Clinical case

临床病例
  • 文章类型: Case Reports
    本文报告1例脆弱拟杆菌性脊柱炎。通过血液培养和病原体检测脓液的宏基因组测序确认诊断。由于持续的腰椎疼痛,手术干预变得势在必行,导致良好的术后结果。详细的患者病史显示,在症状发作前两周有严重的口腔溃疡发作,尽管与感染的直接联系仍然难以捉摸。利用这个案例的见解,我们对脆弱芽孢杆菌脊柱炎进行了全面的文献综述,阐明临床表现,诊断方法,和治疗策略。
    This paper reports a case of Bacteroides fragilis induced spondylitis. Diagnosis was confirmed through blood culture and metagenomic sequencing of pus for pathogen detection. Due to persistent lumbar pain, surgical intervention became imperative, resulting in favorable postoperative outcomes. A detailed patient history revealed a severe episode of oral ulceration two weeks before symptom onset, although a direct link to the infection remained elusive. Leveraging insights from this case, we conducted a comprehensive literature review on B. fragilis spondylitis, elucidating clinical manifestations, diagnostic methodologies, and therapeutic strategies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    从未报道过罕见的假丝酵母与人类感染有关。我们报告了C.saopaulonensis的第一个临床分离株的基因组序列草案,从患有败血症的早产儿中分离出来。这是该物种的第一个基因组组装达到接近完整的染色体水平,具有结构注释,为探索发病机制的进化模式和遗传机制开辟了途径。
    The rare fungus Candida saopaulonensis has never been reported to be associated with human infection. We report the draft genome sequence of the first clinical isolate of C. saopaulonensis, which was isolated from a very premature infant with sepsis. This is the first genome assembly reaching the near-complete chromosomal level with structural annotation for this species, opening up avenues for exploring evolutionary patterns and genetic mechanisms of pathogenesis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:间质性肺病(ILD)是在自身免疫性疾病如皮肌炎/多发性肌炎(DM/PM)中经常观察到的合并症,它与特定的自身抗体类型显著相关。一种独特的抗体类型是抗转录中间因子-1γ抗体(抗TIF-1γAb),阳性率仅为7%。它通常与恶性肿瘤合并,很少与ILD合并。特别是快速进行性ILD(RPILD)。在某些情况下,DM患者中ILD的存在可能提示副肿瘤综合征.肺孢子虫肺炎(PJP)通常是由于强化免疫抑制治疗而发生的。人类免疫缺陷病毒(HIV)感染,或者恶性肿瘤,很少是孤立的。
    方法:一名52岁男子,有快速减肥史,但未感染HIV且未受到免疫抑制,出现发热,咳嗽,呼吸困难,四肢的弱点,特征性皮疹和机械师的手。致病试验建议PJP,实验室测试表明单一抗TIF-1γAb阳性DM,成像建议ILD,病理显示无恶性肿瘤。抗感染和类固醇激素治疗后出现RPILD和急性呼吸窘迫综合征(ARDS)。在体外膜氧合(ECMO)等机械支持治疗后,患者出现迟发性巨细胞病毒肺炎(CMVP),复杂的细菌感染,最终死亡。此外,我们讨论了快速减肥的潜在原因,抗TIF-1γAb可能导致ILD的机制,以及抗TIF-1γAb阳性之间的可能联系,快速减肥,免疫异常,和机会性感染。
    结论:本案例强调了早期识别恶性肿瘤和肺部病变的重要性,评估身体的免疫状态,立即开始免疫抑制治疗,和预防单一抗TIF-1γAb阳性DM个体的机会性感染,表现为快速体重减轻。
    BACKGROUND: Interstitial lung disease (ILD) is a frequently observed comorbidity in autoimmune diseases such as dermatomyositis/polymyositis (DM/PM), and it is significantly associated with specific autoantibody types. One unique antibody type is the anti-transcription intermediate factor-1γ antibody (anti-TIF-1γ Ab), which has a positive rate of only 7%. It is often found in combination with malignancy and rarely with ILD, particularly rapidly progressive ILD (RPILD). In some cases, the presence of ILD in individuals with DM may indicate a paraneoplastic syndrome. Pneumocystis jiroveci pneumonia (PJP) typically occurs due to intensive immunosuppressive therapy, human immunodeficiency virus (HIV) infection, or malignancy, and rarely as an isolated condition.
