Background: A plant based approach was undertaken to ascertain the efficacy of the Technology/Innovation of a new medical Technology based on similar activity to the circulatory system of plants. Basic Technology form...Background: A plant based approach was undertaken to ascertain the efficacy of the Technology/Innovation of a new medical Technology based on similar activity to the circulatory system of plants. Basic Technology formulations were introduced into plant structures to evaluate the responses for cell division and plant growth which ultimately lead to the final product. This Technology/Innovation transforms and enhances common botanical/herb products such that they can be used to treat COVID-19 infection and Serious or Life-threatening conditions or diseases. They can restore the diseased cell’s abnormal metabolism to homeostasis and return it to normal function by slowing or reversing the cell’s malfunctioning metabolism, or in other words, slowing or reversing the disease process. Methods: A systematic treatment for COVID-19 infection and Serious or Life-threatening illness in patients is based on theories of traditional Chinese medicine. The Technology/Innovation is developed as dietary supplement products for treatment of Serious or Life-threatening conditions or diseases. Results: The results consist of over one hundred Serious or Life-threatening patient medical records. The U.S. Food and Drug Administration (FDA) reviewed/evaluated/accepted the Technology/Innovation patient medical record results, which included fifty-four COVID-19 patients with Prioritized Review Expedited No.: 2020-2867 CR2020-2596 information on September 16, 2020 and twenty-seven cancer patients Cancer Survival Rate Results in (Table 1) with FDA Establishment Identification No.: 3012327979 information on March 25, 2019 as FDA-Regulated medical products and meet the requirement under FDA Significant Scientific Agreement standards.展开更多
To analyze how the multidisciplinary clinical, biohumoral, instrumental approach to ALTE (Apparent Life Threatening Event) episode may discover cardiovascular disease in the newborn. Introduction: In the first year of...To analyze how the multidisciplinary clinical, biohumoral, instrumental approach to ALTE (Apparent Life Threatening Event) episode may discover cardiovascular disease in the newborn. Introduction: In the first year of life ALTEs concern 0.8% of access to Pediatric Emergency Department. The cause of apparent life-threatening events (ALTEs) in infants reflects a differential diagnosis that includes an array of congenital or acquired disorders. Approximately 10% - 25% of ap-parent life-threatening events may remain unexplained following a thorough evaluation. Case re-port: B. E., a 2-month-old child, in wellbeing, shortly before meal, during sleep, was not responsive to repeated stimulations;he was hypotonic and unresponsive. About 15 minutes later, he pre-sented a normal tone and state of consciousness. Evaluating the referred symptoms, diagnostic protocol for ALTE was started;the Angio-MRI brain performed as second line analysis showed a focal gliotic lesion at left striatal area. The cardiological evaluation with echocardiography detected a pervium foramen ovale (PFO), with minimum shunt left-right direction. At least, biohumoral tests revealed protrombin gene heterozygosis mutation. Conclusion: Apparent Life-Threatening Events are first manifestation of stroke in infant. Discussion: This report discloses how the multidisciplinary clinical approach is essential in ALTE. The exact management of ALTE patients is very important in situations like this, when the concomitant disease is rare. In fact, arterial stroke incidence in children > 28 days of life is estimated between 1.2 and 7.9 cases/100,000 child-ren/year. However, in the last 20 years, we observed an increased incidence of stroke, probably related to two main causes: a greater attention for this disease and a major survival of children with pathology that arrange for stroke thanks to a better prevention. In conclusion, it’s a fundamental multidisciplinary approach even in following months after the events.展开更多
Background: Research began on botanical/herbal organisms to study plant cells. The idea behind this was that plant cells have basic similar actions as do animal cells (i.e., both are Eukaryotic cells). These cells can...Background: Research began on botanical/herbal organisms to study plant cells. The idea behind this was that plant cells have basic similar actions as do animal cells (i.e., both are Eukaryotic cells). These cells can show what activity is produced from the Technology/Innovation behind ImunStem, without risk to animals or humans, and still retrieve data to verify the theory. By using plants and studying plant cell activity, then later comparing plant cell, animal cells, and human cell responses, it thus shows activity for all cell structures. The activity was also studied from