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Tuberculosis septic shock, an elusive pathophysiology and hurdles in management: A case report and review of literature 预览
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作者 Rashmi Mishra Harish K Patel +1 位作者 Rakesh Singasani Trupti Vakde 《世界重症医学杂志》 2019年第5期72-81,共10页
BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the ma... BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the management. We present three cases of TBSS with poor outcome in the majority despite timely and susceptible antibiotic administration. CASE SUMMARY Sixty-seven-year-old woman with latent TB presented with fever, cough, and shortness of breath. She was promptly diagnosed with active TB and started on the appropriate anti-microbial regimen;she had a worsening clinical course with septic shock and multi-organ failure after initiation of antibiotics. Thirty-threeyear- old man immunocompromised with acquired immune deficiency syndrome presented with fever, anorexia and weight loss. He had no respiratory symptoms, and first chest X-ray was normal. He had enlarged liver, spleen and lymph nodes suspicious for lymphoma. Despite broad-spectrum antibiotics, he succumbed to refractory septic shock and multi-organ failure. It was shortly before his death that anti-TB antimicrobials were initiated based on pathology reports of bone marrow and lymph node biopsies. Forty-nine-year-old woman with asthma and latent TB admitted with cough and shortness of breath. Although Initial sputum analysis was negative, a subsequent broncho-alveolar lavage turned out to be positive for acid fast bacilli followed by initiation of susceptible ant-TB regimen. She had a downward spiral clinical course with shock, multi-organ failure and finally death. CONCLUSION Worse outcome despite timely initiation of appropriate antibiotics raises suspicion of TB immune reconstitution as a possible pathogenesis for TB septic shock. 展开更多
关键词 TUBERCULOSIS SEPTIC shock TUBERCULOSIS and immune RECONSTITUTION TUBERCULOSIS in intensive care unit CASE FATALITY for TUBERCULOSIS SEPTIC shock CASE report
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创业环境对大学生创业绩效的影响研究--基于虚拟现实VR体验馆 预览
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作者 孙曦曦 昂昊 《武汉职业技术学院学报》 2019年第2期86-90,共5页
良好的创业环境是创业成功的前提,创业环境对创业绩效有着一定的影响,近些年各界学者对大学生创业的研究掀起一股热浪,基于案例研究的方法以安徽财经大学创业孵化基地内虚拟现实VR体验馆为例,对VR体验馆的创始人及其团队进行深入访谈,... 良好的创业环境是创业成功的前提,创业环境对创业绩效有着一定的影响,近些年各界学者对大学生创业的研究掀起一股热浪,基于案例研究的方法以安徽财经大学创业孵化基地内虚拟现实VR体验馆为例,对VR体验馆的创始人及其团队进行深入访谈,分析创业环境对大学生创业成效的影响。研究发现:政府创业政策、高效创业环境、创业者个人特质、团队建设及技术创新能力等内外部创业环境因素影响着大学生创业成效,并对创业环境的改善提出前瞻性的理论策略和实践性的指导建议。 展开更多
关键词 创业环境 创业绩效 VR体验 虚拟现实
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Application of a 3D-printed “fistula stent” in plugging enteroatmospheric fistula with open abdomen: A case report 预览
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作者 Zi-Yan Xu Hua-Jian Ren +2 位作者 Jin-Jian Huang Zong-An Li Jian-An Ren 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1775-1782,共8页
BACKGROUND Open abdomen (OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the m... BACKGROUND Open abdomen (OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the meantime, OA calls for a mass of nursing and the subsequent enteroatomospheric fistula (EAF), which is one of the most common complications of OA therapy, remains a thorny challenge. CASE SUMMARY Our team applied thermoplastic polyurethane as a befitting material for producing a 3D-printed “fistula stent” in the management of an EAF patient, who was initially admitted to local hospital because of abdominal pain and distension and diagnosed with bowel obstruction. After a series of operations and OA therapy, the patient developed an EAF. CONCLUSION Application of this novel “fistula stent” resulted in a drastic reduction in the amount of lost enteric effluent and greatly accelerated rehabilitation processes. 展开更多
关键词 3D PRINTING Enteroatmospheric FISTULA Open ABDOMEN ISOLATION technique Case report
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Primary esophageal tuberculosis mimicking esophageal carcinoma on computed tomography:A case report 预览
