Autoimmune pancreatitis(AIP)is radiologically characterized by sausage-like diffuse swelling of the pancreatic parenchyma but may also be found as a localized mass that is easily misdiagnosed as a pancreatic neoplasm.AIP presenting as multifocal masses is rare.Here we report a case of multifocal IgG4-related AIP,in which the lesions grew in size and finally fused to become radiologically typical.
Perioperative restrictive red blood cell(RBC)transfusion strategy,in which a trigger of hemoglobin(Hb)<7 g/dl is used,is of great benefits to save blood storage and reduce transfusion-related adverse events including infections,immunologic risks,and circulatory overload.Human body can display a series of compensatory mechanisms to acute anemia,including increased cardiac output,favored oxyhemoglobin dissociation,and lung vascular dilation.Therefore,moderate Hb decrease does not necessarily lead to hypoxemia.Patients undergoing hip surgery or suffering from septic shock and/or upper gastrointestinal bleeding can benefit from restrictive RBC transfusion;however,restrictive transfusion may be associated with adverse outcomes in patients with coronary heart disease or undergoing cardiac surgery.Restrictive RBC transfusion strategies have been included in described in many different guidelines.Most of them recommended Hb<7 g/dl to be a trigger for allogeneic RBC transfusion.For patients with an Hb of 7-10 g/dl,the
To investigate the sexual quality of life and its influencing factors in patients with cervical cancer undergoing radiotherapy. Methods Totally 205 patients with cervical cancer who received radiotherapy in Peking Union Medical College Hospital from December 2013 to December 2018 were enrolled in this study.The Female Sexual Function Index(FSFI)scale was used to assess the sexual quality of life of these patients.The demographic data(including age,education level,marital status,family status,and occupation)and clinical data(including tumor stage and treatment method)were collected.Mann-Whitney test and Kruskal-Wallis test were used to analyze the influence of various factors on the sexual quality of life. Results Female sexual dysfunction was common among patients with cervical cancer undergoing radiotherapy.The total FSFI score was 5.5(3.6,16.3),and the scores of subscales were as follows:desire,1.20(0,1.80);sexual arousal,0.90(0,1.80);vaginal lubrication,0.30(0,3.30);orgasm,0(0,2.80);satisfaction,2.40(1.60,
To investigate the expressions of mucosal barrier proteins in colon cell line DLD-1 under hypoxic environment and its mechanism. Methods After DLD-1 cells were treated separately with hypoxia(l% O ),vitamin D(100 nmol/L),or vitamin D plus hypoxia for 48 hours,the expressions of vitamin D receptor(VDR),tight junction proteins zonula occludens-1(ZO-1),occludin,Claudin-1,and adherent junction protein(E-cadherin)were determined by Western blot.Stable VDR knock-down(Sh-VDR)DLD-1 cell line and control DLD-1 cell line were established by lentivirus package technology and the protein expressions after hypoxia treatment were detected. Results Compared with control group,the expressions of occludin,Claudin-1,and VDR increased significantly after hypoxia treatment(all <0.001).In addition to the protein expressions of occludin,Claudin-1 and VDR,the expressions of ZO-1 and E-cadherin were also obviously higher in vitamin D plus hypoxia group than in single vitamin D treatment group(all <0.001).After hypoxia treatment,Sh-V
Bronchogenic cysts are rare congenital cysts caused by anomalism of foregut in the embryonic stage.They locate most frequently in the mediastinum and are rarely seen in stomach.Here we report a case of gastric bronchogenic cysts that was diagnosed and treated in Peking Union Medical College Hospital from April 2 to 9,2018.
Epilepsy has high incidence and complex etiologies,and its treatment remains challenging.For around 70% of people with epilepsy,seizures can be controlled after proper antiepileptic treatment.The availability of some new antiepileptic drugs in recent years has offered new options for epileptic patients.A solid knowledge on the pharmacokinetics,efficacy,and tolerability profiles of these new antiepileptic drugs will help to provide safe,proper,reasonable,and standardized treatment for patients.