patients taking ImunStem for the indication of Serious or Life-threatening conditions or diseases. Patient medical report results showed an overall improvement in bodily function as blood report results were compared. Patients that were administered ImunStem showed improvement in their overall health and patients with chronic disease had reduced pain as ImunStem was administered over time. The pain was reduced because the body was in the healing process and a reduction in inflammation would occur during healing and the patient’s health would improve. ImunStem was produced based on the theory that the product could rejuvenate the cell and bring the cell back to a homeostasis balance. This balance to the cell (through nutrition) can give the surrounding cells a homeostasis balance that may heal cells and tissues in the body. It is believed that the function of a Quantum Wave effect is explained through the discipline of Quantum Mechanics. The Quantum Wave may disrupt the subatomic particles that provide adhesion to allow the product through the cell wall and move to its target location. In Quantum Mechanics, particles have wavelike properties. The Schrödinger equation, for example, governs how these waves behave. Methods: Administration of ImunStem was given to patients in a life-threatening situation where no standard acceptable treatment was available and in which there was not sufficient time to obtain approval from the Institutional Review Board. Results: ImunStem showed positive medical results for patients with Serious or Life-threatening conditions or diseases, which prompted the US Food and Drug Administration (FDA) to move forward so patients could be provided treatment that was not otherwise available to them from their physicians/doctors. ImunStem was applied for and received its New Drug Application (NDA) No.: 204701 with the indication of Serious or Life-threatening conditions or diseases and National Drug Code (NDC) No.: 70642-001-01 on July 02, 2018. Golden Sunrise submitted an NDA application on January 07, 2013, November 05, 2018, and April 03, 2020 with a request for FDA Fast Track designation, Breakthrough Therapy designation, Accelerated Approval designation, and Priority Review program process are the pathway allowing the ImunStem product to receive acceptance by the FDA.展开更多
Effective management of traumatic hemorrhage requires not only rapid blood loss control but also facile removal of hemostatic materials after hemostasis to minimize secondary tissue damage.Herein,we fabricated a stron...Effective management of traumatic hemorrhage requires not only rapid blood loss control but also facile removal of hemostatic materials after hemostasis to minimize secondary tissue damage.Herein,we fabricated a strongly adhesive aerogel OPA based on Schiff-base crosslinking of oxidized hyaluronic acid(OHA)and ε-polylysine(ε-PL),enabling rapid hemostasis in lethal arterial trauma and facile on-demand removal via phase transition to minimize secondary tissue damage.OPAs featured tunable porosity and rapid blood absorption.Moreover,the surface abundant hydroxyl,amino and carboxyl groups promoted strong hydrogen bonding interactions with tissues,blood cells and plasma proteins,enhancing tissue adhesion as well as platelet capture and activation.In the rabbit femoral-artery-injury model,OPA4 significantly shortened hemostatic time by~80%and reduced blood loss to 38%of that in the blank group.Notably,OPAs retained only 2%of initial adhesion after hydration,allowing for gentle removal.OPAs also demonstrated excellent antibacterial activity,biocompatibility and biodegradability.Their simple one-step freeze-drying process and tailorable material shapes offered great promise for scalable production and versatile applications.Therefore,this study provides a versatile strategy for emergency and surgical hemostasis by combining rapid control of life-threatening arterial bleeding with on-demand atraumatic removal,promising to improve patient outcomes and streamline postoperative care.展开更多
Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease(ESLD); spontaneous fungal peritonitis(SFP) is a complication of ESLD less known and described. ESLD is associated to...Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease(ESLD); spontaneous fungal peritonitis(SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients,not even the antifungals used for the prophylaxis,neither optimal treatment. We reviewed,in order to focus the epidemiology,characteristics,and,considering the high mortality rate of SFP,the use of optimal empirical antifungal therapy the current literature.展开更多