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作者 Muhammad Salman Khan Muhammad Hassaan Arif Maan +1 位作者 Amir Humza Sohail Wasim Ahmed Memon 《世界胃肠外科杂志:英文版(电子版)》 2019年第9期373-380,共8页
BACKGROUND Tuberculosis(TB)has a rare extrapulmonary manifestation known as esophageal tuberculosis,accounting for 0.2%of total TB patients.Esophageal TB typically presents with dysphagia,with retrosternal pain or ody... BACKGROUND Tuberculosis(TB)has a rare extrapulmonary manifestation known as esophageal tuberculosis,accounting for 0.2%of total TB patients.Esophageal TB typically presents with dysphagia,with retrosternal pain or odynophagia,but generalized symptoms such as low-grade fever,decreased appetite,and weight loss are also observed.Esophageal carcinoma and Crohn’s disease of the esophagus are important differential diagnoses with similar presentation.CASE SUMMARY We present a case of a 25-year-old male,who presented with esophageal TB mimicking an esophageal carcinoma.Lab work-up,Mantoux test,and chest X-ray were normal.Barium-swallow examination showed moderate dilatation of distal esophagus with a nodular and irregular mucosa.Computed tomography showed significant thickening of thoracic and distal esophagus with infiltration into the lesser omentum and large,centrally necrotic lymph nodes on gastro-hepatic ligament suggestive of a possible malignancy.Esophagoscopy was performed and a biopsy of mural thickening was performed and sent for histopathological examination.The histopathology report and TB-polymerase chain reaction confirmed the diagnosis of esophageal TB.The patient was started on antituberculous therapy(ATT),and complete resolution of symptoms and disease was achieved in 6 mo.CONCLUSION Esophageal TB is an extremely rare,yet important differential diagnosis in a patient presenting with dysphagia.Esophageal TB can mimic esophageal carcinoma on computed tomography scan.The patient responded well to a complete course of ATT. 展开更多
关键词 Case report ESOPHAGEAL TUBERCULOSIS ESOPHAGEAL carcinoma COMPUTED TOMOGRAPHY
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Recurrent surgical site infection after anterior cruciate ligament reconstruction:A case report 预览
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作者 Don Koh Shi Ming Tan Andrew Hwee Chye Tan 《世界骨科杂志(英文版)》 2019年第6期255-261,共7页
BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of t... BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of the knee after an ACL reconstruction,and discuss the importance of accurate diagnosis and appropriate management,including the issue of graft preservation versus removal.CASE SUMMARY A 33-year-old gentleman underwent ACL reconstruction using a hamstring tendon autograft with suspensory Endobutton fixation to the distal femur and an interference screw fixation to the proximal tibia.Four years after ACL reconstruction,he developed an abscess over the proximal tibia and underwent incision and drainage.Remnant suture material was found at the base of the abscess and was removed.Five years later,he re-presented with a lateral distal thigh abscess that encroached the femoral tunnel.He underwent incision and drainage of the abscess which was later complicated by a chronic discharging sinus.Repeated magnetic resonance imaging revealed a fistulous communication between the lateral thigh wound extending toward the femoral tunnel with suggestion of osteomyelitis.Decision was made for a second surgery and the patient was counselled about the need for graft removal should there be intraarticular involvement.Knee arthroscopy revealed the graft to be intact with no evidence of intra-articular involvement.As such,the decision was made to retain the ACL graft.Re-debridement,excision of the sinus tract and removal of Endobutton was also performed in the same setting.Joint fluid cultures did not grow bacteria.However,tissue cultures from the femoral tunnel abscess grew Enterobacter cloacae complex,similar to what grew in tissue cultures from the tibial abscess five years earlier.In view of the recurrent and indolent nature of the infection,antibiotic therapy was escalated from Clindamycin to Ertapenem.He completed a six-week course of intravenous antibiotics and has been well for six months since surgery,with excellent 展开更多
