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Bow-and-arrow sign on point-of-care ultrasound for diagnosis of pacemaker lead-induced heart perforation:A case report and literature review

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World Journal of Clinical Cases 2023年第7期11卷 1615-1625页

作者： Ni Chen Guang-Xian Miao Liang-Qin Peng Yun-Hang Li Juan Gu Ying He Tao Chen Xiao-Yun Fu Zhou-Xiong Xing Department of Critical Care Medicine Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Ultrasound Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Cardiology Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Pharmacy Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina

BACKGROUND Pacemaker lead-induced heart perforation is a rare but life-threatening complication of pacemaker implantation,and timely diagnosis remains a challenge for ***,we report a case of pacemaker lead-induced cardiac perforation rapidly diagnosed by a“bow-and-arrow”sign on point-of-care ultrasound(POCUS).CASE SUMMARY A 74-year-old Chinese woman who had undergone permanent pacemaker implantation 26 d before suddenly developed severe dyspnea,chest pain,and *** patient had received emergency laparotomy for an incarcerated groin hernia and was transferred to the intensive care unit 6 d *** tomography was not available due to unstable hemodynamic status,so POCUS was performed at the bedside and revealed severe pericardial effusion and cardiac *** pericardiocentesis yielded a large volume of bloody pericardial *** POCUS by an ultrasonographist revealed a unique“bow-and-arrow”sign indicating right ventricular(RV)apex perforation by the pacemaker lead,which facilitated the rapid diagnosis of lead *** the persistent drainage of pericardial bleeding,urgent off-pump open chest surgery was performed to repair the ***,the patient died of shock and multiple organ dysfunction syndrome within 24 h *** addition,we also performed a literature review on the sonographic features of RV apex perforation by *** POCUS enables the early diagnosis of pacemaker lead perforation at the bedside.A step-wise ultrasonographic approach and the“bow-and-arrow”sign on POCUS are helpful for rapid diagnosis of lead perforation.

关键词： Point-of-care ultrasound Heart perforation Pacemaker lead Cardiac pacemaker Review Case report

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Relationship of familial cytochrome P450 4V2 gene mutation with liver cirrhosis:A case report and review of the literature

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World Journal of Clinical Cases 2022年第28期10卷 10346-10357页

作者： Jin-Lian Jiang Jiang-Fu Qian De-Hui Xiao Xia Liu Fang Zhu Jie Wang Zhou-Xiong Xing De-Lin Xu Yuan Xue Yi-Huai He Department of Infectious Diseases Affiliated Hospital of Zunyi Medical UniversityZunyi 563003Guizhou ProvinceChina Department of Digestion Dafang County People’s HospitalBijie 551600Guizhou ProvinceChina Department of Intensive Care Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Cell Biology Zunyi Medical UniversityZunyi 563099Guizhou ProvinceChina Department of Liver Diseases the Third People’s Hospital of ChangzhouChangzhou 213000Jiangsu ProvinceChina

BACKGROUND Many genetic and metabolic diseases affect the liver,but diagnosis can be difficult because these diseases may have complex clinical manifestations and diverse clinical *** is also incomplete clinical knowledge of these many different diseases and limitations of current testing *** SUMMARY We report a 53-year-old female from a rural area in china who was hospitalized for lower limb edema,abdominal distension,cirrhosis,and *** excluded the common causes of liver disease(drinking alcohol,using traditional Chinese medicines,hepatitis virus infection,autoimmunity,and hepatolenticular degeneration).When she was 23-years-old,she developed night-blindness that worsened to complete blindness,with no obvious *** parents were first cousins,and both were *** of the patient’s family history indicated that all 5 siblings had night blindness and impaired vision;one sister was completely blind;and another sister had night-blindness complicated with cirrhosis and subclinical *** exome sequencing showed that the patient,parents,and siblings all had mutations in the cytochrome P450 4V2gene(CYP4V2).The CYP4V2 mutations of the parents and two sisters were heterozygous,and the others were *** siblings also had heterozygous dual oxidase activator 2(DUOXA2) *** Mutations in the CYP4V2 gene may affect lipid metabolism and lead to chronic liver injury,fibrosis,and cirrhosis.

关键词： Cirrhosis Genetic metabolic liver disease Cytochrome P4504V2 Dual Oxidase activator 2 Bietti Crystalline corneoretinal dystrophy Case report

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Methyl CpG binding domain protein 2(MBD2)in inflammation

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Chinese Medical Journal 2022年第23期135卷 2880-2882页

作者： Qian Lei Wei Zhang Department of Critical Care Medicine Affiliated Hospital of Zunyi Medical UniversityZunyiGuizhou 563000China Department of Critical Care Medicine Kweichou Moutai HospitalRenhuaiGuizhou 563000China

To the Editor:Methyl CpG binding domain protein 2(MBD2)belongs to the histone deacetylase family,which promotes multi-gene expression by inhibiting methylation and participates in the pathological process of various *** and inflammatory response are the main mechanisms leading to a variety of immune ***2,as an important methylation protein reader,has in recent years been shown to be indispensable in the inflammatory *** paper summarizes the current understanding of inflammatory MBD2 biology and provides additional direction for the study of inflammatory mechanisms by summarizing the current understanding of the regulatory mechanisms of MBD2 in inflammatory diseases and the inflammatory pathways that may regulate ***,Embase,and Wanfang Data were searched up to May 2022 with no language restriction for reports on MBD2 in inflammatory pathways,immune cell differentiation,and macrophage polarization,among others.

关键词： MBD2 inflammation CpG

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