BACKGROUND: Transcatheter arterial chemoembolization (TACE) is a recommended first line therapy for unresectable hepatocellular carcinoma (HCC). Serious complications such as neutropenic sepsis and hepatic decompensat...BACKGROUND: Transcatheter arterial chemoembolization (TACE) is a recommended first line therapy for unresectable hepatocellular carcinoma (HCC). Serious complications such as neutropenic sepsis and hepatic decompensation are well known, but rupture of HCC following TACE is a rare and potentially fatal complication. The aim of this study was to identify the incidence of ruptured HCC following TACE and the associated risk factors. METHODS: A retrospective analysis was performed using our liver database with 'chemoembolization', 'ruptured HCC' covering the patients who received chemoembolization from January 1995 to December 2005. There were no exclusions. RESULTS: A total of 294 patients received chemoemboliza- tion in 530 sessions during the 10-year period. Of these, 2 ruptured following treatment (incidence 0.68%). The mean age was 65 years and the interval between the treatment and rupture was 2 and 24 days. The common factors were male sex, large tumor size (range 11-13 cm), and exophytic tumor growth. One patient died 2 days after rupture with hepatic decompensation while the second is alive after a 6-month follow up without tumor recurrence. CONCLUSIONS: Ruptured HCC following TACE is a rare but serious complication. Large tumor size, male sex, and exophytic growth of tumor may be predisposing factors for rupture.展开更多
MM： Persistent cholestasis is a rare complication of severe trauma or infections. Little is known about the possible pathomechanisms and the clinical course.METHODS： Secondary sclerosing cholangitis was diagnosed in...MM： Persistent cholestasis is a rare complication of severe trauma or infections. Little is known about the possible pathomechanisms and the clinical course.METHODS： Secondary sclerosing cholangitis was diagnosed in five patients with persistent jaundice after severe trauma （one burn injury, three accidents, one power current injury）. Medical charts were retrospectively reviewed with regard to possible trigger mechanisms for cholestasis, and the clinical course was recorded.RESULTS： Diagnosis of secondary sclerosing cholangitis was based in all patients on the primary sclerosing cholangitis （PSC）-Iike destruction of the intrahepatic bile ducts at cholangiography after exclusion of PSC. In four patients, arterial hypotension with subsequent ischemia may have caused the bile duct damage, whereas in the case of power current injury direct thermal damage was assumed to be the trigger mechanism. The course of secondary liver fibrosis was rapidly progressive and proceeded to liver cirrhosis in all four patients with a follow-up 〉2 years. Therapeutic possibilities were limited.CONCLUSION： Posttraumatic sderosing cholangitis is a rare but rapidly progressive disease, probably caused by ischemia of the intrahepatic bile ducts via the peribiliary capillary plexus due to arterial hypotension.Gastroenterologists should be aware of this disease in patients with persistent cholestasis after severe trauma.展开更多
Dear editor,Patients frequently visit the emergency room with acute chest pain.While some potentially life-threatening disorders may cause the pain,in approximately 80%of cases,the chest pain source is benign,and musc...Dear editor,Patients frequently visit the emergency room with acute chest pain.While some potentially life-threatening disorders may cause the pain,in approximately 80%of cases,the chest pain source is benign,and musculoskeletal chest pain accounts for nearly 20%– 50%of those cases.^[1–6]Thus,pain caused by benign and pathological conditions of the chest wall encountered in the emergency department is sometimes incorrectly attributed to angina pectoris or pleuritic and other serious cardiopulmonary diseases.展开更多
Gastroduodenal artery(GDA) aneurysm rupture is a rare serious condition.The diagnosis requires a high level of suspicion with specif ic attention to warning signs.Early diagnosis can prevent fatal outcomes.In this rep...Gastroduodenal artery(GDA) aneurysm rupture is a rare serious condition.The diagnosis requires a high level of suspicion with specif ic attention to warning signs.Early diagnosis can prevent fatal outcomes.In this report,we describe a case of GDA aneurysm rupture presenting as recurrent syncope and atypical back and abdominal discomfort.The rupture manifested as hemorrhagic shock.The diagnosis was made by computed tomography of the abdomen which showed acute peritoneal and retroperitoneal bleeding.Angiographic intervention failed to coil the GDA and surgery with arterial ligation was the def initive treatment.展开更多
