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Clinical features of SARS-CoV-2-associated encephalitis and meningitis amid COVID-19 pandemic

World Journal of Clinical Cases 2021年第5期9卷 1058-1078页

作者： Liang Huo Kai-Li Xu Hua Wang department of pediatrics Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina department of pediatric Neurology Children’s Hospital Affiliated to Zhengzhou UniversityZhengzhou 450018Henan ProvinceChina department of pediatric Neurology Henan Children’s HospitalZhengzhou 450018Henan ProvinceChina department of pediatric Neurology Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

BACKGROUND Since the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)epidemic,numerous studies have been published on SARS-CoV-2-related encephalitis/meningitis,but it has not been established if there are specific clinical characteristics of encephalitis/meningitis associated with SARS-CoV-2 infection.AIM To identify the specific clinical features of cases of encephalitis/meningitis associated with SARS-CoV-2 infection in the context of this virus infection pandemic and investigate their relationship with SARS-CoV-2 infection.METHODS We searched PubMed,and included single case reports and case series with full text in English,reporting original data of coronavirus disease-19(COVID-19)patients with encephalitis/meningitis and a confirmed recent SARS-CoV-2 infection.Clinical data were extracted.RESULTS We identified 22 articles(18 single case reports and 4 case series)reporting on a total of 32 encephalitis/meningitis patients with confirmed SARS-CoV-2 infection.SARS-CoV-2 infection was confirmed through reverse transcriptase-polymerasechain-reaction(RT-PCR)in 96.88%of cases.A total of 22(68.75%)patients had symptoms of SARS-CoV-2 infection in about 1 wk(7.91 d)preceding the onset of neurologic symptoms.The most common neurological symptoms were consciousness disturbance(59.38%),seizure(21.88%),delirium(18.75%),and headache(18.75%).Four cases were confirmed by positive RT-PCR results in cerebrospinal fluid(CSF),one was confirmed by positive RT-PCR results in postoperative brain tissue,and one by the presence of SARS-CoV-2 antibodies in CSF.The mainly damaged targets identified by neuroimaging included the temporal lobe(15.63%),white matter(12.5%),frontal lobe(9.38%),corpus callosum(9.38%),and cervical spinal cord(9.38%).Eighty percent of patients had electroencephalograms that showed a diffuse slow wave.Twenty-eight(87.5%)patients were administered with specific treatment.The majority(65.63%)of patients improved following systemic therapy.CONCLUSION Encephalitis/meningitis is the common neurological com

关键词： COVID-19 SARS-CoV-2 Encephalitis Meningitis Clinical features System review

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Distal clavicle fractures treated by anteroinferior plating with a single screw: Two case reports

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World Journal of Clinical Cases 2023年第30期11卷 7502-7507页

作者： Xin-Lei Zhao Yan-Qing Liu Jian-Guo Wang You-Cai Liu Jia-Xuan Zhou Bei-Yu Wang Yi-Jun Zhang department of Orthopaedic surgery The First Affiliated Hospital of Baotou Medical CollegeInner Mongolia University of Science and TechnologyBaotou 014010Inner Mongolia Autonomous RegionChina

BACKGROUND For the treatment of distal clavicle fractures,each treatment method has its own advantages and disadvantages,and there is no optimal surgical solution.CASE SUMMARY Based on this,we report 2 cases of distal clavicle fractures treated utilizing an anterior inferior plate with a single screw placed in the distal,in anticipation of providing a better surgical approach to distal clavicle fracture treatment.Two patients were admitted to the hospital after trauma with a diagnosis of distal clavicle fracture,and were admitted to the hospital for internal fixation of clavicle fracture by incision and reduction,with good postoperative functional recovery.CONCLUSION With solid postoperative fixation and satisfactory prognostic functional recovery,this technique has been shown to be simple,easy to perform and effective.

