BACKGROUND Shwachman-Diamond syndrome(SDS)is a rare genetic disorder that affects multiple organs,primarily the liver.Most patients are diagnosed during infancy or early childhood.As they grow older,the majority of af...BACKGROUND Shwachman-Diamond syndrome(SDS)is a rare genetic disorder that affects multiple organs,primarily the liver.Most patients are diagnosed during infancy or early childhood.As they grow older,the majority of affected children may experience spontaneous remission,and cases of cirrhosis in adults are rarely reported.CASE SUMMARY A 36-year-old male patient presented with massive ascites.Laboratory tests revealed pancytopenia and a serum-ascites albumin gradient greater than 1.1 g/dL.An abdominal computed tomography scan demonstrated cirrhosis,splenomegaly,pancreatic fat infiltration,and a substantial accumulation of peritoneal fluid.Gastroscopy identified esophageal varices.Liver stiffness measurement indicated a value of 32.7 kPa.Based on the results of auxiliary examinations,common causes of cirrhosis were excluded,and a mutation in the Shwachman-Bodian-Diamond syndrome gene was ultimately identified through whole-exome sequencing.The patient was diagnosed with cirrhosis secondary to SDS.Following the correction of hypoalbuminemia and administration of diuretics,the patient's ascites resolved.CONCLUSION Patients with liver cirrhosis who also exhibit pancreatic fat infiltration and pancytopenia necessitate further exon testing to exclude the possibility of SDS.展开更多
Shwachman-Diamond syndrome (SDS) is a multi-system disorder characterized by bone marrow failure, pancreatic insufficiency, skeletal abnormalities, and increased risk of leukemic transformation. Most patients with S...Shwachman-Diamond syndrome (SDS) is a multi-system disorder characterized by bone marrow failure, pancreatic insufficiency, skeletal abnormalities, and increased risk of leukemic transformation. Most patients with SDS contain mutations in the Shwachman- Bodian-Diamond syndrome gene (SBDS), encoding a highly conserved protein that has been implicated in ribosome biogenesis. Emerging evidence also suggests a distinct role of SBDS beyond protein translation. Using the yeast model of SDS, we examined the underlying mechanisms that cause cells lacking Sdolp, the yeast SBDS ortholog, to exhibit reduced tolerance to various stress conditions. Our analysis indicates that the environmental stress response (ESR), heat shock response (HSR), and endoplasmic reticulum unfolded protein response (UPR) of sdolA cells are functional and that defects in these pathways do not produce the phenotypes observed in sdolh yeast. Depletion of mitochondlial DNA (mtDNA) was observed in sdolh cells, and this is a probable cause of the mitochondrial insufficiency in SDS. Prior disruption of POR1, encoding the mitochondrial voltage dependent anion channel (VDAC), abrogated the effects of SD01 deletion and substantially restored resistance to environmental stressors and protected against damage to mtDNA. Conversely, wild-type cells over-expressing POR1 exhibited growth impairment and increased stress sensitivity similar to that seen in sdolA cells. Overall, our results suggest that specific VDAC inhibitors may have therapeutic benefits for SDS patients.展开更多
BACKGROUND The features of Shwachman-Diamond syndrome(SDS)include exocrine pancreatic insufficiency,skeletal abnormalities and bone marrow dysfunction;an often overlooked feature is hepatic involvement.CASE SUMMARY We...BACKGROUND The features of Shwachman-Diamond syndrome(SDS)include exocrine pancreatic insufficiency,skeletal abnormalities and bone marrow dysfunction;an often overlooked feature is hepatic involvement.CASE SUMMARY We report a child who initially presented with failure to thrive and mildly elevated transaminase levels and was determined to have pancreatic insufficiency due to SDS.During follow-up he had persistently elevated transaminase levels and developed hepatosplenomegaly.An investigation was performed to determine the etiology of ongoing liver injury,including a liver biopsy which revealed hepatic cirrhosis.CONCLUSION Cirrhosis has rarely been reported with SDS.While many of the hepatic disorders associated with SDS improve with age,there are rare exceptions with serious implications for long-term outcome.展开更多
OBJECTIVE:To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy(IMN)patients by literature research and expert investigation(interviews and a Delphi met...OBJECTIVE:To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy(IMN)patients by literature research and expert investigation(interviews and a Delphi method).METHODS:Our study was consistent with T/CACM 1336-2020.We searched the monographs and references published in the past 40 years(1983-2022),and established the diagnostic criteria pool of waterdampness syndrome and dampness-turbidity syndrome in Traditional Chinese Medicine(TCM)based on literature by using frequency statistics and correlation analysis.Expert investigation(interview method and two rounds of Delphi method)was used to form the diagnostic criteria of water-dampness syndrome and dampnessturbidity syndrome of idiopathic membranous nephropathy.Clinical diagnostic test research was carried out,and compared with“Diagnostic Criteria for dampness syndrome”(T/CACM 1454-2023)to evaluate the authenticity,reliability and clinical application value of the standard.RESULTS:A total of 122 relevant guides,standards,monographs and documents were included through searching books and Chinese databases.Four experts were interviewed and two rounds of delphi method(75 experts nationwide)were carried out.The experts'opinions are relatively concentrated and the differences are small.Based on the weight of each index,the diagnostic criteria indexes of water-dampness syndrome and dampness-turbidity syndrome were selected.After discussion by the core group members,the diagnostic model of"necessary symptoms and optional symptoms"was established,and the final diagnostic criteria of waterdampness syndrome and dampness-turbidity syndrome were established.One hundred and ninety-one inpatients and outpatients of Guangdong Provincial Hospital of Chinese Medicine from January 2021 to February 2023 were included in Diagnostic test study.There was no statistical difference in gender,age and course of disease(P>0.05).The sensitivity and specificity of the trial standard were 90.34%and 73.33%respectively,while the sensitivity and specificity of T/CACM 1454-2023 were 99.43%and 6.67%,respectively.CONCLUSIONS:The consensus-based diagnostic criteria for IMN can be widely incorporated in TCM.A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our IMN criteria.展开更多
