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Novel electrocardiographic dyssynchrony criteria that may improve patient selection for cardiac resynchronization therapy

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Journal of Geriatric Cardiology 2022年第1期19卷 31-43页

作者： Gábor Katona András Vereckei Department of Medicine and Hematology Semmelweis UniversityBudapestHungary

Cardiac resynchronization therapy(CRT)is an evidence-based effective therapy of symptomatic heart failure with reduced ejection fraction refractory to optimal medical treatment associated with intraventricular conduction disturbance,that results in electrical dyssynchrony and further deterioration of systolic ventricular function.However,the non-response rate to CRT is still 20%−40%,which can be decreased by better patient selection.The main determinant of CRT outcome is the presence or absence of significant ventricular dyssynchrony and the ability of the applied CRT technique to eliminate it.The current guidelines recommend the determination of QRS morphology and QRS duration and the measurement of left ventricular ejection fraction for patient selection for CRT.However,QRS morphology and QRS duration are not perfect indicators of electrical dyssynchrony,which is the cause of the not negligible non-response rate to CRT and the missed CRT implantation in a significant number of patients who have the appropriate substrate for CRT.Using imaging modalities,many ventricular dyssynchrony criteria were devised for the detection of mechanical dyssynchrony,but their utility in patient selection for CRT is not yet proven,therefore their use is not recommended for this purpose.Moreover,CRT can eliminate only mechanical dyssynchrony due to underlying electrical dyssynchrony,for this reason ECG has a greater role in the detection of ventricular dyssynchrony than imaging modalities.To improve assessment of electrical dyssynchrony,we devised two novel ECG dyssynchrony criteria,which can estimate interventricular and left ventricular intraventricular dyssynchrony in order to improve patient selection for CRT.Here we discuss the results achieved by the application of these new ECG dyssynchrony criteria,which proved to be useful in predicting the CRT response in patients with nonspecific intraventricular conduction disturbance pattern(the second greatest group of CRT candidates),and the significance of other new ECG dyssynchrony

关键词： patient synchronization eliminate

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A biomimetic nanoplatform for customized photothermal therapy of HNSCC evaluated on patient-derived xenograft models

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International Journal of Oral Science 2023年第1期15卷 87-98页

作者： Qi Wu Lan Chen Xiaojuan Huang Jiayi Lin Jiamin Gao Guizhu Yang Yaping Wu Chong Wang Xindan Kang Yanli Yao Yujue Wang Mengzhu Xue Xin Luan Xin Chen Zhiyuan Zhang Shuyang Sun Department of Oral and Maxillofacial-Head&Neck Oncology Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of Medicine/College of StomatologyShanghai Jiao Tong University/National Center for Stomatology/National Clinical Research Center for Oral Diseases/Shanghai Key Laboratory of Stomatology/Shanghai Research Institute of StomatologyShanghaiChina Shanghai Frontiers Science Center for Chinese Medicine Chemical Biology Institute of Interdisciplinary Integrative Medicine ResearchShanghai University of Traditional Chinese MedicineShanghaiChina School of Chemical Engineering and Technology Shaanxi Key Laboratory of Energy Chemical Process IntensificationInstitute of Polymer Science in Chemical EngineeringXi’an Jiao Tong UniversityXi’anChina

Cancer cell membrane(CCM)derived nanotechnology functionalizes nanoparticles(NPs)to recognize homologous cells,exhibiting translational potential in accurate tumor therapy.However,these nanoplatforms are majorly generated from fixed cell lines and are typically evaluated in cell line-derived subcutaneous-xenografts(CDX),ignoring the tumor heterogeneity and differentiation from inter-and intra-individuals and microenvironments between heterotopic-and orthotopic-tumors,limiting the therapeutic efficiency of such nanoplatforms.Herein,various biomimetic nanoplatforms(CCM-modified gold@Carbon,i.e.,Au@C-CCM)were fabricated by coating CCMs of head and neck squamous cell carcinoma(HNSCC)cell lines and patient-derived cells on the surface of Au@C NP.The generated Au@C-CCMs were evaluated on corresponding CDX,tongue orthotopic xenograft(TOX),immunecompetent primary and distant tumor models,and patient-derived xenograft(PDX)models.The Au@C-CCM generates a photothermal conversion efficiency up to 44.2% for primary HNSCC therapy and induced immunotherapy to inhibit metastasis via photothermal therapy-induced immunogenic cell death.The homologous CCM endowed the nanoplatforms with optimal targeting properties for the highest therapeutic efficiency,far above those with mismatched CCMs,resulting in distinct tumor ablation and tumor growth inhibition in all four models.This work reinforces the feasibility of biomimetic NPs combining modular designed CMs and functional cores for customized treatment of HNSCC,can be further extended to other malignant tumors therapy.