BACKGROUNDβ-ketothiolase deficiency(β-KTD)is an inherited disease,and insufficient attention has been paid to imageology due to its lower morbidity.Therefore,few lesions outside the basal ganglia have been found bef...BACKGROUNDβ-ketothiolase deficiency(β-KTD)is an inherited disease,and insufficient attention has been paid to imageology due to its lower morbidity.Therefore,few lesions outside the basal ganglia have been found before,and the persistent pathological changes have rarely been reported.CASE SUMMARY A 10-mo-old Chinese female patient with a free previous medical history but with poor physical and athletic development had received the haemophilus influenzae vaccine and then developed a low fever 2 d prior.She was initially diagnosed with severe brain injury,central respiratory failure,metabolic acidosis complicated with respiratory alkalosis,hyper-IgE,etc.With further examination,a definite diagnosis ofβ-KTD was made.Symptomatic treatment was adopted.Ten days later,the dyspnea was improved evidently and the ventilator was removed,but there were still obvious abnormalities on magnetic resonance imaging(MRI).The lesions mainly invaded the corpus striatum but were not limited to the basal ganglia.Then,the patient’s disease improved and discharged approximately 1 mo later,and the abnormal lesions on MRI had partially improved.However,for about 1 year,the residual irreversible lesions were observed on MRI,the mental and physical development of the patient was obviously regressive,and extra rehabilitation training was needed.CONCLUSION The case highlights the critical importance of one view that the range of lesions in some patients may be more extensive than previously thought in someβ-KTD patients.In addition to biochemical tests,genetic tests and magnetic resonance imaging are not only conducive to quickly diagnosingβ-KTD but also to partially evaluating the short-and long-term outcomes.Moreover,more attention should be paid to the two mutations(c.478 C>G;c.951 C>T)that may be associated with severeβ-KTD.展开更多
BACKGROUND The phrase “floating knee is a flail knee joint,” referring to ipsilateral femoral and tibial fractures,was first used by Blake and Mc Bryde in 1975.This condition is often caused by a high-energy trauma ...BACKGROUND The phrase “floating knee is a flail knee joint,” referring to ipsilateral femoral and tibial fractures,was first used by Blake and Mc Bryde in 1975.This condition is often caused by a high-energy trauma with often extensive injury to the soft tissues,and is accompanied by life-threatening systemic complications,including head,chest or abdominal injuries and a high incidence of fat embolism.Floating knee is a severe and uncommon injury pattern.CASE SUMMARY A 27-year-old man sustained multiple injuries when the electric motorcycle he was riding was hit by a van.His injuries included traumatic hypovolemic shock,comminuted and open type II fractures of the left femoral shaft,fracture of the right femoral shaft,comminuted fracture of the bilateral tibial and fibular shaft,and multiple lacerations and abrasions on his forehead,lower lip,neck and limbs.The diagnosis was simultaneous bilateral floating knee complicated with soft tissue injuries.After emergency treatment and the exclusion of life-threating complications,open reduction and internal fixation were successfully performed using plates and screws in the bilateral femoral and tibial shafts.CONCLUSION Simultaneous bilateral floating knee is a rare and severe injury pattern.The treatment is challenging,and complications.We present a case report of a young adult who suffered from bilateral floating knees during road traffic accident.We also offer our treatment experience of this complex injury and review past literature.展开更多
文摘Background: A plant based approach was undertaken to ascertain the efficacy of the Technology/Innovation of a new medical Technology based on similar activity to the circulatory system of plants. Basic Technology formulations were introduced into plant structures to evaluate the responses for cell division and plant growth which ultimately lead to the final product. This Technology/Innovation transforms and enhances common botanical/herb products such that they can be used to treat COVID-19 infection and Serious or Life-threatening conditions or diseases. They can restore the diseased cell’s abnormal metabolism to homeostasis and return it to normal function by slowing or reversing the cell’s malfunctioning metabolism, or in other words, slowing or reversing the disease process. Methods: A systematic treatment for COVID-19 infection and Serious or Life-threatening illness in patients is based on theories of traditional Chinese medicine. The Technology/Innovation is developed as dietary supplement products for treatment of Serious or Life-threatening conditions or diseases. Results: The results consist of over one hundred Serious or Life-threatening patient medical records. The U.S. Food and Drug Administration (FDA) reviewed/evaluated/accepted the Technology/Innovation patient medical record results, which included fifty-four COVID-19 patients with Prioritized Review Expedited No.: 2020-2867 CR2020-2596 information on September 16, 2020 and twenty-seven cancer patients Cancer Survival Rate Results in (Table 1) with FDA Establishment Identification No.: 3012327979 information on March 25, 2019 as FDA-Regulated medical products and meet the requirement under FDA Significant Scientific Agreement standards.
