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Perforated appendiceal diverticulitis associated with appendiceal neurofibroma in neurofibromatosis type 1

World Journal of Gastroenterology 2015年第33期21卷 9817-9821页

作者： Akihiko Ozaki Manabu Tsukada Kazuo Watanabe Masaharu Tsubokura Shigeaki Kato Tetsuya Tanimoto Masahiro Kami Hiromichi Ohira Yukio Kanazawa Division of Surgery Minamisoma Municipal General Hospital Division of Diagnostic Pathology Fukushima Pathology Laboratory Division of Social Communication System for Advanced Clinical Research Institute of Medical ScienceUniversity of Tokyo Division of Internal Medicine Soma Central Hospital Jyoban Hospital of Tokiwakai Group Division of Endoscopy Minamisoma Municipal General Hospital

An appendiceal neurofibroma(ANF) is a rare neoplasm associated with neurofibromatosis type 1(NF-1),an inheritable neurocutaneous disorder that involves multiple systems including the intraabdominal *** diverticulitis occasionally ruptures in the absence of intense abdominal pain,which can lead to serious *** reports highlight the association between appendiceal diverticulum and appendiceal neoplasms; however,there is still little information on the association between appendiceal diverticulitis and ANF in NF-1.A 51-year-old Japanese male with NF-1 was referred to the division of surgery for mild right lower quadrant *** was suspected he had perforated acute appendicitis with periappendiceal abscess based on clinical manifestations and findings of computed *** emergency appendectomy was *** pathological examination revealed diffusely proliferated tumor cells of a neurofibroma,coexistent with multiple appendiceal diverticulums,leading to the diagnosis ofperforated appendiceal diverticulitis associated with *** he developed a remnant abscess,he recovered with the conservative treatments of antibiotics and *** case suggests that appendiceal diverticulitis might be a complication of appendiceal involvement of NF-1,and that it occasionally ruptures in the absence of intense abdominal *** should recognize that NF-1 can cause various abdominal manifestations.

关键词： Appendiceal diverticulum Appendiceal diverticuliti

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Vinyl chloride accident unleashes a toxic legacy

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Environmental Science and Ecotechnology 2023年第2期14卷 1-2页

作者： Chengjun Li Peng Gao Riqing Yu Huan Zhong Mengjie Wu Su Shiung Lam Christian Sonne institute of Environmental Research at Greater Bay Area Guangzhou UniversityGuangzhou510006China Department of Environmental and Occupational Health and Department of Civil and Environmental EngineeringUniversity of PittsburghPittsburghPA15261United States UPMC Hillman Cancer Center PittsburghPA15232United States Department of Biology Center for EnvironmentBiodiversity and ConservationThe University of Texas at TylerTylerTX75799United States School of Environment Nanjing UniversityNanjingChina Higher Institution Centre of Excellence(HICoE) Institute of Tropical Aquaculture and Fisheries(AKUATROP)Universiti Malaysia Terengganu21030Kuala NerusTerengganuMalaysia Center for Transdisciplinary Research Saveetha Institute of Medical and Technical SciencesSaveetha UniversityChennaiIndia Department of Ecoscience Arctic Research Centre(ARC)Aarhus UniversityFrederiksborgvej 399PO Box 358DK-4000RoskildeDenmark Sustainability Cluster School of EngineeringUniversity of Petroleum&Energy StudiesDehradunUttarakhand248007India

A railroad accident on February 3,2023,led to the release and combustion of 115,580 gallons,equivalent to over 437,000 L,of vinyl chloride monomer(VCM)in East Palestine,Ohio[1].This monomer is used in polyvinyl chloride(PVC)production,and its burning produces additional toxins such as hydrochloric acid and lethal phosgene,known as a notorious chemical weapon during World War I[2].acute exposure to these chemicals causes immediate adverse effects on local ecosystems,including the deaths of wild and farmed animals and pets.