关键词： xenograft patient custom

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A patient with glycogen storage disease type IA combined with hepatic adenoma: A case report

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Genes & Diseases 2023年第3期10卷 701-704页

作者： Maohui Yin Lei Chang Ping Jiang Zhiyong Yang Zhonglin Zhang Wanyu Zhang Zhisu Liu Department of Hepatobiliary and Pancreatic Surgery Zhongnan Hospital of Wuhan UniversityWuhanHubei 430062China Department of Pathology Zhongnan Hospital of Wuhan UniversityWuhanHubei 430071China

Glycogen storage disease(GSD)is a rare autosomal recessive disease by abnormal accumulation of intracellular glycogen.1 Mutations in genes encoding G-6-P or G-6-Pase lead to dysfunction of the body's glycogen metabolism.Without adequate metabolic treatment,patients with GSD can die during infancy or childhood from severe hypoglycemia and acidosis.The patient's symptoms generally achieve remission during adolescence,except in rare cases when cirrhosis of the liver or myopathy occurs.Once GSD is identified in adults,the patients are often accompanied by many complications,such as fasting hypoglycemia.

关键词： patient adenoma hepatic

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Suspected malignant hyperthermia in a young Chinese patient undergoing a micro varicocelectomy surgery

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Chinese Medical Journal 2023年第17期136卷 2116-2118页

作者： Hongjiao Xu Zhaomin Wang Zhongmei Peng Jianhai Zhang Xiang Li Di Liu Jie Qi Jinbao Li Department of Anesthesiology Shanghai Jiaotong University First People’s Hospital(Shanghai General Hospital)Shanghai 200080China

To the Editor:Malignant hyperthermia(MH)is a pharmacogenetic disorder of skeletal muscles that presents as an acute hypermetabolic state triggered by depolarizing muscle relaxants and volatile anesthetics in susceptible individuals.[1]The reported incidence of MH reaction ranged from 1:250,000 to 1:10,000.[1]However,the exact incidence in the Asian population remains unknown.A recent report suggested that the incidence of MH in Japan was 1 to 2 per 100,000 anesthetics,[2]which was similar to that in Western countries.In China,there are only a few reported cases,which may be attributed to incomplete records,and the actual incidence might be higher.[3,4]In China,between January 1978 and March 2004,only 34 cases of MH were recorded.[5]Due to the lack of the effective drug dantrolene,the mortality rate at that time was 73.5%.[5]Here,we reported the onset and treatment of a patient with suspected MH.

关键词： hyperthermia patient mortality

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patient satisfaction and associated factors among psychiatry outpatients of St Paulo's Hospital,Ethiopia

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General Psychiatry 2020年第1期33卷 37-44页

作者： Kebebew Wogi Goben Endalamaw Salelew Abegaz Samuel Tolesa Abdi Psychiatry Army Force Comprehensive Referral HospitalAddis AbabaEthiopia Department of Psychiatry University of Gondar College of Medicine and Health ScienceGondarEthiopia Psychiatry Amanuel Mental Specialized HospitalAddis AbabaEthiopia

Background patient satisfaction with mental healthcare service is recognised as an important integral part of measuring the outcomes and performance of clinical service delivery.It is not well studied in Ethiopia.Therefore,it is essential to improve service in the future.Aims To assess patient satisfaction and associated factors among psychiatry outpatients at St.Paulo's Hospital Millennium Medical College,Addis Ababa,Ethiopia.Methods An institutional-based cross-sectional study was conducted with consecutive sampling technique from May to June 2018.Data were collected using a Client Satisfaction Questionnaire(CSQ-8).Both bivariate and multivariate ordinal logistic regression analyses were used.Variables with p valuepatient satisfaction,50.3%(95% CI 46.0 to 54.2)were highly satisfied,31.0%(95% CI 27.2 to 34.8)were satisfied,and 18.7%(95% CI 15.4 to 22.1)were dissatisfied.Male sex(adjusted OR(A0R)2.30,95%Cl 1.57 to 3.36),inability to read and write(A0R 2.23,95% CI 1.10 to 4.66),being unemployed(AOR 1.69,95% CI 1.15 to 2.47),obtaining services for free(A0R 1.57,95% CI 1.11 to 2.22),and availability of medication(AOR 1.62,95% CI 1.13 to 2.23)were significantly associated with patient satisfaction.Conclusions The study showed that further improvements in patient satisfaction are required.Male sex,inability to read and write,being unemployed,obtaining services free of charge,and availability of medication were significantly associated with patient satisfaction.More than half of the participants were dissatisfied with the waiting time to receive services.The provision of services within a reasonable timeframe and meeting patient expectations are helpful for good health outcomes.

关键词： patient Ethiopia services

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Rapid progression of atherosclerosis in a patient with acute coronary syndrome and ANCA-associated vasculitis:split or confluence?