Apoptosis plays important roles in maintaining normal development and homeostasis and in the pathophysiological processes of various diseases.Previous studies have shown that cardiomyocyte apoptosis is involved in the development of various cardiovascular diseases.The apoptosis repressor with caspase recruitment domain(ARC)is abundantly expressed in heart,which makes ARC a unique and central cardioprotective factor via anti-apoptotic pathway.This article reviews the structure and characteristics of ARC as well as the roles and mechanisms of ARC in cardiovascular diseases.
To systematically evaluate the risks of cardiocerebral vascular events in patients with primary biliary cholangitis(PBC). Methods We carried out a Meta analysis by RevMan 5.3 software to investigate literatureon the risk of cardiocerebral vascular events in patients with PBC and controls. Results Compared with non-PBC controls,PBC patients had significantly higher risk of coronary events( =1.56, =0.0002);however,the risk of cerebrovascular events showed no significant difference between these two groups( =1.01, =0.94).Subgroup analysis demonstrated a significantly lower risk of transient ischemic attack or carotid stenosis in PBC patients( =0.63, =0.03);however,there was no significant difference in the risk of stroke( =1.11, =0.40). Conclusion Patients with PBC have an increased risk of coronary events but may have a lower risk of transient ischemic attack or carotid stenosis.
To analyze the potential associations of ultrasound-guided fine-needle aspiration(FNA),BRAF gene mutation detection,and the combination of these two techniques with the clinicopathological features of papillary thyroid cancer(PTC). Methods Patients with PTC confirmed by surgery from April 2016 to July 2017 were included in this study.The relationship between clinicopathological features and BRAF mutation,FNA results,and the combination of them were explored. Results The sensitivity of FNA was 86.3%(227/263)and the mutation rate of BRAF was 85.9%(226/263)in 263 patients with PTC.The mutation rate of papillary thyroid microcarcinoma(PTMC)was 91.1%(153/168)and that of non-PTMC was 76.8%(73/95).A total of 225 patients underwent lymph node dissection.The lymph node metastasis rate was 35.6%(80/225),and it was 23.8%(34/143)in PTMC,56.1%(46/82)in non-PTMC;in addition,9.9%(26/263)of PTC patients had extracapsular invasion.BRAF mutation rate was higher in patients with the following features:aged over 45 years( =0.043
To study the clinicopathologic characteristics,immunohistochemical features,differential diagnosis,and prognosis of solitary fibrous tumours(SFT)/hemangiopericytomas(HPC)in the maters(meninx). Methods A series of 7 cases previously diagnosed as SFT/HPC at the Department of Pathology,Peking Union Medical College Hospital,during the period from 2008 to 2018 were analyzed for clinical data,histopathology,and immunohistochemical findings.The patients were followed up and the relevant literatures were reviewed. Results These seven patients included two males and 5 females aged 22 to 77 years(mean,49 years).Headache was the most common symptom.The magnetic resonance imaging of SFT/HPC showed irregularly contoured masses and dural tail sign was observed at the periphery of the lesion in 4 cases.The major axis of the tumor ranged from 1.8 cm to 10 cm(mean,4 cm).The tumors were located in the mater in 6 cases and in the spinal meninx in 1 case.The tumors were surgically removed in all cases.Under light microscope,the
Objective To evaluate the early and midterm results of surgical repair of thoracoabdominal aortic aneurysm(TAAA)in patients with Marfan syndrome(MFS). Methods The clinical data of patients with MFS undergoing TAAA repair in Fuwai Hospital between January 2009 and December 2017 were retrospectively analyzed.These patients were divided into two groups:MFS group( =58)and non-MFS group( =98).The baseline data,early postoperative results,and midterm follow-up outcomes were compared between these two groups. Results MFS patients were significantly younger(32 years old 45 years old, =9.603, =0.000)and more frequently had a history of aortic aneurysm or dissection(19% 0, =19.996, =0.000)than non-MFS patients.However,the proportions of males and smokers were significantly lower when compared with non-MFS patients(55.2% 80.6%, =11.489, =0.001;13.8% 46.9%, =17.686, =0.001).There was no significant difference in proportion of emergency operation,prophylactic cerebrospinal fluid drainage,operation time,intra-operative cir