关键词： monomer hydrochloric vinyl

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经冠状动脉自体骨髓间充质干细胞移植治疗小型猪急性心肌梗死

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中国医学科学院学报 2005年第6期27卷 696-699,i0013页

作者：阴赪茜陈纪林王韫芳曹丰程芮裴雪涛中国医学科学院中国协和医科大学阜外心血管病医院冠心病诊疗中心北京100037 Department of Stem Cell and Regenerative Medicine Institute of Blood TransfusionAcademy of Military Medical Science

目的评价经冠状动脉移植体外分离培养自体骨髓间充质干细胞(MSCs)治疗急性心肌梗死(AMI)的可行性及疗效。方法通过结扎冠状动脉左前降支90min后恢复血流的方法建立AMI模型。采用密度梯度离心法分离骨髓单个核细胞、传代培养后,在AMI造... 详细信息

目的评价经冠状动脉移植体外分离培养自体骨髓间充质干细胞(MSCs)治疗急性心肌梗死(AMI)的可行性及疗效。方法通过结扎冠状动脉左前降支90min后恢复血流的方法建立AMI模型。采用密度梯度离心法分离骨髓单个核细胞、传代培养后,在AMI造模10～14d后将培养扩增的自体MSCs经冠状动脉植入梗死区,应用超声心动图观察移植前后心功能变化情况,冰冻切片荧光显微镜示踪4'G6-二脒-2-苯基吲哚(DAPI)标记的MSCs,Ⅷ因子免疫荧光染色测定新生血管数目。结果MSCs生长呈纺锤样,生长旺盛呈旋涡样;DAPI标记率为100%。AMI造模10～14d后MSCs移植数量平均为(4～6)×107个,移植术后3个月,MSCs治疗组与对照组比较,左心室射血分数(LVEF)显著升高[(54.65±3.39)%vs(43.98±4.21)%(P<0.01)],可见DAPI标记胞核为蓝色荧光的移植细胞,MSCs治疗组与对照组比较,新生血管数目显著升高[(13.28±4.39)vs(4.27±2.28)个G(P<0.01)]。结论通过体外培养扩增在短期内可以获得相当数量的生物性状稳定的MSCs,在AMI造模10～14d后进行经冠状动脉MSCs自体移植,促进左室功能的恢复。MSCs移植与目前广泛运用的介入治疗相结合,方法简便、经济、有效,可望改善AMI患者的预后,具有良好的临床应用前景。

关键词：骨髓间充质干细胞急性心肌梗死心肌再生小型猪

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Minimally invasive treatment of pancreatic pseudocysts

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World Journal of Gastroenterology 2015年第22期21卷 6850-6860页

作者： Enver Zerem Goran Hauser Svjetlana Loga-Zec Suad Kunosi Predrag Jovanovi Dino Crnki Department of Gastroenterology University Clinical Center Tuzla Department of Medical Sciences The Academy of Sciences and Arts of Bosnia and Herzegovina Department of Internal Medicine Division of Gastroenterology Clinical Hospital Centre Rijeka institute of Pharmacology Medical FacultyUniversity of Sarajevo Department of Physics Faculty of Natural Sciences and Mathematics University of Tuzla Faculty of Pharmacology University of Tuzla

A pancreatic pseudocyst(PPC) is typically a complication of acute and chronic pancreatitis, trauma or pancreatic duct obstruction. The diagnosis of PPC can be made if an acute fluid collection persists for 4 to 6 wk and is enveloped by a distinct *** PPCs regress spontaneously and require no treatment, whereas some may persist and progress until complications occur. The decision whether to treat a patient who has a PPC, as well as when and with what treatment modalities, is a difficult one. PPCs can be treated with a variety of methods: percutaneous catheter drainage(PCD), endoscopic transpapillary or transmural drainage, laparoscopic surgery, or open pseudocystoenterostomy. The recent trend in the management of symptomatic PPC has moved toward less invasive approaches such as endoscopic- and image-guided PCD. The endoscopic approach is suitable because most PPCs lie adjacent to the stomach. The major advantage of the endoscopic approach is that it creates a permanent pseudocysto-gastric track with no spillage of pancreatic enzymes. However, given the drainage problems, the monitoring, catheter manipulation and the analysis of cystic content are very difficult or impossible to perform endoscopically, unlike in the PCD approach. Several conditions must be met to achieve the complete obliteration of the cyst *** duct anatomy is an important factor in the prognosis of the treatment outcome, and the recovery of disrupted pancreatic ducts is the main prognostic factor for successful treatment of PPC, regardless of the treatment method used. In this article, we review and evaluate the minimally invasive approaches in the management of PPCs.

