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Neuroimaging studies on cognitive impairment due to cerebral small vessel disease

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Stroke & Vascular Neurology 2019年第2期4卷 99-101页

作者： Jing Du Qun Xu Neurology Shanghai Jiao Tong University School of Medicine Affiliated Renji HospitalShanghaiChina health manage center Shanghai Jiao Tong University School of Medicine Affiliated Renji HospitalShanghaiChina

Vascular cognitive impairment (VCI) is a major contributor to age-related dementing illnesses which imposes a tremendous burden on families and society. It is a heterogeneous group of brain disorders. However, cerebral small vessel disease (CSVD) accounts for about 50%-70% of VCI, which represented a more homogeneous subtype of VCI. Advanced multimodal neuroimaging techniques like brain network connectome analyses are currently applied to explore the underlying mechanism of VCI. Some progress in the field of structural and functional brain network researches on a poststroke longitudinal CSVD cohort (Renji CSVD Cohort Study) was reported. Global and regional brain network characters were compared between patients with CSVD and healthy control. It suggested that distributed brain structural network disruption may play a pivot role in the cognitive decline. The results showed that brain structural network characters have distinctive differentiating capacity on the cognition of patients with CSVD.

关键词： cerebral impairment network

How do we manage post-OLT redundant bile duct?

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World Journal of Gastroenterology 2013年第16期19卷 2501-2506页

作者： Victor Torres Nicholas Martinez Gabriel Lee Jose Almeda Glenn Gross Sandeep Patel Laura Rosenkranz Division of Gastroenterology and Nutrition Department of Medicine University of Texas Health Science Center at San Antonio Department of Pancreatic and Hepatobiliary Surgery University of Texas Health Science Center at San Antonio

AIM: To address endoscopic outcomes of post-Orthotopic liver transplantation (OLT) patients diagnosed with a "redundant bile duct" (RBD). METHODS: Medical records of patients who underwent OLT at the Liver Transplant center, University Texas health Science center at San Antonio Texas were retrospectively analyzed. Patients with suspected biliary tract complications (BTC) underwent endoscopic retrograde cholangiopancreatography (ERCP). All ERCP were performed by experienced biliary endoscopist. RBD was defined as a looped, sigmoid-shaped bile duct on cholangiogram with associated cholestatic liver biomarkers. Patients with biliary T-tube placement, biliary anastomotic strictures, bile leaks, bile-duct stonessludge and suspected sphincter of oddi dysfunction were excluded. Therapy included single or multiple biliary stents with or without sphincterotomy. The incidence of RBD, the number of ERCP corrective sessions, and the type of endoscopic interventions were recorded. Successful response to endoscopic therapy was defined as resolution of RBD with normalization of associated cholestasis. Laboratory data and pertinent radiographic imaging noted included the pre-ERCP period and a follow up period of 6-12 mo after the last ERCP intervention. RESULTS: One thousand two hundred and eighty-two patient records who received OLT from 1992 through 2011 were reviewed. Two hundred and twenty-four patients underwent ERCP for suspected BTC. RBD was reported in each of the initial cholangiograms. Twentyone out of 1282 (1.6%) were identified as having RBD. There were 12 men and 9 women, average age of 59.6 years. Primary indication for ERCP was cholestatic pattern of liver associated biomarkers. Nineteen out of 21 patients underwent endoscopic therapy and 2/21 required immediate surgical intervention. In the endoscopically managed group: 65 ERCP procedures were performed with an average of 3.4 per patient and 1.1 stent per session. Fifteen out of 19 (78.9%) patients were successfully

关键词： Redundant bile duct Orthotopic liver transplantation Biliary complications Biliary stent Endoscopic retrograde cholangiopancreatography

Clinicians’prescription preferences for treating patients with Alzheimer’s disease in Shanghai

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Translational Neurodegeneration 2016年第1期5卷 67-74页

作者： Chun-Xia Ban Shi-Fu Xiao Xiang Lin Tao Wang Qi Qiu Min-Jie Zhu Xia Li Alzheimer’s Disease and Related Disorders center Department of Geriatric PsychiatryShanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina Mental health center of Jiading District in Shanghai ShanghaiChina

Background:China has more cases of Alzheimer’s disease(AD)than any other country in the *** training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescription preferences for treating patients with ***:This study surveyed neurologists,psychiatrists,and general physicians(GPs)in Shanghai who had outpatients with AD,using a questionnaire asking about their prescription preferences for these ***:Among the 148 clinicians in the study,26.4%were psychiatrists,44.6%were neurologists,and 29.1%were *** groups did not differ significantly in age,gender,or their monthly cases of new patients with mild or moderate AD(P>0.05).Most clinicians prescribed Cholinesterase inhibitors(ChEIs),including Huperzine A,but there were significant group-differences in prescribing specific ChEIs(P0.05),and all three groups prescribed piracetam,ergot,and ginkgo biloba *** three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics,although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs(P<0.05).Conclusion:Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD.A relatively high proportion also prescribed cognitive enhancers,which lack evidence-based support of their use,and *** is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.