To analyze the clinical features and prognosis of ulcerative colitis(UC)complicated with acute massive lower gastrointestinal bleeding(LGIB). Methods Eleven patients hospitalized in Peking Union Medical College Hospital from January 2006 to December 2017 for treatment of UC,suffering from acute massive LGIB,were enrolled and descriptively analyzed. Results The proportion of UC patients with acute massive LGIB was 0.7% among all 1486 UC patients hospitalized during the study period.The disease was moderately or severely active in these 11 patients,among whom 9 patients(81.8%)had chronic relapsing pancolitis.Cytomegalovirus infection was present in 5 patients,among whom 4 patients received antiviral treatments.All the 11 patients received treatments including food and water fasting,rehydration,blood transfusion,and use of somatostatin.Four patients received emergency surgical treatment after the first episode of massive bleeding,and 3 of them suffered from re-bleeding after the surgery.Among the remaining seven
To explore the correlation between hematoma expansion within 24 hours of hypertensive intracerebral hemorrhage and signs on nonenhanced computed tomography(NECT). Methods The clinical data and CT images of 185 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed.The differences in CT parameters were compared between the expansion group and the unexpanded group.Binary logistic regression analysis was performed on the indicators with statistical significance between the two groups to identify the potential correlation between CT parameters and hematoma expansion.The roles of blend sign,lobulation sign,and black hole sign in predicting early hematoma expansion were assessed. Results The CT quantitative data including initial volume,maximum diameter,minimum diameter,maximum CT value,mean CT value,difference between maximum diameter and minimum diameter showed no significant difference between these two group(all >0.05).CT qualitative data including blend sign,lobulation sign,and black
To investigate the effect of N-acetylcysteine(NAC)on cognitive function and nuclear factor erythroid 2 related factor 2/ heme oxygenase-1(Nrf2/HO-1)pathway in mouse models of postoperative cognitive dysfunction. Methods Fifty-four male C57BL/6J mice(3-4 months old)were randomly divided into control group,surgery group,and surgery+NAC group by block randomization.The intramedullary fixation for left tibial fracture surgery was performed to establish postoperative cognitive dysfunction models.NAC(150 mg/kg)was administered intraperitoneally in group surgery+NAC 30 minutes before and 3 hours,6 hours after surgery,while saline was given in control group and surgery group.Six mice in each group were selected randomly underwent Morris water maze test on the third day after surgery.Animals were sacrificed at the first and third postoperative days,and the hippocampus was harvested.Enzyme-linked immunosorbent assay was used to quantify the levels of interleukin-6(IL-6)and malondialdehyde(MDA)in hippocampus.Western blo
Objective To analyze the differences in biological functions between bone marrow(BM)-derived CD106 mesenchymal stem cells(MSCs)and the CD106 subgroup. Methods The MSCs from normal BM were isolated and expanded.The subgroups of CD106 and CD106 MSCs were sorted.The cell proliferation and adhesion functions,chemotactic activities,adipogenic and osteogenic potentials,senescence,and senescence protein 21(p21)were detected.The capacity of translocation into nucleus of nuclear factor-kappa B(NF-κB)when stimulated by tumor necrosis factor(TNF-α)was measured. Results The proliferative ability was higher in CD106 MSCs than that in CD106 MSCs.In 48 hours,the value of optical density(OD)was significantly higher in CD106 MSCs than that in CD106 subgroup(1.004±0.028 0.659±0.023, =3.946, =0.0225).In 72 hours,this phenomenon was even more pronounced(2.574±0.089 1.590±0.074, =11.240, =0.0000).The adhesive capacity of CD106 MSCs was significantly stronger than that of CD106 subgroup(0.648±0.018 0.418±0.023, =7.869, =0.0002).Be
