• 文章类型: Case Reports
    新型SARS-CoV-2引入了几种新的炎症条件,包括SARS-CoV-2相关的横纹肌溶解和病毒性肌炎。我们介绍了一名22岁的男子,他注意到咳嗽一周,然后是肌痛,深色尿液,和减少口服摄入量。SARS-CoV-2试验呈急性阳性后,发现他患有急性非创伤性横纹肌溶解症。初始肌酸激酶(CK)水平高于参考范围,肝酶也反映了肌肉分解。治疗包括液体复苏和疼痛控制,密切监测肾脏,肝脏,和骨骼标志物在住院五天内,直到临床和症状改善。
    The novel SARS-CoV-2 introduced several new inflammatory conditions including SARS-CoV-2-associated rhabdomyolysis and viral myositis. We present a 22-year-old man who noted a week of cough followed by myalgias, dark-colored urine, and decreased oral intake. He was found to have acute nontraumatic rhabdomyolysis after an acutely positive SARS-CoV-2 test. Initial creatine kinase (CK) level was above the reference range as were liver enzymes reflective of muscle breakdown. Treatment involved fluid resuscitation and pain control, with close monitoring of kidney, liver, and skeletal markers over five days of hospitalization till there was clinical and symptomatic improvement.
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  • 文章类型: Journal Article
    抗生素经常引起肝功能异常。Omadacycline是一种新型的氨甲基环素抗生素,对革兰氏阳性和革兰氏阴性需氧显示出有效的活性,厌氧,和非典型(包括嗜肺军团菌)细菌。值得注意的是,奥马环素在大多数肝功能损害患者中可以耐受。然而,关于奥马环素在经历肝功能障碍后的肺炎军团菌肺炎患者中应用的证据很少。
    目前的研究报告了6例肺炎军团菌患者在经历肝功能障碍后接受omadacycline作为后续抗生素。
    这6例因肺炎入院并接受抗生素治疗,包括哌拉西林他唑巴坦,亚胺培南,美罗培南,和莫西沙星.在接受这些抗生素后,注意到肝酶增加。尽管给予了保肝治疗(如异甘草酸镁和谷胱甘肽),肝功能仍然异常。根据宏基因组下一代测序,这些患者被诊断为嗜肺军团菌肺炎.考虑到肝功能异常,抗生素治疗改用含有奥马环素的抗生素治疗.之后,肝功能得到改善,感染得到改善。最终,所有出院的病人,包括2例临床症状完全改善的患者和4例临床症状部分改善的患者。
    这项研究强调了在嗜肺军团菌肺炎患者经历肝功能异常后改用奥马环素的成功治疗。这项研究表明,奥马环素可以作为肺炎军团菌肺炎患者的可选抗生素,尤其是发生肝功能障碍时。然而,需要更多的临床研究来验证我们的发现.
    UNASSIGNED: Antibiotics frequently induce abnormal liver function. Omadacycline is a novel aminomethylcycline antibiotic, which shows potent activity against Gram-positive and Gram-negative aerobic, anaerobic, and atypical (including Legionella pneumophila) bacteria. Of note, omadacycline is tolerable in most patients with liver impairment. However, evidence regarding the application of omadacycline in patients with Legionella pneumophila pneumonia after experiencing liver dysfunction is scarce.
    UNASSIGNED: The current study reported 6 cases of patients with Legionella pneumophila pneumonia receiving omadacycline as subsequent antibiotics after experiencing liver dysfunction.
    UNASSIGNED: These 6 cases were admitted to the hospital for pneumonia and received antibiotic therapy, including piperacillin-tazobactam, imipenem, meropenem, and moxifloxacin. After receiving these antibiotics, increased liver enzymes were noted. Although hepatoprotective therapy (such as magnesium isoglycyrrhizinate and glutathione) was given, the liver function was still abnormal. According to metagenomic next-generation sequencing, these patients were diagnosed with Legionella pneumophila pneumonia. Considering the abnormal liver function, the antibiotic therapy was switched to omadacycline-containing antibiotic therapy. After that, liver function was improved, and the infection was ameliorated. Ultimately, all patients discharged from the hospital, including 2 patients who achieved complete clinical symptomatic improvement and 4 patients who achieved partial clinical symptomatic improvement.
    UNASSIGNED: This study emphasizes the successful treatment of switching to omadacycline after experiencing abnormal liver function in patients with Legionella pneumophila pneumonia. This study suggests that omadacycline may serve as an optional antibiotic for patients with Legionella pneumophila pneumonia, especially when occurring liver dysfunction. However, more clinical studies are required to validate our findings.