Objective To explore the clinical characteristics and methods for syndrome differentiation prediction,as well as to construct a predictive model for Qi deficiency and blood stasis syndrome in patients with acute ische...Objective To explore the clinical characteristics and methods for syndrome differentiation prediction,as well as to construct a predictive model for Qi deficiency and blood stasis syndrome in patients with acute ischemic stroke(AIS).Methods This study employed a retrospective case-control design to analyze patients with AIS who received inpatient treatment at the Neurology Department of The First Hospital of Hunan University of Chinese Medicine from January 1,2013 to December 31,2022.AIS patients meeting the diagnostic criteria for Qi deficiency and blood stasis syndrome were stratified into case group,while those without Qi deficiency and blood stasis syndrome were stratified into control group.The demographic characteristics(age and gender),clinical parameters[time from onset to admission,National Institutes of Health Stroke Scale(NIHSS)score,and blood pressure],past medical history,traditional Chinese medicine(TCM)diagnostic characteristics(tongue and pulse),neurological symptoms and signs,imaging findings[magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)],and biochemical indicators of the two groups were collected and compared.The indicators with statistical difference(P<0.05)in univariate analysis were included in multivariate logistic regression analysis to evaluate their predictive value for the diagnosis of Qi deficiency and blood stasis syndrome,and the predictive model was constructed by receiver operating characteristic(ROC)curve analysis.Results The study included 1035 AIS patients,with 404 cases in case group and 631 cases in control group.Compared with control group,patients in case group were significantly older,had extended onset-to-admission time,lower diastolic blood pressure,and lower NIHSS scores(P<0.05).Case group showed lower incidence of hypertension history(P<0.05).Regarding tongue and pulse characteristics,pale and dark tongue colors,white tongue coating,fine pulse,astringent pulse,and sinking pulse were more common in case group.Imaging examinations demonstrated higher proportions of centrum semiovale infarction,cerebral atrophy,and vertebral artery stenosis in case group(P<0.05).Among biochemical indicators,case group showed higher proportions of elevated fasting blood glucose and glycated hemoglobin(HbA1c),while lower proportions of elevated white blood cell count,reduced hemoglobin,and reduced high-density lipoprotein cholesterol(HDL-C)(P<0.05).Multivariate logistic regression analysis identified significant predictors for Qi deficiency and blood stasis syndrome including:fine pulse[odds ratio(OR)=4.38],astringent pulse(OR=3.67),superficial sensory abnormalities(OR=1.86),centrum semiovale infarction(OR=1.57),cerebral atrophy(OR=1.55),vertebral artery stenosis(OR=1.62),and elevated HbA1c(OR=3.52).The ROC curve analysis of the comprehensive prediction model yielded an area under the curve(AUC)of 0.878[95%confidence interval(CI)=0.855-0.900].Conclusion This study finds out that Qi deficiency and blood stasis syndrome represents one of the primary types of AIS.Fine pulse,astringent pulse,superficial sensory abnormalities,centrum semiovale infarction,cerebral atrophy,vertebral artery stenosis,elevated blood glucose,elevated HbA1c,pale and dark tongue colors,and white tongue coating are key objective diagnostic indicators for the syndrome differentiation of AIS with Qi deficiency and blood stasis syndrome.Based on these indicators,a syndrome differentiation prediction model has been developed,offering a more objective basis for clinical diagnosis,and help to rapidly identify this syndrome in clinical practice and reduce misdiagnosis and missed diagnosis.展开更多
Objective:To evaluate the value of rehabilitation nursing based on mind mapping model combined with psychological intervention for patients with nephrotic syndrome(NS).Methods:A total of 60 patients with NS who visite...Objective:To evaluate the value of rehabilitation nursing based on mind mapping model combined with psychological intervention for patients with nephrotic syndrome(NS).Methods:A total of 60 patients with NS who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into groups.The observation group received rehabilitation nursing based on the mind mapping model combined with psychological intervention,while the control group received routine intervention.The differences in emotional scores,self-care ability scores,compliance,and complications were compared between the two groups.Results:The anxiety(SAS)and depression(SDS)scores of the observation group were lower than those of the control group,while the self-care ability scale(ESCA)score was higher than that of the control group(P<0.05).The compliance rate of the observation group was higher than that of the control group(P<0.05).The complication rate of NS in the observation group was lower than that in the control group(P<0.05).Conclusion:Rehabilitation nursing based on the mind mapping model combined with psychological intervention can enhance self-care ability,reduce negative emotions,and reduce complications in NS nursing,which is efficient and feasible.展开更多
BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as th...BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as the arms,abdomen,face,neck,head,and genital area.There are only a few reports of the RLS variant affecting the head.AIM To assess the epidemiological,clinical,and other aspects of the RLS variant affecting the head.METHODS We conducted a retrospective study of 17 adult patients(>18 years)who met the RLS criteria and simultaneously experienced RLS-like symptoms in the head.RESULTS The median age at which symptoms appeared was 41.6 years.Males and females were equally affected(1.1:1).All 17 patients had uncomfortable sensations in the lower legs.Insomnia or disturbed sleep was the most common comorbidity(n=16,88.2%).However,headache was the most common presenting or primary symptom(n=10,70.5%).Dizziness or an abnormal sensation in the head was the second most common presenting symptom(5 patients,29.4%).Other presenting features were leg pain,backache,and generalized body pain.All patients responded favorably to dopaminergic medications.CONCLUSION If RLS-related unpleasant sensations and pain are felt in the head,they may be misinterpreted as headache,dizziness,or psychosomatic symptoms.RLS and headaches in a subset of patients may be two phenotypic manifestations of the same disorder.展开更多
BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyc...BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyces boulardii(S.boulardii),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered FPIES.In this report,we describe a new clinical FPIES in which S.boulardii was the sole triggering factor of acute FPIES adverse reaction in seven healthy infants.CASE SUMMARY Seven FPIES cases triggered by only S.boulardii were gathered from 2011 to the present.None of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary food.The age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of S.boulardii,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated diarrhea.All patients experienced severe repetitive vomiting 1-3 hours after S.boulardii ingestion.Extreme lethargy,marked pallor,and cyanosis were also observed.No IgE-mediated hypersensitivity developed in any patient.Diarrhea was followed by initial intense vomiting in approximately 5-10 hours after S.boulardii ingestion,and only one case showed bloody,purulent,and foul-smelling diarrhea.The patients stabilized quickly,mostly within 6 hours.Symptoms got all improved within 24 hours after discontinuation of S.boulardii.CONCLUSION S.boulardii can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.展开更多
PURPOSE:To investigate the differences in gut microbial characteristics between two traditional Chinese syndromes of premature ovarian insufficiency(POI).METHODS:Forty women with POI were recruited from the Department...PURPOSE:To investigate the differences in gut microbial characteristics between two traditional Chinese syndromes of premature ovarian insufficiency(POI).METHODS:Forty women with POI were recruited from the Department of Traditional Chinese Medicine at Shenzhen Maternity and Child Healthcare Hospital between June and December 2020.Women with POI were divided into the kidney deficiency and blood stasis syndrome(SDBS)and Qi and blood deficiency syndrome(QBDS)groups.Gut microbial community profiles were analyzed by 16S rRNA gene sequencing using an Illumina Mi Seq system.A retrospective study comparing hormone levels and gut microbiota information was performed between the SDBS and QBDS groups.RESULTS:Compared with the QBDS group,the serum levels of estradiol(E2)and anti-Müllerian hormone(AMH)were significantly decreased in the SDBS group.The quantities of Adlercreutzia,Eggerthella,Klebsiella,and Paraprevotella significantly increased in the SDBS group,whereas Lactobacillus decreased significantly.Moreover,alterations in the microbiome in the SDBS and QBDS groups were closely related to the levels of E2 and AMH.The area under the receiver operating characteristic curve for the classification of the two syndromes by the gut microbiome was 0.71.CONCLUSIONS:There were significant differences in the dominant microbiota between the SDBS and QBDS groups,and the change in Proteobacteria in the QBDS group was more significant.The characteristics of gut microbiota help us differentiate between the SDBS and QBDS groups,which may provide a basis for the objectification of TCM syndrome types.展开更多
BACKGROUND Serrated polyposis syndrome(SPS)is a polyposis condition with neoplastic potential,but its psychological impact is not well understood.AIM To assess health anxiety prevalence in a regional Australian cohort...BACKGROUND Serrated polyposis syndrome(SPS)is a polyposis condition with neoplastic potential,but its psychological impact is not well understood.AIM To assess health anxiety prevalence in a regional Australian cohort of SPS patients and explore factors influencing it,including workforce impacts of regular surveillance.METHODS This cross-sectional study screened patients aged 18-65 undergoing colonoscopy in a regional gastroenterology practice between January 2015 and June 2022.Eligible SPS patients were invited to participate.Data included the Short Health Anxiety Inventory,employment status,and previous demographic and medical findings.RESULTS Health anxiety was found in 21.57%of SPS patients,with anxious patients being significantly more concerned about surveillance(OR=7.70).Patients lost an average of 11.04 work hours per colonoscopy.CONCLUSION Health anxiety in SPS patients aligns with rates in other gastroenterology populations.Identifying it may improve management,though further research is needed to better understand prevalence and care improvements.展开更多
BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique mani...BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique manifestation of OHSS involving pleural effusion(PE)in a patient without identifiable risk factors.CASE SUMMARY A 39-year-old woman who underwent controlled ovarian hyperstimulation for an in vitro fertilization(IVF)cycle experienced dyspnea on the eleventh day of post oocyte retrieval.The diagnosis was severe OHSS with a unique manifestation of PE without ascites.Clinical management involved fluid balance and treatment with albumin,furosemide,thromboembolic prophylaxis,and thoracentesis.A continued drainage of the pleural cavity was performed.The patient had a favo-rable outcome,and a dichorionic diamniotic gestation passed without incident.CONCLUSION OHSS and its potential complications can include respiratory distress and PE,as well as thromboembolic disorders.展开更多
BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardi...BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardiac monitoring.CASE SUMMARY Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment,respectively,presenting with syncope and palpit-ations.Electrocardiogram confirmed SSS,and different treatment approaches were taken for each patient.One patient received a dual-chamber permanent pacemaker,while the other discontinued the medication and experienced symptom resolution.CONCLUSION Anlotinib can induce SSS,suggesting that cardiac monitoring is crucial during anlotinib treatment.Individualized management strategies are necessary for affected individuals.展开更多
Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopme...Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.展开更多
Pseudoephedrine (PSE) is a widely used nasal decongestant. A review by the European Medicines Agency has reported that PSE may be associated with risks of posterior reversible encephalopathy syndrome (PRES) and revers...Pseudoephedrine (PSE) is a widely used nasal decongestant. A review by the European Medicines Agency has reported that PSE may be associated with risks of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS). PRES and RCVS are rare but serious conditions that affect cerebral blood flow. This review discusses the pharmacology of PSE and potential risks for PRES and RCVS and concludes that considering the common use of PSE, with over 70 million packs of PSE taken each year in the European Union and the United Kingdom, and the rare occurrence of PRES and RCVS, that the risks of developing PRES/RCVS on exposure to PSE are likely to be very low.展开更多
