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Relieved Depressive State and Glycemic Control in Type 2 Diabetes (T2D) Patient Treated by Imeglimin (Twymeeg) 依美美明治疗2型糖尿病(T2D)患者抑郁状态缓解及血糖控制
Pub Date : 2023-06-12 DOI: 10.36502/2023/asjbccr.6303
M. Okada, H. Bando, Noboru Iwatsuki, K. Sakamoto, T. Ogawa
The patient is a 66-year-old female being treated for hypertension. She developed a cerebral vascular accident (CVA) in October 2019, and was subsequently diagnosed with type 2 diabetes (T2D) due to an HbA1c level of 9.8%. She began a low carbohydrate diet (LCD) and started taking oral hypoglycemic agents (OHAs) such as metformin and linagliptin. From July 2021, she occasionally experienced anxiety and palpitations, leading to a diagnosis of reactive depression (adjustment disorder). Despite treatment with etizolam as needed, these symptoms persisted. In December 2022, due to an increase in HbA1c levels to 7.7%, metformin was switched to imeglimin (Twymeeg). By April 2023, her HbA1c had decreased to 6.9%, and she reported a sustained sense of well-being without psychosomatic symptoms.
患者为66岁女性,正在接受高血压治疗。她于2019年10月发生脑血管意外(CVA),随后因HbA1c水平为9.8%而被诊断为2型糖尿病(T2D)。她开始低碳水化合物饮食(LCD),并开始服用口服降糖药(OHAs),如二甲双胍和利格列汀。从2021年7月起,她偶尔感到焦虑和心悸,导致诊断为反应性抑郁症(适应障碍)。尽管依需给予依替唑仑治疗,这些症状仍持续存在。2022年12月,由于HbA1c水平上升至7.7%,二甲双胍被换成了伊米明(Twymeeg)。到2023年4月,她的糖化血红蛋白已降至6.9%,并且她报告了持续的幸福感,没有心身症状。
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引用次数: 3
Acute Massive Pulmonary Embolism During Craniotomy: A Case Report 开颅术中急性大面积肺栓塞1例报告
Pub Date : 2023-06-06 DOI: 10.36502/2023/asjbccr.6302
Xuemei He, Rurong Wang, Ta-Yu Yang, Yali Chen
Background: Venous thrombosis is a common complication among critically ill patients with intracerebral hemorrhage, which may lead to pulmonary embolism.Case Presentation: In this report, we present a case of a man who was diagnosed with left basal ganglia region hemorrhage, hypertension, and venous thromboembolism. Considering the risks, including rebleeding and the expansion of the hematoma, he did not receive any anticoagulation after onset. The thrombus located in the pulmonary artery was found by transesophageal echocardiography after he suffered cardiac arrest during the craniotomy. Additionally, a thrombus attached to the central venous catheter was observed by ultrasound. Unfortunately, he died of PE without receiving any effective treatment.Conclusions: This case emphasizes the importance of prophylactic and therapeutic strategies for thromboembolic events among critically ill populations. It also underscores the critical role of perioperative ultrasound.
背景:静脉血栓形成是脑出血危重患者常见的并发症,可能导致肺栓塞。病例介绍:在这个报告中,我们提出了一个病例的男子谁被诊断为左基底节区出血,高血压,静脉血栓栓塞。考虑到再出血和血肿扩大的风险,他在发病后没有接受任何抗凝治疗。在开颅术中心脏骤停后经食管超声心动图发现血栓位于肺动脉。此外,超声观察到中心静脉导管上有血栓。不幸的是,他在没有接受任何有效治疗的情况下死于PE。结论:本病例强调了危重患者预防和治疗血栓栓塞事件策略的重要性。这也强调了围手术期超声的关键作用。
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引用次数: 0
CT Image of Consolidation and Ground-Glass Opacification (GGO) of COVID-19 in Diabetic Patient 糖尿病患者COVID-19实变及磨玻璃混浊(GGO)的CT表现
Pub Date : 2023-05-20 DOI: 10.36502/2023/asjbccr.6299
K. Ogura, H. Bando, Y. Kato, H. Yamashita, Y. Kato
The case involves a 70-year-old female with Type 2 Diabetes (T2D) who had been prescribed EquMet (vildagliptin/metformin) and had a stable HbA1c. In August 2022, she tested positive for real-time polymerase chain reaction (RT-PCR) without showing any symptoms. By November 2022, her HbA1c had increased to 7.4%, and a chest CT scan revealed a consolidation lesion in her left lower lung, suggesting post-inflammatory pathology of COVID-19. Imeglimin (Twemeeg) was added to her treatment regimen, and it proved effective, resulting in a 0.9% reduction in HbA1c over 4 months without any gastrointestinal adverse effects (GIAEs). The combined treatment of EquMet and Twymeeg was effective, and the interrelationship between T2D and COVID-19 will be followed up.
