简介：DearEditor,Wearewritingthislettertopresentaveryrarecaseofidiopathicorbitallipogranuloma.Lipogranulomaisagranulomatousinflammatorysofttissuereaction,consistingoflipiddepositionand/oranoil-likesubstancecommonly

简介：自发的oligoasthenoteratozoospermia(i燕麦)影响约30%所有不肥沃的人。这微型评论在这域里讨论了最近的数据。年龄，在testicular以后机关的非煽动性的功能的改变，传染物(Chlamydiatrachomatis，疱疹病毒和联系adeno的病毒)，在配偶子染色体的改变，mitochondrial改变，环境污染物质和“微妙”的神经质的改变都被认为i燕麦的可能的原因。在小管并且在精液的血浆并且apoptosis的反应的氧种类的增加是被认为的影响精子集中，活动性和形态学。i燕麦被排除通常诊断，但光谱主要阴囊的动脉的踪迹可以为i被用作一个诊断工具燕麦。下列能为i燕麦被认为治疗：1)tamoxifen柠檬酸盐(20mg/d)+睾丸激素undecanoate(120mg/d)(妊娠率每夫妇/月[prcm]：3.8%)；2)folic(66mg/d)+硫酸锌(5mg/d)；3)L肉毒碱(2g/d)独自或在有acetyl-L-carnitine(1g/d)的联合(prcm：2.3%)；并且4)两肉毒碱=一个30mgcinnoxicam栓剂每4天(prcm：8.5%)。堵住Alpha药改进了精子集中然而并非形态学，活动性或妊娠率。Tranilast(300mg/d)在起始的不受管束的研究增加了精子参数和妊娠率。它精子集中上的功效(然而并非在精子活动性，形态学或prcm上)在随后的出版报告被证实。tamoxifen+睾丸激素undecanoate的功效，tamoxifen独自一个，并且recombinant刺激滤泡的荷尔蒙仍然是为讨论的一件事。

简介：Acutepancreatitisduringpregnancyisarareevent,andcanbeassociatedwithhighmaternalmortalityandfetalloss.Gallstonediseaseisthoughttobethemostcommoncausativefactorofacutepancreatitis,but,inmanycases,thecauseremainsunclear.Wereportacaseofa36-year-oldwomanat35wkofgestation,whopresentedwithseverepainconfinedtotheupperabdomenandradiatingtotheback.Thepatientwasdiagnosedwithacuteidiopathicpancreatitis,whichwasmanagedconservatively;sherecoveredwithinseveraldaysandthendeliveredahealthybaby.Thereforeitisimportanttoconsideracutepancreatitiswhenapregnantwomanpresentswithupperabdominalpain,nauseaandvomitinginordertoimprovefetalandmaternaloutcomesforpatientswithacutepancreatitis.

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简介：AbstractEtiology of adolescent idiopathic scoliosis (AIS), a complicated three-dimensional spinal deformity with early-onset, receives continuous attention but remains unclear. To gain an insight into AIS pathogenesis, this review searched PubMed database up to June 2019, using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis," "etiology," "genetics," "mesenchymal stem cells," and their combinations, summarized existing literatures and categorized the theories or hypothesis into nine aspects. These aspects include bone marrow mesenchymal stem cell studies, genetic studies, tissue analysis, spine biomechanics measurements, neurologic analysis, hormone studies, biochemical analysis, environmental factor analysis, and lifestyle explorations. These categories could be a guidance for further etiology or treatment researches to gain inspiration.

简介：肝的动脉pseudoaneurysm(幸运)是很稀罕的疾病但是在复杂并发症的情况下，有很高的死亡。幸运的最普通的原因是象肝活体检视那样的因医生之治疗而引的损伤，transhepatic胆汁的排水，胆囊炎和hepatectomy。幸运可以也与象与联系的感染或发炎那样的复杂并发症发生腐败emboli。幸运与尖锐胰腺炎在病人很少被报导了。根据我们知道，没有尖锐自发的胰腺炎特别地引起的一个案例的报告。我们报导在一个61岁的女人发展了的尖锐自发的胰腺炎引起的幸运的一个案例。开始由于未知原因与尖锐胰腺炎介绍的女人。在保守管理以后，她的症状似乎改善了。但是在承认以后的八天，腹的疼痛突然地再变得更坏。腹的计算断层摄影术(CT)被再核对，它检测了没在以前的腹的CT被看见的新幸运。内视镜后退因为hemobilia的怀疑，cholangiopancreatography(ERCP)作为加重的腹的疼痛的一个原因被执行。ERCP由在cholangiogram上在远侧的普通胆汁管在两耳细颈瓶和几充满缺点的开始观察新鲜的血块证实了hemobilia。没有象embolization或外科的结扎那样的任何特别治疗，幸运thrombosed自发地。在分泌物以后的三个月，腹的CT证明在左侧面的片断的那幸运消失了。

