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1.
《Journal of plastic, reconstructive & aesthetic surgery》2022,75(1):145-151
BackgroundNecrotising myositis (NM) is a life-threatening emergency. Prompt treatment is associated with more favourable outcomes, but early diagnosis is challenging. The initial absence of cutaneous signs and symptoms coupled with delayed recognition commonly result in higher rates of morbidity and mortality.ObjectivesAnalyse data regarding demographics, epidemiology, aetiology, clinical manifestations, diagnosis and treatment of previously reported cases. This publication is intended for plastic surgeons in training to help them look out for this disease.Search methods/criteriaPublications reporting necrotising myositis between 1974 to January 2020 were identified from Embase, Medline All, Web of Science Core Collection, Google Scholar and Cochrane Central Register of Controlled Trial.Data collection and analysis: Identified studies were exported to an end note library. In animal studies, studies relating to statin-induced myotoxicity and auto-immune myositis were excluded. The quality of included case reports was assessed using JBI Critical Appraisal Checklist for Case Reports.Main resultsThe most common initial presentation was a few days of antecedent prodromal flu-like symptoms associated with muscle pain. The mean age was 43.3 years and 82% had no significant medical history. The most frequent misdiagnoses were muscle strain (11%), deep vein thrombosis (10%) and viral illness (9%). Seventy-four per cent of presentations were due to Group A Streptococcus infections and only 3.5% of cases were polymicrobial. The most common clinical course following the initial presentation was rapid deterioration into profound sepsis and progression into multi-organ failure. The overall mortality rate was 36.5%.ConclusionsNM is a life-threatening muscle infection. It is a diagnostic conundrum as initial presentation is often only myalgia without features of preceding trauma. We propose that a high index of suspicion and increased awareness will reduce morbidity.OtherPROSPERO (registration number CRD42018087060). Nil funding/conflict of interest. 相似文献
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《HPB : the official journal of the International Hepato Pancreato Biliary Association》2022,24(5):681-690
BackgroundThe American Joint Committee on Cancer (AJCC) made improvements for staging pancreatic neuroendocrine tumors (pNETs) in its 8th Edition; however, multicenter studies were not included.MethodsWe collected multicenter datasets (n = 1,086, between 2004 and 2018) to validate the value of AJCC 8 and other coexisting staging systems through univariate and multivariate analysis for well-differentiated (G1/G2) pNETs.ResultsCompared to other coexisting staging systems, AJCC 7 only included 12 (1.1%) patients with stage III tumors. Patients with European Neuroendocrine Tumor Society (ENETS) stage IIB disease had a higher risk of death than patients with stage IIIA (hazard ratio [HR]: 4.376 vs. 4.322). For the modified ENETS staging system, patients with stage IIB disease had a higher risk of death than patients with stage III (HR: 6.078 vs. 5.341). According to AJCC 8, the proportions of patients with stage I, II, III, and IV were 25.7%, 40.3%, 23.6%, and 10.4%, respectively. As the stage advanced, the median survival time decreased (NA, 144.7, 100.8, 72.0 months, respectively), and the risk of death increased (HR: II = 3.145, III = 5.925, and IV = 8.762).ConclusionThese findings suggest that AJCC 8 had a more reasonable proportional distribution and the risk of death was better correlated with disease stage. 相似文献
