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BACKGROUND: Autoimmune pancreatitis (AIP) is increasingly recognized as a unique subtype of pancreatitis. This study aimed to analyze the diagnosis and treatment of AIP patients from a tertiary care center in China.
METHODS: One hundred patients with AIP who had been treated from January 2005 to December 2012 in our hospital were enrolled in this study. We retrospectively reviewed the data of clinical manifestations, laboratory tests, imaging examinations, pathological examinations, treatment and outcomes of the patients.
RESULTS: The median age of the patients at onset was 57 years (range 23-82) with a male to female ratio of 8.1:1. The common manifestations of the patients included obstructive jaundice (49 patients, 49.0%), abdominal pain (30, 30.0%), and acute pancreatitis (11, 11.0%). Biliary involvement was one of the most extrapancreatic manifestations (64, 64.0%). Fifty-six (56.0%) and 43 (43.0%) patients were classified into focal-type and diffuse-type respectively according to the imaging examinations. The levels of serum IgG and IgG4 were elevated in 69.4% (43/62) and 92.0% (69/75) patients. Pathological analysis of specimens from 27 patients supported the diagnosis of lymphoplasmacytic sclerosing pancreatitis, and marked (>10 cells/HPF) IgG4 positive cells were found in 20 (74.1%) patients. Steroid treatment and surgery as the main initial treatments were given to 41 (41.0%) and 28 (28.0%) patients, respectively. The remission rate after the initial treatment was 85.0%. Steroid was given as the treatment after relapse in most of the patients and the total remission rate at the end of follow-up was 96.0%.
CONCLUSIONS: Clinical manifestations, laboratory tests, imaging and pathology examinations in combination could increase the diagnostic accuracy of AIP. Steroid treatment with an initial dose of 30 or 40 mg prednisone is effective and safe in most patients with AIP.  相似文献   
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Hepatitis A and hepatitis E are acute infectious diseases caused by hepatitis A virus (HAV) and hepatitis E virus (HEV), which are mainly transmitted through the fecal-oral route [1]. The early clinical symptoms of patients with hepatitis A or E are nonspecific, including fever, chills, abdominal pain, diarrhea, and rash [2]. Moreover, the levels of specific laboratory diagnostic biomarkers, such as serum anti-HAV/HEV IgM antibodies, are too low to be detectable which make the early diagnosis difficult [1,3]. These patients are sometimes misdiagnosed in the early stage which result in inappropriate treatments [1]. Atypical lymphocyte is most common in Epstein-Barr virus (EBV) infection [4,5]. However, there are few reports of atypical lymphocyte caused by hepatitis virus. In this study, we report two cases of acute hepatitis with atypical lymphocyte to provide values for the diagnosis of the disease.  相似文献   
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Background: Minimally invasive surgery is becoming increasingly popular in the field of pancreatic surgery. However, there are few studies of robotic distal pancreatectomy(RDP) for pancreatic ductal adenocarcinoma(PDAC). This study aimed to investigate the efficacy and feasibility of RDP for PDAC. Methods: Patients who underwent RDP or laparoscopic distal pancreatectomy(LDP) for PDAC between January 2015 and September 2020 were reviewed. Propensity score matching analyses were performed. Results...  相似文献   
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PURPOSETo facilitate understanding of limbic lobe anatomy by showing embryologic transformations of the medial surface of the cerebral hemisphere.METHODSBrains from fetal specimens ranging from 13 to 24 weeks of gestational age were dissected. Photographs were made of the medial surface of the cerebral hemisphere. MR images of different fetal specimens of similar age were made for comparison of MR anatomy with dissected material.RESULTSAt 13 weeks, the entire inner limbic arch of the hippocampal formation is visible on the medial surface of the cerebral hemisphere. The hippocampal sulcus extends from frontal lobe to temporal lobe. At 16 weeks, the outer neocortical limbic arch of the subcallosal area, cingulate gyrus, and parahippocampus gyrus is present. Growth of the corpus callosum is associated with reduction in size of the hippocampal formation in the frontal lobe. The sulcus of the corpus callosum is the remnant of the anterior part of the hippocampal sulcus. At 18 weeks, growth of the parahippocampal gyrus begins to conceal the hippocampal formation. The supracallosal gyrus (indusium griseum), hidden from view by the corpus callosum, and the paraterminal gyrus are remnants of the previously larger hippocampal formation.CONCLUSIONSAnalysis of fetal specimens in different developmental stages with dissection and MR provides insight into embryologic transformations responsible for the complex anatomy of the limbic lobe.  相似文献   
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