简介：Itiswell-knownthatidiopathicthrombocytopenicpurpura(ITP)isanacquiredorgan-specificautoimmunehemorrhagicdiseaseanddysfunctionalcellularimmunityisconsideredimportantinthepathophysiologyofITP.However,polarizationpatternsandapoptosisprofilesofTlymphocytesremainunclear.Inthisstudy,weinvestigatedthepolarizationofTcellsubsets,theexpressionsofapoptoticproteinsFas/FasLonthesubsetsandthelevelofanti-apoptoticgenebcl-2andbaxmRNA.ItwasdemonstratedthattheratiosofTh1/Th2andTc1/Tc2inITPchildrenwereincreasedobviouslyandthattheaveragepercentageswereincreasedclearlyforTh1andTh2,butnotforTc1andTc2.InITPchildren,theenhancingexpressionsweredetectedforFasLonTh1andTc1andforFasonTh2andTc2.Withincreasinglevelofbcl-2mRNAanddecreasingexpressionofbaxmRNAinITPchildren,theratioofbcl-2/baxmRNAwasimprovedobviously,whichwaspositivecorrelatedwiththeratioofTh1/Th2.Takentogether,ourfindingsindicatethatITPisaTh1predominantdisease.ThispolarizationpatternofTcellsubsetsmightberelatedtothehighratioofbcl-2/baxmRNAandtheabnormalexpressionsofFasandFasLonTcellsubsets.Cellular&MolecularImmunology.

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简介：TodeterminewhetherthepossessionofcertainHLA-DQA1alleleswasassociatedwiththeriskofdevelopingidiopathicdilatedcardiomyopathy(IDC)andtosubstantiatetheroleofanautoimmunologicpathogenesisinIDC.TypetheallelesofHLA-DQA1bypolymerasechainreactionwithsequence-specificprimers(PCR-SSP)techniquein38patientsofidiopathicdilatedcardiomyopathy(7womenand31men),agedfrom17to56yearsoldwithdiagnosisbeingaccordingtoWorldHealthOrganizationcriteria(IDCgroup),in50patientsofend-stageheartfailureofknownetiology(18womenand32men),withagesrangingfrom34to72(HFgroup),andinthecontrolgroupconsistingofpresumably100healthysubjects(39womenand61men)fromthehealthsurvey,agedfrom30to59yearsold.ThefrequencyofHLA-DQA1*0501intheDCMpatientswassignificantlyelevatedthanthatintheHFandthecontrolgroup.MolecularanalysisoftheDQA1genepolymorphismperformedinthethreesubgroupsshowsanincreasedfrequencyofDQA1*0501amongpatientswithlessEF.TheHFgroupcarriesahighfrequencyofHLA-DQA1*0301.AnincreasedfrequencyofDQA1*0201andDQA1*0103wasfoundinthecontrolgroup.HLA-DQA1*0501isanassociatedgeneofidiopathicdilatedcardiomyopathyandthepossessionofDQA1*0301maybeindicativeoftheknownetiologicheartfailure,suggestingthatthemechanismsinvolvedinthepathogenesisofIDCandotherwiseheartfailurearedifferent.ImmunologicabnormalitiesmaybeamajorcontributortothesusceptibilityofdevelopingofIDC.

简介：AIM:Topredictthevisualoutcomeinpatientsundergoingmacularholesurgerybytwonovelthree-dimensionalmorphologicalparametersonopticalcoherencetomography(OCT):arearatiofactor(ARF)andvolumeratiofactor(VRF).METHODS:Aclinicalcaseserieswasconducted,including54eyesof54patientswithanidiopathicmacularhole(IMH).EachpatienthadanOCTexaminationbeforeandaftersurgery.Morphologicalparametersofthemacularhole,suchasminimumdiameter,basediameter,andheightweremeasured.Then,themacularholeindex(MHI),tractionalholeindex(THI),andholeformfactor(HFF)werecalculated.Meanwhile,novelpostoperativemacularhole(MH)factors,ARFandVRFwerecalculatedbythree-dimensionalmorphology.Bivariatecorrelationswereperformedtoacquireasymptoticsignificancevaluesbetweenthesteadybestcorrectedvisualacuity(BCVA)aftersurgeryand2D/3DargumentsofMHbythePearsonmethodwithtwo-tailedtest.Allsignificantfactorswereanalyzedbythereceiveroperatingcharacteristic(ROC)curveanalysisofSPSSsoftwarewhichwereresponsibleforvisionrecovery.ROCcurvesanalyseswereperformedtofurtherdiscussthedifferentparametersonthepredictionofvisualoutcome.RESULTS:Themeanandstandarddeviationvaluesofpatients'age,symptomsduration,andfollow-uptimewere64.8±8.9y(range:28-81),18.6±11.5d(range:2-60),and11.4±0.4mo(range:6-24),respectively.Steady-postBCVAanalyzedwithbivariatecorrelationswasfoundtobesignificantlycorrelatedwithbasediameter(r=0.521,P<0.001),minimumdiameter(r=0.514,P<0.001),MHI(r=-0.531,P<0.001),THI(r=-0.386,P=0.004),HFF(r=-0.508,P<0.001),andARF(r=-0.532,P<0.001).Othercharacteristicparameterssuchasage,durationofsurgery,height,diameterholeindex,andVRFwerenotstatisticallysignificantwithsteady-post-BCVA.Accordingtoareaunderthecurve(AUC)values,valuesofARF,MHI,HFF,minimumdiameter,THI,andbasediameterare0.806,0.772,0.750,0.705,0.690,and0.686,respectively.However,Steady-post-BCVAanalysiswithbivar