关键词 Chronic SURGICAL SITE INFECTION Anterior CRUCIATE ligament reconstruction SURGICAL SITE INFECTION Graft preservation ENTEROBACTER CLOACAE complex Septic arthritis Case report
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妊娠期高血压疾病患者的ICD-10编码分析 预览
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作者 梁彩琼 《医学信息》 2019年第17期26-27,共2页
妊娠期高血压实为一种由高血压与妊娠合并在一起的病症,诸如子痫、高血压、子痫前期及慢性高血压合并妊娠等均属于此范畴。疾病编码是一项科学且严谨的工作,通过对妊娠期高血压疾病进行合理编码,有助于更好的明确诊断与治疗。本文以妊... 妊娠期高血压实为一种由高血压与妊娠合并在一起的病症,诸如子痫、高血压、子痫前期及慢性高血压合并妊娠等均属于此范畴。疾病编码是一项科学且严谨的工作,通过对妊娠期高血压疾病进行合理编码,有助于更好的明确诊断与治疗。本文以妊娠期高血压典型病例为研究对象,分析其ICD-10编码,明确妊娠期高血压疾病患者的诊断选择方法,了解其ICD-10编码的要求与规则,为编码人员工作提供依据,提高编码的总体质量。 展开更多
关键词 妊娠期高血压 ICD-10编码 案例
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Novel technique for anastomotic salvage using transanal minimally invasive surgery:A case report 预览
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作者 Oscar A Olavarria Robert L Kress +1 位作者 Shinil K Shah Amit K Agarwal 《世界胃肠外科杂志:英文版(电子版)》 2019年第5期271-278,共8页
Anastomotic leak(AL)after low anterior resection(LAR)can be a highly morbid complication.The incidence of AL ranges from 5%to 20%depending on patient characteristics and the distance of the anastomosis from the anal v... Anastomotic leak(AL)after low anterior resection(LAR)can be a highly morbid complication.The incidence of AL ranges from 5%to 20%depending on patient characteristics and the distance of the anastomosis from the anal verge.Low anastomoses and leaks pose technical challenges for endoscopic treatment.The aim of this report was to describe the use of a commercially available laparoscopic energy device through a transanal minimally invasive surgery(TAMIS)port for the management of a symptomatic leak not requiring relaparotomy(grade B)after a LAR with diverting loop ileostomy.CASE SUMMARY A TAMIS GelPOINT Path port was inserted into the anus to access the distal rectum.Pneumorectum was achieved with AirSeal insufflation and a 30 degree laparoscope was introduced through a trocar.A LigaSureTM Retractable L-Hook device was then used to perform a septotomy of the chronic sinus tract identified posterior to the coloproctostomy.The procedure was then repeated twice in three weeks intervals with ultimate resolution of the chronic leak cavity.Several months after serial TAMIS septotomies,barium enema demonstrated a patent anastomosis with no evidence of persistent leak or stricture.The patient subsequently underwent ileostomy reversal and has had no significant postoperative issues.CONCLUSION TAMIS septotomy with the LigaSureTM Retractable L-Hook is a feasible and effective,minimally invasive salvage technique for the treatment of grade B ALs.Larger studies are needed to assess the generalizability and long-term results of this technique. 展开更多
关键词 TRANSANAL MINIMALLY invasive surgery LIGASURE hook Anastomotic LEAK Low ANTERIOR resection Septotomy Case report
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Propofol pump controls nonconvulsive status epilepticus in a hepatic encephalopathy patient: A case report 预览
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作者 Shao Hor Chih-Yu Chen Sheng-Ta Tsai 《世界临床病例杂志》 2019年第18期2831-2837,共7页
BACKGROUND Status epilepticus is an emergent and critical condition which needs management without hesitation. Nonconvulsive status epilepticus (NCSE) tends to be less recognized, and its diagnosis is delayed in compa... BACKGROUND Status epilepticus is an emergent and critical condition which needs management without hesitation. Nonconvulsive status epilepticus (NCSE) tends to be less recognized, and its diagnosis is delayed in comparison with overt status epilepticus because of the absence of specific clinical signs. It is often difficult to make a diagnosis, particularly in patients with hepatic encephalopathy. CASE SUMMARY A 38-year-old man with a history of alcoholic liver cirrhosis presented with altered mental status;the initial diagnosis was hepatic encephalopathy. Although optimal treatment for hepatic encephalopathy was administered, the patient's mental status did not improve. A final diagnosis of NCSE was made by continuous electroencephalogram (EEG) monitoring. Treatment with levetiracetam and propofol pump was