A case of recurrent pneumothorax related to oral methylphenidate

Primary spontaneous pneumothorax (PSP) commonly occurs in young, tall, and thin males, without any identifiable cause except for emphysema-like changes (ELCs). However, other risk factors may be overlooked. Herein, we report the case of a 19-year-old male who presented with recurrent spontaneous pneumothorax while taking oral methylphenidate.     

妊娠合并自发性卵巢过度刺激综合征一例

卵巢过度刺激综合征是辅助生殖技术常见的并发症,通常在排卵后2周或2周以上发生。然而自发性卵巢过度刺激综合征极其罕见,一些病例报道表明,自发性卵巢过度刺激综合征的发生与卵泡刺激素受体突变、高人绒毛膜促性腺激素水平、高促甲状腺激素水平、促性腺激素垂体腺瘤等有关。现报告1例双胎妊娠合并自发性卵巢过度刺激综合征的病例,并进一步探讨自发性卵巢过度刺激综合征的可能病因、诊断和治疗原则。     

Spontaneous regression of stage Ⅲ neuroblastoma: A case report

BACKGROUND Neuroblastoma(NB) is the most common type of extracranial solid tumour in children. The overall prognosis of NB is poor, but at the same time, NB shows significant clinical diversity. NB can demonstrate spontaneous regression or can differentiate into benign ganglioneuroma.CASE SUMMARY This study retrospectively analyzed the clinical data of a patient with spontaneous regression of stage Ⅲ NB who was admitted in May 2015. Studies of the spontaneous regression of NB published from October 1946 to September 2019 were retrieved through Pub Med. The clinical manifestations, diagnosis,treatment, and follow-up results were analysed.CONCLUSION Spontaneous regression of stage Ⅲ NB is rare in the clinic. The report of this case is an important supplement to the study of the spontaneous regression of NB.     

血清降钙素原在肝硬化腹水中的早期抗菌治疗研究

目的通过对血清降钙素原(PCT)水平在肝硬化腹水多形核中性粒细胞(PMN)250个/μL患者中早期抗菌治疗的研究,为肝硬化腹水患者的早期抗菌治疗提供参考依据。方法选取我院2014年1月~2016年12月住院治疗腹水PMN250个/μL的肝硬化患者100例,随机选取23例为常规治疗组,77例为抗感染治疗组。根据治疗前测得的血清PCT值,将抗感染治疗组分为抗感染治疗A组(PCT0.43 ng/m L,32例)、抗感染治疗B组(0.43 ng/m L≤PCT≤2 ng/m L,24例)和抗感染治疗C组(PCT2 ng/m L,21例),治疗后对四组患者的临床疗效和肝功能指标进行检测。结果治疗后各PCT水平的抗感染治疗组与常规治疗组患者的临床综合疗效比较,差异无统计学意义(P0.05)。治疗后四组患者的ALT和TBIL值较治疗前均有显著降低(P0.05),ALB值显著升高(P0.05),但治疗后各组间各指标值比较无统计学意义(P0.05)。结论血清PCT水平对早期抗菌治疗的临床指导价值还有待进一步研究,不能作为肝硬化腹水早期抗感染的精确指标,需结合临床实际情况综合评估再确定是否行抗感染治疗。     

Symptomatic Tarlov Cyst Following Spontaneous Subarachnoid Hemorrhage

Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient''s life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.     

A novel application of CT angiography to detect extracoronary vascular abnormalities in patients with spontaneous coronary artery dissection

BackgroundSpontaneous coronary artery dissection (SCAD) is associated with extracoronary vascular abnormalities, which depending on type and location may warrant treatment or provide additional diagnostic or prognostic information about this uncommon entity. Fibromuscular dysplasia (FMD), aneurysms, and dissections have been detected in multiple vascular territories by magnetic resonance angiography, CT angiography (CTA), and catheter angiography. The optimal modality to detect extracoronary vascular abnormalities is unknown. We highlight the technique and feasibility of a novel CTA protocol to detect extracoronary vascular abnormalities in these patients, incorporating patient safety and convenience.MethodsThe complete CTA protocol consisting of a single CTA of the neck, chest, abdomen, and pelvis was performed on 39 SCAD outpatients. All examinations were performed with 200 mL of low-osmolar contrast agent and used radiation dose modulation techniques. Average volume CT dose index was 9 mGy for the chest, abdomen, and pelvis portions and 21 mGy for the neck portion. Studies were independently reviewed by 2 senior vascular radiologists.ResultsTwo patients had nondiagnostic CTA neck evaluation because of technical acquisition errors. Extracoronary vascular abnormalities were detected in 27 of 39 patients (69%). Catheter angiography detected brachial artery FMD in 1 patient, a vascular bed not included in the SCAD CTA protocol. Extracoronary vascular abnormalities were common, including FMD, aneurysms, dissection, and aortic tortuosity, and were seen in the iliac (36%), carotid and/or vertebral (31%), splanchnic (10%), and renal (26%) arteries and in the thoracic and/or abdominal aorta (10%).ConclusionsThe frequency of extracoronary vascular abnormalities and extent of territories identified the CTA protocol in our cohort are high. A tailored CTA may be the optimal imaging technique for detecting extracoronary vascular abnormalities in patients with suspected underlying vasculopathy. Although the clinical significance of extracoronary vascular abnormalities remains unclear, detection of these abnormalities has identified patients in whom cerebral imaging and serial monitoring have been recommended.