简介：结肠的静脉曲张是更低的胃肠的流血的一个很稀罕的原因。少数在英语文学比自发的结肠的静脉曲张(ICV)的结肠的静脉曲张，和30个案例的100个案例被报导了。在ICV的这30个案例之中，19个案例被血管造影术诊断，并且7个操作案例以后作为回盲肠静脉赤字被诊断，缝血管瘤，并且在1自发，1，5个案例分别地。我们报导受不了在11年岁时改变学位的便血的多重事件的一个24岁的人的案例。他与21g/L的血红素有严重贫血症。在结肠镜检查上，曲折地扩大了特别在书籍的右页sigmoid区域被黑暗坏死的纸巾盖住的粘膜下层静脉和脆的溃疡从直肠被看见直到远侧的下降结肠。它开始看起来是有静脉曲张的癌。肠系膜angiographic学习建议了一个结肠的缝血管瘤。低前面的切除术由于难处理的医学上和周期性的便血被做。另外的肠和mes伤寒脉管的结构显得正常。没有代表新容器生长，显微镜检查在整个粘膜下层和浆膜与扩大静脉揭示了正常结肠的粘膜。一起这些调查结果拿所有，病人作为ICV被诊断。他的手术后的功课是平静的。

简介：AbstractBackground:Myxofibrosarcoma (MFS), especially radiation-Induced MFS (RIMFS) in the head and neck, is an extremely rare malignant fibroblastic tumor. The diagnosis and treatment of MFS remain great challenges. In the present study, we presented one case of RIMFS. Combined with previous literature, the clinical features, essentials of diagnosis, and treatment modalities of MFS in the head and neck were reviewed to better understand this rare entity.Case presentation:We reported a case of RIMFS under the left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006. A total tumor resection was performed with preservation of the overlying scalp the underlying bone, and no adjuvant therapy was administered after the first operation. The postoperative pathological diagnosis was high-grade MFS. The tumor relapsed 6 months later, and then, a planned extensive resection with negative surgical margins was carried out, followed by radiotherapy. No relapse occurred in a 12-month postoperative follow-up.Conclusions:Planned gross total resection (GTR) with negative margins is the reasonable choice and footstone of other treatments for MFS. Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck, so adjuvant radiotherapy and chemotherapy seem more necessary for these lesions.

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简介：Autoimmunemechanismsarelikelyinvolvedinthepathogenesisofidiopathicdilatedcardiomyopathy(IDC)andcomponentsofMHCmayserveasmarkersforthepropensitytodevelopimmune-mediatedmyocardialdamage.ThisstudywasconductedtoinvestigatethepossibleassociationbetweenHLA-DQA1,-DQB1allelesandIDCinHanpopulationfromnorthernChinabyusingPCR-basedsequence-specificprimer(PCR-SSP)techniqueforHLAgenotyping.Among68unrelatedIDCpatients,4probandsofIDCpedigreesand100healthycontrols,wefoundthattheallelesofHLA-DQA1*0501andHLA-DQB1*0303conferredsusceptibilitytoIDCwhileHLA-DQA1*0201andHLA-DQB1*0502,*0504alleleswereinnegativeassociationwithIDC.Theserineatposition57(SER57)intheexonofHLA-DQB1*0502and*0504wasconfirmedinourexperimentasamarkerforresistancetoIDC.TheresultssuggestthatHLA-DQpolymorphismmaybeinvolvedinthepathogenesisofIDC.