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  • 文章类型: Case Reports
    随着右肺动脉发育不全(PAA)的儿科患者的成熟,她逐渐出现肺动脉高压和咯血的症状。关于这种情况的临床文献有限,目前,关于其诊断和治疗尚无共识。本文介绍一例16岁女性右肺动脉发育不全患者的病例研究,提供对她的发育进展的全面总结和分析,病理学,诊断,和治疗。
    As the pediatric patient with right pulmonary artery agenesis (PAA) matured, she progressively presented symptoms of pulmonary hypertension and hemoptysis. There is limited clinical literature on this condition, and currently, there is no consensus regarding its diagnosis and treatment. This article presents a case study of a 16-year-old female patient with right pulmonary artery hypoplasia, providing a comprehensive summary and analysis of her developmental progression, pathology, diagnosis, and treatment.
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  • 文章类型: Case Reports
    该报告描述了一名20多岁的男性,他有2个月的反复咯血和胸痛病史。慢性感染,如肺结核,被怀疑。过去,他曾接受过心包内包虫囊肿的手术切除。他的血液检查显示周围嗜酸性粒细胞增多,他的胸部X光检查显示左上区有囊性卵圆病变。CT肺血管造影显示,双侧节段和亚节动脉充盈缺损,左上叶囊性病变。进一步的工作,包括支气管肺泡灌洗培养和胸部MRI,确诊为包虫囊肿的肺包虫病。此病例说明了在没有其他危险因素的年轻男性中出现多系统包虫病。最初接受手术切除和抗蠕虫治疗。这种疾病后来复发,这需要长时间的药物治疗,使病人得到缓解.
    This report describes a male in his late 20s who presented with a 2-month history of recurrent haemoptysis and chest pain. A chronic infection, such as tuberculosis, was suspected. He had undergone surgical resection of an intrapericardial hydatid cyst in the past. His blood investigations showed peripheral eosinophilia, and his chest X-ray showed a cystic oval lesion in the left upper zone. A CT pulmonary angiogram revealed filling defects in the bilateral segmental and subsegmental arteries with a cystic lesion in the left upper lobe. Further workup, including bronchoalveolar lavage culture and MRI of the thorax, confirmed the diagnosis of a hydatid cyst of pulmonary echinococcosis. This case illustrates the presentation of multisystemic echinococcosis in a young male with no other risk factors, initially treated with surgical resection and antihelminthic therapy. The disease later recurred, which required prolonged medications, which brought the patient into remission.
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  • 文章类型: Journal Article
    恢复期血浆被提议用于对COVID-19的被动免疫;但到目前为止,结果相互矛盾,仍然存在悬而未决的问题。然而,除了抗体,其他血浆蛋白可能是进一步研究和应用的良好候选者。血栓炎症经常使严重的COVID-19复杂化,经典的抗凝剂如肝素似乎效果有限。天然蛋白酶抑制剂抗凝血酶III(ATIII),α1-抗胰蛋白酶(α1-AT)和α2-巨球蛋白(α2-M),在重度COVD-19中发现降低,在血栓形成和炎症通路中起关键作用。虽然ATIII和α1-AT被许可作为商业制备的治疗浓缩物,没有可用的α2-M制剂。诊断,预后,甚至血浆蛋白酶抑制剂的治疗潜力应该进一步探索。
    Convalescent plasma was proposed for passive immunization against COVID-19; but so far there are conflicting results and still open questions. However, besides antibodies, other plasma proteins may be good candidates for further research and application. Thromboinflammation frequently complicates severe COVID-19, and classical anticoagulants like heparins seem to have limited effect. The natural protease inhibitors antithrombin III (ATIII), α1-antitrypsin (α1-AT) and α2-macroglobulin (α2-M), which are found decreased in severe COVD-19, play a crucial role in prothrombotic and inflammatory pathways. While ATIII and α1-AT are licensed as commercially prepared therapeutic concentrates, there is no preparation of α2-M available. The diagnostic, prognostic, and even therapeutic potential of plasma protease inhibitors should be further explored.
