BACKGROUND We describe the treatment strategy for a patient who was found to have a partial hydatidiform mole and coexisting fetus(PHMCF)during the second trimester.The patient was a 38-year-old Chinese woman who had ...BACKGROUND We describe the treatment strategy for a patient who was found to have a partial hydatidiform mole and coexisting fetus(PHMCF)during the second trimester.The patient was a 38-year-old Chinese woman who had become pregnant following in vitro fertilization and embryo transplantation.We wanted to determine the safest therapeutic strategy to terminate the PHMCF during the second trimester.CASE SUMMARY In this case,we present a patient who was found to have a PHMCF complicated with serious continuous vaginal bleeding and pre-eclampsia during the second trimester.After careful evaluation,the pregnancy was considered to be unsustainable and was terminated via caesarean section(CS).An infant with weak vital signs and a partially cystic placenta measuring 110 mm×95 mm×35 mm were delivered by CS.The patient was discharged after 4 d.The serum levels ofβ-human chorionic gonadotropin decreased to within a normal range 5 wk after the operation,and no evidence of persistent trophoblastic disease or lung metastases was noticed at the 6-mo follow-up.CONCLUSION CS termination of PHMCF during the second trimester may be a relatively safe therapeutic strategy.展开更多
Riboflavin is an essential micronutrient for humans and must be obtained exogenously from foods or sup-plements.Numerous studies have suggested a major role of riboflavin in the prevention and treatment of various dis...Riboflavin is an essential micronutrient for humans and must be obtained exogenously from foods or sup-plements.Numerous studies have suggested a major role of riboflavin in the prevention and treatment of various diseases.There are mainly three strategies for riboflavin synthesis,including total chemical syn-thesis,chemical semi-synthesis,and microbial fermentation,the latter being currently the most promis-ing strategy.In recent years,flavinogenic microbes have attracted increasing attention.Fungi,including Eremothecium ashbyii and Ashbya gossypii,and bacteria,including Bacillus subtilis,Escherichia coli,and lac-tic acid bacteria,are ideal cell factories for riboflavin overproduction.Thus they are good candidates for enhancing the level of riboflavin in fermented foods or designing novel riboflavin bio-enriched foods with improved nutritional value and/or beneficial properties for human health.This review briefly describes the role of riboflavin in human health and the historical process of its industrial production,and then highlights riboflavin biosynthesis in bacteria and fungi,and finally summarizes the strategies for ribofla-vin overproduction based on both the optimization of fermentation conditions and the development of riboflavin-overproducing strains via chemical mutagenesis and metabolic engineering.Overall,this review provides an updated understanding of riboflavin biosynthesis and can promote the research and development of fermented food products rich in riboflavin.展开更多
BACKGROUND Preterm birth accounts for about 12%of all pregnancies worldwide and is the leading cause of neonatal morbidity and mortality.In order to avoid premature birth and prolong gestational age,tocolytics are the...BACKGROUND Preterm birth accounts for about 12%of all pregnancies worldwide and is the leading cause of neonatal morbidity and mortality.In order to avoid premature birth and prolong gestational age,tocolytics are the first and the best choice.Ritodrine is the most commonly used tocolytic medication.However,side effects such as pulmonary edema,hypokalemia,and hyperglycemia are known.Here we report a rare but serious side effect–toxic epidermal necrolysis(TEN)–caused by ritodrine.CASE SUMMARY A woman(31 years,gravida 4,para 2)was hospitalized because of premature contractions at 27+6 wk of gestation.A skin rash with pruritus appeared at 32+3 wk of gestation after administration of ritodrine,indomethacin,and dexamethasone,and it spread throughout the whole body in 3 d,particularly the four limbs.After 11 d’treatment,she was diagnosed with TEN.An emergency cesarean section was performed immediately to deliver the baby and intensive symptomatic treatment was promptly commenced after delivery.She recovered from the severe condition without any sequelae except for slight pigmentation after symptomatic treatment.CONCLUSION When a skin rash appears during the administration of ritodrine,we are supposed to consider the risk of TEN.展开更多
BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating ...BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating the recovery process,and improving the quality of life.AIM To impact of systematic nursing intervention on recovery,complications prevention,and quality of life after endoscopic surgery for intestinal polyps.METHODS This retrospective study included 157 patients who underwent endoscopic mucosal resection or endoscopic submucosal dissection at our hospital.The patients were divided into intervention and conventional groups,with no significant differences in age,sex,or surgical methods.The intervention group received multidimensional nursing interventions,including preoperative evaluation,intraoperative cooperation,postoperative rehabilitation,psychological support and nutritional management.The conventional group received standardized care.Clinical efficacy,inflammation and infection indicators,complication rates,rehabilitation indicators,and visual analog scale(VAS)scores were compared.RESULTS On the 7th day after surgery,C-reactive protein(CRP)and white blood cell levels were lower in the intervention group than in the conventional group.Complications occurred in 9.33%of the patients in the intervention group and 23.17%in the conventional group,with significant differences in fever and abdominal distension.The intervention group had shorter first exhaust and hospitalization durations than the control group.By day 3 post-surgery,the intervention group showed lower VAS scores and reduced anxiety and depression.High-risk factors included diabetes[relative risk(RR)=2.43,95%CI:1.21-4.86],laparotomy(RR=2.86,95%CI:1.22-6.71),CRP>15 mg/L(RR=3.12,95%CI:1.54-6.33),and procalcitonin>0.5 ng/mL 1 day after surgery(RR=2.91.95%CI:1.31-6.44),while systematic nursing interventions(OR=0.40,95%CI:0.18-0.89)reduced the complication risk by 60%.CONCLUSION Multidimensional nursing interventions have clinical value in endoscopic treatment of intestinal polyps and early stage cancer,reducing complications and hospital stay.This study provides a basis for establishing patientcentered guidelines.展开更多
文摘BACKGROUND We describe the treatment strategy for a patient who was found to have a partial hydatidiform mole and coexisting fetus(PHMCF)during the second trimester.The patient was a 38-year-old Chinese woman who had become pregnant following in vitro fertilization and embryo transplantation.We wanted to determine the safest therapeutic strategy to terminate the PHMCF during the second trimester.CASE SUMMARY In this case,we present a patient who was found to have a PHMCF complicated with serious continuous vaginal bleeding and pre-eclampsia during the second trimester.After careful evaluation,the pregnancy was considered to be unsustainable and was terminated via caesarean section(CS).An infant with weak vital signs and a partially cystic placenta measuring 110 mm×95 mm×35 mm were delivered by CS.The patient was discharged after 4 d.The serum levels ofβ-human chorionic gonadotropin decreased to within a normal range 5 wk after the operation,and no evidence of persistent trophoblastic disease or lung metastases was noticed at the 6-mo follow-up.CONCLUSION CS termination of PHMCF during the second trimester may be a relatively safe therapeutic strategy.