Objective:Polycystic ovary syndrome(PCOS)is a common endocrine disorder that affects women’s health.This study aims to investigate gene and transcription factor(TF)expression differences between PCOS patients and hea...Objective:Polycystic ovary syndrome(PCOS)is a common endocrine disorder that affects women’s health.This study aims to investigate gene and transcription factor(TF)expression differences between PCOS patients and healthy individuals using bioinformatics approaches,and to verify the function of key transcription factors,with the goal of providing new insights into the pathogenesis of PCOS.Methods:Differentially expressed genes(DEGs)and differentially expressed transcription factors(DETFs)between PCOS patients and controls were identified from the RNA sequencing dataset GSE168404 using bioinformatics methods.Functional enrichment analysis was performed using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)databases.The expression and function of core transcription factors were further validated in ovarian tissues of PCOS model mice and control mice using Western blotting and reverse transcription quantitative polymerase chain reaction(RTqPCR).Results:A total of 332 DEGs were identified between PCOS patients and controls,including 259 upregulated and 73 downregulated genes in the PCOS group.19 DETFs were further screened,of which 16 were upregulated and 3 were downregulated in PCOS.The upregulated DETFs(including TFCP2L1,DACH1,ESR2,AFF3,SMAD9,ZNF331,HOPX,ATOH8,HIF3α,DPF3,HOXC4,HES1,ID1,JDP2,SOX4,and ID3)were primarily associated with lipid metabolism,development,and cell adhesion.Protein and mRNA expression analysis in PCOS model mice revealed significantly decreased levels of hypoxia-inducible factor(HIF)1αand HIF2α,and significantly increased expression of HIF3αcompared to control mice(all P<0.001).Conclusion:Significant differences in gene and TF expression exist between PCOS patients and healthy individuals.HIF-3αmay play a crucial role in PCOS and could serve as a novel biomarker for diagnosis and a potential therapeutic target.展开更多
BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgica...BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.展开更多
Kasabach-Merritt Syndrome consists of a set of signs and symptoms associated with capillary hemangioma with thrombocytopenia, which causes bleeding accompanied by petechiae, ecchymosis, and spontaneous hematomas. This...Kasabach-Merritt Syndrome consists of a set of signs and symptoms associated with capillary hemangioma with thrombocytopenia, which causes bleeding accompanied by petechiae, ecchymosis, and spontaneous hematomas. This present study aims to report a rare case of cervical lymphangioma (cystic hygroma) that later evolved into Kasabach-Merritt Syndrome, demonstrating the importance of systemic evaluation of veno-lymphatic malformations. Although rare, prompt diagnosis and therapy are necessary due to the high severity and potential fatality of the condition.”展开更多
Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the inju...Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the injury and pathophysiological mechanisms underlying PCAS remain unclear.Experimental animal models are valuable tools for exploring the etiology,pathogenesis,and potential interventions for CA and PCAS.Current CA animal models include electrical induction of ventricular fibrillation(VF),myocardial infarction,high potassium,asphyxia,and hemorrhagic shock.Although these models do not fully replicate the complexity of clinical CA,the mechanistic insights they provide remain highly relevant,including post-CA brain injury(PCABI),post-CA myocardial dysfunction(PAMD),systemic ischaemia/reperfusion injury(IRI),and the persistent precipitating pathology.Summarizing the methods of establishing CA models,the challenges encountered in the modeling process,and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.展开更多
Cyclops lesion is a fibrous nodule on the tibial side of the knee and it is one of the common complications that arises after anterior cruciate ligament (ACL) reconstruction, causing loss of knee extension. A presenta...Cyclops lesion is a fibrous nodule on the tibial side of the knee and it is one of the common complications that arises after anterior cruciate ligament (ACL) reconstruction, causing loss of knee extension. A presentation dominated by recurrent hemarthrosis is a rare presentation of this lesion. In this case report, we have discussed about a male patient who presented with recurrent hemarthrosis and inability to extend the knee joint fully 8 months after ACL reconstruction. Cyclops lesion was identified by clinical examination and magnetic resonance imaging (MRI). Recurrence after initial excision of the lesion occurred and complete resolution happened during the second operation when cauterization was done. It is imperative that treatment should include coagulation of the vascularized stump to avoid any recurrence.展开更多
文摘BACKGROUND Shwachman-Diamond syndrome(SDS)is a rare genetic disorder that affects multiple organs,primarily the liver.Most patients are diagnosed during infancy or early childhood.As they grow older,the majority of affected children may experience spontaneous remission,and cases of cirrhosis in adults are rarely reported.CASE SUMMARY A 36-year-old male patient presented with massive ascites.Laboratory tests revealed pancytopenia and a serum-ascites albumin gradient greater than 1.1 g/dL.An abdominal computed tomography scan demonstrated cirrhosis,splenomegaly,pancreatic fat infiltration,and a substantial accumulation of peritoneal fluid.Gastroscopy identified esophageal varices.Liver stiffness measurement indicated a value of 32.7 kPa.Based on the results of auxiliary examinations,common causes of cirrhosis were excluded,and a mutation in the Shwachman-Bodian-Diamond syndrome gene was ultimately identified through whole-exome sequencing.The patient was diagnosed with cirrhosis secondary to SDS.Following the correction of hypoalbuminemia and administration of diuretics,the patient's ascites resolved.CONCLUSION Patients with liver cirrhosis who also exhibit pancreatic fat infiltration and pancytopenia necessitate further exon testing to exclude the possibility of SDS.