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  • 文章类型: Journal Article
    最近人工智能系统的兴起,比如ChatGPT,给教育部门带来了一个根本性的问题。在大学和学校,多种形式的评估,比如课程,没有监考就完成了。因此,学生可以把工作作为自己的工作,这实际上是由人工智能完成的。自从COVID大流行以来,该行业还加快了对无人监督的“在家考试”的依赖。如果学生使用人工智能作弊,而这是未被发现的,学生评估方式的完整性受到威胁。我们报告了一个严格的,盲目研究,我们在五个本科模块的考试系统中注入了100%的人工智能书面材料,在所有多年的研究中,在英国一所著名大学获得心理学学士学位。我们发现,94%的人工智能提交没有被发现。授予我们的AI提交的成绩平均比实际学生的成绩高出一半。在所有模块中,模块上的AI提交有83.4%的可能性超过随机选择相同数量的真实学生提交。
    The recent rise in artificial intelligence systems, such as ChatGPT, poses a fundamental problem for the educational sector. In universities and schools, many forms of assessment, such as coursework, are completed without invigilation. Therefore, students could hand in work as their own which is in fact completed by AI. Since the COVID pandemic, the sector has additionally accelerated its reliance on unsupervised \'take home exams\'. If students cheat using AI and this is undetected, the integrity of the way in which students are assessed is threatened. We report a rigorous, blind study in which we injected 100% AI written submissions into the examinations system in five undergraduate modules, across all years of study, for a BSc degree in Psychology at a reputable UK university. We found that 94% of our AI submissions were undetected. The grades awarded to our AI submissions were on average half a grade boundary higher than that achieved by real students. Across modules there was an 83.4% chance that the AI submissions on a module would outperform a random selection of the same number of real student submissions.
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  • 文章类型: Journal Article
    流产衣原体肺炎在正常人中非常罕见。目前,缺乏有关此类感染患者的临床特征和诊治经验的临床数据。我们的团队最近治疗了这些患者中的7例。本研究旨在全面总结和分析流产衣原体肺炎的临床特点和治疗方法,为流产衣原体肺炎的诊断和治疗提供临床依据。
    通过肺和重症医学科的宏基因组下一代测序(mNGS)从诊断为流产衣原体肺炎的患者中回顾性收集临床数据,梅州市人民医院.
    7例流产衣原体肺炎患者报告有家禽接触史,伴有呼吸道或消化道症状的发热。血液炎症标志物明显升高,伴有低蛋白血症和肝损伤,被观察到。胸部CT扫描显示肺炎和胸腔积液。通过mNGS在血液或支气管肺泡灌洗液(BALF)中检测到流产衣原体,常与鹦鹉衣原体或其他细菌感染并存。值得注意的是,多西环素在治疗流产衣原体方面显示出疗效。
    流产衣原体感染是一种人畜共患疾病,特别是在有家禽接触史的个体中,mNGS成为其检测的可靠诊断工具。流产衣原体感染表现为全身和肺部炎症,通过多西环素治疗有效解决。
    UNASSIGNED: Chlamydia abortus pneumonia is very rare in normal people. At present, there is a lack of clinical data on the clinical characteristics and diagnosis and treatment experience of patients with this type of infection. Our team had recently treated 7 cases of these patients. This study aims to comprehensively summarize and analyze the clinical characteristics and treatment methods of Chlamydia abortus pneumonia, and to provide clinical evidence for the diagnosis and treatment of Chlamydia abortus pneumonia.
    UNASSIGNED: Clinical data were retrospectively collected from patients diagnosed with Chlamydia abortus pneumonia through metagenomic next-generation sequencing (mNGS) at the Department of Pulmonary and Critical Care Medicine, Meizhou People\'s Hospital.
    UNASSIGNED: Seven patients with Chlamydia abortus pneumonia reported a history of poultry exposure, experiencing fever alongside respiratory or digestive symptoms. Marked elevation of blood inflammation markers, accompanied by hypoproteinemia and liver damage, was observed. Chest CT scans revealed pneumonia and pleural effusion. Chlamydia abortus was detected in blood or bronchoalveolar lavage fluid (BALF) through mNGS, often co-occurring with Chlamydia psittaci or other bacteria infections. Notably, Doxycycline demonstrated efficacy in treating Chlamydia abortus.
    UNASSIGNED: Chlamydia abortus infection is a zoonotic disease, particularly among individuals with a history of poultry exposure, and mNGS emerges as a reliable diagnostic tool for its detection. Chlamydia abortus infection manifests with systemic and lung inflammation, effectively addressed through Doxycycline therapy.
