Henryarsenault7126
A 21-year-old woman was admitted at 35 +4 weeks due to disappearance of fetal movement for one day. The ultrasound from other hospital indicated fetal gastroschisis. Abdominal ultrasound in our hospital confirmed that the discontinuity of the fetal abdominal wall by 4.5 cm. The stomach and part of the intestine were herniating into the amniotic cavity. Considering the possibility of gastroschisis and fetal distress, electronic fetal monitoring was implemented continuously and consultations of relevant departments were called immediately, including anesthesiology, neonatology and general pediatric surgery. After Cesarean section under general anesthesia, pediatric surgeons performed an intrapartum surgery for the neonate. The tension of abdominal wall was slightly higher after the operation, but had no significant negative effect on ventilation. After surgery, the neonate was transferred to neonatal pediatrics for further treatments. The abdominal distention of the neonate relieved gradually. The patient was discharged after receiving full enteral nutrition without any discomfort. It was found in the follow-up that the patient had no discomforts such as infection, wound dehiscence, intestinal necrosis, abdominal hernia or other complications. Oxaliplatin in vivo The prenatal examinations should be completed and the pregnant mother of gastroschisis fetus should be transferred to the experienced center where the intrapartum surgery or early stage I repair surgery is possible for the neonate.Desmoplastic small round cell tumor (DSRCT) is a rare malignant tumor, which is prone to occur in teenagers DSRCT is a rare malignant tumor that often occurs in adolescents. Early diagnosis is difficult and the prognosis is poor. In this case report, the ultrasonography of DSRCT showed that the huge solid mass was in the abdomen with unclear boundary, irregular shape, insufficient blood supply but without obvious liquefaction and calcification. The masses encircled the vessels, but no evidence of vascular invasion. Intrahepatic metastases with peripheral hypoechoic aureole and abdominal lymph node metastases were observed. The tumor mass compressed adjacent tissues and organs, causing bilateral hydronephrosis and bone erosion. In a word, the ultrasonographic characteristics could be used for diagnosing the DSRCT in the clinic.Two cases with high corneal astigmatism and mixed astigmatism were reported. Both cases showed significantly increased astigmatism after cycloplegia. Combined with the patients' refractive error, corneal topography and wavefront aberration changes, the possible causes were analyzed. Aberration changes caused by pupil dilation, corneal astigmatism differences in different diameter ranges, and changes in lens astigmatism before and after cycloplegia may lead to increased astigmatism after cycloplegia. It was found that cycloplegic refraction may not accurately reflect the refractive status in daily life for children with high corneal astigmatism, especially mixed astigmatism. Because children need refractive correction in the state of natural pupil, it is recommended that the cycloplegic refraction result could not be directly used as prescription for such children. The final prescription should be based on the topography and the refraction result under natural pupil.
To evaluate the clinical efficacy of transcatheter embolization for patients with gastrointestinal stromal tumor and gastrointestinal hemorrhage.
From June 2006 to June 2019, 17 patients with gastrointestinal stromal tumor and who were gastrointestinal bleeding treated with transcatheter embolization due to gastrointestinal hemorrhage in our hospital were included in this study. The technical and clinical success rates and clinical success rate were analyzed retrospectively.
Among 17 patients who underwent angiography before embolotherapy, 5 patients (29.4%) showed tumor staining and contrast extravasation, 9 patients (52.9%) showed tumor staining but no significant contrast extravasation, and 3 patients (17.6%) were negative. 14 patients had with positive angiographic findings and then underwent transcatheter embolization. Technical success was achieved in 13 patients (76.5%). Of the 13 technically successful patients, 12 patients (70.6%) achieved clinical success, one patient (5.9%) suffered from repeated gastrointestinal bleeding, which was improved after conservative treatment. No embolization-related complication occurred. The 30-day mortality rate was 0%.
Transcatheter embolization for gastrointestinal stromal tumor with gastrointestinal hemorrhage is a safe and effective minimally invasive technique.
Transcatheter embolization for gastrointestinal stromal tumor with gastrointestinal hemorrhage is a safe and effective minimally invasive technique.
To summarize the clinicopathological characteristics, diagnosis and treatment of IgG4-related disease (IgG4-RD).
The clinical data of 43 cases with IgG4-RD diagnosed from January 2013 to December 2017 were retrospectively analyzed. The clinical data of the patients including clinical characteristics, accessory examinations, diagnosis, and treatment were collected.
Among the 43 patients with IgG4-RD, the ratio of male to female was 3∶1, the mean age was (51.3±15.9) years. Eleven patients had gastrointestinal symptoms, including 5 cases of IgG4-related cholangitis with the feature of dilation of the biliary system and narrowing of the lumen in the abdominal enhanced CT scans, and 6 cases of IgG4-related autoimmune pancreatitis with the feature of pancreatic enlargement or soft tissue density shadow in the abdominal enhanced CT scans. There were 10 cases (23.3%) with periorbital involvement, with the feature of intraorbital soft tissue nodule in the CT scan. Besides, 9 cases (20.9%) had lymphadenopathy, 6 efore, the standardized diagnosis and treatment of IgG4-RD should be strengthened.
To explore the risk factors of acute kidney injury (AKI) in patients with sepsis in intensive care unit (ICU).
The medical records of patients diagnosed with sepsis in ICU of West China Hospital of Sichuan University from March 2009 to June 2016 were retrospectively analyzed. Differences between AKI group and Non-AKI group in general data, background disease, ICU entry and exit dates, complications, laboratory data and other related data were analyzed through univariate and multivariate statistical methods.
A total of 2331 patients with sepsis were included in the study, including 626 patients in the AKI group and 1695 patients in the Non-AKI group. The multivariate logistic regression analysis revealed that age >40 yr. (odds ratio (
) =2.752), diabetes (
=2.563), hypertension/coronary heart disease (
=1.851), chronic kidney disease (
=15.876), heart failure (
=2.295), acute respiratory distress syndrome (
=2.067), severe acute pancreatitis (
=2.725), hypotension (
=2.140), hypoproteinemia (
=1.