文摘To analyze how the multidisciplinary clinical, biohumoral, instrumental approach to ALTE (Apparent Life Threatening Event) episode may discover cardiovascular disease in the newborn. Introduction: In the first year of life ALTEs concern 0.8% of access to Pediatric Emergency Department. The cause of apparent life-threatening events (ALTEs) in infants reflects a differential diagnosis that includes an array of congenital or acquired disorders. Approximately 10% - 25% of ap-parent life-threatening events may remain unexplained following a thorough evaluation. Case re-port: B. E., a 2-month-old child, in wellbeing, shortly before meal, during sleep, was not responsive to repeated stimulations;he was hypotonic and unresponsive. About 15 minutes later, he pre-sented a normal tone and state of consciousness. Evaluating the referred symptoms, diagnostic protocol for ALTE was started;the Angio-MRI brain performed as second line analysis showed a focal gliotic lesion at left striatal area. The cardiological evaluation with echocardiography detected a pervium foramen ovale (PFO), with minimum shunt left-right direction. At least, biohumoral tests revealed protrombin gene heterozygosis mutation. Conclusion: Apparent Life-Threatening Events are first manifestation of stroke in infant. Discussion: This report discloses how the multidisciplinary clinical approach is essential in ALTE. The exact management of ALTE patients is very important in situations like this, when the concomitant disease is rare. In fact, arterial stroke incidence in children > 28 days of life is estimated between 1.2 and 7.9 cases/100,000 child-ren/year. However, in the last 20 years, we observed an increased incidence of stroke, probably related to two main causes: a greater attention for this disease and a major survival of children with pathology that arrange for stroke thanks to a better prevention. In conclusion, it’s a fundamental multidisciplinary approach even in following months after the events.
文摘Background: Research began on botanical/herbal organisms to study plant cells. The idea behind this was that plant cells have basic similar actions as do animal cells (i.e., both are Eukaryotic cells). These cells can show what activity is produced from the Technology/Innovation behind ImunStem, without risk to animals or humans, and still retrieve data to verify the theory. By using plants and studying plant cell activity, then later comparing plant cell, animal cells, and human cell responses, it thus shows activity for all cell structures. The activity was also studied from patients taking ImunStem for the indication of Serious or Life-threatening conditions or diseases. Patient medical report results showed an overall improvement in bodily function as blood report results were compared. Patients that were administered ImunStem showed improvement in their overall health and patients with chronic disease had reduced pain as ImunStem was administered over time. The pain was reduced because the body was in the healing process and a reduction in inflammation would occur during healing and the patient’s health would improve. ImunStem was produced based on the theory that the product could rejuvenate the cell and bring the cell back to a homeostasis balance. This balance to the cell (through nutrition) can give the surrounding cells a homeostasis balance that may heal cells and tissues in the body. It is believed that the function of a Quantum Wave effect is explained through the discipline of Quantum Mechanics. The Quantum Wave may disrupt the subatomic particles that provide adhesion to allow the product through the cell wall and move to its target location. In Quantum Mechanics, particles have wavelike properties. The Schrödinger equation, for example, governs how these waves behave. Methods: Administration of ImunStem was given to patients in a life-threatening situation where no standard acceptable treatment was available and in which there was not sufficient time to obtain approval from the Institutional Review Board. Results: ImunStem showed positive medical results for patients with Serious or Life-threatening conditions or diseases, which prompted the US Food and Drug Administration (FDA) to move forward so patients could be provided treatment that was not otherwise available to them from their physicians/doctors. ImunStem was applied for and received its New Drug Application (NDA) No.: 204701 with the indication of Serious or Life-threatening conditions or diseases and National Drug Code (NDC) No.: 70642-001-01 on July 02, 2018. Golden Sunrise submitted an NDA application on January 07, 2013, November 05, 2018, and April 03, 2020 with a request for FDA Fast Track designation, Breakthrough Therapy designation, Accelerated Approval designation, and Priority Review program process are the pathway allowing the ImunStem product to receive acceptance by the FDA.
