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The Pathways in Endometrial Carcinogenesis and an Overview of its Histology, Grade and Stage 子宫内膜癌的发生途径及其组织学、分级和分期综述
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.1000231
Qin Zhou, Soobhug Rishikesh Singh, Soobhug Shalini Devi Tina, J. Wena, Zhou Yiying, S. Mac, R. Mariella
Endometrial carcinoma is the most common female genital tract cancer in the developed countries. It is classified as Type I and II endometrial cancer. Understanding of the pathogenesis of each type plays a pivotal role in identifying their precursors. The histological subtype, grade and stage guide the treatment strategies and portend the prognosis in endometrial carcinoma. Hysterectomy is regarded curative in early stage disease. By contrast, uterine serous carcinoma is the most aggressive histologic subtype associated with a low 5-year overall survival rate. Substantial rise in uterine corpus carcinoma parallels with the increase in obesity and diabetes. As they share similar etiologies, measures can be adopted to tackle the modifiable risk factors. No screening consensus is available for low or average risk populations.
子宫内膜癌是发达国家最常见的女性生殖道癌症。它被分为I型和II型子宫内膜癌。了解每种类型的发病机制在识别其前体中起着关键作用。子宫内膜癌的组织学亚型、分级和分期指导着治疗策略,预示着预后。子宫切除术被认为是治疗早期疾病的有效方法。相比之下,子宫浆液性癌是最具侵袭性的组织学亚型,其5年总生存率较低。子宫体癌的大量增加与肥胖和糖尿病的增加是平行的。由于它们具有相似的病因,因此可以采取措施来解决可改变的风险因素。对于低风险人群或平均风险人群,目前尚无筛查共识。
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引用次数: 2
Reviving an Old Technique Forgotten:Insertion Central Venous Catheter by ExternalJugular Vein: Description of Technical andSeries of Cases 一项被遗忘的老技术的复兴:经颈外静脉插入中心静脉导管:技术及一系列病例描述
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.100243
Juan Esteban Gómez Tobar, Adolfo León Trochez Zuleta
Background: The insertion of the central venous catheter (CVC) is a widely used procedure in intensive care units (ICUs). However, the use of the external jugular vein (EJV) for central venous cannulation, has been relegated as the time goes by. The purpose of this study is to describe the technique used to implant the CVC via EJV, performing at the same time, a number of case reports, characterizing the early mechanical complications presented in intensive care patients, which required placing central venous catheter without the use of ultrasound. Methodology: Case series report, with a population of 70 critically ill patients who required insertion of CVC by EJV, describing the early mechanical complications from the procedure. Results: Out of the 70 CVC, 90% were successfully inserted, the main early mechanical complication was subcutaneous hematoma in the 7.93%, and bad position was observed in 22% of cases. Conclusions: Technique without pulmonary complications, with low rate of early mechanical complications, to be considered in critically ill patients.
背景:中心静脉导管(CVC)的插入是在重症监护病房(icu)广泛使用的程序。然而,随着时间的推移,使用颈外静脉(EJV)进行中心静脉插管已经被降级。本研究的目的是描述通过EJV植入CVC的技术,同时进行了一些病例报告,描述了重症监护患者早期出现的机械并发症,这些患者需要在不使用超声的情况下放置中心静脉导管。方法:病例系列报告,70例危重患者需要EJV插入CVC,描述该手术的早期机械并发症。结果:70例CVC中90%置入成功,早期机械并发症以皮下血肿为主,占7.93%,体位不良占22%。结论:无肺部并发症,早期机械并发症发生率低,是危重患者可考虑的技术。
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引用次数: 1
Two Cases of Pneumorrhachis with Different Causes 不同病因肺气炎2例
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.1000220
A. Rashidi, W. Albanna, J. Gallego, J. Weyer, R. Buh
We present two interesting and rare cases of pneumorrhachis (intraspinal air). The first patient is a 43- year-old male patient who had a road traffic accident and trauma CT showed impressive pneumocephalus and pneumorrhachis within the cervical canal. Treatment was conservative and the patient improved the following weeks with reabsorption of the air. Another 60-year-old female patient had known diverticulitis and developed paraparesis of her legs with associated fever. MRI of her spine showed extensive intraspinal air in the thoracolumbar space. She was operated combined with neurosurgeons and abdominal surgeons with colostomy and laminectomy. After a long treatment on ICU and rehab center 6 months after surgery she was able to walk with help.
