BACKGROUND Intrahepatic portosystemic venous shunt(IPSVS)is a rare hepatic disease with different clinical manifestations.Most IPSVS patients with mild shunts are asymptomatic,while the patients with severe shunts pre...BACKGROUND Intrahepatic portosystemic venous shunt(IPSVS)is a rare hepatic disease with different clinical manifestations.Most IPSVS patients with mild shunts are asymptomatic,while the patients with severe shunts present complications such as hepatic encephalopathy.For patients with portal hypertension accompanied by intrahepatic shunt,portal hypertension may lead to hemodynamic changes that may result in exacerbated portal shunt and increased shunt flow.CASE SUMMARY A 57-year-old man,with the medical history of chronic hepatitis B and liver cirrhosis,was admitted to our hospital with abnormal behavior for 10 mo.He had received the esophageal varices ligation and entecavir therapy 1 year ago.Comparing with former examination results,the degree of esophageal varices was significantly reduced,while the right branch of the portal vein was significantly expanded and tortuous.Meanwhile,abdominal ultrasound presented the right posterior branch of portal vein connected with the retrohepatic inferior vena cava.The imaging findings indicated the diagnosis of IPSVS and hepatic encephalopathy.Instead of radiologic interventions or surgical therapies,this patient had only accepted symptomatic treatment.No recurrence of hepatic encephalopathy was observed during 1-year follow-up.CONCLUSION Hemodynamic changes may exacerbate intrahepatic portosystemic shunt.The intervention or surgery should be carefully applied to patients with severe portal hypertension due to the risk of hemorrhage.展开更多
目的探索外科干预联合超声内镜下穿刺引流治疗感染性胰腺坏死(infected pancreatic necrosis,IPN)的临床疗效。方法本研究采用回顾性、历史对照研究设计,收集2016年6月至2023年1月期间成都市第三人民医院收治的98例符合纳入和排除标准...目的探索外科干预联合超声内镜下穿刺引流治疗感染性胰腺坏死(infected pancreatic necrosis,IPN)的临床疗效。方法本研究采用回顾性、历史对照研究设计,收集2016年6月至2023年1月期间成都市第三人民医院收治的98例符合纳入和排除标准的急性胰腺炎(acute pancreatitis,AP)合并IPN患者作为研究对象。根据超声内镜下穿刺引流开展时间点(2020年6月),将2020年5月及之前的患者分入非EUS组(52例),将2020年6月及之后的患者分入EUS组(46例)。分析比较2组患者的基线资料、外科干预、总住院时间、重症医学科(intensive care unit,ICU)住院时间、感染时间、多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)、生存情况、近远期并发症等指标。结果EUS组的经皮穿刺置管引流(percutaneous catheter drainage,PCD)次数(1.0次vs.1.0次)、PCD引流管留置数量(1.0根vs.2.0根)、经腹膜后清创引流次数(1.0次vs.2.0次)、总住院时间(42.0 d vs.45.5 d)、ICU时间(11.0 d vs.14.0 d)、感染时间(10.5 d vs.18.5 d)、MODS发生率[43.5%(20/46)vs.67.3%(35/52)]及残余感染发生率[28.3%(13/46)vs.48.1%(25/52)]均短于(低于)非EUS组(P<0.05);但2组患者的经内镜胰管支架置入次数、开腹手术次数、经腹腔入路腹腔镜手术次数,以及腹腔出血、消化道瘘、消化道梗阻、慢性胰瘘、慢性胰腺炎和切口疝发生率比较差异均无统计学意义(P>0.05)。结论对于合并IPN的AP患者,外科干预联合超声内镜下穿刺引流治疗可减少PCD次数和引流管数目,同时缩短总住院时间、ICU时间和感染时间,减少MODS和残余感染的发生。展开更多
Inspired by the adaptation of cells to the surrounding environment,the combination of cell membrane and nanomaterials has gradually become a new type of biomimetic nanocomposite.The construction of endogenous membrane...Inspired by the adaptation of cells to the surrounding environment,the combination of cell membrane and nanomaterials has gradually become a new type of biomimetic nanocomposite.The construction of endogenous membrane biomimetic nanocarriers(EMBNs)not only retains the structure of membrane surface protein,but also has the properties of nanoparticles(NPs),also provides the ability of natural interaction between nanomaterials and organisms,thus overcoming the severe challenges faced by traditional nanodelivery systems in clinical application.In this paper,the construction methods of EMBNs are reviewed,focusing on a simple method to prepare membrane proteins.Secondly,EMBNs were classified according a variety of cell membranes.Finally,the unique advantages of EMBNs in nanomedicine are introduced,including improving biocompatibility,homologous targeting ability,prolonging blood circulation time and immune escape abilty.In nanomedicine,such as targeted delivery,phototherapy,immunotherapy and tumor imaging,multifaceted biological interfaces through membrane masking provide a new approach for the development of multifunctional NPs.展开更多