immediately started. The patient’s consciousness gradually improved after discontinuation of propofol therapy, and no further epileptic discharge was observed by EEG monitoring. After 1 wk, the patient returned to full consciousness, and he was able to walk in the hospital ward without assistance. He was discharged with minimal sequela of bilateral conjunctivitis. CONCLUSION In cases of persistent altered mental status without reasonable diagnosis, NCSE should be considered in hepatic encephalopathy patients with persistently altered levels of consciousness, and EEG monitoring is very important. We also recommend propofol as a safe and efficient therapy for NCSE in liver cirrhosis patients. 展开更多
关键词 Nonconvulsive status epilepticus Hepatic ENCEPHALOPATHY ELECTROENCEPHALOGRAM PROPOFOL MULTIDISCIPLINARY TEAM Case report
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Teriparatide as nonoperative treatment for femoral shaft atrophic nonunion: A case report 预览
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作者 Meng-Huan Tsai Chih-Chien Hu 《世界临床病例杂志》 2019年第18期2838-2842,共5页
BACKGROUND Femoral shaft fractures are a common type of fracture among adults and have high union rates. However, clinical decisions are difficult to make because of the different types of nonunions. Atrophic nonunion... BACKGROUND Femoral shaft fractures are a common type of fracture among adults and have high union rates. However, clinical decisions are difficult to make because of the different types of nonunions. Atrophic nonunion usually requires revision surgery combined with bone grafting. Furthermore, no study of teriparatide administration for femoral atrophic nonunion have been previously reported. CASE SUMMARY A 60-year-old woman had a right femoral shaft fracture due to a traffic accident, and she immediately underwent closed reduction and internal fixation surgery with an intramedullary nailing. However, after 6 mo of rehabilitation, the fracture site showed no signs of healing, and her condition was diagnosed as atrophic nonunion. Subsequently, teriparatide was administered for 6 mo. Complete union was observed at the fracture site 6 mo after teriparatide discontinued. CONCLUSION The use of teriparatide can be a promising treatment to improve the healing of nonunion fractures. 展开更多
关键词 TERIPARATIDE NONUNION FEMORAL FRACTURES Case report
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Adult intussusception caused by colonic anisakis:A case report 预览
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作者 Youn I Choi Dong Kyun Park +5 位作者 Hyun Yee Cho Seung Joon Choi Jun-Won Chung Kyung Oh Kim Kwang An Kwon Yoon Jae Kim 《世界临床病例杂志》 2019年第17期2536-2541,共6页
BACKGROUND Colo-colonic intussusception is an uncommon phenomenon in an adult.Adult intussusception accounts for < 5% of total cases,and the colo-colonic type is < 30% of cases.Although surgical management has b... BACKGROUND Colo-colonic intussusception is an uncommon phenomenon in an adult.Adult intussusception accounts for < 5% of total cases,and the colo-colonic type is < 30% of cases.Although surgical management has been the treatment of choice for intestinal intussusception in adults,because most frequent causes for adult intussusception are malignant in origin,the importance of the roles of preoperative colonoscopic evaluation has recently been emerging.CASE SUMMARY We report an extremely rare case of adult colo-colonic intussusception caused by colonic anisakiasis and successfully treated by endoscopic removal of the Anisakis body.A 59-year-old man visited the emergency department due to 1 day of lower abdominal colicky pain.Abdominopelvic computed tomography (APCT) revealed the presence of mid-transverse colon intussusception without definite necrosis,which was possibly related with colorectal cancer.Because there was no evidence of necrosis at the intussusception site,a colonoscopy was performed to target the colonic lesion and obtain tissue for a histopathological diagnosis.An Anisakis body was found when inspecting the suspicious colonic lesion recorded by APCT.The Anisakis body was removed with forceps assisted by colonoscopy.The patient’s symptoms improved dramatically after removing the Anisakis.A reduced colon without any pathological findings was seen on the follow-up APCT.Without any further treatment,the patient was discharged 5 d after the endoscopy.CONCLUSION When colonic intussusception without necrosis occurs in an adult,physician should consider a colonoscopy to exclude causes cured by endoscopy. 展开更多