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Journal of Geriatric Cardiology 2022年第5期19卷 403-408页

作者： Ya-Chao LI Meng-Jie LEI Yan-Li YANG Zeng-Ming XUE Department of Cardiology Langfang People’s HospitalHebei Medical UniversityLangfang Core Laboratory of Precision Treatment of CADLangfangHebei ProvinceChina

A59-year-old female patient was admitted to our hospital on 9 March 2021,due to recurrent chest pain.She underwent percutaneous coronary intervention,with a focus on the proximal segment of the left anterior descending(LAD)artery,six months prior to admission.The patient had a long-term history of hyperlipidaemia and obstructive sleep apnoea syndrome(OSAS).She also had rheumatoid arthritis and ANCA-associated vasculitis that lasted for more than 10 years and a 9-year history of concomitant hypertension.She was on long-term oral leflunomide and intermittent oral prednisone.The patient underwent a computed tomography angiogram(CTA)six years ago(2015),which showed minor atherosclerotic plaque build-up in the LAD artery and the right coronary artery(RCA)(Figure 1).

关键词： coronary patient admitted

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An adult patient of X-linked hypophosphatemia with joint manifestation mimicking spondylarthritis

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Chinese Medical Journal 2022年第10期135卷 1255-1257页

作者： Chuhan Wang Jiuliang Zha Hongbo Yang Yan Jiang Yan Zha Weibo Xia Department of Rheumatology and Clinical Immunology Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID) Ministry of Science and TechnologyBeijing 100730China State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital(PUMCH)Beijing 100730China Key Laboratory of Rheumatology and Clinical Immunology Ministry of EducationBeijing 100730China Department of Endocrinology and Key Laboratory of Endocrinology National Health CommissionPeking Union Medical College Hospital(PUMCH)Peking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China

To the Editor:X-linked hypophosphatemia(XLH)is a rare hereditary metabolic disorder characterized by hypophos-phatemic rickets associated with phosphate wasting.[1]It is caused by a loss-of-function mutation in the PHEX(Phosphate regulating gene with Homology to Endopepti-dases located on the X chromosome)gene.[2]The clinical manifestations of the adult patient are usually not specific,often including bone pain,muscle weakness,and so on.

关键词： patient clinical adult

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Severe aortic stenosis and acute coronary syndrome in an elderly patient with idiopathic thrombocytopenic purpura:a therapeutic challenge

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Journal of Geriatric Cardiology 2022年第3期19卷 241-244页

作者： Mehmet Rasih Sonsoz Selin Berk Hamdi Pusuroglu Ahmet Guler Fatih Uzun Department of Cardiology Basaksehir Cam&Sakura City HospitalIstanbulTurkey Department of Hematology Basaksehir Cam&Sakura City HospitalIstanbulTurkey

Severe valvular aortic stenosis is a commonly encountered disorder in the elderly,and the intervention is indicated when the pa-tient is symptomatic.Transcatheter aortic valve im-plantation(TAVI)is a safer therapeutic option in symptomatic patients who cannot undergo surgery or who have high,intermediate,or even low surgic-al risk.[1]Idiopathic thrombocytopenic purpura(ITP)is acquired thrombocytopenia caused by autoan-tibodies against platelet antigens.[2]Herein,we re-port an 81-year-old patient,who was diagnosed with primary ITP two years ago,was admitted to the hospital for heart failure with acute coronary syndrome and severe aortic stenosis.We describe our experience in the peri-operative management of the case of coronary and structural intervention in a patient with ITP.

关键词： coronary aortic patient

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A patient with glucocorticoid hypersensitivity syndrome

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Chinese Medical Journal 2022年第21期135卷 2611-2613页

作者： Chenwei Wu Anran Ma Quanya Sun Xiaolong Zhao Department of Endocrinology and Metabolism Shanghai Public Health Clinical CenterShanghai Medical SchoolFudan UniversityShanghaiChina Department of Endocrinology and Metabolism Huashan HospitalShanghai Medical SchoolFudan UniversityShanghaiChina

To the Editor:Primary generalized glucocorticoid hypersensitivity is a rare condition characterized by generalized,partial target-tissue hypersensitivity to glucocorticoids.Therefore,low concentration of glucocorticoids is sufficient to effectively maintain the patient’s cell physiological effects and to suppress the hypothalamic-pituitary-adrenal axis.Our study aims to provide some insight into when glucocorticoid hypersensitivity should be considered and how to diagnose it.We also propose a diagnostic flow chart for glucocorticoid hypersensitivity for the first time based on our experience and previous literature review.The study was reviewed and approved by the Institutional Review Board of Huashan Hospital,Fudan University(No.KY2020-049).

关键词： glucocorticoid hypersensitivity patient

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Unilateral blurred vision in pediatric patient associated with cavum velum interpositum cyst

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International Journal of Ophthalmology(English edition) 2023年第7期16卷 1164-1166页

作者： Margarita Zamorano Esperanza García-Romo Román Blanco-Velasco Belén Fernández Francisco J.Monescillo Bernardo Fernández de Arévalo Department of Ophthalmology University Hospital GuadalajaraGuadalajara 19002Spain

Dear Editor,We present for the first time,a case of a paediatric patient with symptoms of intermittent blurred vision as first symptom of a cavum of the velum interpositum(CVI).Intracranial anterior midline cysts can ... 详细信息

关键词： patient pediatric vel

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