关键词： Alzheimer’s disease Clinicians Cognitive enhancers Prescriptions Survey research

Pathogenesis of Thrombocytopenia in Chronic HCV Infection:A Review

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Journal of Clinical and Translational Hepatology 2020年第2期8卷 184-191页

作者： Sarah Rawi George Y Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

A large proportion of patients with chronic hepatitis C have associated thrombocytopenia (TCP). Due to bleeding risks, TCP, when severe, can limit diagnostic and therapeutic procedures, treatments, and increases risk of complications, especially excessive bleeding. It is important to understand the mechanisms that cause TCP in order to manage it. In general, TCP can be due to increased destruction or decreased production. Proposed mechanisms of increased destruction include autoantibodies to platelets and hyper-splenism with sequestration. Proposed mechanisms of de-creased production include virus-induced bone marrow suppression and decreased TPO production. Autoantibodies directed against platelet surface antigens have demonstrated an inverse correlation with platelet counts. Hypersplenism with sequestration involves the interaction of portal hyper-tension, splenomegaly, and platelet destruction. Decreased production mechanisms involve appropriate and inappropri-ate levels of TPO secretion. There is limited evidence to support viral-induced bone marrow suppression. In contrast, there is strong evidence to support low levels of TPO in liver failure as a major cause of TCP. TPO-agonists, specifically eltrombopag, have been shown in hepatitis C patients to increase platelet counts without reducing portal hypertension or splenomegaly. We conclude that TCP in hepatitis C virus-induced liver disease is often multifactorial, but an under-standing of the mechanisms can lead to judicious use of new drugs for treatment.

关键词： Thrombocytopenia Chronic hepatitis Autoantibodies Hypersplenism Thrombopoietin

Success of intravenous immunoglobulin and steroids in managing severe COVID-19 following lung transplantation:A case report

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World Journal of Transplantation 2025年第1期15卷 178-184页

作者： Yen-Shou Kuo Kuan-Hsun Lin Ying-Yi Chen Yuan-Ming Tsai Ti-Hui Wu Hsu-Kai Huang Tsai-Wang Huang Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114202Taiwan

BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following *** immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised *** case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung *** SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung ***,he developed COVID-19 pneumonia,severe septic shock,and *** recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse *** IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 *** aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant *** further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.

关键词： COVID-19 Septic shock Intravenous immunoglobulin Lung transplantation Post-transplant complications Case report

Petrogenesis and tectonic setting of granite porphyry in Keyouzhongqi area,Inner Mongolia

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Global Geology 2014年第1期17卷 24-33页

作者： WU Qing YANG Weihong HE Zhonghua YANG Deming MA Rui WANG Jianguo College of Earth Sciences Jilin University manage center of Central Geological Exploration Fund Ministry of Land and Resources

The authors studied the geochemistry, zircon U-Pb ages, Hf isotope of the granite porphyry and its petrogenesis and tectonic setting in the studied area. The zircon U-Pb dating indicates the formation of the granite porphyry is in Early Cretaceous （ 125.1 ± 1.5 Ma）. The granite porphyry has high-SiO2 and alkali-rich features, which belongs to high-K talc-alkaline series rocks （ A/CNK = 0. 95%-1. 25% ）. The analyses of trace elements show the characteristics of a swallow-shaped REE distribution pattern with enrichment in LREEs and most of LILEs and HFSEs, depletion in Ba, Sr, Nb, P and Ti, and especially strong depletion in Eu, which indicates the granite porphyry belongs to the aluminous A-type granite. Their εHf（t） range from 5.94 to 8.80 with Hf two-stage model ages （TDM2 ） of 620 Ma to 803 Ma. Combining with the regional tectonic background, we conclude that the source of the rocks is the new crust materials accreted from depleted mantle in Neoproterozoic and is the product of partial melting of middle and lower crustal rocks, which may be suffered from the dual impact of the subduction of the Palaeo-Pacific Ocean and the closure of the Mongol-Okhotsk Ocean.

关键词： petrogenesis granite prophyry A-type granite zircon U-Pb dating Keyouzhongqi area Inner Mongolia

Prehospital response to respiratory distress by the public ambulance system in a Ukrainian city

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World Journal of Emergency Medicine 2019年第1期10卷 42-45页

作者： Colin A.Meghoo Stanislav Gaievskyi Oleksandr Linchevskyy Bindhu Oommen Kateryna Stetsenko Research Department Patriot Defence School of Public health Kyiv-Mohyla Academy Clinical Hospital #17 Hunt Regional Medical center center of Emergency Medical Care and Disaster Medicine