关键词： Complications Pseudocyst Treatment Drainage Outcomes

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急性肝衰时颅内高压的发病机制:炎症、氨和脑血流

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世界核心医学期刊文摘（胃肠病学分册） 2005年第3期1卷 57-58页

作者： Jalan R. Olde Damink S.W.M. Hayes P.C. 姜志茹 Liver Failure Group Institute of Hepatology Roy. Free Univ. Coll. London Med. S. London United Kingdom

Background/Aims The study aims were to determine the role of inflammation in the pathogenesis of increased intracranial pressure (ICP) in patients with acute liver failure (ALF) and its interplay with cerebral blood flow (CBF) and ammonia. Methods Twenty one patients with ALF were studied from the time they were ventilated for grade 4 encephalopathy until receiving specific treatment for increased ICP. Depending upon the ICP, the patients were divided into two groups; those that required specific treatment (ICP>20 mmHg, group 1: n=8, ICP: 32 (28-54) mmHg); and those that did not (ICP≤20 mmHg, group 2: n=13, ICP: 15 (10-20) mmHg). Results Inflammatory markers, arterial ammonia and CBF were significantly higher in the group 1 patients. TNF αlevels correlated with CBF (r=0.80). Four patients from group 2 developed surges of increased ICP (32 (15-112) hours from enrolment). These were associated increases in markers of inflammation and TNF α, and an increase in CBF. There was no change in these inflammatory markers, CBF or ICP in the other 9 group 2 patients. Conclusions The results of this study suggest that inflammation plays an important synergistic role in the pathogenesis of increased ICP possibly through its effects on CBF.

关键词：急性肝衰颅内高压脑血流发病机制特异性治疗机械性通气 α水平脑病波动性协同作用

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进行性腔隙性脑白质病:一种新型儿童期疾病

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世界核心医学期刊文摘（神经病学分册） 2006年第5期2卷 14-15页

作者： Naidu S Bibat G 张玉春 Kennedy Krieger institute Johns Hopkins Medical Institutions Department of Neurogenetics 707 N. Broadway Baltimore MD 21205 United StatesDr.

We report 19 patients with a previously undelineated neurodegenerative syndrome characterized by episodic acute onset of irritability or neurological deficits between 2 months and 3.5 years of age, followed by steady or intermittent clinical deterioration. Seven children died between 11 months and 14 years of age. Cranial magnetic resonance imaging (MRI) shows patchy leukoencephalopathy with cavities, and vascular permeability, in actively affected regions. Early lesions affect corpus callosum and centrum semiovale, with or without cerebellar or cord involvement. After repeated episodes, areas of tissue loss coalesce with older lesions to become larger cystic regions in brain or spinal cord. Diffuse spasticity, dementia, vegetative state, or death ensues. Gray matter is spared until late in the course. In some, incomplete clinical or MRI recovery occurs after episodes. The clinical course varies from rapid deterioration to prolonged periods of stability that are unpredictable by clinical or MRI changes. Elevated levels of lactate in brain, blood, and cerebrospinal fluid, abnormal urine organic acids, and changes in muscle respiratory chain enzymes are present but inconsistent, without identifiable mitochondrial DNA mutations or deletions. Pathological studies show severe loss of myelin sparing U-fibers, axonal disruption, and cavitary lesions without inflammation. Familial occurrence and consanguinity suggest autosomal recessive inheritance of this distinct entity.