文摘BACKGROUND Intrahepatic portosystemic venous shunt(IPSVS)is a rare hepatic disease with different clinical manifestations.Most IPSVS patients with mild shunts are asymptomatic,while the patients with severe shunts present complications such as hepatic encephalopathy.For patients with portal hypertension accompanied by intrahepatic shunt,portal hypertension may lead to hemodynamic changes that may result in exacerbated portal shunt and increased shunt flow.CASE SUMMARY A 57-year-old man,with the medical history of chronic hepatitis B and liver cirrhosis,was admitted to our hospital with abnormal behavior for 10 mo.He had received the esophageal varices ligation and entecavir therapy 1 year ago.Comparing with former examination results,the degree of esophageal varices was significantly reduced,while the right branch of the portal vein was significantly expanded and tortuous.Meanwhile,abdominal ultrasound presented the right posterior branch of portal vein connected with the retrohepatic inferior vena cava.The imaging findings indicated the diagnosis of IPSVS and hepatic encephalopathy.Instead of radiologic interventions or surgical therapies,this patient had only accepted symptomatic treatment.No recurrence of hepatic encephalopathy was observed during 1-year follow-up.CONCLUSION Hemodynamic changes may exacerbate intrahepatic portosystemic shunt.The intervention or surgery should be carefully applied to patients with severe portal hypertension due to the risk of hemorrhage.
文摘目的探索外科干预联合超声内镜下穿刺引流治疗感染性胰腺坏死(infected pancreatic necrosis,IPN)的临床疗效。方法本研究采用回顾性、历史对照研究设计,收集2016年6月至2023年1月期间成都市第三人民医院收治的98例符合纳入和排除标准的急性胰腺炎(acute pancreatitis,AP)合并IPN患者作为研究对象。根据超声内镜下穿刺引流开展时间点(2020年6月),将2020年5月及之前的患者分入非EUS组(52例),将2020年6月及之后的患者分入EUS组(46例)。分析比较2组患者的基线资料、外科干预、总住院时间、重症医学科(intensive care unit,ICU)住院时间、感染时间、多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)、生存情况、近远期并发症等指标。结果EUS组的经皮穿刺置管引流(percutaneous catheter drainage,PCD)次数(1.0次vs.1.0次)、PCD引流管留置数量(1.0根vs.2.0根)、经腹膜后清创引流次数(1.0次vs.2.0次)、总住院时间(42.0 d vs.45.5 d)、ICU时间(11.0 d vs.14.0 d)、感染时间(10.5 d vs.18.5 d)、MODS发生率[43.5%(20/46)vs.67.3%(35/52)]及残余感染发生率[28.3%(13/46)vs.48.1%(25/52)]均短于(低于)非EUS组(P<0.05);但2组患者的经内镜胰管支架置入次数、开腹手术次数、经腹腔入路腹腔镜手术次数,以及腹腔出血、消化道瘘、消化道梗阻、慢性胰瘘、慢性胰腺炎和切口疝发生率比较差异均无统计学意义(P>0.05)。结论对于合并IPN的AP患者,外科干预联合超声内镜下穿刺引流治疗可减少PCD次数和引流管数目,同时缩短总住院时间、ICU时间和感染时间,减少MODS和残余感染的发生。
基金This work was supported by the Development Plan of Youth Innovation Team in Colleges and Universities of Shandong Province(2020KJC003).
文摘Inspired by the adaptation of cells to the surrounding environment,the combination of cell membrane and nanomaterials has gradually become a new type of biomimetic nanocomposite.The construction of endogenous membrane biomimetic nanocarriers(EMBNs)not only retains the structure of membrane surface protein,but also has the properties of nanoparticles(NPs),also provides the ability of natural interaction between nanomaterials and organisms,thus overcoming the severe challenges faced by traditional nanodelivery systems in clinical application.In this paper,the construction methods of EMBNs are reviewed,focusing on a simple method to prepare membrane proteins.Secondly,EMBNs were classified according a variety of cell membranes.Finally,the unique advantages of EMBNs in nanomedicine are introduced,including improving biocompatibility,homologous targeting ability,prolonging blood circulation time and immune escape abilty.In nanomedicine,such as targeted delivery,phototherapy,immunotherapy and tumor imaging,multifaceted biological interfaces through membrane masking provide a new approach for the development of multifunctional NPs.