BACKGROUND: The capability of the public ambulance system in Ukraine to address urgent medical complaints in a prehospital environment is unknown. Evaluation using reliable sources of patient data is needed to provide insight into current treatments and outcomes. METHODS: We obtained access to de-identifi ed computer records from the emergency medical services(EMS) dispatch center in Poltava, a medium-sized city in central Ukraine. Covering a fi vemonth period, we retrieved data for urgent calls with a patient complaint of respiratory distress. We evaluated ambulance response and treatment times, field diagnoses, and patient disposition, and analyzed factors related to fatal outcomes. RESULTS: Over the f ive-month period of the study, 2,029 urgent calls for respiratory distress were made to the Poltava EMS dispatch center. A physician-led ambulance typically responded within 10 minutes. Seventy-seven percent of patients were treated and released, twenty percent were taken to hospital, and three percent died in the prehospital phase. On univariate analysis, age over 60 and altered mental status at the time of the call were strongly associated with a fatal outcome. CONCLUSION: The EMS dispatch center in a medium-sized city in Ukraine has adequate organizational infrastructure to ensure that a physician-led public ambulance responds rapidly to complaints of respiratory distress. That EMS system was able to manage most patients without requiring hospital admission. However, a prehospital fatality rate of three percent suggests that further research is warranted to determine training, equipment, or procedural needs of the public ambulance system to manage urgent medical conditions.

关键词： Emergency Medical Services Dyspnea Ukraine

Differentiating Cystic Liver Lesions:A Review of Imaging Modalities, Diagnosis and management

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Journal of Clinical and Translational Hepatology 2018年第2期6卷 208-216页

作者： Marianna G.Mavilia Tina Pakala Marco Molina George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA Department of Medicine Division of Gastroenterology-HepatologyNew York Presbyterian HospitalNew YorkNYUSA Department of Radiology University of Connecticut Health CenterFarmingtonCTUSA

Hepatic cysts(HCs)are frequently discovered incidentally on abdominal *** prevalence of HCs has been reported as high as 15–18%in the United *** most cysts are benign,some are malignant or *** is impor-tant to diagnose cystic lesions in order to properly manage *** with conventional ultrasound,computed to-mography,magnetic resonance imaging,or contrast-enhanced ultrasound can be used to further characterize and diagnose *** is typically the first-line imaging modality,whereas more advanced imaging can help narrow down the specific ***-enhanced ultrasound is a newer mo-dality,recently approved in the United States,which offers non-invasive evaluation in *** first step in diagnosis is stratifying risk by differentiating simple and complex *** are several features that can help identify HCs,including septae,mural consistency,calcifications,and quality of cystic *** cysts are mainly congenital cysts,but also occur in polycystic liver *** cysts include mucinous neoplasms,echinococcal cysts,hemorrhagic cysts,cystic hep-atocellular carcinoma and other rare *** is indicated in symptomatic cysts or those suspicious for malig-nant or premalignant *** modalities include fenestration,aspiration sclerotherapy,or surgical resection.

关键词： Hepatic cyst Simple cyst Complex cyst Hepatic imaging Contrast-enhanced ultrasound Treatment

Larvicidal activities of chinaberry,neem and Bacillus thuringiensis israelensis(Bti) to an insecticide resistant population of Anopheles arabiensis from Tolay,Southwest Ethiopia

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Asian Pacific Journal of Tropical Biomedicine 2016年第7期6卷 554-561页

作者： Assalif Demissew Meshesha Balkew Melaku Girma Department of Medicine College of Medicine and Health SciencesAmbo University Aklilu Lemma Institute of Pathobiology Addis Ababa University Human health Malaria Control DepartmentInternational Center of Insect Physiology and Ecology

Objective:To elucidate the larvicidal potency of neem, chinaberry and Bacillus thuringiensis israelensis(Bti) to larvae of Anopheles arabiensis under semi-field condition and adult susceptibility/resistance to the conventionally used insecticides in Tolay,Southwestern ***: Wild collected 3rd and 4th stage larvae were exposed to neem, and chinaberry seed powder dissolved in water and Bti in artificial containers at three treatment levels:0.2, 0.1 and 0.05 g/m^2 and controls were free of treatments. Larval and pupal mortalities were monitored daily and residual activities were determined. The experiments were replicated three times. The World health Organization tube test for all classes of insecticides was conducted on adult Anopheles arabiensis reared from field collected larvae and pupae. Data were analyzed using STATA software version ***: In the first application, neem powder caused 88.9%, 87.9% and 79.4% larval and pupal mortality at 0.2, 0.1 and 0.05 g/m^2 after 4.3, 6.0 and 5.7 days, respectively. The corresponding killing effect of chinaberry was 80.3%, 62.1% and 30.3% after 7.0, 7.7 and 8.3days respectively. Bti at all treatments killed 100% after 24 h except 2.7 days for 0.05 g/m^*** mosquitoes were susceptible only for fenitrothion and pirimiphos-methyl with 100%mortality while resistant to deltamethrin, alpha-cypermethrin, etofenprox and dichlorodiphenyl-tricgloroethane with only 9.0%, 3.0%, 5.1% and 2.0% mortalities ***: Neem, chinaberry and Bti showed potent larvicidal and pupicidal activities. However, in the area, high level of mosquito resistance to pyrethroids and dichlorodiphenyl-tricgloroethane was seen which will pose serious challenge to vector control in the future. Therefore, using integrated approach including these botanical larvicides is warranted to manage insecticide resistance.

关键词： Larvicide Anopheles arabiensis Tolay Insecticide Resistance Botanical Bio-efficacy