关键词：疾病患者脑白质病腔隙性常染色体隐性遗传性疾病儿童期进行性线粒体DNA突变头部磁共振成像 MRI改变应激状态

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以腺病毒为载体的基因治疗对急性肺损伤治疗效果的影响及其意义

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中华医学杂志 2008年第26期88卷 1841-1845页

作者：王燕陆权滕国良 Feistein S. Sheldon Micheal F. Beers Aron B. Fisher 上海交通大学附属儿童医院呼吸科 200040 上海交通大学附属儿童医院急救中心 200040 the institute of Environmental Medicine the Center of Lung Biology University of Pennsylvania Philadelphia PA USA Department of Pulmonary andCritical Care Medicine University of Pennsylvania Philadelphia PA USA

目的评价腺病毒自身的致炎作用在以其为载体的基因治疗中，对小鼠急性肺损伤（ALI）治疗效果的影响及意义。方法C57／B6雄性小鼠随机分为4组：（1）以腺病毒为载体的靶基因LacZ治疗组（AdLacZ组）：43只；（2）3个对照组：①O2吸入前组... 详细信息

目的评价腺病毒自身的致炎作用在以其为载体的基因治疗中，对小鼠急性肺损伤（ALI）治疗效果的影响及意义。方法C57／B6雄性小鼠随机分为4组：（1）以腺病毒为载体的靶基因LacZ治疗组（AdLacZ组）：43只；（2）3个对照组：①O2吸入前组（Con组）：26只；②O2吸入后组：TBS＋磷酸盐缓冲液（PBS）治疗组（PBS组）36只；③无治疗对照组（无治疗组）：33只。100％O2吸入诱导小鼠高氧性ALI动物模型；在100％O2吸入前48h经鼻腔通道给予装载LacZ DNA的腺病毒质粒感染小鼠，并观察小鼠的死亡率。β-半乳糖酶活性测定法用于确定转染的LacZ基因在肺脏的蛋白活性的表达水平；肺的干／湿重比、支气管-肺泡灌洗液内的蛋白浓度和细胞分类分析用于评价肺炎症反应的程度。结果经鼻腔通路的以腺病毒为载体的基因治疗，可造成转染基因LacZ的蛋白表达活性在肺脏持续有效地高表达，而且其表达水平在O2吸入72h后仍可维持为O2吸入前的2倍以上（3．688U／mg vs 1．589U／mg）；该组小鼠对高氧吸入敏感性高于各对照组，50％的小鼠生存时间短于PBS组[（86±3）h vs （94±7）h]；同时，该组小鼠的支气管-肺泡内炎症细胞的渗出在100％O2吸入48h后明显高于各对照组，继续O2吸入24h后明显下降约50％；肺干／湿重比和支气管-肺泡灌洗液内蛋白浓度无明显下降。结论腺病毒自身的致炎作用对ALI基因治疗效果的影响是轻度和暂时的，但需在评价治疗效果时加以重视。

关键词：腺病毒科基因疗法呼吸窘迫综合征,成人

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暂时性抗磷脂抗体出现合并儿童急性感染:3例报道及文献回顾

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世界核心医学期刊文摘（儿科学分册） 2006年第11期2卷 20-21页

作者： Mizumoto H. Maihara T. Hiejima E. D. Hata 朱新菊 De-partment of Pediatrics Kitano Hospital Tazuke Kofukai Medical Research Institute 2-4-20 Ohgimachi Kita-kuOsaka 530-8480 Japan

We describe two previously healthy children who had multiple ecchymoses several days after acute infection. In both cases,the prothrombin time (PT) and the activated partial thromboplastin time (APTT) were prolonged. Further examinations revealed the presence of lupus anticoagulant (LA), phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT), and low serum complement. In both cases, we confirmed the presence of a serum immune complex. The patients’ symptoms improved spontaneously within 1 week, and all laboratory data normalized within several months. We also describe another asymptomatic case positive for LA and aPS/PT presumably associated with cytomegalovirus infection. The prevalence of transient antiphospholipid antibodies associated with viral infections in children must be much higher than we *** have to take it into consideration when we see abnormalcoagulation results, but the occurrence of significant bleeding symptoms is rare.