我们报告两例有趣而罕见的肺气炎(椎管内空气)。第一个病人是一个43岁的男性病人,他有一个道路交通事故和外伤CT显示明显的气脑和气管内的肺。治疗是保守的,患者在接下来的几周内随着空气的重新吸收而改善。另一名60岁女性患者已知患有憩室炎,并出现腿部麻痹并伴有发热。脊柱MRI显示胸腰椎间隙有大量椎内空气。她接受了神经外科医生和腹部外科医生的联合手术,包括结肠造口和椎板切除术。经过ICU和康复中心的长期治疗,手术后6个月,她能够在帮助下行走。
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引用次数: 0
Interaction of Mycobacterium tuberculosis H37Rv with Microfold Cell leads to a New Era of infection in Host 结核分枝杆菌H37Rv与微褶细胞相互作用开启宿主感染新时代
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.100246
S. Meena, Shivangi, L. Meena
Tuberculosis (TB) is widely distributed dangerous disease that spreads at faster rate and caused by Mycobacterium tuberculosis H37Rv (M. tuberculosis H37Rv) which is highly successful lipid and GC rich bacteria. The bacterium gains its success as it utilizes host macrophages for its survival and replication. M. tuberculosis H37Rv uses at least two separate pathways to recruit macrophages. It uses its PGL surface lipid to recruit macrophages through host CCL2 and Micro fold cells to enter deep in tissues. M-cells express many different carbohydrate markers on their surface which helps in cell and pathogen or antigen interaction. These cells transfer substances from gut across epithelium and to immune cells. M-cells have the potential to intricate the life cycle of this pathogen by internalizing pathogen. M-cells are targeted for vaccine to induce immunity and it has experimented on mice, humans and primates. Nanoparticles and microspheres can also be used successfully for drug or vaccine delivery through micro fold cells because microspheres used for vaccine delivery system to increase mucosal antibody responses that provide prolonged therapeutic effects and nanoparticles are easily accepted by cells so these particles also useful in drug delivery. In this manuscript we have describe the significance of M- cells that could be helpful in TB treatment.
结核病(TB)是由结核分枝杆菌H37Rv (M. Tuberculosis H37Rv)引起的一种分布广泛、传播速度较快的危险疾病,是一种非常成功的富含脂质和GC的细菌。细菌获得成功是因为它利用宿主巨噬细胞来生存和复制。结核分枝杆菌H37Rv至少使用两种不同的途径来招募巨噬细胞。它利用其PGL表面脂质通过宿主CCL2和微褶细胞招募巨噬细胞进入组织深处。m细胞在其表面表达许多不同的碳水化合物标记物,这有助于细胞与病原体或抗原的相互作用。这些细胞通过上皮将物质从肠道转移到免疫细胞。m细胞有可能通过内化病原体使这种病原体的生命周期复杂化。m细胞是疫苗诱导免疫的目标,并已在小鼠、人类和灵长类动物身上进行了实验。纳米颗粒和微球也可以通过微细胞成功地用于药物或疫苗递送,因为用于疫苗递送系统的微球可以增加粘膜抗体反应,从而提供持久的治疗效果,纳米颗粒很容易被细胞接受,因此这些颗粒也可用于药物递送。在这篇手稿中,我们描述了M细胞在结核病治疗中可能有帮助的意义。
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引用次数: 3
Management and Outcome of Heterotopic Pregnancy 异位妊娠的处理和结局
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.1000228
Li-Ping Han, Hui-Min Zhang, Jun-Bi Gao, Chao-Yue Tan, Xiao-Xiao Han
Objective: The aim of this study was to investigate the clinical efficacy of laparoscopic surgery for women with heterotopic pregnancy. Method: The clinical outcomes of 12 patients with intrauterine and ectopic pregnancy undergoing laparoscopic operation were analyzed retrospectively. Results: The products of ectopic pregnancy were removed by laparoscopically. The median operation time was 12 minutes, and the average blood loss was 21.4 ml. There were no postoperative complications. The wounds recovered well in all cases. Among these women, ten delivered at term whereas two failed to continue their pregnancies, one had an abortion after 8 days of the surgery and another one had an abortion due to preterm premature rupture of the membrane at 15 gestational weeks. Conclusion: Laparoscopic surgery is an effective technique in successful management of heterotopic pregnancy.