基金supported by China Central Public-Interest Scientific Institution Basal Research Fund, Chinese Academy of Agricultural Sciences, China (Y2020XK05)the Shanghai Pujiang Talent Plan, Shanghai, China (18PJ1404600)
文摘Riboflavin is an essential micronutrient for humans and must be obtained exogenously from foods or sup-plements.Numerous studies have suggested a major role of riboflavin in the prevention and treatment of various diseases.There are mainly three strategies for riboflavin synthesis,including total chemical syn-thesis,chemical semi-synthesis,and microbial fermentation,the latter being currently the most promis-ing strategy.In recent years,flavinogenic microbes have attracted increasing attention.Fungi,including Eremothecium ashbyii and Ashbya gossypii,and bacteria,including Bacillus subtilis,Escherichia coli,and lac-tic acid bacteria,are ideal cell factories for riboflavin overproduction.Thus they are good candidates for enhancing the level of riboflavin in fermented foods or designing novel riboflavin bio-enriched foods with improved nutritional value and/or beneficial properties for human health.This review briefly describes the role of riboflavin in human health and the historical process of its industrial production,and then highlights riboflavin biosynthesis in bacteria and fungi,and finally summarizes the strategies for ribofla-vin overproduction based on both the optimization of fermentation conditions and the development of riboflavin-overproducing strains via chemical mutagenesis and metabolic engineering.Overall,this review provides an updated understanding of riboflavin biosynthesis and can promote the research and development of fermented food products rich in riboflavin.
文摘BACKGROUND Preterm birth accounts for about 12%of all pregnancies worldwide and is the leading cause of neonatal morbidity and mortality.In order to avoid premature birth and prolong gestational age,tocolytics are the first and the best choice.Ritodrine is the most commonly used tocolytic medication.However,side effects such as pulmonary edema,hypokalemia,and hyperglycemia are known.Here we report a rare but serious side effect–toxic epidermal necrolysis(TEN)–caused by ritodrine.CASE SUMMARY A woman(31 years,gravida 4,para 2)was hospitalized because of premature contractions at 27+6 wk of gestation.A skin rash with pruritus appeared at 32+3 wk of gestation after administration of ritodrine,indomethacin,and dexamethasone,and it spread throughout the whole body in 3 d,particularly the four limbs.After 11 d’treatment,she was diagnosed with TEN.An emergency cesarean section was performed immediately to deliver the baby and intensive symptomatic treatment was promptly commenced after delivery.She recovered from the severe condition without any sequelae except for slight pigmentation after symptomatic treatment.CONCLUSION When a skin rash appears during the administration of ritodrine,we are supposed to consider the risk of TEN.
文摘BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating the recovery process,and improving the quality of life.AIM To impact of systematic nursing intervention on recovery,complications prevention,and quality of life after endoscopic surgery for intestinal polyps.METHODS This retrospective study included 157 patients who underwent endoscopic mucosal resection or endoscopic submucosal dissection at our hospital.The patients were divided into intervention and conventional groups,with no significant differences in age,sex,or surgical methods.The intervention group received multidimensional nursing interventions,including preoperative evaluation,intraoperative cooperation,postoperative rehabilitation,psychological support and nutritional management.The conventional group received standardized care.Clinical efficacy,inflammation and infection indicators,complication rates,rehabilitation indicators,and visual analog scale(VAS)scores were compared.RESULTS On the 7th day after surgery,C-reactive protein(CRP)and white blood cell levels were lower in the intervention group than in the conventional group.Complications occurred in 9.33%of the patients in the intervention group and 23.17%in the conventional group,with significant differences in fever and abdominal distension.The intervention group had shorter first exhaust and hospitalization durations than the control group.By day 3 post-surgery,the intervention group showed lower VAS scores and reduced anxiety and depression.High-risk factors included diabetes[relative risk(RR)=2.43,95%CI:1.21-4.86],laparotomy(RR=2.86,95%CI:1.22-6.71),CRP>15 mg/L(RR=3.12,95%CI:1.54-6.33),and procalcitonin>0.5 ng/mL 1 day after surgery(RR=2.91.95%CI:1.31-6.44),while systematic nursing interventions(OR=0.40,95%CI:0.18-0.89)reduced the complication risk by 60%.CONCLUSION Multidimensional nursing interventions have clinical value in endoscopic treatment of intestinal polyps and early stage cancer,reducing complications and hospital stay.This study provides a basis for establishing patientcentered guidelines.
