Peliosis lienalis with atraumatic splenic rupture in a patient with chronic myelomonocytic leukemia: A case report

IntroductionAtraumatic splenic rupture is a rare but life-threatening condition which may be associated with hematological malignancies.Presentation of caseWe present the case of a 63-year-old male patient with a history of chronic myelomonocytic leukemia and sarcoidosis under therapy with prednisone, who suffered an atraumatic splenic rupture with hemodynamic instability. He was managed with proximal splenic artery embolization and secondary open splenectomy. On pathology the diagnosis of peliosis lienalis was established.DiscussionPeliosis is a rare pathological entity, which presents with multiple blood-filled cavities within parenchymatous organs and is of unknown etiology and pathogenesis. In retrospect a rapid increase in splenomegaly and inhomogeneous parenchyma of the spleen on sonography was realized.ConclusionSonographic changes in size and parenchyma of the spleen in patients with hematological malignancies might help suspecting peliosis lienalis with impending splenic rupture and could alter clinical management towards a prophylactic splenectomy.     

Spontaneous regression of lung metastases in hepatocellular carcinoma: A case report

IntroductionSpontaneous regression of hepatocellular carcinoma (HCC) is a rare condition. However, although there have been multiple reports of spontaneous regression, the definitive pathogenic mechanism of this phenomenon is still unclear.Case presentationWe encountered a case of a 78-year-old man who was undergoing dialysis for end-stage kidney disease with hepatitis C virus-associated chronic hepatitis presenting with HCC. The patient had previously undergone right lobectomy of the liver, but the cancer recurred with multiple lung metastases after 5 months. Approximately 13 months after the initial diagnosis of recurrence, the lung metastases decreased in size and eventually resolved without any anticancer therapy. The patient remains alive for over 41 months after recurrence.DiscussionBased on our case and literature, Hypoxia with hypotension due to hemodialysis can reduce the blood and oxygen supply of the body, which may lead to the spontaneous regression of the metastatic tumors.ConclusionWe herein reported a case of spontaneous regression of HCC undergoing dialysis.     

中国国家出生队列建设背景和设计简介

随着生活行为方式、自然和社会环境的急剧变化,育龄人口生殖健康状况持续下降,快速增加的由辅助生殖技术（ART）孕育的子代的远期健康状况亟待评估。因此,妇幼保健和生殖健康相关研究关注的重点亟需从妊娠期、围产期的死亡和严重疾病表型逐渐向全生命周期和全疾病谱拓展。为了满足这样的研究需求,在我国12个省（自治区、直辖市）启动了中国国家出生队列（China National Birth Cohort）建设,计划以家庭为单位,招募3万个自然妊娠家庭和3万个ART家庭的人群,并对夫妻双方以及孕育的子代开展长期随访,收集夫妻和子代的环境暴露、生殖生育、精神心理、行为习惯等多方面暴露数据。同时采集外周血、尿液、脐血、卵泡液和精浆、精子等多种类型的生物样本。该出生队列对于我国妇幼健康和生殖医学研究具有极其重要支撑作用和深远影响。本文即是对国家出生队列的建设概况和基本设计做简要介绍。     

中国国家出生队列研究调查对象的基线特征分析

目的 探讨生命早期环境因素、遗传因素和遗传与环境交互作用对子代近期和远期健康的影响以及系统评价和比较辅助生殖受孕和自然受孕人群的妊娠结局和子代健康相关结局。方法 中国国家出生队列（CNBC）研究是一项覆盖辅助生殖受孕家庭和自然受孕家庭的多中心前瞻性出生队列研究。2016年,CNBC项目陆续在我国12个省（自治区、直辖市）的24所医院启动,以家庭为单位纳入研究对象,并在辅助生殖治疗前、胚胎移植、孕早期、孕中期、孕晚期及分娩时以及出生后第42天、6个月、12个月、36个月多个时点采集数据信息和生物样本。结果 截至2020年6月,CNBC共纳入27 044个辅助生殖受孕家庭,29 589个自然受孕家庭,CNBC的研究人群中绝大部分为城市居民。在辅助生殖受孕家庭中,男女双方分别有65.5%和63.7%为大学及以上文化程度,年龄为（33.83±5.52）和（32.38±4.67）岁;女方83.2%为初产妇,吸烟率为0.8%,饮酒率为2.1%。在自然受孕家庭中,男女双方分别有81.5%和86.5%为大学及以上文化程度,年龄为（32.06±5.09）和（30.40±4.27）岁,女方67.2%为初产妇,吸烟率为0.1%,饮酒率为2.2%。不同地区的辅助生殖受孕家庭和自然受孕家庭的基线特征均有差异。结论 CNBC的建立将为研究生命早期遗传、环境因素、遗传-环境交互作用以及辅助生殖技术治疗相关因素对出生后子代健康的影响提供了重要资源。     

History of pandemic H1N1-containing influenza vaccination and risk for spontaneous abortion and birth defects