该病例涉及一名患有2型糖尿病(T2D)的70岁女性,她服用了EquMet(维格列汀/二甲双胍),并且HbA1c稳定。2022年8月,她的实时聚合酶链反应(RT-PCR)检测呈阳性,但没有出现任何症状。到2022年11月,她的糖化血红蛋白升高到7.4%,胸部CT扫描显示她的左下肺有实变病变,提示COVID-19炎症后病理。在她的治疗方案中加入了依米明(Twemeeg),事实证明它是有效的,在4个月的时间里,HbA1c降低了0.9%,没有任何胃肠道不良反应(giae)。EquMet与Twymeeg联合治疗有效,随访T2D与COVID-19的相互关系。
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引用次数: 1
Unexpected Bronchomalacia Combined with Excessive Dynamic Airway Collapse was Diagnosed by Intraoperative Bronchoscopy: A Case Report 术中支气管镜诊断意外支气管软化合并过度动态气道塌陷1例
Pub Date : 2023-05-10 DOI: 10.36502/2023/asjbccr.6298
Yuling Tang, Yu Li
Expiratory central airway collapse (ECAC) comprises tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC). ECAC is a progressive disease that can be congenital or acquired, and it can be confirmed by inspiratory-dynamic expiratory chest CT or dynamic bronchoscopy. We present the case of a 65-year-old man who underwent radiofrequency ablation for hepatocellular carcinoma under general anesthesia. After tracheal intubation in the operating room, the respiratory sound in the left lung disappeared, and the respiratory sound in the right lung was clear during chest auscultation. Bronchoscopy revealed complete collapse of the left main bronchus. Intraoperative bronchoscopy confirmed that the patient had ECAC (both TBM and EDAC).
呼气性中央气道塌陷(ECAC)包括气管支气管软化症(TBM)和过度动态气道塌陷(EDAC)。ECAC是一种进行性疾病,可先天性也可获得性,可通过吸气-动态呼气胸部CT或动态支气管镜检查确诊。我们报告一位65岁男性病患,在全身麻醉下接受肝细胞癌的射频消融。在手术室气管插管后,左肺呼吸音消失,胸部听诊时右肺呼吸音清晰。支气管镜检查显示左主支气管完全塌陷。术中支气管镜检查证实患者有ECAC (TBM和EDAC)。
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引用次数: 0
Ultrasound-Guided Pericapsular Nerve Group (PENG) Block Combined with Lateral Femoral Cutaneous Nerve Block for Total Hip Arthroplasty 超声引导下囊周神经群阻滞联合股外侧皮神经阻滞用于全髋关节置换术
Pub Date : 2023-05-05 DOI: 10.36502/2023/asjbccr.6297
Jun Li, Rurong Wang
With the arrival of an aging society and the progress of surgical procedures, total hip arthroplasty (THA) has been carried out more and more. However, postoperative pain severely affected the patient’s recovery, and there is currently no reliable analgesic method available. Evidence-based international expert consensus also recommends, compared to LIA, peripheral nerve block (PNB) as a central analgesic approach use in THA for improved outcomes [1]. In this case report, we described 4 cases of postoperative analgesia with pericapsular nerve group (PENG) block combined with lateral femoral cutaneous nerve block (LFCNB) in patients undergoing THA.
随着老龄化社会的到来和外科技术的进步,全髋关节置换术的应用越来越广泛。然而,术后疼痛严重影响患者的康复,目前尚无可靠的镇痛方法。以证据为基础的国际专家共识还建议,与LIA相比,外周神经阻滞(PNB)作为THA的中枢镇痛方法可改善预后[10]。在本病例报告中,我们描述了4例THA患者术后使用包膜神经阻滞(PENG)联合股外侧皮神经阻滞(LFCNB)镇痛。
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引用次数: 0
Airway Management of a Patient with Montgomery T-tube in situ undergoing Neurosurgery 一例Montgomery T型管原位神经外科患者的气道管理
Pub Date : 2023-04-29 DOI: 10.36502/2023/asjbccr.6296
Yongwei Su, Xiaoqiang Li
This article stipulates the airway management in a patient requiring cranial debridement and cranioplasty with a Montgomery T-tube (MTT) in situ. Anesthetic techniques that have been previously described for surgeries with MTT in situ which can be managed by applying a laryngeal mask or intubating a trachea tube easily. The airway management of patients with an MTT in situ, requiring a supine position with the head rightly tilted and flexed, has not yet been addressed. In this article, we explored some possible approaches to cope with this arising problem. We present how we managed to intubate a double-lumen endotracheal tube onto the superior tracheal limb of the T-tube since the 5.0 mm ID tracheal tube (equivalent to a 6.9 mm ED) could not pass through the tube readily. This technique could possibly be considered for patients in similar clinical scenarios.
