Comprehensive Tool to Assess Oral Feeding Support for Functional Recovery in Post-acute Rehabilitation

Objective

To determine the influence of the Kuchi-kara Taberu (KT) index on rehabilitation outcomes during hospitalized convalescent rehabilitation.

Intrathoracic caudate lobe of the liver:A case report and literature review

Heterotopic supradiaphragmatic livers are rare.A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature.The clinical presentations of heterotopic supradiaphragmatic liver are variable.The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare,and only one case has previously been reported.It is difficult to make a correct diagnosis preoperatively.We presented a 53-year-old woman with complaints of an intermittent,productive cough and dyspnea for two months that was refractory to medical treatment.She had no previous history of trauma or surgery.A chest radiograph only showed a widening of the mediastinum.Contrast-enhanced computed tomography of the chest revealed a well-circumscribed homogenous soft-tissue mass,approximately 4.35 cm×2.5 cm×6.14 cm in size,protruding through the right diaphragmatic crura to the right pleural cavity,attached to the inferior vena cava,esophagus and liver.There was no conclusive diagnosis before surgery.After the operation,we discovered that this patient was the first case of a supradiaphragmatic heterotopic liver,which passed through the inferior vena cava foramen and was coincidentally combined with an intralobar pulmonary sequestration that was found intraoperatively.We discussed its successful management with surgical resection via a thoracic approach and reviewed the published literature.     

噻托溴铵治疗中重度支气管哮喘30例临床观察

目的:探讨噻托溴铵在中重度支气管哮喘治疗中的意义。方法:将60例中重度支气管哮喘患者随机分为观察组和对照组,两组患者均依据2009 GINA规范治疗3个月,其中观察组每天增加吸入一次噻托溴铵18μg。比较两组患者治疗前后性别、年龄、病程、哮喘控制测试(ACT)评分、血清免疫球蛋白E(IgE)、嗜酸细胞计数(EOS)、吸入支气管扩张剂后一秒钟用力呼气量(FEV1)、用力呼气中期流速(FEF25%~75%)值、用力呼气峰速(PEF)及每周急救药使用次数等指标变化并进行统计学分析。结果:①两组间患者性别、年龄、病程、治疗前各指标差异无统计学意义(P0.05)。②治疗后两组各指标与治疗前比较,差异有统计学意义(P0.01)。③治疗后,观察组的ACT评分、FEV1、PEF、FEF及每周急救药使用喷数与对照组比较,差异有统计学意义(P0.01)。治疗后观察组EOS、IgE与对照组比较,差异无统计学意义(P0.05)。结论:噻托溴铵治疗中重度支气管哮喘有效,且以扩张气道、改善症状和肺功能为主,其是否有非特异性抗炎作用还需进一步研究论证。