BackgroundOne recent study suggested an association between receipt of pandemic H1N1 (pH1N1)-containing vaccines in consecutive influenza seasons and spontaneous abortion, but corroborating scientific evidence is limited. In the present study, we leveraged a population of vaccine-compliant pregnant military women to examine history of pH1N1-containing influenza vaccination and adverse pregnancy outcomes. Because seasonal influenza vaccination is compulsory for military service, safety concerns regarding repeat vaccination are particularly relevant in this population.MethodsPregnancies and live births from Department of Defense Birth and Infant Health Research program data were linked with military personnel immunization records to identify women vaccinated with a pH1N1-containing vaccine in pregnancy prior to 21 6/7 weeks’ gestation, October 2009–April 2015. Cox and modified Poisson regression models estimated associations between vaccination with pH1N1- versus non–pH1N1-containing influenza vaccine in the season prior to the index pregnancy, and spontaneous abortion and birth defects, respectively. Cox models were calculated for two periods of follow-up: through (1) 21 6/7 weeks’ gestation and (2) 28 days postvaccination.ResultsOf 26,264 pregnancies, 21,736 (82.8%) were among women who received a dose of pH1N1-containing vaccine in the prior influenza season and 4,528 (17.2%) were among women who received non–pH1N1-containing vaccine in the prior influenza season. Among 23,121 infants, 19,365 (83.8%) and 3,756 (16.2%) had mothers exposed and unexposed to pH1N1-containing vaccine in the prior influenza season, respectively. The adjusted hazard ratio (aHR) for spontaneous abortion approximated 1.0 across the complete follow-up period (95% confidence interval [CI]: 0.89–1.13) and was slightly elevated when censored at 28 days postvaccination, though the CI was imprecise (aHR: 1.19; 95% CI: 0.97–1.46). No associations with birth defects were observed.ConclusionThis work lends additional safety evidence and support for vaccination against pH1N1 in pregnancy, regardless of the vaccine received in the prior influenza season.     

Modification of spontaneous activity in primary vestibular neurons during development in the cat

Summary The spontaneous activity of primary vestibular neurons was studied during postnatal development in the cat. Activities were categorized as regular, intermediate and irregular on the basis of the coefficient of variation. At birth, few regularly firing units were found while the percentage of intermediate and irregular units was high. During development, the percentage of units meeting the criterion of regularity increased steadily with age. At the same time the number of intermediate and irregular units decreased. The average resting rate of all categories of unit showed an increase in firing from birth up to the adult stage, i. e., around the second postnatal month. The mean firing rate of regularly firing units was always higher than the two other categories throughout all the stages of development. These results were compared with similar work performed in the rat.Supported by grants from the C.N.R.S. (E.R.A.-187) and D.G.R.S.T. (no. 79-7-1073)     

支气管哮喘与行为特征的关系

目的：了解支气管哮喘患儿的行为特征,找出行为特征与支气管哮喘相互关系的规律。方法：使用Rutter行为量表对小儿支气管哮喘病人做心理测验,先将男女在一组比较,再将男女分成两组分别比较,将每组的总分数、神经质（N）和焦虑（A）比较,进行统计学处理,最后再分析检验组具体的行为问题的发生率。结果：总体比较检验组的总分及神经质和焦虑的分数均高于对照组;男患儿组的总分与N分数明显高于对照组;女患儿组的总分与A分数明显高于对照组。结论：支气管哮喘患儿较普通儿童有较多的行为问题,在生物学治疗的同时也需要考虑行为问题的矫正。     

Video-assisted thoracoscopic suturing of apical bullae

We prospectively studied thoracoscopic suturing of apical bullae in the management of primary spontaneous pneumothorax. From June 1993 to July 1994, we performed 29 such procedures in 27 patients. (All males ranging in age from 15 to 40.) Bullae less than 2 cm in diameter were imbricated (18), while larger bullae were resected and repaired with 3/0 polypropylene suture (11). Postoperative morbidity was minimal. Averaged postoperative parenteral narcotic (Pethidine) requirement was 88 mg, chest drainage was 1.7 (range 1–4) days, and hospital stay was 2.5 (range 1–7) days. There was no recurrence after a mean follow-up of 10 months. In comparison, 32 patients prior to this study period underwent staple resection of apical bulla. Demographic data in the two groups were similar. Averaged Pethidine requirement in the staple group was 98 mg, chest drainage was 1.8 (range 1–5) days, and hospital stay was 2.6 (range 1–7) days. There was no statistical difference in the two groups with respect to pain medication, chest drainage, or hospital stay. The technique of thoracoscopic suturing can be easily acquired. In view of the high cost of staple-cutters, endoscopic suturing should be considered as a viable alternative to staple resection of apical bullae in the treatment of primary spontaneous pneumothorax.Presented in part at the 4th World Congress of Endoscopic Surgery, Kyoto, Japan, June 16–19, 1994 [6]