关键词：抗磷脂抗体文献回顾巨细胞病毒感染凝血酶原时间抗凝血酶原阳性病例狼疮抗凝物血清补体出血

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Surgical minimal invasive left atrial decompression during venoarterial extracorporeal membrane oxygenation for pediatric acute fulminant myocarditis

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World Journal of Pediatric Surgery 2021年第4期4卷 44-46页

作者： Li Fen Ye Qiang Shu Chenmei Zhang Yong Fan Liyang Ying Lijun Yang Ru Lin Heart institute Zhejiang University School of Medicine Children's HospitalHangzhouZhejiangChina Pediatric Intensive Care Unit Zhejiang University School of Medicine Children's HospitalHangzhouZhejiangChina Extracorporeal Circulation and Extracorporeal Life Support Zhejiang University School of Medicine Children's HospitalHangzhouZhejiangChina

Venoarterial extracorporeal membrane oxygenation(VA ECMO)has been considered as the first-line treatment for acute fulminant myocarditis(AFM)when traditional treatment is *** vascular VA ECMO can partially reduce right ventricular preload,but it can increase left ventricular(LV)after-load.1 The increased afterload may cause difficulty in LV blood ejection in patients with severely impaired LV function.

关键词： impaired arterial acute

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Why do some trauma patients die while others survive?A matched-pair analysis based on data from Trauma Register DGU(R)

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Chinese Journal of Traumatology 2020年第4期23卷 224-232页

作者： Dan Bieler Thomas Paffrath Annelie Schmidt Maximilian V(o)llmecke Rolf Lefering Martin Kulla Erwin Kollig Axel Franke Sektion NIS of the German Trauma Society Department of Trauma Surgery and Orthopaedics Reconstructive and Hand SurgeryBurn MedicineGerman Armed Forces Central Hospital KoblenzKoblenz 56072Germany Department of Trauma and Orthopaedic Surgery Witten/Herdecke UniversityFaculty of Health-School of MedicineCologne51109Germany institute for Research in Operative Medicine Witten/Herdecke UniversityCologne51109Germany Department of Anaesthesiology and Intensive Care German Armed Forces Hospital UlmUlm89081Germany Committee on Emergency Medicine Intensive Care and Trauma Management(Sektion NIS)of the German Trauma Society(DGU)Germany Department of Orthopaedics and Trauma Surgery Heinrich Heine University HospitalDusseldorf40225Germany

Purpose:The mortality rate for severely injured patients with the injury severity score(ISS)>16 has decreased in *** is robust evidence that mortality is influenced not only by the acute trauma itself but also by physical health,age and *** aim of this study was to identify other possible influences on the mortality of severely injured ***:In a matched-pair analysis of data from Trauma Register DGU(R),non-surviving patients from Germany between 2009 and 2014 with an ISS_>16 were compared with surviving matching *** was performed on the basis of age,sex,physical health,injury pattern,trauma mechanism,conscious state at the scene of the accident based on the Glasgow coma scale,and the presence of shock on arrival at the emergency ***:We matched two homogeneous groups,each of which consisted of 657 patients(535 male,average age 37 years).There was no significant difference in the vital parameters at the scene of the accident,the length of the pre-hospital phase,the type of transport(ground or air),pre-hospital fluid management and amounts,ISS,initial care level,the length of the emergency room stay,the care received at night or from on-call personnel during the weekend,the use of abdominal sonographic imaging,the type of X-ray imaging used,and the percentage of patients who developed *** found a significant difference in the new injury severity score,the frequency of multi-organ failure,hemoglobine at admission,base excess and international normalized ratio in the emergency room,the type of accident(fall or road traffic accident),the pre-hospital intubation rate,reanimation,in-hospital fluid management,the frequency of transfusion,tomography(whole-body computed tomography),and the necessity of emergency ***:Previously postulated factors such as the level of care and the length of the emergency room stay did not appear to have a significant influence in this *** studies should be condu

关键词： Emergency medicine Registries Mortality Severely injured patients

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