关键词： Distal clavicle fractures Anteroinferior Plating Single screw Case report

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Melatonin alleviates intervertebral disc degeneration by disrupting the IL-1β/NF-κB-NLRP3 inflammasome positive feedback loop

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Bone Research 2020年第2期8卷 169-181页

作者： Fan Chen Guowei Jiang Hui Liu Zemin Li Yuxin Pei Hua Wang Hehai Pan Haowen Cui Jun Long Jianru Wang Zhaomin Zheng department of Spine surgery The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China department of pediatric Intensive Care Unit The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Pain Research Center Sun Yat-Sen UniversityGuangzhou 510080China

The inflammatory response is induced by the overexpression of inflammatory cytokines, mainly interleukin(IL)-1β, and is one of the main causes of intervertebral disc degeneration(IVDD). NLR pyrin domain containing 3(NLRP3) inflammasome activation is an important source of IL-1β. As an anti-inflammatory neuroendocrine hormone, melatonin plays various roles in different pathophysiological conditions. However, its roles in IVDD are still not well understood and require more examination. First, we demonstrated that melatonin delayed the progression of IVDD and relieved IVDD-related low back pain in a rat needle puncture IVDD model;moreover, NLRP3 inflammasome activation(NLRP3, p20, and IL-1β levels) was significantly upregulated in severely degenerated human discs and a rat IVDD model. Subsequently, an IL-1β/NF-κB-NLRP3 inflammasome activation positive feedback loop was found in nucleus pulposus(NP) cells that were treated with IL-1β. In these cells, expression of NLRP3 and p20 was significantly increased, NF-κB signaling was involved in this regulation, and mitochondrial reactive oxygen species(mt ROS)production increased. Furthermore, we found that melatonin disrupted the IL-1β/NF-κB-NLRP3 inflammasome activation positive feedback loop in vitro and in vivo. Melatonin treatment decreased NLRP3, p20, and IL-1β levels by inhibiting NF-κB signaling and downregulating mt ROS production. Finally, we showed that melatonin mediated the disruption of the positive feedback loop of IL-1β in vivo. In this study, we showed for the first time that IL-1β promotes its own expression by upregulating NLRP3 inflammasome activation. Furthermore, melatonin disrupts the IL-1β positive feedback loop and may be a potential therapeutic agent for IVDD.

关键词： NLRP3 degeneration inflam

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Association of allergic rhinitis with hypothyroidism, asthma, and chronic sinusitis: clinical and radiological features

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World Journal of Otorhinolaryngology-Head and Neck surgery 2022年第3期8卷 262-268页

作者： Aljuaid Eidha Fawzan Sara Ahmad Assiri Raad M.M.Althaqafi Atheer Alsufyani Ahmad Saeed A.Alghamdi Otorhinolaryngology-Head and Neck surgery department Al-Hada Armed Forces Military HospitalTaifSaudi Arabia Taif University School of Medicine TaifSaudi Arabia

Background: Allergic rhinitis (AR) is characterized by mucosal inflammation that leads to a variety of symptoms, such as nasal congestion, rhinorrhea, and sneezing. This rhinitis is triggered by inhalation of allergens, such as pollen, and this condition has a negative impact on the quality of life. AR was shown to be associated with a number of co-morbidities, including hypothyroidism, asthma, and chronic sinusitis.Objective: This study aimed to assess AR-associated comorbidities in patients presenting symptoms and paranasal sinus computed tomography (CT) scan findings in Taif City, Saudi Arabia.Methods: This cross-sectional study evaluated medical and radiological records of AR patients retrospectively from the period of December 2018 to September 2019 in Al-Hada Armed Forces Military Hospital, Taif City, Saudi Arabia.Results: A total of 103 AR patients with a mean age of 39.0 ± 15.6 years with 55.3% males and 44.7% females. The three most common associated comorbidities in allergic rhinitis patients were chronic sinusitis (28.2%), hypothyroidism (21.4%), and asthma (8.7%). Nasal obstruction (30.1%) was the symptom most frequently presented by all patients. Mucosal thickening occurred most frequently in patients with associated chronic sinusitis, while bilateral osteomeatal complex obliteration was observed mostly in asthmatic patients, and bony boundary thinning was more prevalent among patients with associated hypothyroidism.Conclusion: The gender distribution of AR was 10% more common among males;however, the most common three comorbidites in allergic rhinitis patients were chronic sinusitis, hypothyroidism, and asthma, and most of those patients were females. Hypothyroidism can be a hidden predisposing factor for AR, while chronic sinusitis can be caused by AR due to secretion stasis or immune system activation.

