Rhabdomyolosis and its pathogenesis

BACKGROUND:Rhabdomyolysis may cause severe damage to the human body because of acute renal failure,fatal heart rhythm disturbances,hypovolemic shock,disturbances of electrolyte balance,metabolic acidosis,hyperthermia,disseminated intravascular coagulation,etc.Drugs and toxins are the most common factors for the disease.This article aimed to review the prognosis of rhabdomyolysis.DATA SOURCES:Based on the reported studies of cell and molecular biology,we reviewed the clinical presentations,laboratory findings,and mechanisms of rhabdomyolysis in the Pubmed.RESULTS:The clinical symptoms of rhabdomyolysis were dependent on the severity of the condition and whether kidney failure develops.Since the necrosis and dissolution of muscle cells,entocytes such as myoglobin,creatine phosphokinase(CPK),electrolytes,proteins and non-protein substances were released into the plasma,the detection of the entocytes may contribute to the early diagnosis of rhabdomyolysis.CONCLUSION:Despite the etiology of the disease is multifactorial,the potential causes of rhabdomyolysis share the same pathophysiological pathway involving an increase in intracellular calcium.

Asymptomatic traumatic rupture of an intracranial dermoid cyst:A case report

BACKGROUND Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous,and only a few were traumatic,with asymptomatic much rarer than the symptomatic ruptures.Hence,how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.CASE SUMMARY A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography(CT)scan due to a car accident.A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa,accompanied with lipid droplet drifts in brain sulci,fissures,cisterns,and ventricles.After 1 wk of conservative observation,no change was observed on the updated cranial CT scan.After 2 wk of conservative observation,magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts.As the patient exhibited no adverse symptoms throughout the 2 wk,a 6-mo follow-up visit was arranged for him instead of aggressive treatment.Nonetheless,the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.CONCLUSION Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.

Male reproductive system and simulated high-altitude environment:preliminary results in rats

This study assessed the effects of a simulated high-altitude environment on the reproductive system of prepubertal male rats and the reversibility of these effects upon return to a normal environment.Three-week-old male Wistar rats were randomly allocated to 4 groups that were exposed to different conditions:a normal environment for 6 weeks and 12 weeks,respectively,hypobaric hypoxia for 6 weeks,and hypobaric hypoxia for 6 weeks followed by a normal environment for 6 weeks.Multiple pathophysiological parameters were evaluated at the histological,endocrine,and molecular levels.Hypobaric hypoxia exposure for 6 weeks during the prepubertal phase significantly altered physiological parameters,body functions,blood indices,and reproductive potential.Six weeks after returning to a normal environment,the damaged reproductive functions partially recovered due to compensatory mechanisms.However,several changes were not reversed after returning to a normal environment for 6 weeks,including disorders of body development and metabolism,increased red blood cells,increased fasting blood glucose,abnormal blood lipid metabolism,decreased testicular and epididymis weights,abnormal reproductive hormone levels,excessive apoptosis of reproductive cells,and decreased sperm concentration.In summary,a hypobaric hypoxic environment significantly impaired the reproductive function of prepubertal male rats,and a return to normal conditions during the postpubertal phase did not fully recover these impairments.

Difference between 2 h and 3 h 75 g glucose tolerance test in the diagnosis of gestational diabetes mellitus(GDM):Results from a national survey on prevalence of GDM

The possibility of the 2 h oral glucose tolerance test(OGTT)as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes.Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test(GCT).All of the 4 glucose levels during their OGTT were collected and analyzed.According to American Diabetes Association(ADA)gestational diabetes mellitus(GDM)diagnostic criteria,among the 4179 pregnant women who required OGTT,3429(82.1%)were normal and 750(17.9%)were diagnosed as GDM.If the 3rd h glucose levels were omitted from OGTT,79 cases of GDM(10.5%)would be overlooked.No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted(χ^(2) for trend=0.038,P>0.05).No significant differences were found in the rate of cesarean section(CS),preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed.It shows that in order to diagnose one woman with GDM,another 52 pregnant women would have an innocent 3rd h glucose test.Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience,better compliance and a small number of possibly miss-diagnosed cases,and their pregnancy outcomes have no significant difference from those of normal pregnant women.