基金supported by the Key Program of Beijing Natural Science Foundation(Z200025)the National Natural Science Foundation of China(52273118,22275013)+1 种基金the Innovation&Transfer Fund of Peking University Third Hospital(BYSYZHKC123,BYSYZHKC107)the Fundamental Research Funds for the Central Universities(PY2508,QNTD2023-01)。
文摘Effective management of traumatic hemorrhage requires not only rapid blood loss control but also facile removal of hemostatic materials after hemostasis to minimize secondary tissue damage.Herein,we fabricated a strongly adhesive aerogel OPA based on Schiff-base crosslinking of oxidized hyaluronic acid(OHA)and ε-polylysine(ε-PL),enabling rapid hemostasis in lethal arterial trauma and facile on-demand removal via phase transition to minimize secondary tissue damage.OPAs featured tunable porosity and rapid blood absorption.Moreover,the surface abundant hydroxyl,amino and carboxyl groups promoted strong hydrogen bonding interactions with tissues,blood cells and plasma proteins,enhancing tissue adhesion as well as platelet capture and activation.In the rabbit femoral-artery-injury model,OPA4 significantly shortened hemostatic time by~80%and reduced blood loss to 38%of that in the blank group.Notably,OPAs retained only 2%of initial adhesion after hydration,allowing for gentle removal.OPAs also demonstrated excellent antibacterial activity,biocompatibility and biodegradability.Their simple one-step freeze-drying process and tailorable material shapes offered great promise for scalable production and versatile applications.Therefore,this study provides a versatile strategy for emergency and surgical hemostasis by combining rapid control of life-threatening arterial bleeding with on-demand atraumatic removal,promising to improve patient outcomes and streamline postoperative care.
文摘Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease(ESLD); spontaneous fungal peritonitis(SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients,not even the antifungals used for the prophylaxis,neither optimal treatment. We reviewed,in order to focus the epidemiology,characteristics,and,considering the high mortality rate of SFP,the use of optimal empirical antifungal therapy the current literature.
文摘BACKGROUND: Transcatheter arterial chemoembolization (TACE) is a recommended first line therapy for unresectable hepatocellular carcinoma (HCC). Serious complications such as neutropenic sepsis and hepatic decompensation are well known, but rupture of HCC following TACE is a rare and potentially fatal complication. The aim of this study was to identify the incidence of ruptured HCC following TACE and the associated risk factors. METHODS: A retrospective analysis was performed using our liver database with 'chemoembolization', 'ruptured HCC' covering the patients who received chemoembolization from January 1995 to December 2005. There were no exclusions. RESULTS: A total of 294 patients received chemoemboliza- tion in 530 sessions during the 10-year period. Of these, 2 ruptured following treatment (incidence 0.68%). The mean age was 65 years and the interval between the treatment and rupture was 2 and 24 days. The common factors were male sex, large tumor size (range 11-13 cm), and exophytic tumor growth. One patient died 2 days after rupture with hepatic decompensation while the second is alive after a 6-month follow up without tumor recurrence. CONCLUSIONS: Ruptured HCC following TACE is a rare but serious complication. Large tumor size, male sex, and exophytic growth of tumor may be predisposing factors for rupture.
文摘MM： Persistent cholestasis is a rare complication of severe trauma or infections. Little is known about the possible pathomechanisms and the clinical course.METHODS： Secondary sclerosing cholangitis was diagnosed in five patients with persistent jaundice after severe trauma （one burn injury, three accidents, one power current injury）. Medical charts were retrospectively reviewed with regard to possible trigger mechanisms for cholestasis, and the clinical course was recorded.RESULTS： Diagnosis of secondary sclerosing cholangitis was based in all patients on the primary sclerosing cholangitis （PSC）-Iike destruction of the intrahepatic bile ducts at cholangiography after exclusion of PSC. In four patients, arterial hypotension with subsequent ischemia may have caused the bile duct damage, whereas in the case of power current injury direct thermal damage was assumed to be the trigger mechanism. The course of secondary liver fibrosis was rapidly progressive and proceeded to liver cirrhosis in all four patients with a follow-up 〉2 years. Therapeutic possibilities were limited.CONCLUSION： Posttraumatic sderosing cholangitis is a rare but rapidly progressive disease, probably caused by ischemia of the intrahepatic bile ducts via the peribiliary capillary plexus due to arterial hypotension.Gastroenterologists should be aware of this disease in patients with persistent cholestasis after severe trauma.