关键词 INTUSSUSCEPTION ANISAKIS COLONOSCOPY Case report
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Successful repair of acute type A aortic dissection during pregnancy at 16th gestational week with maternal and fetal survival: A case report and review of the literature 预览
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作者 Su-Wei Chen Yong-Liang Zhong +4 位作者 Yi-Peng Ge Zhi-Yu Qiao Cheng-Nan Li Jun-Ming Zhu Li-Zhong Sun 《世界临床病例杂志》 2019年第18期2843-2850,共8页
BACKGROUND Aortic dissection during pregnancy is a rare but life-threatening event for mothers and fetuses. It often occurs in the third trimester of pregnancy and the postpartum period. Most patients have connective ... BACKGROUND Aortic dissection during pregnancy is a rare but life-threatening event for mothers and fetuses. It often occurs in the third trimester of pregnancy and the postpartum period. Most patients have connective tissue diseases such as Marfan syndrome. Thus, the successful repair of a sporadic aortic dissection with maternal and fetal survival in the early second trimester is extremely rare. CASE SUMMARY A 28-year-old woman without Marfan syndrome presented with chest pain at the 16th gestational week. Aortic computed tomographic angiography confirmed an acute type A aortic dissection (TAAD) with aortic arch and descending aorta involvement. Preoperative fetal ultrasound confirmed that the fetus was stable in the uterus. The patient underwent total arch replacement with a frozen elephant trunk using moderate hypothermic circulatory arrest with the fetus in situ. The patient recovered uneventfully and continued to be pregnant after discharge. At the 38^th gestational week, she delivered a healthy female infant by cesarean section. After 2.5 years of follow-up, the patient is uneventful and the child’s development is normal. CONCLUSION A fetus in the second trimester may have a high possibility of survival and healthy growth after aortic arch surgery. 展开更多
关键词 Aortic dissection PREGNANCY CARDIOPULMONARY BYPASS HYPOTHERMIA circulatory ARREST Case report
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Robotic-assisted resection of ovarian tumors in children:A case report 预览
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作者 Xiao-Xiao Xie Ning Wang +3 位作者 Zi-Hao Wang Yue-Yue Zhu Jing-Ru Wang Xian-Qiang Wang 《世界临床病例杂志》 2019年第17期2542-2548,共7页
BACKGROUND Ovarian tumors are common gynecological diseases in children,and the most commonly seen ovarian tumors are germ cell tumors.Robotic surgery is the new access for children ovarian tumors.CASE SUMMARY From Ju... BACKGROUND Ovarian tumors are common gynecological diseases in children,and the most commonly seen ovarian tumors are germ cell tumors.Robotic surgery is the new access for children ovarian tumors.CASE SUMMARY From June to October 2017,4 children with ovarian tumors were admitted and treated in the Department of Pediatric Surgery of People’s Liberation Army General Hospital.The mean age,height,and weight of these patients were 7.5 (1- 13) years old,123.75 (71-164) cm,and 36.8 (8.5-69.5) kg,respectively.Roboticassisted resection of ovarian tumors was performed for all 4 patients.The 3-port approach was used for robotic manipulation.The surgical procedures were as follows.After creation of the pneumoperitoneum,the robotic scope was placed to explore and find the left ovarian tumor.The trocars for robotic arms 1 and 2 were placed at the sites to the lower right and left of the port of the scope.The tumor capsule in the fallopian tube was incised,and the tumor was completely stripped by an electric hook along the junction of the tumor and the capsule.The resected tumor was completely removed using an endobag.The average docking time of the robotic system was 18.5 min,the average operative time was 120 min,and the average blood loss was 20 mL.No drainage tube was placed except in one patient with a mucinous tumor of the ovary.No fever,pelvic fluid,or intestinal obstruction was reported after surgery.No antibiotics were used during the perioperative period,and the average length of hospital stay after surgery was 3 CONCLUSION Robotic-assisted resection of ovarian tumors is a simple,safe,and effective surgical procedure for selected patients. 展开更多