基金supported by the Faculty of Science,Mahidol University(ANJ)
文摘Shwachman-Diamond syndrome (SDS) is a multi-system disorder characterized by bone marrow failure, pancreatic insufficiency, skeletal abnormalities, and increased risk of leukemic transformation. Most patients with SDS contain mutations in the Shwachman- Bodian-Diamond syndrome gene (SBDS), encoding a highly conserved protein that has been implicated in ribosome biogenesis. Emerging evidence also suggests a distinct role of SBDS beyond protein translation. Using the yeast model of SDS, we examined the underlying mechanisms that cause cells lacking Sdolp, the yeast SBDS ortholog, to exhibit reduced tolerance to various stress conditions. Our analysis indicates that the environmental stress response (ESR), heat shock response (HSR), and endoplasmic reticulum unfolded protein response (UPR) of sdolA cells are functional and that defects in these pathways do not produce the phenotypes observed in sdolh yeast. Depletion of mitochondlial DNA (mtDNA) was observed in sdolh cells, and this is a probable cause of the mitochondrial insufficiency in SDS. Prior disruption of POR1, encoding the mitochondrial voltage dependent anion channel (VDAC), abrogated the effects of SD01 deletion and substantially restored resistance to environmental stressors and protected against damage to mtDNA. Conversely, wild-type cells over-expressing POR1 exhibited growth impairment and increased stress sensitivity similar to that seen in sdolA cells. Overall, our results suggest that specific VDAC inhibitors may have therapeutic benefits for SDS patients.
文摘BACKGROUND The features of Shwachman-Diamond syndrome(SDS)include exocrine pancreatic insufficiency,skeletal abnormalities and bone marrow dysfunction;an often overlooked feature is hepatic involvement.CASE SUMMARY We report a child who initially presented with failure to thrive and mildly elevated transaminase levels and was determined to have pancreatic insufficiency due to SDS.During follow-up he had persistently elevated transaminase levels and developed hepatosplenomegaly.An investigation was performed to determine the etiology of ongoing liver injury,including a liver biopsy which revealed hepatic cirrhosis.CONCLUSION Cirrhosis has rarely been reported with SDS.While many of the hepatic disorders associated with SDS improve with age,there are rare exceptions with serious implications for long-term outcome.
基金the Special Project of State Key Laboratory of Dampness Syndrome of Chinese Medicine:Study on Criteria for Diagnosis of Dampness Syndrome of Idiopathic Membranous Nephropathy,Cohort Study on Pathogenesis and Material Basis of Dampness Syndrome of Idiopathic Membranous Nephropathy,Randomized Controlled Clinical Study of Sanqi Qushi Granule in Treatment of Membranous Nephropathy(No.SZ2021ZZ02,SZ2021ZZ09 and SZ2021ZZ36)the 2020 Guangdong Provincial Science and Technology Innovation Strategy Special Fund:Guangdong-Hong Kong-Macao Joint Lab(No.2020B1212030006)+2 种基金the Natural Science Foundation of Guangdong Province:Study on the Mechanism of Sanqi Qushi Prescription Delaying Podocellular Senescence in Membranous Nephropathy based on Cyclic Guanosine Monophosphate-Adenosine Monophosphate Synthase-Stimulator of Interferon Genes-Nuclear Factor Kappa-B Signaling Pathway(No.2022A1515011628)the Guangzhou Science and Technology Plan Project:to Explore the Mechanism of Treating Membranous Nephropathy from the Perspective of Regulating Amino Acid Metabolism Disorder(No.2023A03J0746)Special Funding for Scientific and Technological Research on Traditional Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine:a Multimodular Machine Learning Prediction Model based on Pathological Image-transcriptomics and Traditional Chinese Medicine Syndromes was Used to Investigate the Prognostic Correlation of Long non-coding RNA Molecules in Nephropathy and the Intervention Mechanism of Sanqi Qushi Formula,to Investigate the Pathogenesis and Microbiological Mechanism of Dampness Syndrome of Membranous Nephropathy based on the Microecological Changes of Tongue Coating(No.YN2023MB02,YN2023MB10)。
文摘OBJECTIVE:To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy(IMN)patients by literature research and expert investigation(interviews and a Delphi method).METHODS:Our study was consistent with T/CACM 1336-2020.We searched the monographs and references published in the past 40 years(1983-2022),and established the diagnostic criteria pool of waterdampness syndrome and dampness-turbidity syndrome in Traditional Chinese Medicine(TCM)based on literature by using frequency statistics and correlation analysis.Expert investigation(interview method and two rounds of Delphi method)was used to form the diagnostic criteria of water-dampness syndrome and dampnessturbidity syndrome of idiopathic membranous nephropathy.Clinical diagnostic test research was carried out,and compared with“Diagnostic Criteria for dampness syndrome”(T/CACM 1454-2023)to evaluate the authenticity,reliability and clinical application value of the standard.RESULTS:A total of 122 relevant guides,standards,monographs and documents were included through searching books and Chinese databases.Four experts were interviewed and two rounds of delphi method(75 experts nationwide)were carried out.The experts'opinions are relatively concentrated and the differences are small.Based on the weight of each index,the diagnostic criteria indexes of water-dampness syndrome and dampness-turbidity syndrome were selected.After discussion by the core group members,the diagnostic model of"necessary symptoms and optional symptoms"was established,and the final diagnostic criteria of waterdampness syndrome and dampness-turbidity syndrome were established.One hundred and ninety-one inpatients and outpatients of Guangdong Provincial Hospital of Chinese Medicine from January 2021 to February 2023 were included in Diagnostic test study.There was no statistical difference in gender,age and course of disease(P>0.05).The sensitivity and specificity of the trial standard were 90.34%and 73.33%respectively,while the sensitivity and specificity of T/CACM 1454-2023 were 99.43%and 6.67%,respectively.CONCLUSIONS:The consensus-based diagnostic criteria for IMN can be widely incorporated in TCM.A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our IMN criteria.
