Morphological,Functional, and Tissue Characterization of Silent Myocardial Involvement in Patients With Primary Biliary Cholangitis

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米索前列醇联合依沙吖啶在中晚期妊娠引产中的临床应用

目的 探讨米索前列醇联合依沙吖啶在中晚期妊娠引产中的应用效果。方法 选取西安交通大学附属3201医院2012年1月—2017年12月收治的138例中晚期妊娠引产患者，按引产方式分为对照组、观察组，各69例。对照组使用乳酸依沙吖啶注射液进行引产，观察组在对照组的基础上联合使用米索前列醇进行引产。比较两组引产效果、胎儿娩出时间、阴道出血量及不良反应的发生情况。结果 观察组引产有效率是100%，显著高于对照组的91.75%（P<0.05）。观察组胎儿娩出时间<35 h的人数占比显著高于对照组（P<0.05）。观察组患者阴道出血量显著低于对照组（P<0.05），两组不良反应的发生率间差异不显著。结论 米索前列醇联合依沙吖啶在中晚期妊娠引产中的效果较好，可显著提高引产有效率、缩短胎儿娩出时间，值得临床应用。     

The microbiome in pediatric oncology

The human microbiome comprises a diverse set of microorganisms, which play a mostly cooperative role in processes such as metabolism and host defense. Next-generation genomic sequencing of bacterial nucleic acids now can contribute a much broader understanding of the diverse organisms composing the microbiome. Emerging evidence has suggested several roles of the microbiome in pediatric hematology/oncology, including susceptibility to infectious diseases, immune response to neoplasia, and contributions to the tumor microenvironment as well as changes to the microbiome from chemotherapy and antibiotics with unclear consequences. In this review, the authors have examined the evidence of the role of the microbiome in pediatric hematology/oncology, discussed how the microbiome may be modulated, and suggested key questions in need of further exploration.     

Differentiating benign from malignant cardiac tumors with cardiac magnetic resonance imaging

Background

The purpose of this analysis is to describe the differences in cardiac magnetic resonance characteristics between benign and malignant tumors, which would be helpful for surgical planning.

Anton’s syndrome due to a giant anterior fossa meningioma. The problem of routine use of advanced diagnostic imaging in psychiatric care

Summary We present a case of blindness and Anton’s syndrome in a psychiatric patient with late diagnosis of a giant frontal meningioma. The criteria for advanced diagnostic imaging in the psychiatric population are discussed. We conclude that MR or CT scan is indicated in psychiatric in-patients who fail to improve with standard psychiatric treatment. This strategy should be submitted to a cost-benefit analysis.     

Mycophenolate Mofetil Use Is Associated with Decreased Risk of Late Acute Rejection in Adult Liver Transplant Recipients

Mycophenolate mofetil (MMF) used in a triple-drug regimen has been shown to decrease acute rejection rates, compared to a double-drug regimen. The impact of MMF on late acute rejection (LAR) episodes has not been well described. To investigate the risk of LAR (rejection > or = 6 months post-transplantation) data from the Scientific Registry of Transplant Recipients (SRTR) were used. We studied adult primary liver transplant recipients transplanted between June 1, 1995, and April 30, 2004, with hepatitis C virus (HCV) (n = 3356), hepatitis B virus (HBV) (n = 550) or a nonviral (n = 5740) primary cause of liver disease who were recorded as receiving continuous 3-(MMF + Tacro + steroids) versus 2-drug (Tacro + steroids) therapy for at least 6 months immediately post transplantation. Kaplan-Meier analysis showed significantly lower LAR rates 4 years post-transplant in 3- versus 2-drug HCV, HBV and nonviral disease patients. Multivariate regression confirmed 3- versus 2-drug therapy to be associated with a decreased risk of LAR. Late graft survival was significantly lower at 4 years post-transplant for patients with LAR 6-12 months post-transplantation versus patients with early rejection (78.0% vs. 87.0%, p < 0.001) and no rejection (88.1%, p < 0.001). Three-drug versus 2-drug therapy for a minimum of 6 months may offer a better treatment strategy to avoid the consequences and expense of LAR episodes.     

Neurology of the neuronal ceroid-lipofuscinoses: Late infantile and juvenile types

My experience with more than 80 cases of the late infantile and juvenile forms of the neuronal ceroid-lipofuscinoses over the last 5 years has led to the following realizations. The 2 variants are neurologically distinct entities and probably are the result of different genetic defects. Treatment includes supportive measures and anticonvulsant medication. Therapy for behavioral and psychiatric disturbances in the juvenile type proves to be particularly challenging as neuroleptic medications tend to worsen parkinsonian like symptoms. Neuropathologic and neuro radiologic explanation of clinical symptomatology correlates best with neuronal loss and not neuronal storage. There is a paucity of neuropathologic documentation of these 2 types; additional reports are encouraged.     

CT引导下无水乙醇阻滞双侧腹腔神经丛治疗腹部癌性疼痛的评价

目的探讨CT引导下腹腔神经丛无水乙醇阻滞治疗腹部癌性疼痛的价值。方法对无法切除和无法有效止痛的12例晚期上腹部癌症病例，CT引导下以无水酒精10-15毫升实施双侧腹腔神经丛阻滞。评价其止痛效果、不良反应、生存质量等。结果疼痛完全缓解7例，部分缓解3例，患者仅口服或肌注曲马多即能止痛．有效率83.3％；6例完全或部分缓解持续3个月，1例持续4．3个月。全部病例精神状态、饮食和睡眠明显好转。结论CT引导下腹腔神经丛无水乙醇阻滞可较有效地解除上腹部顽固性的癌性疼痛。