关键词 Children ROBOTIC surgery OVARIAN TUMOR RESECTION Case report
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Inferior pancreaticoduodenal artery pseudoaneurysm in a patient with calculous cholecystitis: A case report 预览
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作者 Qiao-Dong Xu Song-Gang Gu +4 位作者 Jia-Hong Liang Shao-Dong Zheng Zhi-Hua Lin Pei-Dong Zhang Jiang Yan 《世界临床病例杂志》 2019年第18期2851-2856,共6页
BACKGROUND Pancreaticoduodenal artery (PDA) aneurysms are extremely rare. The complicated clinical presentations and high incidence of rupture make it difficult to diagnose and treat. PDA pseudoaneurysms often rupture... BACKGROUND Pancreaticoduodenal artery (PDA) aneurysms are extremely rare. The complicated clinical presentations and high incidence of rupture make it difficult to diagnose and treat. PDA pseudoaneurysms often rupture into the gastrointestinal tract and result in life-threatening gastrointestinal hemorrhage. CASE SUMMARY A 69-year-old man was admitted to our hospital due to right upward abdominal pain. A computed tomography (CT) scan demonstrated acute cholecystitis and cholecystolithiasis. Percutaneous gallbladder drainage was performed subsequently. He was discharged after 3 d and readmitted to hospital for cholecystectomy as arranged 1 mo later. A repeat CT scan revealed an emerging enhancing mass between the pancreatic head and the descending duodenum. Then, he suffered hematochezia and hemorrhagic shock suddenly. Emergency percutaneous angiogram was performed and selective catheterization of the superior mesenteric artery demonstrated a pseudoaneurysm in the inferior PDA. Coil embolization was performed and his clinical condition improved quickly after embolization and blood transfusion. He underwent laparoscopic cholecystectomy and was discharged from hospital after surgery under satisfactory conditions. CONCLUSION PDA pseudoaneurysms are uncommon. Acute haemorrhage is a severe complication of pseudoaneurysm with high mortality which clinicians should pay attention to. 展开更多
关键词 Calculous CHOLECYSTITIS INFERIOR pancreaticoduodenal ARTERY PSEUDOANEURYSM Gastrointestinal HAEMORRHAGE Coil EMBOLIZATION Case report
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Synovial sarcoma in the plantar region:A case report and literature review 预览
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作者 Jie Gao Yu-Song Yuan +2 位作者 Ting Liu Hao-Run Lv Hai-Lin Xu 《世界临床病例杂志》 2019年第17期2549-2555,共7页
BACKGROUND Synovial sarcoma (SS),a rare malignant soft tissue tumor whose histological origin is still unknown,often occurs in limbs in young people and is easily misdiagnosed.CASE SUMMARY We report a 24-year-old man ... BACKGROUND Synovial sarcoma (SS),a rare malignant soft tissue tumor whose histological origin is still unknown,often occurs in limbs in young people and is easily misdiagnosed.CASE SUMMARY We report a 24-year-old man who sought treatment for plantar pain thought to be caused by a foot injury that occurred 4 years prior.Currently,he had been seen at another hospital for a 1-wk history of unexplained pain in the left plantar region and was treated with acupuncture,a kind of therapy of Chinese medicine,which partly relieved the pain.Because of this,the final diagnosis of biphasic SS was made after two subsequent treatments by pathological evaluation after the last operation.SS is rarely seen in the plantar area,and his history of a left plantar injury confused the original diagnosis.CONCLUSION This study shows that pathological and imaging examinations may play a vital role in the early diagnosis and treatment of SS. 展开更多
关键词 Imaging EXAMINATION PATHOLOGICAL EXAMINATION PLANTAR SYNOVIAL SARCOMA Case report
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ALK-positive anaplastic large cell lymphoma of the thoracic spine occurring in pregnancy: A case report 预览