文摘Dear editor,Patients frequently visit the emergency room with acute chest pain.While some potentially life-threatening disorders may cause the pain,in approximately 80%of cases,the chest pain source is benign,and musculoskeletal chest pain accounts for nearly 20%– 50%of those cases.^[1–6]Thus,pain caused by benign and pathological conditions of the chest wall encountered in the emergency department is sometimes incorrectly attributed to angina pectoris or pleuritic and other serious cardiopulmonary diseases.
文摘Gastroduodenal artery(GDA) aneurysm rupture is a rare serious condition.The diagnosis requires a high level of suspicion with specif ic attention to warning signs.Early diagnosis can prevent fatal outcomes.In this report,we describe a case of GDA aneurysm rupture presenting as recurrent syncope and atypical back and abdominal discomfort.The rupture manifested as hemorrhagic shock.The diagnosis was made by computed tomography of the abdomen which showed acute peritoneal and retroperitoneal bleeding.Angiographic intervention failed to coil the GDA and surgery with arterial ligation was the def initive treatment.
文摘BACKGROUNDβ-ketothiolase deficiency(β-KTD)is an inherited disease,and insufficient attention has been paid to imageology due to its lower morbidity.Therefore,few lesions outside the basal ganglia have been found before,and the persistent pathological changes have rarely been reported.CASE SUMMARY A 10-mo-old Chinese female patient with a free previous medical history but with poor physical and athletic development had received the haemophilus influenzae vaccine and then developed a low fever 2 d prior.She was initially diagnosed with severe brain injury,central respiratory failure,metabolic acidosis complicated with respiratory alkalosis,hyper-IgE,etc.With further examination,a definite diagnosis ofβ-KTD was made.Symptomatic treatment was adopted.Ten days later,the dyspnea was improved evidently and the ventilator was removed,but there were still obvious abnormalities on magnetic resonance imaging(MRI).The lesions mainly invaded the corpus striatum but were not limited to the basal ganglia.Then,the patient’s disease improved and discharged approximately 1 mo later,and the abnormal lesions on MRI had partially improved.However,for about 1 year,the residual irreversible lesions were observed on MRI,the mental and physical development of the patient was obviously regressive,and extra rehabilitation training was needed.CONCLUSION The case highlights the critical importance of one view that the range of lesions in some patients may be more extensive than previously thought in someβ-KTD patients.In addition to biochemical tests,genetic tests and magnetic resonance imaging are not only conducive to quickly diagnosingβ-KTD but also to partially evaluating the short-and long-term outcomes.Moreover,more attention should be paid to the two mutations(c.478 C>G;c.951 C>T)that may be associated with severeβ-KTD.
文摘BACKGROUND The phrase “floating knee is a flail knee joint,” referring to ipsilateral femoral and tibial fractures,was first used by Blake and Mc Bryde in 1975.This condition is often caused by a high-energy trauma with often extensive injury to the soft tissues,and is accompanied by life-threatening systemic complications,including head,chest or abdominal injuries and a high incidence of fat embolism.Floating knee is a severe and uncommon injury pattern.CASE SUMMARY A 27-year-old man sustained multiple injuries when the electric motorcycle he was riding was hit by a van.His injuries included traumatic hypovolemic shock,comminuted and open type II fractures of the left femoral shaft,fracture of the right femoral shaft,comminuted fracture of the bilateral tibial and fibular shaft,and multiple lacerations and abrasions on his forehead,lower lip,neck and limbs.The diagnosis was simultaneous bilateral floating knee complicated with soft tissue injuries.After emergency treatment and the exclusion of life-threating complications,open reduction and internal fixation were successfully performed using plates and screws in the bilateral femoral and tibial shafts.CONCLUSION Simultaneous bilateral floating knee is a rare and severe injury pattern.The treatment is challenging,and complications.We present a case report of a young adult who suffered from bilateral floating knees during road traffic accident.We also offer our treatment experience of this complex injury and review past literature.
