dickinson(1830-1886) uses the riddle as literary form in her poetry.There are mainly three kinds of riddle:enigma,charade,and conundrum.She uses riddles in her poetry to discuss the relationship ...American writer Emily Dickinson(1830-1886) uses the riddle as literary form in her poetry.There are mainly three kinds of riddle:enigma,charade,and conundrum.She uses riddles in her poetry to discuss the relationship of man to nature and death.展开更多
Helicobacter pylori(H.pylori)is the causative agent of gastritis,peptic ulcer disease,mucosa associated lymphoid tissue lymphoma and gastric cancer(GC).While this bacterium infects 50%of the world’s population,in Afr...Helicobacter pylori(H.pylori)is the causative agent of gastritis,peptic ulcer disease,mucosa associated lymphoid tissue lymphoma and gastric cancer(GC).While this bacterium infects 50%of the world’s population,in Africa its prevalence reach as high as 80%as the infection is acquired during childhood.Risk factors for H.pylori acquisition have been reported to be mainly due to overcrowding,to have infected siblings or parent and to unsafe water sources.Despite this high H.pylori prevalence there still does not exist an African guideline,equivalent to the Maastricht V/Florence Consensus Report of the European Helicobacter and Microbiota Study Group for the management of this infection.In this continent,although there is a paucity of epidemiologic data,a contrast between the high prevalence of H.pylori infection and the low incidence of GC has been reported.This phenomenon is the so-called“African Enigma”and it has been hypothesized that it could be explained by environmental,dietary and genetic factors.A heterogeneity of data both on diagnosis and on therapy have been published.In this context,it is evident that in several African countries the increasing rate of bacterial resistance,mainly to metronidazole and clarithromycin,requires continental guidelines to recommend the appropriate management of H.pylori.The aim of this manuscript is to review current literature on H.pylori infection in Africa,in terms of prevalence,risk factors,impact on human health,treatment and challenges encountered so as to proffer possible solutions to reduce H.pylori transmission in this continent.展开更多
在漫长的前寒武纪,存在若干谜一样的问题,如叠层石的生长机理、臼齿状构造的成因、白云岩的形成机制和宏观藻类化石的生物学属性及其分类归属等。宏观藻类化石是指那些肉眼可见的低等植物化石,因为与现代藻类的亲缘关系尚未完全确定,它...在漫长的前寒武纪,存在若干谜一样的问题,如叠层石的生长机理、臼齿状构造的成因、白云岩的形成机制和宏观藻类化石的生物学属性及其分类归属等。宏观藻类化石是指那些肉眼可见的低等植物化石,因为与现代藻类的亲缘关系尚未完全确定,它们的生物学属性及其分类位置还存在较多的争议,所以宏观藻类化石成为一个"前寒武纪谜"。发现于天津蓟县剖面高于庄组第三段非叠层石灰岩(均一石灰岩)中的可能的实体宏观藻类化石,与成因还存在争议的臼齿状构造共生,包括球状丘尔藻、椭球状寿县藻、带状塔乌藻和豆荚状荚藻等4种类型,尤其以前两种居多,组成一个丘尔藻-寿县藻组合;这些多为球状体的化石,曾经被认为是臼齿状构造的一种,称为"球状臼齿状构造",但是,由于这些宏观藻类化石具有规则的形态、较为明显的可能的细胞显微结构,与充填臼齿状构造的方解石微亮晶形成明显的区别,不属于臼齿状构造;而且以实体化石产出,与多年来所描述的碳质压型化石又存在较大的区别;同时,该球状化石的中心部位硅化而边部为钙化体,也明显区别于一般的钙质结核、燧石结核、凝灰岩结核和气泡构造等。这些球状实体化石,要比H.J.Hofmann所报道的加拿大麦肯齐山小达尔群(Little Dal Group)的臼齿状构造灰岩中的实体宏观藻类化石的形成时代要老得多,有可能是最为古老的实体宏观藻类化石。高于庄组臼齿状构造灰岩中的实体宏观藻类化石,成为思考若干前寒武纪谜的重要现象。展开更多
AIM： To conduct a detailed histological study of gastritis in adult patients attending an endoscopy clinic at a Kenyan teaching and referral hospital.METHODS： Biopsy specimens from consecutive patients were examined...AIM： To conduct a detailed histological study of gastritis in adult patients attending an endoscopy clinic at a Kenyan teaching and referral hospital.METHODS： Biopsy specimens from consecutive patients were examined and graded according to the Updated Sydney System for H pylori infection, chronic inflammation, neutrophil activity, glandular atrophy and intestinal metaplasia. Also documented were gastric tissue eosinophil counts and presence of lymphoid follicles.RESULTS： The rate of the graded variables, in the antrum and corpus respectively, were as follows： H pylori infection （91%, 86%）, chronic inflammation （98%, 93%）, neutrophil activity （91%, 86%）, glandular atrophy （57%, 15%） and intestinal metaplasia （11%, 2%）. Lymphoid follicles were noted in 11% of cases. Duodenal and gastric ulcers were documented in 32% and 2% respectively. The mean eosinophil count was 5.9 ±0.74 eosinophils/ HPF and 9.58 ± 0.93 eosinophils/HPF in the corpus and antrum respectively. Significant association was found between the degree of H pylori colonisation with chronic inflammation, neutrophil activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant histopathological discordance for all the graded variables. H pylori negative cases were associated with recent antibiotic use.CONCLUSION： The study the chief cause of gastritis reaffirms that H pylori is in this environment. The majority of patients show a moderate to high degree of inflammation but a low degree of glandular atrophy and intestinal metaplasia. The study shows that interrelationships between the histological variables in this African population are similar to those found in other populations worldwide including non-African populations.展开更多