基金National Natural Science Foundation of China(U22A20377)Natural Science Foundation of Hunan Province of China(23C0168).
文摘Objective To explore the clinical characteristics and methods for syndrome differentiation prediction,as well as to construct a predictive model for Qi deficiency and blood stasis syndrome in patients with acute ischemic stroke(AIS).Methods This study employed a retrospective case-control design to analyze patients with AIS who received inpatient treatment at the Neurology Department of The First Hospital of Hunan University of Chinese Medicine from January 1,2013 to December 31,2022.AIS patients meeting the diagnostic criteria for Qi deficiency and blood stasis syndrome were stratified into case group,while those without Qi deficiency and blood stasis syndrome were stratified into control group.The demographic characteristics(age and gender),clinical parameters[time from onset to admission,National Institutes of Health Stroke Scale(NIHSS)score,and blood pressure],past medical history,traditional Chinese medicine(TCM)diagnostic characteristics(tongue and pulse),neurological symptoms and signs,imaging findings[magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)],and biochemical indicators of the two groups were collected and compared.The indicators with statistical difference(P<0.05)in univariate analysis were included in multivariate logistic regression analysis to evaluate their predictive value for the diagnosis of Qi deficiency and blood stasis syndrome,and the predictive model was constructed by receiver operating characteristic(ROC)curve analysis.Results The study included 1035 AIS patients,with 404 cases in case group and 631 cases in control group.Compared with control group,patients in case group were significantly older,had extended onset-to-admission time,lower diastolic blood pressure,and lower NIHSS scores(P<0.05).Case group showed lower incidence of hypertension history(P<0.05).Regarding tongue and pulse characteristics,pale and dark tongue colors,white tongue coating,fine pulse,astringent pulse,and sinking pulse were more common in case group.Imaging examinations demonstrated higher proportions of centrum semiovale infarction,cerebral atrophy,and vertebral artery stenosis in case group(P<0.05).Among biochemical indicators,case group showed higher proportions of elevated fasting blood glucose and glycated hemoglobin(HbA1c),while lower proportions of elevated white blood cell count,reduced hemoglobin,and reduced high-density lipoprotein cholesterol(HDL-C)(P<0.05).Multivariate logistic regression analysis identified significant predictors for Qi deficiency and blood stasis syndrome including:fine pulse[odds ratio(OR)=4.38],astringent pulse(OR=3.67),superficial sensory abnormalities(OR=1.86),centrum semiovale infarction(OR=1.57),cerebral atrophy(OR=1.55),vertebral artery stenosis(OR=1.62),and elevated HbA1c(OR=3.52).The ROC curve analysis of the comprehensive prediction model yielded an area under the curve(AUC)of 0.878[95%confidence interval(CI)=0.855-0.900].Conclusion This study finds out that Qi deficiency and blood stasis syndrome represents one of the primary types of AIS.Fine pulse,astringent pulse,superficial sensory abnormalities,centrum semiovale infarction,cerebral atrophy,vertebral artery stenosis,elevated blood glucose,elevated HbA1c,pale and dark tongue colors,and white tongue coating are key objective diagnostic indicators for the syndrome differentiation of AIS with Qi deficiency and blood stasis syndrome.Based on these indicators,a syndrome differentiation prediction model has been developed,offering a more objective basis for clinical diagnosis,and help to rapidly identify this syndrome in clinical practice and reduce misdiagnosis and missed diagnosis.
文摘Objective:To evaluate the value of rehabilitation nursing based on mind mapping model combined with psychological intervention for patients with nephrotic syndrome(NS).Methods:A total of 60 patients with NS who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into groups.The observation group received rehabilitation nursing based on the mind mapping model combined with psychological intervention,while the control group received routine intervention.The differences in emotional scores,self-care ability scores,compliance,and complications were compared between the two groups.Results:The anxiety(SAS)and depression(SDS)scores of the observation group were lower than those of the control group,while the self-care ability scale(ESCA)score was higher than that of the control group(P<0.05).The compliance rate of the observation group was higher than that of the control group(P<0.05).The complication rate of NS in the observation group was lower than that in the control group(P<0.05).Conclusion:Rehabilitation nursing based on the mind mapping model combined with psychological intervention can enhance self-care ability,reduce negative emotions,and reduce complications in NS nursing,which is efficient and feasible.