关键词： Allergic Rhinitis Asthma Chronic Sinusitis CT scan Hypothyroidism Nasal obstruction Paranasal sinuses

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Tumor heterogeneity of gastric cancer: From the perspective of tumor-initiating cell

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World Journal of Gastroenterology 2018年第24期24卷 2567-2581页

作者： Jian-Peng Gao Wei Xu Wen-Tao Liu Min Yan Zheng-Gang Zhu department of surgery Shanghai Institute of Digestive SurgeryRuijin HospitalShanghai Jiao Tong University

Gastric cancer(GC) remains one of the most common and malignant types of cancer due to its rapid progression, distant metastasis, and resistance to conventional chemotherapy, although efforts have been made to understand the underlying mechanism of this resistance and to improve clinical outcome. It is well recognized that tumor heterogeneity, a fundamental feature of malignancy, plays an essential role in the cancer development and chemoresistance. The model of tumor-initiating cell(TIC) has been proposed to explain the genetic, histological, and phenotypical heterogeneity of GC. TIC accounts for a minor subpopulation of tumor cells with key characteristics including high tumorigenicity, maintenance of self-renewal potential, giving rise to both tumorigenic and non-tumorigenic cancer cells, and resistance to chemotherapy. Regarding tumor-initiating cell of GC(GATIC), substantial studies have been performed to(1) identify the putative specific cell markers for purification and functional validation of GATICs;(2) trace the origin of GATICs; and(3) decode the regulatory mechanism of GATICs. Furthermore, recent studies demonstrate the plasticity of GATIC and the interaction between GATIC and its surrounding factors(TIC niche or tumor microenvironment). All these investigations pave the way for the development of GATIC-targeted therapy, which is in the phase of preclinical studies and clinical trials. Here, we interpret the heterogeneity of GC from the perspectives of TIC by reviewing the above-mentioned fundamental and clinical studies of GATICs. Problems encountered during the GATIC investigations and the potential solutions are also discussed.

关键词： Gastric cancer Tumor heterogeneity Tumor-initiating cell

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Innovations in otorhinolaryngology in the age of COVID-19: A systematic literature review

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World Journal of Otorhinolaryngology-Head and Neck surgery 2022年第3期8卷 224-238页

作者： E.Berryhill McCarty Liuba Soldatova Jason A.Brant Jason G.Newman Perelman School of Medicine at the Universityof Pennsylvania PhiladelphiaPAUSA department of Otorhinolaryngology-Head and Neck surgery Universityof Pennsylvania Health SystemPhiladelphiaPennsylvaniaPAUSA

Objective: Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that need.Data Sources: PubMed, Ovid/Medline, and ScopusMethods: A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.Results: A total of 41 papers met inclusion criteria and were organized into 5 categories ("General Recommendations for Otolaryngologic surgery’, "Equipment Shortage Solutions’, "Airway Procedures’, "Nasal Endoscopy and Skull Base Procedures’, and "Otologic Procedures’). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 transmission.Conclusions: Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically. This review examines and organizes creative so

关键词： COVID-19 Innovations Inventions Literature Review Otolaryngology

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Simultaneous laparoscopic multi-organ resection combined with colorectal cancer:Comparison with non-combined surgery

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World Journal of Gastroenterology 2012年第8期18卷 806-813页

作者： Hye Jin Kim Gyu-Seog Choi Jun Seok Park Soo Yeun Park Soo Han Jun department of surgery Kyungpook National University Hospital School of Medicine Kyungpook National University department of surgery Daegu Catholic Medical Center Catholic University of Daegu