To evaluate the effectiveness of minimally invasive bridging for the lateral malleolar fractures in the open comminuted ankle fractures with dislocation. Methods The clinical data of 24 patients [19 males and 5 females aged 40 to 65 years,mean(47.5±8.6)years] with open comminuted ankle fractures with dislocation who were treated in the Second Hospital of Tangshan from September 2015 to June 2017 were retrospectively analyzed.All patients were treated with minimally invasive bridging for the lateral malleolar fractures.The ankle function after treatment was assessed with the Olerud Molander Ankle(OMA)score. Results All the 24 patients were followed up from 12-26 months [mean:(14.5±2.6)months].Good fracture union was achieved in all patients after 2 - 5 months(mean:3 months).No deep infection,skin necrosis,or bone nonunion occurred after 12 months of follow-up.Only one patient suffered from partial skin necrosis at lateral malleolus,which was cured after changing wound dressings.The OMA score was 93.5(range:85-
To compare the accuracy of SHA.LIN,S.T.O.N.E.nephrolithometry scoring system,and Clinical Research Office of the Endourological Society(CROES)nephrolithometry nomogram in predicting percutaneous nephrolithotomy(PCNL)outcomes including stone free rate(SFR)and perioperative status. Methods The clinical data of 90 patients with nephrolithiasis undergoing PCNL in department of urology,China-Japan Friendship Hospital from January 2015 to March 2018 were retrospectively analyzed.The general data,stone characteristics,operation approaches,and perioperative variables were recorded.SHA.LIN,S.T.O.N.E.score,and CROES nomogram were assigned according to the computed tomography(CT)findings before surgery.Stone free status was evaluated by kidney-ureter-bladder one month after PCNL.The relationships of SHA.LIN score,S.T.O.N.E.score,and CROES score with SFR,postoperative complications,operation time(OT),length of hospital stay(LOS),estimated blood loss(EBL),and decrease of hemoglobin was evaluated.Receiver operating charact
Exosomes are 30-100 nm vesicles secreted from almost all types of cells.They contain various molecular constituents,including proteins,lipids,and RNA.As important mediators of cell-to-cell communication,exosomes are involved in a variety of physiological and pathological processes such as inflammatory reaction,cell proliferation and differentiation,tissue repair,immune signal transduction,and stress response.Exosomes can regulate and maintain the initiation and progression of many autoimmune diseases,especially rheumatoid arthritis.Meanwhile,exosomes may be a new biomarker for the diagnosis of rheumatoid arthritis and a potential treatment vector for this disease.
To analyze the treatment and prognosis of T cell acute lymphoblastic leukemia(T-ALL)in adults. Method The clinicobiogical and survival data of 68 adult patients with newly diagnosis T-ALL were retrospectively analzyed. Results The median age of these 68 patients was 23 years(14-60 years).T-ALL was more common in men(81%).After the first cycle of treatment,complete remission was achieved in 50 patients(73%).The highest complete remission(CR) rate was in patients with cortex T-ALL(100%),followed by other T-ALL(73%)and early T-cell precursor lymphoblastic leukemia(54%),( =5.712, =0.058).The CR rate for adults aged >35 years was significantly lower than that of patients aged ≤ 35 years(40% 79%, =6.364, =0.012).The overall CR rate after the second treatment course was 93%.For patients treated with chemotherapy,autograft hematopoietic stem cell transplantation(auto-SCT),and allogeneic SCT,the median relapse free survival was 10 months,24 months,and not reached,respectively( =0.002).The 5-year overall survival rate
Leukemia is a disease featured by the malignant proliferation of hematopoietic stem cells or progenitor cells in the blood system.While chemotherapy remains its mainstream treatment,disease relapse and drug resistance are still challenging problems.As one of the epigenetic mechanisms,histone methylation is involved in cell proliferation,differentiation,and apoptosis by regulating gene transcription.Recent studies have found that the histone demethylase lysine-specific demethylase 6A(KDM6A),also known as ubiquitously transcribed tetratricopeptide repeat on chromosome X(UTX),is closely related to the occurrence of a variety of tumors,especially leukemia.KDM6A activates gene expression by demethylating H3K27me3 to H3K27me2 or H3K27me1.Besides,KDM6A can regulate the activation of the target gene transcription through its non-demethylase functions.It can serve as the subunit of complex of proteins associated with Set1,thus getting involved in the regulation of H3K4me1.It can be combined with yeast mating type conv