本文规定了一名需要进行颅骨清创术和原位蒙哥马利T型管颅骨成形术的患者的气道管理。先前描述的用于MTT原位手术的麻醉技术,可以通过应用喉罩或气管插管轻松管理。原位MTT患者的气道管理,需要仰卧位,头部正确倾斜和弯曲,尚未得到解决。在这篇文章中,我们探讨了一些可能的方法来处理这个出现的问题。我们介绍了我们是如何将双腔气管插管插管到T型管的气管上肢上的,因为5.0 mm内径的气管插管(相当于6.9 mm ED)无法轻易穿过插管。这项技术可能被考虑用于类似临床情况下的患者。
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引用次数: 0
Ultrasound-Guided Transmuscular Quadratus Lumborum Block Provides Effective Postoperative Analgesia for High Ligation of Spermatic Vein 超声引导下腰四方肌阻滞对精静脉高位结扎术后镇痛效果观察
Pub Date : 2023-04-21 DOI: 10.36502/2023/asjbccr.6295
Jun Ma, Hongwei Xu
Postoperative pain management after varicocele surgery poses a challenge for pediatric patients. The quadratus lumborum block (QLB) is a novel regional analgesia technique that entails injecting a local anesthetic around the quadratus lumborum muscle using ultrasound guidance. In this study, we present the utilization of a single transmuscular QLB in two children as an effective postoperative analgesic method for laparoscopic extraperitoneal high ligation of the spermatic vein (LEHLSV).
精索静脉曲张手术后的疼痛管理对儿科患者提出了挑战。腰方肌阻滞(QLB)是一种新型的局部镇痛技术,需要在超声引导下在腰方肌周围注射局部麻醉剂。在本研究中,我们介绍了在两名儿童中使用单个经肌QLB作为腹腔镜下精索静脉高位结扎(LEHLSV)的有效术后镇痛方法。
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引用次数: 0
Vogt-Koyanagi-Harada Syndrome in a Pregnant Patient with Azathioprine-Induced Hepatitis and Cholestasis Vogt-Koyanagi-Harada综合征合并硫唑嘌呤引起的肝炎和胆汁淤积的妊娠患者
Pub Date : 2023-04-17 DOI: 10.36502/2023/asjbccr.6294
Tahani Aljuhani
Vogt-Koyanagi-Harada disease (VKH) is a central nervous system condition that specifically affects vision and hearing. Descriptions of this disease date back to the 12th century, but the disease is named after three 20th-century physicians who described the collective manifestations of this disease. Alfred Vogt initially described bilateral iridocyclitis and eyebrow depigmentation in 1906, followed by Yoshizo Koyanagi’s 1926 description of bilateral serous detachments in association with cerebrospinal fluid (CSF) pleocytosis. Einosuke Harada identified the integumentary symptoms of the condition shortly thereafter. The disease presents with signs and symptoms of a loss of immune tolerance to melanocytes within the meninges, eyes, skin, hair, and ears [1]. The exact etiology of VKH is not firmly established, but current theories posit that patients develop T cell-mediated immunity against melanocytes following recovery from an inciting viral environmental factor [2]. Recent genetic studies have implicated the presence of human leukocyte antigen (HLA) cell surface markers HLA-DRB4, HLA-DRB1-04*05, and HLA-DRB-04*01, as well as non-HLA genes involving lymphocyte regulations in IL-12 production and IL-17 production [3,4]. Downregulation of microRNA in the production of interleukins and changes in non-coding RNA may also play a role in this condition [5].