    METHODS: A 52-year-old man with a history of rapid weight loss but non-HIV infected and not immunosuppressed who presented with fever, cough, dyspnea, weakness of the extremities, characteristic rash and mechanic\'s hand. Pathogenic tests suggested PJP, laboratory tests suggested a single anti-TIF-1γ Ab positive DM, imaging suggested ILD, and pathology revealed no malignancy. RPILD and acute respiratory distress syndrome (ARDS) developed after anti-infection and steroid hormone therapy. After mechanical support therapy such as Extracorporeal Membrane Oxygenation (ECMO), the patient developed late-onset cytomegalovirus pneumonia (CMVP), complicated bacterial infection, and ultimately death. Additionally, we discuss the potential causes of rapid weight loss, the mechanisms by which anti-TIF-1γ Ab may lead to ILD, and the possible connection between anti-TIF-1γ Ab positivity, rapid weight loss, immune abnormalities, and opportunistic infections.
    CONCLUSIONS: This case emphasizes the importance of early recognition of malignant tumors and pulmonary lesions, assessment of the body\'s immune status, prompt initiation of immunosuppressive treatment, and prevention of opportunistic infections in individuals with single anti-TIF-1γ Ab positive DM presenting with rapid weight loss.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    多发性硬化(MS)是最常见的特发性炎症性脱髓鞘疾病之一。治疗MS的挑战之一是如何克服复发而没有严重的副作用。由于它们的免疫调节特性和安全性,间充质干细胞(MSCs),为MS的治疗提供了潜在的替代方案。MS中的长期MSC疗法的功效和安全性仍有待确定。在这份通讯中,我们报告的临床状况和疾病进展的MS患者治疗了11年,多次输注来自他的骨髓(BM)的MSCs,汇集的人脐带(UC),或者是他自己孩子的脐带.诊断为进行性MS(EDSS评分3)的男性患者被纳入我们的研究,并接受1×106细胞/kg的MSCs,至少一年一次,持续9年。MSC治疗具有良好的耐受性,没有显著的副作用。MSCs移植后,患者的总体EDSS评分在10年的观察期内下降.MRI检查未发现任何新的病变。然而,在MSC治疗停止后,EDSS评分从1.0增加到3.5,进一步支持这样的观点,即在这样的患者中,MSCs的移植,有显著的有益效果。本案例研究首次报道了BM-MSC和脐带间充质干细胞(UC-MSCs)在进行性MS患者中多次输注的有益作用,在11年的时间里,在没有任何其他治疗的情况下。因此,MSCs的多次输注可能为侵袭性MS患者提供新的治疗途径。
    Multiple sclerosis (MS) is one of the most common idiopathic inflammatory demyelinating disease. One of the challenges in the treatment of MS is how to overcome relapses without severe adverse effects. Due to their immunoregulatory properties and safety, mesenchymal stem cells (MSCs), present a potential alternative for treatment for MS. The efficacy and safety of a long-term MSCs therapy in MS remain to be established. In this communication, we report the clinical condition and disease progression of an MS patient treated for 11 years, with multiple infusions of MSCs derived from either his bone marrow (BM), pooled human umbilical cords (UC), or from his own child umbilical cord. A male patient diagnosed as progressive MS (EDSS score 3) was enrolled into our study and received 1 × 106 cells/kg of MSCs, at least once a year for 9 years. The MSCs treatment was well tolerated with no significant side effects. Following the transplantation of MSCs, the overall EDSS scores of the patient decreased over the 10 years period of observation. MRI investigation did not reveal any new lesions. However, upon the cessation of the MSCs treatment, the EDSS score increased from 1.0 to 3.5, further supporting the notion that in such a patient, the transplantation of MSCs, had a significant beneficial effect. This case study is the first to report on the beneficial effects of multiple infusions of BM-MSC and umbilical cord mesenchymal stem cells (UC-MSCs) in a progressive MS patient, over a period of 11 years, in absence of any other treatments. Hence, multiple infusions of MSCs may provide a novel therapeutic avenue for patients with aggressive MS.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Letter