文摘BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as the arms,abdomen,face,neck,head,and genital area.There are only a few reports of the RLS variant affecting the head.AIM To assess the epidemiological,clinical,and other aspects of the RLS variant affecting the head.METHODS We conducted a retrospective study of 17 adult patients(>18 years)who met the RLS criteria and simultaneously experienced RLS-like symptoms in the head.RESULTS The median age at which symptoms appeared was 41.6 years.Males and females were equally affected(1.1:1).All 17 patients had uncomfortable sensations in the lower legs.Insomnia or disturbed sleep was the most common comorbidity(n=16,88.2%).However,headache was the most common presenting or primary symptom(n=10,70.5%).Dizziness or an abnormal sensation in the head was the second most common presenting symptom(5 patients,29.4%).Other presenting features were leg pain,backache,and generalized body pain.All patients responded favorably to dopaminergic medications.CONCLUSION If RLS-related unpleasant sensations and pain are felt in the head,they may be misinterpreted as headache,dizziness,or psychosomatic symptoms.RLS and headaches in a subset of patients may be two phenotypic manifestations of the same disorder.
基金Supported by The Keimyung University Dongsan Medical Center in 2006.
文摘BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyces boulardii(S.boulardii),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered FPIES.In this report,we describe a new clinical FPIES in which S.boulardii was the sole triggering factor of acute FPIES adverse reaction in seven healthy infants.CASE SUMMARY Seven FPIES cases triggered by only S.boulardii were gathered from 2011 to the present.None of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary food.The age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of S.boulardii,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated diarrhea.All patients experienced severe repetitive vomiting 1-3 hours after S.boulardii ingestion.Extreme lethargy,marked pallor,and cyanosis were also observed.No IgE-mediated hypersensitivity developed in any patient.Diarrhea was followed by initial intense vomiting in approximately 5-10 hours after S.boulardii ingestion,and only one case showed bloody,purulent,and foul-smelling diarrhea.The patients stabilized quickly,mostly within 6 hours.Symptoms got all improved within 24 hours after discontinuation of S.boulardii.CONCLUSION S.boulardii can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.
基金Sanming Project of Medicine in Shenzhen:the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Luo Songping National Famous Chinese Medicine Practitioner Female Reproductive Disorders Prevention and Treatment Team(SZZYSM202311010)Guangdong Provincial Administration of Traditional Chinese Medicine:Investigation of the Mechanism of Regulating Ren-Tong-Du Acupuncture on Ovarian Granulosa Cells in Polycystic Ovary Syndrome based on Activin A/Smads Signalling Pathway(No.20181229)+1 种基金Guangdong Provincial Administration of Traditional Chinese Medicine:Evaluation of the Efficacy of Menstrual Regulation and Pregnancy Promotion by Acupuncture in the Treatment of Premature Ovarian Insufficiency(No.20201294)Shenzhen Science and Innovation Commission:Investigating the Mechanism of Action of Acupuncture in Regulating the Gut Microbiome to Inhibit Apoptosis of Ovarian Granulosa Cells in Premature Ovarian Insufficiency Mice based on the Rictor/Torepamycin Target Protein C2 Pathway(No.JCYJ20210324130001004)。
文摘PURPOSE:To investigate the differences in gut microbial characteristics between two traditional Chinese syndromes of premature ovarian insufficiency(POI).METHODS:Forty women with POI were recruited from the Department of Traditional Chinese Medicine at Shenzhen Maternity and Child Healthcare Hospital between June and December 2020.Women with POI were divided into the kidney deficiency and blood stasis syndrome(SDBS)and Qi and blood deficiency syndrome(QBDS)groups.Gut microbial community profiles were analyzed by 16S rRNA gene sequencing using an Illumina Mi Seq system.A retrospective study comparing hormone levels and gut microbiota information was performed between the SDBS and QBDS groups.RESULTS:Compared with the QBDS group,the serum levels of estradiol(E2)and anti-Müllerian hormone(AMH)were significantly decreased in the SDBS group.The quantities of Adlercreutzia,Eggerthella,Klebsiella,and Paraprevotella significantly increased in the SDBS group,whereas Lactobacillus decreased significantly.Moreover,alterations in the microbiome in the SDBS and QBDS groups were closely related to the levels of E2 and AMH.The area under the receiver operating characteristic curve for the classification of the two syndromes by the gut microbiome was 0.71.CONCLUSIONS:There were significant differences in the dominant microbiota between the SDBS and QBDS groups,and the change in Proteobacteria in the QBDS group was more significant.The characteristics of gut microbiota help us differentiate between the SDBS and QBDS groups,which may provide a basis for the objectification of TCM syndrome types.
文摘BACKGROUND Serrated polyposis syndrome(SPS)is a polyposis condition with neoplastic potential,but its psychological impact is not well understood.AIM To assess health anxiety prevalence in a regional Australian cohort of SPS patients and explore factors influencing it,including workforce impacts of regular surveillance.METHODS This cross-sectional study screened patients aged 18-65 undergoing colonoscopy in a regional gastroenterology practice between January 2015 and June 2022.Eligible SPS patients were invited to participate.Data included the Short Health Anxiety Inventory,employment status,and previous demographic and medical findings.RESULTS Health anxiety was found in 21.57%of SPS patients,with anxious patients being significantly more concerned about surveillance(OR=7.70).Patients lost an average of 11.04 work hours per colonoscopy.CONCLUSION Health anxiety in SPS patients aligns with rates in other gastroenterology populations.Identifying it may improve management,though further research is needed to better understand prevalence and care improvements.