Vogt-Koyanagi-Harada病(VKH)是一种中枢神经系统疾病,特别影响视力和听力。这种疾病的描述可以追溯到12世纪,但这种疾病是以三位20世纪的医生命名的,他们描述了这种疾病的集体表现。Alfred Vogt最初于1906年描述了双侧虹膜睫状体炎和眉毛色素脱失,随后是Yoshizo Koyanagi在1926年描述了与脑脊液(CSF)多细胞症相关的双侧浆液脱离。此后不久,Einosuke Harada发现了这种疾病的表皮症状。该病表现为脑膜、眼睛、皮肤、头发和耳部黑色素细胞免疫耐受丧失的体征和症状。VKH的确切病因尚不明确,但目前的理论认为,患者在从刺激的病毒环境因子[2]中恢复后,会产生T细胞介导的针对黑素细胞的免疫。最近的遗传学研究表明,存在人类白细胞抗原(HLA)细胞表面标记物HLA- drb4、HLA- drb1 -04*05和HLA- drb -04*01,以及参与淋巴细胞调节IL-12和IL-17产生的非HLA基因[3,4]。白细胞介素生成过程中microRNA的下调和非编码RNA的变化也可能在这种情况下发挥作用[0]。
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引用次数: 0
Combined Treatment of Vildagliptin/Metformin (Equmet) and Imeglimin (Twymeeg) with Clinical Efficacy 维格列汀/二甲双胍(Equmet)与依米明(Twymeeg)联合治疗临床疗效观察
Pub Date : 2023-04-14 DOI: 10.36502/2023/asjbccr.6293
H. Bando, H. Yamashita, Y. Kato, K. Ogura, Y. Kato
Background: Vildagliptin/Metformin (EquMet) and imeglimin (Twymeeg) are effective oral hypoglycemic agents (OHAs) for patients with type 2 diabetes (T2D).Case Presentation: The patient was a 68-year-old male with T2D and fatty liver for several years. In November 2022, his HbA1c had increased to 8.2%, and he was started on Twymeeg, followed by EquMet.Results: Over the course of four months, the patient’s HbA1c value successfully decreased from 8.2% to 6.7%, and he did not experience any gastrointestinal adverse effects (GIAEs).Discussion and Conclusion: The combined treatment of EquMet and Twymeeg demonstrated clinical efficacy without any adverse effects. The Trials of IMeglimin for Efficacy and Safety (TIMES) provided various evidence of imeglimin’s effectiveness.
背景:维格列汀/二甲双胍(EquMet)和伊美米明(Twymeeg)是治疗2型糖尿病(T2D)的有效口服降糖药(OHAs)。病例介绍:患者为男性,68岁,t2dm合并脂肪肝多年。2022年11月,他的糖化血红蛋白上升到8.2%,开始服用Twymeeg,随后服用EquMet。结果:在4个月的治疗过程中,患者的HbA1c值成功地从8.2%降至6.7%,且未出现任何胃肠道不良反应(giae)。讨论与结论:EquMet与Twymeeg联合治疗临床疗效良好,无不良反应。伊美美明的疗效和安全性试验(TIMES)提供了伊美美明有效性的各种证据。
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引用次数: 4
Research Progress on Prevention and Treatment of Hypoxemia in Painless Gastroscopy: A Review Article 无痛胃镜检查中低氧血症防治研究进展综述
Pub Date : 2023-04-08 DOI: 10.36502/2023/asjbccr.6291
Jun Ma, L. Tan
Compared to ordinary gastroscopy, painless gastroscopy has more advantages due to the application of anesthesia techniques such as sedation and analgesia, providing patients with comfort and a quick recovery. However, patients undergoing painless gastroscopy are often at risk of hypoxia, which can result in serious complications. Fortunately, more anesthesia providers have recognized this problem. Therefore, it is essential for anesthesia providers to identify risk factors to prevent hypoxemia. In conclusion, this review highlights the assessment of risk factors for hypoxemia in painless gastroscopy and common airway management methods to prevent and treat hypoxemia in high-risk populations during painless endoscopy.
与普通胃镜相比,无痛胃镜由于应用了镇静、镇痛等麻醉技术,为患者提供了舒适和快速康复的机会,因此具有更多的优势。然而,接受无痛胃镜检查的患者往往有缺氧的风险,这可能会导致严重的并发症。幸运的是,越来越多的麻醉提供者已经认识到了这个问题。因此,麻醉提供者识别危险因素以预防低氧血症是至关重要的。总之,这篇综述强调了无痛胃镜检查中低氧血症危险因素的评估,以及预防和治疗无痛胃镜检查期间高危人群低氧血症的常见气道管理方法。
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引用次数: 0
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Asploro journal of biomedical and clinical case reports
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