AIM: To access the short-term outcomes of simultaneous laparoscopic surgery combined with resection for synchronous lesions in patients with colorectal cancer. METHODS: Between March 1996 and April 2010 prospectively collected data were reviewed from 93 consecutive patients who had colorectal cancer and underwent simultaneous multiple organ resection (combined group) and 1090 patients who underwent conventional laparoscopic right hemicolectomy or laparoscopic low/ anterior resection for colorectal cancer (non-combined group). In the combined group, there were nine gastric resections, three nephrectomies, nine adrenalectomies, 56 cholecystectomies, and 21 gynecologic resections. In addition, f ive patients underwent simultaneous laparoscopic resection for three organs. The patient demographics, intra-operative outcomes, surgical morbidity, and short-term outcomes were compared between thetwo groups (the combined and non-combined groups). RESULTS: There were no signifi cant differences in the clinicopathological variables between the two groups. The operating time was signifi cantly longer in the combined group than in the non-combined group, regardless of tumor location (laparoscopic right hemicolectomy and laparoscopic low/anterior resection groups; P = 0.048 and P < 0.001, respectively). The other intraoperative outcomes, such as the complications and open conversion rate, were similar in both groups. The rate of post-operative morbidity in the combined group was similar to the non-combined group (combined vs non-combined, 15.1% vs 13.5%, P = 0.667). Oncological safety for the colon and synchronous lesions were obtained in the combined group. CONCLUSION: Simultaneous laparoscopic multiple organ resection combined with colorectal cancer is a safe and feasible option in selected patients.

关键词：手术效果切除术腹腔镜大肠癌合并脏器并发症结直肠癌

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Clinical results of combined palliative procedures for cyanotic congenital heart defects with intractable hypoplasia of pulmonary arteries

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Chinese Medical Journal 2013年第9期126卷 1678-1682页

作者： FAN Xiang-ming ZHU Yao-bin SU Jun-wu ZHANG Jing LI Zhi-qiang XU Yao-qiang LI Xiao-feng LIU Ying-long department of pediatric Heart Center Department of Children Heart Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background Congenital heart defects with intractable hypoplasia of the pulmonary arteries without intercourse or with intercourse stenosis is unsuitable for surgical correction or regular palliative procedures. We reported our experience with combined palliative procedures for congenital heart defects with intractable hypoplasia pulmonary arteries. Methods From 2001 to 2012, a total of 41 patients with cyanotic congenital heart defects and intractable hypoplasia of the pulmonary arteries underwent surgical procedures. From among them, 31 patients had pulmonary atresia with ventricular septal defect （VSD） and the other 10 cases had complicated congenital heart defects with pulmonary stenosis. Different kinds of palliative procedures were performed according to the morphology of the right and left pulmonary arteries in every patient. If the pulmonary artery was well developed, a Glenn procedure was performed. A modified Blalock-Taussig shunt or modified Waterston shunt was performed if pulmonary arteries were hypoplastic. If the pulmonary arteries were severely hypoplastic, a Melbourne shunt was performed. Systemic pulmonary artery shunts were performed bilaterally in 25 cases. A systemic-pulmonary shunt was performed on one side and a Glenn procedure was performed contralaterally in 16 cases. Major aortopulmonary collateral arteries were unifocalized in six cases, ligated in two cases and interventionally embolized in two cases. There was one early death because of cardiac arrest and the hospital mortality was 2.4%. Results Five patients suffered from postoperative low cardiac output syndrome, three had perfusion of the lungs, and two pulmonary infections. Systemic pulmonary shunts were repeated after the original operation in three cases due to the occlusion of conduits. The mean follow-up time was 25 months. The pre- and the post-operation left pulmonary indices were （8.13±3.68） vs. （14.9±6.21） mm2/m2. The pre- and post-operation right pulmonary indices were （12.7±8.13） vs. （17.7±7.78） mm2/m2. The pre- and post-