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简介：AbstractPurpose:Determine the impact of upper eyelid weight placement at 3 months post onset of idiopathic facial paralysis (IFP) on the recovery of facial function in patients with lagophthalmos.Methods:This is a retrospective review of patients with incomplete recovery of IFP—defined as a Sunnybrook Facial Grading Scale (FGS) score of less than 100, 3 months after onset. Only patients with FGS and Facial Clinimetric Evaluation (FaCE) scores recorded at 3 and 12 months were included. Patients were categorized into 3 groups: Group A, lagophthalmos with eyelid weight placement; Group B, lagophthalmos without eyelid weight placement; Group C, complete eye closure (CEC) without eyelid weight placement. The eye comfort domain and composite score of the FaCE questionnaire were analyzed. Voluntary eye closure, synkinesis with eye closure, overall synkinesis and the composite score of the FGS were also analyzed. Paired two-tailed t-test was used to evaluate the data comparing the 3 and 12 month FaCE and FGS scores within and between the 3 groups.Results:The change in composite FGS score significantly increased from month 3 to month 12 in Group A as compared to Group B (37 vs 4.25, P = 0.01). While Group A had significantly lower eye comfort (-12.5, P = 0.01), voluntary eye closure (-1.75, P = 0.05) and overall FGS scores (-28.75, P = 0.04) at 3 months compared to those in Group C, there were no differences between these two groups at 12 month follow-up.Conclusions:For patients with lagophthalmos at 3 months, early eyelid weight placement may lead to improved facial function at 12 months.

简介：AbstractBackground:Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3-5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3-5) and moderate scoliosis (Cobb angle 20°-40°).Methods:From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation.Results:In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = -3.918, P = 0.001), and 3.7 ± 0.4 (t = -6.468, P < 0.001), respectively. No significant improvements of SRS-22 function domain (t = -2.825, P = 0.088) and mental health domain (t = -3.174, P = 0.061) were observed. The mean Cobb angle decreased from 28.9 ± 5.5° to 26.3 ± 5.2° at the final follow-up, despite no statistical significance was observed (t = 1.853, P = 0.102). The mean C2-C7 SVA value decreased from 21.7 ± 8.4 mm to 17.0 ± 8.0 mm (t = -1.224 P = 0.049) and mean T1 tilt decreased from 4.9 ± 4.2 ° to 3.5 ± 3.1° (t = 2.913, P = 0.011). No significant improvement of radiographic parameters and HRQOL were observed in observation group.Conclusions:For AIS patients with a Risser 3-5 and a Cobb angle 20°-40°, Schroth exercises improved HRQOL and halted curve progression during the follow-up period. Both cervical spine alignment and shoulder balance were also significantly improved after Schroth exercises. We recommend Schroth exercises for patients with AIS.

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简介：AbstractThere have been recent extensive studies and rapid advancement on the pathogenesis underlying idiopathic pulmonary fibrosis (IPF), and intricate pathogenesis of IPF has been suggested. The purpose of this study was to clarify the logical relationship between these mechanisms. An extensive search was undertaken of the PubMed using the following keywords: "etiology," "pathogenesis," "alveolar epithelial cell (AEC)," "fibroblast," "lymphocyte," "macrophage," "epigenomics," "histone," acetylation," "methylation," "endoplasmic reticulum stress," "mitochondrial dysfunction," "telomerase," "proteases," "plasminogen," "epithelial-mesenchymal transition," "oxidative stress," "inflammation," "apoptosis," and "idiopathic pulmonary fibrosis." This search covered relevant research articles published up to April 30, 2020. Original articles, reviews, and other articles were searched and reviewed for content; 240 highly relevant studies were obtained after screening. IPF is likely the result of complex interactions between environmental, genetic, and epigenetic factors: environmental exposures affect epigenetic marks; epigenetic processes translate environmental exposures into the regulation of chromatin; epigenetic processes shape gene expression profiles; in turn, an individual’s genetic background determines epigenetic marks; finally, these genetic and epigenetic factors act in concert to dysregulate gene expression in IPF lung tissue. The pathogenesis of IPF involves various imbalances including endoplasmic reticulum, telomere length homeostasis, mitochondrial dysfunction, oxidant/antioxidant imbalance, Th1/Th2 imbalance, M1-M2 polarization of macrophages, protease/antiprotease imbalance, and plasminogen activation/inhibition imbalance. These affect each other, promote each other, and ultimately promote AEC/fibroblast apoptosis imbalance directly or indirectly. Excessive AEC apoptosis and impaired apoptosis of fibroblasts contribute to fibrosis. IPF is likely the result of complex interactions between environmental, genetic, and epigenetic factors. The pathogenesis of IPF involves various imbalances centered on AEC/fibroblast apoptosis imbalance.