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作者 Sen Yang Wei-Min Jiang Hui-Lin Yang 《世界临床病例杂志》 2019年第18期2857-2863,共7页
BACKGROUND Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy. CASE SUMMARY We present the first case of anaplastic lymphoma kinase (ALK)+ ... BACKGROUND Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy. CASE SUMMARY We present the first case of anaplastic lymphoma kinase (ALK)+ ALCL of the thoracic spine during pregnancy. A 25-year-old pregnant woman was presented to us at 24 wk’ gestation with severe back pain and weakness in the left lower limb. Imaging examination showed lesions at T10 and T11. She underwent posterior pedicle screw fixation and vertebroplasty. Pathological examination showed ALK+ ALCL. The patient chose to have therapeutic abortion after surgery and received chemotherapy in the hematology department. She now remains disease free with no neurological deficit after 30 mo’ follow-up. CONCLUSION ALK+ ALCL with the thoracic spine involvement is uncommon, especially in pregnancy. Many symptoms can be misunderstood during pregnancy;therefore, when a pregnant patient has persistent back pain or lower limb neurological symptoms, imaging examinations should be performed. 展开更多
关键词 ANAPLASTIC large cell LYMPHOMA PREGNANCY THORACIC SPINE Surgical treatment Chemotherapy Case report
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Severe serous cavity bleeding caused by acquired factor V deficiency associated with lymphatic leakage in a hemodialysis patient:A case report 预览
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作者 Wen-Bo Zhao Yan-Ru Chen +4 位作者 Dan Luo Hong-Chun Lin Bing Long Zhen-Yu Wu Hui Peng 《世界临床病例杂志》 2019年第17期2556-2561,共6页
BACKGROUND Acquired factor V deficiency is a rare secondary hemorrhagic disease,which can lead to a severe bleeding disorder.CASE SUMMARY We report a 47-year-old hemodialysis patient who presented with severe hemorrha... BACKGROUND Acquired factor V deficiency is a rare secondary hemorrhagic disease,which can lead to a severe bleeding disorder.CASE SUMMARY We report a 47-year-old hemodialysis patient who presented with severe hemorrhagic pleural effusion and hemorrhagic pericardial effusion associated with lymphatic leakage.The laboratory examination revealed decreased factor V activity (2% of population average value).With decreased lymphatic leakage,factor V activity increased (to 46%).Lymph drainage correlated with prothrombin time and active partial thrombin time.The cause of the disease favored an acquired disease.The common causes which trigger factor V inhibitors were excluded.An inhibitor was not detected.It is possible that there was a clotting factor inhibitor leaking with the lymph in the drainage.Inhibitor production may be due to immune dysfunction caused by persistent lymphatic drainage,or that coagulation inhibitors were produced,drained with the lymph,and partly cleared by hemodialysis.CONCLUSION In this case,we have firstly reported factor V deficiency associated with lymphatic leakage in a hemodialysis patient. 展开更多
关键词 ACQUIRED factory V deficiency LYMPHATIC LEAKAGE SEROUS cavity BLEEDING HEMODIALYSIS Case report
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Endoscopic mucosal resection of a bile duct polyp: A case report 预览
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作者 Shu Yang Li Yang +1 位作者 Xiang-Yang Wang Yu-Ming Yang 《世界临床病例杂志》 2019年第18期2864-2870,共7页
BACKGROUND Bile duct polyps are difficult to diagnose and are usually excised by open abdominal surgery or snare polypectomy using choledochoscopy via the T-tube sinus tract. However, these two resection methods requi... BACKGROUND Bile duct polyps are difficult to diagnose and are usually excised by open abdominal surgery or snare polypectomy using choledochoscopy via the T-tube sinus tract. However, these two resection methods require the surgeon to open the abdomen and cut the bile duct to place the “T” tube. Moreover, simple snare polypectomy, without submucosal injection, can only remove pedunculated polyps and not flat polyps. Therefore, a new method is required for the excision of bile duct polyps, including flat polyps. CASE SUMMARY A 63-year-old woman was hospitalized following epigastric