关键词： congenital heart disease hypoplasia of pulmonary artery palliation

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Volvulus of the Sigmoid Colon without Necrosis: Therapeutic Aspects in Hospital Fousseyni Daou Hospital in Kayes, Mali

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Surgical Science 2022年第12期13卷 592-599页

作者： Lamine Issaga Traore Sidy Sangare Mamaye Kouyate Gaoussou Sogoba Drissa Katile Adama S. Diakite Lassana Goita Sadio Dembele Djibril Traore Drissa Traore General surgery department of the Fousseyni DAOU Hospital Kayes Mali National Center for Scientific Research and Technology (CNRST) Bamako Mali pediatric surgery department of the Fousseyni DAOU Hospital Kayes Mali Gastro-Hepato-Enterology Unit of the Fousseyni DAOU Hospital Kayes Mali Urology department of Fousseyni DAOU Hospital Kayes Mali Anesthesia and Intensive Care Unit at Fousseyni DAOU Hospital Kayes Mali General surgery department of Somine DOLO Hospital Mopti Mali General surgery department of the University Hospital of Point G Bamako Mali

The volvulus of the sigmoid is known since ancient Egypt. In the 5th century BC, hippocrates laid the foundations for its management. The first observation of this condition was not reported until 1836 by Von Rokitansky, and then in 1859, Melchior described its physiopathological consequences. It was the Norwegian Brusgaard who reported, for the first time, in 1947, the effectiveness of a non-operative treatment. Purpose: Describe morbidity, mortality and the impact of co-morbidity factors on the choice of operative techniques. Patients and Methods: This is a retrospective cross-sectional study performed at the Fousseyni Daou Hospital in Kayes from January 2014 to December 2021. We included all patients operated for sigmoid volvulus without necrosis. The parameters studied were the comorbidity factor, surgical modalities, morbidity and mortality. Results: We collected 31 patients, of whom 29 were men and 2 were women, for a sex ratio of 14.5. The mean age was 55 years with extremes (29 - 78 years). Sigmoidectomy with colorectal anastomosis was performed in 19 cases (61.3%), the average age of these patients was 46.16 years, the comorbidity factor was 1 case (3.2%), the postoperative course was simple in 12 cases (63.1%), the morbidity was 6 cases (26.3%) and mortality 1 case (3.2%). Untwisting with colopexy was performed in 11 cases (35.5%), the average age was 65.91 years, comorbidities were present in 9 cases (82%), the postoperative course was simple in 9 cases (82%), morbidity was 1 case (9%) and mortality 1 case (9%). Hartman colostomy was performed in 1 case (3.2%), the age was 60 years, the morbidity was nil. Overall, the postoperative course was simple in 22 cases (71%), the overall morbidity was 7 cases (22.6%) and mortality 2 cases (6.4%). Conclusion: At the end of our study, we can note that the choice of the operative technique for the volvulus of the sigmoid without necrosis can be influenced by the presence of major comorbidity and the morbi-mortality depends on it.

关键词： Volvulus without Necrosis Surgical Technique Comorbidity Morbidity Mortality

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Right hemicolectomy and anterior resection using the Versius® robotic surgical system: A technical note

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Laparoscopic, Endoscopic and Robotic surgery 2022年第4期5卷 142-145页

作者： Frances Dixon Parveen Vitish-Sharma Richard O'Hara Anjana Singh Robin Thomas Achal Khanna Barrie D.Keeler department of Colorectal surgery Milton Keynes University HospitalNHS Foundation TrustMK65LDUK CMR Surgical 1 Evolution Business ParkCambridgeCB249NGUK department of General surgery Milton Keynes University

As robotic assisted colorectal surgery increases in prevalence new systems are entering the market,each of which requires technique modifications.In this technical note we describe technical insights and tips gained from our extensive experience of 150 colorectal resections using the Versius®system from CMR Surgical.The triad of optimal bedside unit placement,port placement,and arm configuration is described for right hemicolectomy and anterior resection.

关键词： Versius Robotic Colorectal

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