Acute complicated diverticulitis, particularly with colon perforation, is a rare but serious condition in transplant recipients with high morbidity and mortality. Neither acute diverticulitis nor colon perforation has...Acute complicated diverticulitis, particularly with colon perforation, is a rare but serious condition in transplant recipients with high morbidity and mortality. Neither acute diverticulitis nor colon perforation has been reported in young heart-lung grafted patients. A case of subclinical peritonitis due to perforated acute sigmoid diverticulitis 14 years after heart-lung transplantation is reported. A 26-year-old woman, who received heart-lung transplantation 14 years ago, presented with vague abdominal pain. Physical examination was normal. Blood tests revealed leukocytosis. Abdominal X-ray showed air-fluid levels while CT demonstrated peritonitis due to perforated sigmoid diverticulitis. Sigmoidectomy and end-colostomy (Hartmann's procedure) were performed. Histopathology confirmed perforated acute sigmoid diverticulitis. The patient was discharged on the 8th postoperative day after an uneventful postoperative course. This is the first report of acute diverticulitis resulting in colon perforation in a young heart-lung transplanted patient. Clinical presentation, even in peritonitis, may be atypical due to the masking effects of immunosuppression. A high index of suspicion, urgent aggressive diagnostic investigationof even vague abdominal symptoms, adjustment of immunosuppression, broad-spectrum antibiotics, and immediate surgical treatment are critical. Moreover, strategies to reduce the risk of this complication should be implemented. Pretransplantation colon screening, prophylactic pretransplantation sigmoid resection in patients with diverticulosis, and elective surgical intervention in patients with nonoperatively treated acute diverticulitis after transplantation deserve consideration and further studies.展开更多
From September 2006 to January 2007, 2 patients with end-staged heart and lung disease （congenital disease,Eisenmenger＇s syndrome, severe pulmonary artery hypertension and heart failure） underwent heart and lung tr...From September 2006 to January 2007, 2 patients with end-staged heart and lung disease （congenital disease,Eisenmenger＇s syndrome, severe pulmonary artery hypertension and heart failure） underwent heart and lung transplantation （HLT） at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.展开更多
目的探讨中学生睡眠质量与心肺耐力的关系,为促进中国青少年身心健康全面发展提供参考。方法于2023年9—12月,在上海、苏州、太原、婺源、兴义、乌鲁木齐分别采用分层整群随机抽样法抽取5713名13~18岁中学生,采用匹兹堡睡眠质量指数量表...目的探讨中学生睡眠质量与心肺耐力的关系,为促进中国青少年身心健康全面发展提供参考。方法于2023年9—12月,在上海、苏州、太原、婺源、兴义、乌鲁木齐分别采用分层整群随机抽样法抽取5713名13~18岁中学生,采用匹兹堡睡眠质量指数量表(PSQI)结合心肺耐力测试的方法对中学生的睡眠质量和心肺耐力水平进行评估,采用Pearson相关和多元线性回归分析睡眠质量与心肺耐力的关系。结果中学生睡眠质量差的报告率为33.7%(1926/5713),13~18岁女生的PSQI评分均高于男生(χ^(2)值分别为1.60,12.78,15.62,3.04,10.09,13.65,P值均<0.05)。中学生20 m往返跑(20 m SRT)为40(27,51)次,VO2max为46.27(40.84,51.30)mL/(kg·min),各年龄段女生20 m SRT与VO2max均低于男生(Z=-15.27~-6.41,-18.06~-14.07,P值均<0.05)。男生心肺耐力(VO2max)与睡眠时间和催眠药物评分呈负相关(r值分别为-0.032,-0.005),女生VO2max与睡眠时间、日间功能障碍评分均呈负相关(r值分别为-0.028,-0.008)(P值均<0.05)。控制相关变量后,线性回归分析显示,中学生PSQI总分与VO2max呈负相关(β=-0.347,P<0.01)。结论中学生睡眠质量越好,心肺耐力水平越高。促进中学生睡眠质量有利于改善其心肺耐力水平。展开更多