文摘Ernest Hemingway, one of the brightest stars on the literary stage of both American and the whole world literature in the twentieth century, had gained an everlasting reputation by the image of"the tough man"he created in lots of his works.Hence, to readers, Hemingway must be a strong man both physically and mentally. Though Hemingway had passed away, he left us an inestimable literary treasure, and we can draw some lessons from his suicide tragedy. To modern people who are
文摘Helicobacter pylori(H. pylori) is one of the most widespread infections in humans worldwide that chronically infects up to 50% of the world's population. The infection is involved in the pathogenesis of chronic active gastritis, peptic ulcer, mucosa-associated lymphoid tissue lymphoma and gastric cancer, therefore, it has been classified as class Ⅰ definite carcinogen by the World Health Organization. Despite the established etiological role of H. pylori, its actual distribution and association with related diseases is controversial and there is a large intercountry variation especially among Asian countries. H. pylori infection is more frequent in developing countries like India, Pakistan, and Bangladesh as compared to developed Asian countries like Japan, China and South Korea. However, the frequency of gastric cancer is comparatively lower in India, Pakistan, and Bangladesh with that of Japan, China and South Korea. Such phenomenon of clinical diversity, defined as enigma, is judged by genetic variability of the infecting H. pylori strains, differences in the host genetic background in various ethnic groups, and environmental factors such as dietary habits. Most of the studies have so far focused on the bacterial factor while environmental issues, including dietary components, were not given due attention as one of the factors related with H. pylori associated gastric carcinogenesis. The dietary factor has been suggested to play an important role in H. pylori related carcinogenesis, and in this respect several studies have corroborated the intake of various dietary components as modulatory factors for gastric cancer risk. In this review, such studies, from in vitro experiments to clinical trials, are being focused in detail with respect to enigma associated with H. pylori. It may be conceivably concluded from the available evidence that dietary factor can be a game changer in the scenario of Asian enigma, particularly in high risk population infected with virulent H. pylori strains, however further affirmation studies are desperately needed to achieve conclusive outcomes.
文摘Intrduction: Edema, Hypertension and Hypokalemia occur with inhibition of 11 B-Hydroxysteroid Dehydrogenase Type 2 (11B-HSD2) by chronic Licorice ingestion. However, a similar presentation following a chronic use of another commonly used sweetener “Stevia” is not reported. Objective: To document a first case report of a subject presenting with Edema, Prehypertension and Hypokalemia induced by 11B-HSD2 inhibition induced by chronic ingestion of sweetener stevia. Case Report: 32 year old Caucasian woman presented with generalized edema (feet, hands and face) of over 6 months. She was noted to also manifest Prehypertension (138/88 mmHg) and Hypokalemia (3.4 mM/l). Laboratory tests revealed decline in serum aldosterone and plasma renin activity, an increase in plasma cortisol/cortisone ratio. On persistent interrogation, patient admitted to daily consumption of sweetener stevia for over 9 months. All the presenting manifestations resolved with normalization of the laboratory tests on withdrawal of stevia. Conclusion: This case report indicates that chronic ingestion of sweetener stevia may induce edema, hypertension and hypokalemia via reduced conversion of cortisol into cortisone by inhibition of 11 B-Hydroxysteroid Dehydrogenase Type 2.
文摘The main line of John Fowles' short story The Enigma is the missing of John Marcus Fielding. It mainly narrates people's views on Mr. Fielding, attitudes to him and attempts to clear the mystery up. Fowles inherits the concept of postmodernism in terms of themes, narration and other aspects, which gives a further and deeper expression of his views on freedom, mystery and the relationship between author, characters and readers. In particular, this short story of John Fowles, who was influenced by existentialism, carries out a profound literary interpretation of existentialism in many aspects. Focusing on the themes, the paper will look at the existentialist articulation in The Enigma.
文摘It was more than 40 years ago, as a first-year Urology resident, that I performed my first varicocele ligation （a palomo procedure under the watchful eye and able hands of my staff physician. I dutifully read all I could the night before the procedure and became familiar with the names of Barfield, Macomber and Sanders, Tulloch, MacLeod, Ivanissevich, Palomo, Amelar and Dubin and others who had written about varicoceles being associated with abnormal semen parameters and a potentially surgically correctable cause of male infertility.