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《Vaccine》2022,40(16):2370-2378
Porcine reproductive and respiratory syndrome virus (PRRSV) and Mycoplasma hyopneumoniae (M. hyopneumoniae, Mhp) are two of the most common pathogens involved in the porcine respiratory disease complex (PRDC) resulting in significant economic losses worldwide. Vaccination is the most effective approach to disease prevention. Since PRRSV and Mhp co-infections are very common, an efficient dual vaccine against these pathogens is required for the global swine industry. Compared with traditional vaccines, multi-epitope vaccines have several advantages, they are comparatively easy to produce and construct, are chemically stable, and do not have an infectious potential. In this study, to develop a safe and effective vaccine, B cell and T cell epitopes of PRRSV-GP5, PRRSV-M, Mhp-P46, and Mhp-P65 protein had been screened to construct a recombinant epitope protein rEP-PM that has good hydrophilicity, strong antigenicity, and high surface accessibility, and each epitope is independent and complete. After immunization in mice, rEP-PM could induce the production of high levels of antibodies, and it had good immunoreactivity with anti-rEP-PM, anti-PRRSV, and anti-Mhp antibodies. The anti-rEP-PM antibody specifically recognizes proteins from PRRSV and Mhp. Moreover, rEP-PM induced a Th1-dominant cellular immune response in mice. Our results showed that the rEP-PM protein could be a potential candidate for the development of a safe and effective multi-epitope peptide combined vaccine to control PRRSV and Mhp infections. 相似文献
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目的评价屈颈MRI对青年性上肢远端肌萎缩症的诊断价值。方法男性患者5例,平均年龄21岁,临床表现为一侧或两侧上肢远端肌萎缩。对照组为健康志愿者,21岁男性8例。2组均行常规及屈颈颈椎MR平扫,矢状、轴面SET1WI、T2WI、液体衰减反转恢复(FLAIR)序列扫描。结果常规颈椎扫描:5例患者下段颈髓变细;屈颈位MR扫描:下颈段颈6以下脊髓前屈、变扁平,矢状径4~6mm,硬膜囊后壁前移,硬膜后间隙明显增宽,可见多发条状、迂曲流空信号影及软组织信号。对照组:常规扫描,下颈段脊髓(颈6~胸2)可见颈膨大,屈颈位脊髓略变细(6~7mm),硬膜囊后壁无前移,硬膜后间隙未见扩张血管影。结论屈颈MRI有助于显示下颈段脊髓及硬膜囊改变,结合临床资料可准确诊断青年性上肢远端肌萎缩症。 相似文献
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用颈长肌重建预防颈前路植骨块滑脱的临床应用 总被引:5,自引:1,他引:4
目的:探讨颈长肌重建对颈椎前路手术并发症的预防作用。方法:将颈椎病确诊病例分为实验组126例和对照组128例。对照组病例采用颈椎前路减压、植骨和/或钢板内固定术。实验组病例在完成上述手术之后,利用两种方法使颈长肌瓣重建植骨块或钢板表面。两组病例术后均获得随访,并将两组术后疗效及手术并发症的随访结果进行统计学分析。结果:两组术后随访0.5~6年,平均3.5年。根据Odom评分标准,对两组术后临床疗效进行评价,经统计学分析,P>0.05,说明两组术后疗效无明显差异。而对两组病例术后并发症的统计学分析,P<0.05,两组有统计学意义,表明颈长肌重建可以减少术后并发症的发生。结论:颈长肌重建是预防颈椎前路手术并发症的一种有效方法。 相似文献
10.
目的探讨不同浓度的富组蛋白5(histidine rich protein5,HRPs5)在体外杀灭白念珠菌孢子、芽管的作用及抑制孢子形成芽管的作用。方法将一定数量的孢子和芽管分别与不同浓度的HRPs5混合培养后,置于400倍的倒置显微下观察菌落数,得出杀孢子率、杀芽管率和抑制孢子不形成芽管率。结果当25μml或更高浓度的HRPs5和白色念珠菌孢子作用后,可使90%以上的孢子丧失活力;100μml的HRPs5和白色念珠菌芽管作用后,可使90%以上的孢子丧失活力;400μg/ml的HRPs5和白色念珠菌孢子作用后,可使100%孢子受到抑制而不形成芽管。而50μg/ml的HRPs5对白色念珠菌孢子形成芽管仅有轻微的抑制作用。结论HRPs5在体外具有较强杀灭白念珠菌孢子、芽管的作用及抑制孢子形成芽管的作用,且随着HRPs5浓度的升高其作用愈强。 相似文献