本文报道两项发现:(1)心脏冠状动静脉血管周围间隙内组织液定向流动图像和运动学基本定律;(2)心肺间组织液定向流动图像和运动学基本定律.借助荧光示踪技术,我们发现了如下新现象:(a)心脏血管树上,组织液沿分支血管周围间隙(Perivascula...本文报道两项发现:(1)心脏冠状动静脉血管周围间隙内组织液定向流动图像和运动学基本定律;(2)心肺间组织液定向流动图像和运动学基本定律.借助荧光示踪技术,我们发现了如下新现象:(a)心脏血管树上,组织液沿分支血管周围间隙(Perivascular Space,次流道PVS)向主血管周围间隙(Perivascular and Adventitial Clearances,主流道PAC)汇集,形成聚合流动;(b)心脏主血管周围间隙(主流道PAC)内,组织液从心尖向心底方向流动,构成心脏冠状血管周围间隙内组织液循环;(c)主流道PAC和分支流道PVS内,组织液流动满足三大基本定律,即存在律、同向律和反向律;(d)组织液由心到肺流动,构成心肺间组织液循环;(e)基于外周、心脏和心肺间组织液流动图像,完成全身性组织液流动的“拼图游戏”,建构出生命体内组织液循环图像;(f)组织液循环与血液循环偶联,建构对偶型内外双循环图像.展开更多
文摘Acute complicated diverticulitis, particularly with colon perforation, is a rare but serious condition in transplant recipients with high morbidity and mortality. Neither acute diverticulitis nor colon perforation has been reported in young heart-lung grafted patients. A case of subclinical peritonitis due to perforated acute sigmoid diverticulitis 14 years after heart-lung transplantation is reported. A 26-year-old woman, who received heart-lung transplantation 14 years ago, presented with vague abdominal pain. Physical examination was normal. Blood tests revealed leukocytosis. Abdominal X-ray showed air-fluid levels while CT demonstrated peritonitis due to perforated sigmoid diverticulitis. Sigmoidectomy and end-colostomy (Hartmann's procedure) were performed. Histopathology confirmed perforated acute sigmoid diverticulitis. The patient was discharged on the 8th postoperative day after an uneventful postoperative course. This is the first report of acute diverticulitis resulting in colon perforation in a young heart-lung transplanted patient. Clinical presentation, even in peritonitis, may be atypical due to the masking effects of immunosuppression. A high index of suspicion, urgent aggressive diagnostic investigationof even vague abdominal symptoms, adjustment of immunosuppression, broad-spectrum antibiotics, and immediate surgical treatment are critical. Moreover, strategies to reduce the risk of this complication should be implemented. Pretransplantation colon screening, prophylactic pretransplantation sigmoid resection in patients with diverticulosis, and elective surgical intervention in patients with nonoperatively treated acute diverticulitis after transplantation deserve consideration and further studies.
文摘From September 2006 to January 2007, 2 patients with end-staged heart and lung disease （congenital disease,Eisenmenger＇s syndrome, severe pulmonary artery hypertension and heart failure） underwent heart and lung transplantation （HLT） at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
文摘目的探讨中学生睡眠质量与心肺耐力的关系,为促进中国青少年身心健康全面发展提供参考。方法于2023年9—12月,在上海、苏州、太原、婺源、兴义、乌鲁木齐分别采用分层整群随机抽样法抽取5713名13~18岁中学生,采用匹兹堡睡眠质量指数量表(PSQI)结合心肺耐力测试的方法对中学生的睡眠质量和心肺耐力水平进行评估,采用Pearson相关和多元线性回归分析睡眠质量与心肺耐力的关系。结果中学生睡眠质量差的报告率为33.7%(1926/5713),13~18岁女生的PSQI评分均高于男生(χ^(2)值分别为1.60,12.78,15.62,3.04,10.09,13.65,P值均<0.05)。中学生20 m往返跑(20 m SRT)为40(27,51)次,VO2max为46.27(40.84,51.30)mL/(kg·min),各年龄段女生20 m SRT与VO2max均低于男生(Z=-15.27~-6.41,-18.06~-14.07,P值均<0.05)。男生心肺耐力(VO2max)与睡眠时间和催眠药物评分呈负相关(r值分别为-0.032,-0.005),女生VO2max与睡眠时间、日间功能障碍评分均呈负相关(r值分别为-0.028,-0.008)(P值均<0.05)。控制相关变量后,线性回归分析显示,中学生PSQI总分与VO2max呈负相关(β=-0.347,P<0.01)。结论中学生睡眠质量越好,心肺耐力水平越高。促进中学生睡眠质量有利于改善其心肺耐力水平。
文摘本文报道两项发现:(1)心脏冠状动静脉血管周围间隙内组织液定向流动图像和运动学基本定律;(2)心肺间组织液定向流动图像和运动学基本定律.借助荧光示踪技术,我们发现了如下新现象:(a)心脏血管树上,组织液沿分支血管周围间隙(Perivascular Space,次流道PVS)向主血管周围间隙(Perivascular and Adventitial Clearances,主流道PAC)汇集,形成聚合流动;(b)心脏主血管周围间隙(主流道PAC)内,组织液从心尖向心底方向流动,构成心脏冠状血管周围间隙内组织液循环;(c)主流道PAC和分支流道PVS内,组织液流动满足三大基本定律,即存在律、同向律和反向律;(d)组织液由心到肺流动,构成心肺间组织液循环;(e)基于外周、心脏和心肺间组织液流动图像,完成全身性组织液流动的“拼图游戏”,建构出生命体内组织液循环图像;(f)组织液循环与血液循环偶联,建构对偶型内外双循环图像.