文摘在接触Enigma之前,你需要一点New age music的背景。New age源自于上世纪七十年代,德国的一些音乐家将电子合成音响的概念融入到人的原声和即兴演奏中。后来,这种音乐渐渐发展成以冥思和心灵为创作的出发点,它的素材也汲取于原始部落土著、少数民族、宗教、图腾、外太空等能够拓展精神感染力的领域。Newage音乐在几十年的发展演变中。
文摘American writer Emily Dickinson(1830-1886) uses the riddle as literary form in her poetry.There are mainly three kinds of riddle:enigma,charade,and conundrum.She uses riddles in her poetry to discuss the relationship of man to nature and death.
文摘Helicobacter pylori(H.pylori)is the causative agent of gastritis,peptic ulcer disease,mucosa associated lymphoid tissue lymphoma and gastric cancer(GC).While this bacterium infects 50%of the world’s population,in Africa its prevalence reach as high as 80%as the infection is acquired during childhood.Risk factors for H.pylori acquisition have been reported to be mainly due to overcrowding,to have infected siblings or parent and to unsafe water sources.Despite this high H.pylori prevalence there still does not exist an African guideline,equivalent to the Maastricht V/Florence Consensus Report of the European Helicobacter and Microbiota Study Group for the management of this infection.In this continent,although there is a paucity of epidemiologic data,a contrast between the high prevalence of H.pylori infection and the low incidence of GC has been reported.This phenomenon is the so-called“African Enigma”and it has been hypothesized that it could be explained by environmental,dietary and genetic factors.A heterogeneity of data both on diagnosis and on therapy have been published.In this context,it is evident that in several African countries the increasing rate of bacterial resistance,mainly to metronidazole and clarithromycin,requires continental guidelines to recommend the appropriate management of H.pylori.The aim of this manuscript is to review current literature on H.pylori infection in Africa,in terms of prevalence,risk factors,impact on human health,treatment and challenges encountered so as to proffer possible solutions to reduce H.pylori transmission in this continent.
文摘在漫长的前寒武纪,存在若干谜一样的问题,如叠层石的生长机理、臼齿状构造的成因、白云岩的形成机制和宏观藻类化石的生物学属性及其分类归属等。宏观藻类化石是指那些肉眼可见的低等植物化石,因为与现代藻类的亲缘关系尚未完全确定,它们的生物学属性及其分类位置还存在较多的争议,所以宏观藻类化石成为一个"前寒武纪谜"。发现于天津蓟县剖面高于庄组第三段非叠层石灰岩(均一石灰岩)中的可能的实体宏观藻类化石,与成因还存在争议的臼齿状构造共生,包括球状丘尔藻、椭球状寿县藻、带状塔乌藻和豆荚状荚藻等4种类型,尤其以前两种居多,组成一个丘尔藻-寿县藻组合;这些多为球状体的化石,曾经被认为是臼齿状构造的一种,称为"球状臼齿状构造",但是,由于这些宏观藻类化石具有规则的形态、较为明显的可能的细胞显微结构,与充填臼齿状构造的方解石微亮晶形成明显的区别,不属于臼齿状构造;而且以实体化石产出,与多年来所描述的碳质压型化石又存在较大的区别;同时,该球状化石的中心部位硅化而边部为钙化体,也明显区别于一般的钙质结核、燧石结核、凝灰岩结核和气泡构造等。这些球状实体化石,要比H.J.Hofmann所报道的加拿大麦肯齐山小达尔群(Little Dal Group)的臼齿状构造灰岩中的实体宏观藻类化石的形成时代要老得多,有可能是最为古老的实体宏观藻类化石。高于庄组臼齿状构造灰岩中的实体宏观藻类化石,成为思考若干前寒武纪谜的重要现象。
文摘AIM： To conduct a detailed histological study of gastritis in adult patients attending an endoscopy clinic at a Kenyan teaching and referral hospital.METHODS： Biopsy specimens from consecutive patients were examined and graded according to the Updated Sydney System for H pylori infection, chronic inflammation, neutrophil activity, glandular atrophy and intestinal metaplasia. Also documented were gastric tissue eosinophil counts and presence of lymphoid follicles.RESULTS： The rate of the graded variables, in the antrum and corpus respectively, were as follows： H pylori infection （91%, 86%）, chronic inflammation （98%, 93%）, neutrophil activity （91%, 86%）, glandular atrophy （57%, 15%） and intestinal metaplasia （11%, 2%）. Lymphoid follicles were noted in 11% of cases. Duodenal and gastric ulcers were documented in 32% and 2% respectively. The mean eosinophil count was 5.9 ±0.74 eosinophils/ HPF and 9.58 ± 0.93 eosinophils/HPF in the corpus and antrum respectively. Significant association was found between the degree of H pylori colonisation with chronic inflammation, neutrophil activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant histopathological discordance for all the graded variables. H pylori negative cases were associated with recent antibiotic use.CONCLUSION： The study the chief cause of gastritis reaffirms that H pylori is in this environment. The majority of patients show a moderate to high degree of inflammation but a low degree of glandular atrophy and intestinal metaplasia. The study shows that interrelationships between the histological variables in this African population are similar to those found in other populations worldwide including non-African populations.