pain lasting a month. She had a 30-year history of cholelithiasis and had undergone cholecystectomy because of cholecystolithiasis, and had undergone cholangiolithotomy twice due to choledocholithiasis. Computed tomography (CT) and magnetic resonance imaging showed a communication between the bile duct and duodenal bulb. Inside the communication, CT showed a high-density shadow which was a hypointense lesion in T2 weighted image. The lesion showed no enhancement in T1 weighted image contrast enhanced. Gastroscopy revealed an incarcerated bile duct stone in the anterior wall of the duodenal bulb, which was removed with a basket under gastroscopy. Thereafter, a choledochoduodenal fistula was revealed. Finally, a flat polyp was detected in the lower part of the common bile duct and was removed by endoscopic mucosal resection (EMR) through the fistula. To our knowledge, this is the first reported case of the removal of a bile duct polyp using EMR. CONCLUSION EMR is a safe, effective, and low-cost method for the resection of all bile duct polyps. 展开更多
关键词 Case report Cholangiolithiasis BILE DUCT POLYP ENDOSCOPIC MUCOSAL RESECTION
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Neonatal cholestasis and hepatosplenomegaly caused by congenital dyserythropoietic anemia type 1:A case report 预览
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作者 Catalina Jaramillo Anna K Ermarth +1 位作者 Angelica R Putnam Mark Deneau 《世界肝病学杂志:英文版(电子版)》 2019年第5期477-482,共6页
BACKGROUND Congenital dyserythropoietic anemia type 1(CDA1)is an autosomal recessive disorder of ineffective erythropoiesis,resulting in increased iron storage.CDA1 is usually diagnosed in children and adolescents but... BACKGROUND Congenital dyserythropoietic anemia type 1(CDA1)is an autosomal recessive disorder of ineffective erythropoiesis,resulting in increased iron storage.CDA1 is usually diagnosed in children and adolescents but can rarely present in the neonatal period with severe anemia at birth.There are no prior reports of neonatal liver histologic findings of CDA1.We report a case of CDA1 in a newborn presenting with severe anemia,cholestasis and liver failure,where liver biopsy helped confirm the diagnosis.CASE SUMMARY A term infant,born via emergency Cesarean section,presented with cholestasis,hepatosplenomegaly,multiorgan failure and severe anemia at birth.A prior pregnancy was significant for fetal demise at 35 wk without autopsy or known etiology for the fetal demise.Parents are both healthy and there is no history of consanguinity.On further evaluation,the patient was found to have severe ferritin elevation and pulmonary hypertension.An extensive infectious and metabolic work-up was negative.Salivary gland biopsy was negative for iron deposition.At 2 wk of age,a liver biopsy showed findings consistent with CDA1.A genome rapid sequencing panel revealed novel variants in the CDAN1 gene.The patient’s liver dysfunction,cholestasis and organomegaly resolved,however she remains transfusion-dependent.CONCLUSION We report liver pathology findings of CDA1 with a novel genetic mutation for the first time in a newborn. 展开更多
关键词 CONGENITAL dyserythropoietic ANEMIA HEMOCHROMATOSIS PULMONARY HYPERTENSION JAUNDICE Case report
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基于案例的扶志教育在贫困大学生就业中的作用与路径研究 预览
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作者 陈玲 储昭辉 苏小松 《六盘水师范学院学报》 2019年第3期80-85,共6页
当前我国高校“四位一体”资助体系使大多数贫困大学生的经济压力得到解决或缓解,但部分贫困生自我脱贫的内因不足导致其“等靠要”思想严重。在教育公平、精准扶贫的政策指引下,高校资助工作的育人功能尤显突出,故扶贫应先扶志。通过... 当前我国高校“四位一体”资助体系使大多数贫困大学生的经济压力得到解决或缓解,但部分贫困生自我脱贫的内因不足导致其“等靠要”思想严重。在教育公平、精准扶贫的政策指引下,高校资助工作的育人功能尤显突出,故扶贫应先扶志。通过对贫困大学生在校期间开展扶志教育以及毕业后状态回访的案例分析和研究,总结并设计出扶志教育的实施路径有:合理政策宣传、加强思想引领,增加社会实践、历练意志品质,重视学科技能、夯实专业基础,感恩所获所得、努力回报社会。 展开更多
关键词 案例 扶志教育 贫困大学生 就业
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周末加油站(Ⅶ) 预览
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《疯狂英语:读写版》 2019年第7期51-54,62-64共7页
In case you hadn't noticed-men and women have very different bodies.In general,women are shorter,have narrower shoulders,carry less muscle mass and have proportionally(成比例地)longer legs and shorter backs than men.
关键词 加油站 HAVE CARRY case very LESS THAN
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