目的:探讨腹腔镜手术治疗异位妊娠的临床疗效。方法:回顾性分析12例宫内及异位妊娠行腹腔镜手术的临床结果。结果:宫外孕产物均经腹腔镜取出。手术中位时间12分钟,平均失血量21.4 ml,无术后并发症。所有病例的伤口都恢复良好。在这些妇女中,10名足月分娩,2名未能继续妊娠,1名在手术8天后流产,另一名在妊娠15周时因胎膜过早破裂而流产。结论:腹腔镜手术是成功治疗异位妊娠的有效方法。
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引用次数: 3
Central Retinal Artery Occlusion and Partial Ophthalmoplegia Caused by Hyaluronic Acid Injection Filler Cosmetic 透明质酸填充剂致视网膜中央动脉闭塞及部分眼瘫
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.1000230
A. M. Ichsan, Linda Minar Herawati, Anastasia Vanny, Junely Vimala Jaury, H. Muhiddin, Budu
Central retinal artery occlusion is a rare ocular emergency condition that can lead to a total blindness. Hereby we report a 30-year-old woman with a sudden visual loss of the left eye after being injected by hyaluronic acid filler at the dorsum nasal area for cosmetic purpose. Visual acuity was light perception while anterior segment and intraocular pressure were within normal limit. Partial ophthalmoplegia include restriction to the nasal gaze were found. Funduscopic examination revealed total retinal edema with a cherry red spot at the fovea. Ocular massage was performed as initial management followed by humor aqueous paracentesis. All procedures were done within 90 minutes. The patients discharge with the visual improvement to hand motion and the Partial ophthalmophlegia has been improved after being evaluated less than a month.
视网膜中央动脉闭塞是一种罕见的眼部急症,可导致完全失明。在此,我们报告一位30岁的女性,在鼻背部注射透明质酸填充物用于美容后,突然左眼视力丧失。视敏度为光感,前节及眼压在正常范围内。部分眼麻痹包括鼻部注视受限。眼底检查显示视网膜水肿,中央凹处有樱桃红点。眼部按摩作为初始治疗,随后进行房水穿刺。所有手术均在90分钟内完成。术后不到一个月,患者出院时手部运动视力改善,部分眼漏症状改善。
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引用次数: 2
Airway Complications in an Obese Patient following Anaesthesia for Upper Airway Disease: Perioperative Considerations; Supraglottic Airways (SGAs) as a Rescue Device 肥胖患者上呼吸道疾病麻醉后的气道并发症:围手术期注意事项声门上气道(SGAs)作为抢救设备
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.1000214
Bulbulia Ba, Ahmed Mr
Septoplasty with or without endoscopic sinus surgery (ESS) for chronic sinusitus are routine procedures done for upper airway obstruction. Obesity remains a risk factor for anaesthesia. Problems relate not only to airway management but to all major systems and is a major factor contributing to morbidity and mortality. Clinical indices in predicting difficult airways are helpful and supraglottic airway devices (SGAs) useful as rescue in the event of a difficult or failed intubation.
慢性鼻窦炎的鼻中隔成形术合并或不合并内窥镜鼻窦手术(ESS)是治疗上气道阻塞的常规方法。肥胖仍然是麻醉的一个危险因素。问题不仅涉及气道管理,而且涉及所有主要系统,是导致发病率和死亡率的主要因素。预测气道困难的临床指标是有帮助的,声门上气道装置(SGAs)在困难或插管失败的情况下是有用的。
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引用次数: 0
A Case Study of Prune Belly Syndrome with Congenital Vesico-Subumbilical Skin Fistula 梅干腹综合征合并先天性膀胱-脐下皮肤瘘1例
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.100254
A. Abuhamda, E. Mazen
Prune Belly Syndromes (PBS) usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with congenital vesico-subumbilical skin fistula in a Palestinian male neonate. The patient had defect abdominal muscles, wrinkled abdominal skin, cryptorchidism, urethral atresia, vesico-subumbilical skin fistula and normal kidney function. Baby was discharged home in general condition with once daily prophylactic dose of oral amoxicillin. The baby needed multidisciplinary team approach for surgical repair in future, include; paediatric surgeon, paediatric urologist, paediatric nephrologists and paediatrician.