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    Malignant hyperthermia (MH) is a rare life threatening inherited disorder that is triggered by drugs used for general anesthesia in susceptible persons. The symptoms include rapid increase of body temperature and severe muscle contractions. The present study includes 3 cases of MH and highlights the timely identification of symptoms for rescuing the patient. In case I, a 7-year-old male child underwent surgery with ketamine at a dose of 250 mg. After 4 h of operation, the child went through convulsions, high fever and succumbed within a few hours. High fever was not detected in a timely manner, which is one of the main symptoms of MH. In case II, a 12-year-old male child had convulsions and high fever after simple surgery caused by MH. Once confirmed, immediate measures were taken to lower the body temperature and the child was rescued. In case III, a male 57-year-old was admitted to hospital due to paraplegia. The patient underwent more critical conditions once symptoms of MH appeared. Additionally, antidote dantrolene was unavailable in the first and third case; thus, the progression of disease was not alleviated although active symptomatic and supportive treatment were employed.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    In the field of nerve repair, one major challenge is the formation of neuroma. However, reports on both the promotion of nerve regeneration and prevention of traumatic neuroma in the clinical settings are rare in the field of nerve repair. One of the reasons could be the insufficiency in the follow-up system. We have conducted 33 cases of nerve repair using PRGD/PDLLA/β-TCP conduit without any sign of adverse reaction, especially no neuroma formation. Among them, we have selected two cases as representatives to report in this article. The first case was a patient with an upper limb nerve wound was bridged by PRGD/PDLLA/β-TCP conduit and a plate fixation was given. After nearly 3-years\' follow-up, the examination results demonstrated that nerve regeneration effect was very good. When the reoperation was performed to remove the steel plate we observed a uniform structure of the regenerated nerve without the formation of neuroma, and to our delight, the implanted conduit was completely degraded 23 months after the implantation. The second case had an obsolete nerve injury with neuroma formation. After removal of the neuroma, the nerve was bridged by PRGD/PDLLA/β-TCP conduit. Follow-up examinations showed that the structure and functional recovery were improved gradually in the 10-month follow-up; no end-enlargement and any other abnormal reaction associated with the characteristic of neuroma were found. Based on our 33-case studies, we have concluded that PRGD/PDLLA/β-TCP nerve conduit could both promote nerve regeneration and prevent neuroma formation; therefore, it is a good alternative for peripheral nerve repair.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • Acute cerebral infarction (ACI) caused by cervical arterial dissection (CAD) is a rare clinical disease. Therapeutic approaches include anticoagulant therapy, antiplatelet aggregation, and thrombolytic therapy. Currently, anticoagulant therapy or antiplatelet aggregation is the primary choice, whereas the thrombolytic therapy is still controversial. In this article, we report a patient with ACI caused by right CAD, which led to a compensatory increase in blood supply to the right middle cerebral artery through the anterior communicating artery. After treatment with intravenous thrombolysis, the clinical symptoms of the patient improved, and the National Institutes of Health Stroke Scale (NIHSS) score declined to 2 points from the initial 14 points. In addition, cranial computed tomography scans showed that there were no signs of intracranial or extracranial hemorrhage, but that the vessel occlusion was still uncured. After 17 days of antiplatelet aggregation treatment, a cranial magnetic resonance angiography scan showed complete recanalization of the right internal carotid artery. Furthermore, the NIHSS score was reduced to 1 point when the patient discharged, and for 3 months of follow-up.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号