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  • 文章类型: Case Reports
    纵隔肿瘤在胎儿发育过程中极为罕见,提出了重大的诊断挑战,并可能导致严重的结局,如死产或转移性疾病,如果不及时识别和管理。胸膜肺母细胞瘤是原始间充质肿瘤,通常与DICER1基因突变有关,表明与其他具有显性遗传的常见成人肿瘤相关的遗传模式。该报告描述了一例涉及一名20岁白人妇女的病例,该妇女在妊娠中期因死产而怀孕。最初对纵隔肿瘤的怀疑来自妊娠监测期间的血液检查和超声检查。然而,II型胸膜肺母细胞瘤的明确诊断是通过尸检时的病理检查确定的。此病例强调了诊断胎儿纵隔肿瘤的复杂性,并为有关新生儿胸膜肺母细胞瘤的稀疏文献做出了贡献。我们对鉴别诊断和文献的全面回顾强调了胸膜肺母细胞瘤的独特特征及其与其他软组织肉瘤的相似性,增强对其临床和遗传特征的理解。
    Mediastinal tumors are exceedingly rare during fetal development, presenting significant diagnostic challenges and potentially leading to severe outcomes such as stillbirth or metastatic disease if not promptly identified and managed. Pleuropulmonary blastomas are primitive mesenchymal tumors often linked to mutations in the DICER1 gene, indicating a hereditary pattern associated with other common adult neoplasms with dominant inheritance. This report describes a case involving a 20-year-old Caucasian woman whose pregnancy was complicated by a stillbirth in the second trimester. Initial suspicions of a mediastinal tumor arose from blood tests and ultrasound examinations during pregnancy surveillance. However, the definitive diagnosis of a type II pleuropulmonary blastoma was established through a pathological examination at autopsy. This case underscores the complexities of diagnosing fetal mediastinal tumors and contributes to the sparse literature on neonatal pleuropulmonary blastomas. Our comprehensive review of the differential diagnoses and literature emphasizes the unique characteristics of pleuropulmonary blastoma and its similarities to other soft tissue sarcomas, enhancing understanding of their clinical and genetic profiles.
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  • 文章类型: Case Reports
    产生粒细胞集落刺激因子(G-CSF)的肺肿瘤很少见,他们的成像特征和有效的治疗仍然难以捉摸。同样,间充质-上皮转化(MET)外显子14跳跃突变也不常见。在这里,我们报道一例产生G-CSF的肺腺癌MET第14外显子跳跃突变阳性,模仿肺脓肿。一名61岁男子出现咳嗽和高烧。对比增强胸部计算机断层扫描显示肿块有腔和内部液体积聚。患者最初接受肺脓肿的诊断治疗,但最终被诊断为MET外显子14跳跃突变阳性的肺腺癌。在替替尼治疗后,原发病变缩小,血清G-CSF水平下降,导致产生G-CSF的肺癌的诊断。产生G-CSF的肺肿瘤可以呈现模拟肺脓肿的影像学发现。Tepotinib治疗可能对MET外显子14跳跃突变的患者有效,包括那些产生G-CSF的肺癌。
    Granulocyte colony-stimulating factor (G-CSF)-producing lung tumours are rare, with their imaging features and effective treatments remaining elusive. Similarly, mesenchymal-epithelial transition (MET) exon 14 skipping mutations are also uncommon. Herein, we report a case of G-CSF-producing lung adenocarcinoma positive for a MET exon 14 skipping mutation, mimicking lung abscess. A 61-year-old man presented with cough and high fever. Contrast-enhanced chest computed tomography revealed a mass with a cavity and internal fluid accumulation. The patient initially underwent diagnostic treatment for a lung abscess but was ultimately diagnosed with lung adenocarcinoma positive for a MET exon 14 skipping mutation. Following tepotinib therapy, the primary lesion shrank, and serum G-CSF levels decreased, leading to a diagnosis of G-CSF-producing lung cancer. G-CSF-producing lung tumours can present imaging findings that mimic lung abscesses. Tepotinib therapy may be effective for patients with MET exon 14 skipping mutation, including those with G-CSF-producing lung cancer.
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  • 文章类型: Case Reports
    a静脉动脉瘤(PVA)是一种罕见的血管疾病。我们报告了通过进一步评估由肺栓塞(PE)引起的心脏骤停(CA)而发现的PVA病例。众所周知,PVA会导致PE;然而,很少有PVA引起CA的报道。进行了切向动脉瘤切除术和外侧静脉修补术。患者术后病程顺利。当执行对比增强计算机断层扫描以搜索CA的原因时,应该考虑PVA,因此,建议在膝盖以下进行筛查。在1年的随访中,没有并发症。
    A popliteal venous aneurysm (PVA) is a rare vascular disorder. We report a case of PVA discovered through further evaluation of sudden cardiac arrest (CA) caused by a pulmonary embolism (PE). It is well-known that PVA causes PE; however, there are few reports of PVA causing CA. A tangential aneurysmectomy and lateral venorrhaphy were performed. The patient\'s postoperative course was uneventful. When contrast-enhanced computed tomography is performed to search for the cause of CA, PVA should be considered and thus, screening below the knee is recommended. At 1-year follow-up, there were no complications.
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