除非胎儿膀胱和羊膜囊之间有通信,否则梅干腹部综合征(PBS)通常是致命的。我们报告一例PBS与先天性膀胱-脐下皮肤瘘在巴勒斯坦男性新生儿。患者腹部肌肉缺损,腹部皮肤起皱,隐睾,尿道闭锁,膀胱-脐下皮肤瘘,肾功能正常。婴儿出院时情况一般,每日口服一次阿莫西林预防治疗。婴儿未来需要多学科团队的手术修复方法,包括;儿科外科医生,儿科泌尿科医生,儿科肾病科医生和儿科医生。
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引用次数: 1
Oral Furosemide Therapy in Patients withExudative Retinal Detachment Due toHypertensive Retinopathy-IV 口服速尿治疗高血压视网膜病变致渗出性视网膜脱离- iv
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.100240
Ichsan Am, Stevanie, Habibah Sm, Budu
Introduction: Hypertensive retinopathy is a condition characterized by a spectrum of retinal vascular signs in people with elevated blood pressure. This condition can be accompanied by exudative retinal detachment in hypertensive retinopathy grade IV. Furosemide is considered as a diuretic agent to force fluid absorption across the retinal epithelium. This is consistent with a model for ion transport in the isolated RPE, in which active furosemide-inhibitable transport of chloride from retina to choroid for a significant fraction of the short-circuit current. Objectives: To report the efficacy of oral furosemide in patients with exudative retinal detachment due to hypertensive retinopathy-IV. Case presentation: We reported two young patients, first patient with chronic kidney disease complained with decreased of visual acuity to 20/100 in the right and 20/200 in the left eye. The second patient with preeclampsia suddenly experienced bilateral visual loss to counting finger on both eyes. Those patients showed sub-retinal fluid, macular star and cotton wool spots in both retina. Macular edema was seen by optical coherence tomography (OCT) examination in both eyes. Both cases were diagnosed as hypertensive retinopathy grade IV with exudative retinal detachment. Oral furosemide 40 mg once a day was given. On the first patient visual acuity improve to 20/80 on both eyes and on the second patient visual acuity improve to 20/400 on both eyes. Ocular ultrasonography (USG) examination showed significant decrease of exudative retinal detachment with in the 17 days. Conclusion: Furosemide is diuretic agent and might be effective in resolution of exudative retinal detachment followed by improvement of visual acuities in patient with hypertensive retinopathy grade IV.
高血压视网膜病变是一种以高血压患者的一系列视网膜血管征象为特征的疾病。IV级高血压视网膜病变可伴有渗出性视网膜脱离。速尿被认为是一种利尿剂,以迫使液体通过视网膜上皮吸收。这与孤立RPE中的离子传输模型是一致的,其中活性速尿抑制了氯从视网膜到脉络膜的传输,占短路电流的很大一部分。目的:观察口服速尿治疗高血压性视网膜病变所致渗出性视网膜脱离的疗效。病例介绍:我们报告了两名年轻患者,第一名患者患有慢性肾脏疾病,主诉视力下降至右眼20/100和左眼20/200。第二例先兆子痫患者突然双侧视力丧失,双眼无法数手指。患者双侧视网膜均出现视网膜下积液、黄斑星形和棉絮斑。光学相干断层扫描(OCT)检查发现双眼黄斑水肿。两例均诊断为IV级高血压性视网膜病变伴渗出性视网膜脱离。口服速尿40 mg,每日1次。第一个病人的双眼视力提高到20/80,第二个病人的双眼视力提高到20/400。眼超声检查显示渗出性视网膜脱离在17天内明显减少。结论:速尿是一种利尿剂,可有效解决IV级高血压视网膜病变渗出性视网膜脱离并改善视力。
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引用次数: 0
Imperforate Hymen with Hydrocolpos in Palestinian Neonate: A Case Report 巴勒斯坦新生儿处女膜闭锁伴阴道积水1例报告
Pub Date : 2018-01-01 DOI: 10.21767/2386-5180.100255
A. Abuhamda, Shady Abu El Ajeen, Wesam Shaltout, Salama Abu Nada
Neonatal hydrocolpos is a rare condition, if not diagnosed early could lead to lower urinary tract obstruction and renal failure. At 39th week gestational age antenatal ultrasound showed the fetus had lower abdominal mass 4 × 6 cm. By physical examination at birth, she was the girl with lower abdominal distension and she had a bulging imperforated hymen. Abdominal CT documented hydrocolpos. The pediatric surgeon did a small hymeneal incision, milky secretion drained and abdominal distension significantly improved.
新生儿水肠是一种罕见的情况,如果不及早诊断可能导致下尿路梗阻和肾功能衰竭。孕39周超声示胎儿下腹部肿块4 × 6 cm。出生时体格检查为下腹胀女童,处女膜膨出无穿孔。腹部CT显示直肠积液。小儿外科医生做了一个小的处女膜切口,乳白色分泌物排出,腹胀明显改善。
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引用次数: 0
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Annals of Clinical and Laboratory Research
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