文摘BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique manifestation of OHSS involving pleural effusion(PE)in a patient without identifiable risk factors.CASE SUMMARY A 39-year-old woman who underwent controlled ovarian hyperstimulation for an in vitro fertilization(IVF)cycle experienced dyspnea on the eleventh day of post oocyte retrieval.The diagnosis was severe OHSS with a unique manifestation of PE without ascites.Clinical management involved fluid balance and treatment with albumin,furosemide,thromboembolic prophylaxis,and thoracentesis.A continued drainage of the pleural cavity was performed.The patient had a favo-rable outcome,and a dichorionic diamniotic gestation passed without incident.CONCLUSION OHSS and its potential complications can include respiratory distress and PE,as well as thromboembolic disorders.
文摘BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardiac monitoring.CASE SUMMARY Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment,respectively,presenting with syncope and palpit-ations.Electrocardiogram confirmed SSS,and different treatment approaches were taken for each patient.One patient received a dual-chamber permanent pacemaker,while the other discontinued the medication and experienced symptom resolution.CONCLUSION Anlotinib can induce SSS,suggesting that cardiac monitoring is crucial during anlotinib treatment.Individualized management strategies are necessary for affected individuals.
基金Supported by Natural Science Foundation of Shanghai,No.17ZR1431400National Key R and D Program of China,No.2017YFA0103902.
文摘Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.
文摘Pseudoephedrine (PSE) is a widely used nasal decongestant. A review by the European Medicines Agency has reported that PSE may be associated with risks of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS). PRES and RCVS are rare but serious conditions that affect cerebral blood flow. This review discusses the pharmacology of PSE and potential risks for PRES and RCVS and concludes that considering the common use of PSE, with over 70 million packs of PSE taken each year in the European Union and the United Kingdom, and the rare occurrence of PRES and RCVS, that the risks of developing PRES/RCVS on exposure to PSE are likely to be very low.
基金supported by the Natural Science Foundation of Hunan Province,China(2022JJ30886).
文摘Objective:Polycystic ovary syndrome(PCOS)is a common endocrine disorder that affects women’s health.This study aims to investigate gene and transcription factor(TF)expression differences between PCOS patients and healthy individuals using bioinformatics approaches,and to verify the function of key transcription factors,with the goal of providing new insights into the pathogenesis of PCOS.Methods:Differentially expressed genes(DEGs)and differentially expressed transcription factors(DETFs)between PCOS patients and controls were identified from the RNA sequencing dataset GSE168404 using bioinformatics methods.Functional enrichment analysis was performed using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)databases.The expression and function of core transcription factors were further validated in ovarian tissues of PCOS model mice and control mice using Western blotting and reverse transcription quantitative polymerase chain reaction(RTqPCR).Results:A total of 332 DEGs were identified between PCOS patients and controls,including 259 upregulated and 73 downregulated genes in the PCOS group.19 DETFs were further screened,of which 16 were upregulated and 3 were downregulated in PCOS.The upregulated DETFs(including TFCP2L1,DACH1,ESR2,AFF3,SMAD9,ZNF331,HOPX,ATOH8,HIF3α,DPF3,HOXC4,HES1,ID1,JDP2,SOX4,and ID3)were primarily associated with lipid metabolism,development,and cell adhesion.Protein and mRNA expression analysis in PCOS model mice revealed significantly decreased levels of hypoxia-inducible factor(HIF)1αand HIF2α,and significantly increased expression of HIF3αcompared to control mice(all P<0.001).Conclusion:Significant differences in gene and TF expression exist between PCOS patients and healthy individuals.HIF-3αmay play a crucial role in PCOS and could serve as a novel biomarker for diagnosis and a potential therapeutic target.
文摘BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.
文摘Kasabach-Merritt Syndrome consists of a set of signs and symptoms associated with capillary hemangioma with thrombocytopenia, which causes bleeding accompanied by petechiae, ecchymosis, and spontaneous hematomas. This present study aims to report a rare case of cervical lymphangioma (cystic hygroma) that later evolved into Kasabach-Merritt Syndrome, demonstrating the importance of systemic evaluation of veno-lymphatic malformations. Although rare, prompt diagnosis and therapy are necessary due to the high severity and potential fatality of the condition.”
基金supported by the National Key Research and Development Program(2021YFC3002205)the Postgraduate Research and Innovation Program of Tianjin Municipal Education Commission(2022BKY113),China.
文摘Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the injury and pathophysiological mechanisms underlying PCAS remain unclear.Experimental animal models are valuable tools for exploring the etiology,pathogenesis,and potential interventions for CA and PCAS.Current CA animal models include electrical induction of ventricular fibrillation(VF),myocardial infarction,high potassium,asphyxia,and hemorrhagic shock.Although these models do not fully replicate the complexity of clinical CA,the mechanistic insights they provide remain highly relevant,including post-CA brain injury(PCABI),post-CA myocardial dysfunction(PAMD),systemic ischaemia/reperfusion injury(IRI),and the persistent precipitating pathology.Summarizing the methods of establishing CA models,the challenges encountered in the modeling process,and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.
文摘Cyclops lesion is a fibrous nodule on the tibial side of the knee and it is one of the common complications that arises after anterior cruciate ligament (ACL) reconstruction, causing loss of knee extension. A presentation dominated by recurrent hemarthrosis is a rare presentation of this lesion. In this case report, we have discussed about a male patient who presented with recurrent hemarthrosis and inability to extend the knee joint fully 8 months after ACL reconstruction. Cyclops lesion was identified by clinical examination and magnetic resonance imaging (MRI). Recurrence after initial excision of the lesion occurred and complete resolution happened during the second operation when cauterization was done. It is imperative that treatment should include coagulation of the vascularized stump to avoid any recurrence.