BACKGROUND We report a rare case of a large congenital hemangioma(CH)in the maxillofacial region in a female neonate that caused thrombocytopenia and heart failure.With close multidisciplinary collaboration,the congen...BACKGROUND We report a rare case of a large congenital hemangioma(CH)in the maxillofacial region in a female neonate that caused thrombocytopenia and heart failure.With close multidisciplinary collaboration,the congenital hemangioma was successfully resected with good results.CASE SUMMARY The patient was delivered at gestational age of 36 wk by cesarean section due to cephalopelvic disproportion and lack of onset of labor(birth weight:2630 g).A right-sided facial tumor was detected in the fetus during routine antenatal ultrasound examination of the mother at 32 wk of gestation.Physical examination revealed a 7 cm×7 cm×3 cm hard,dull purple-colored mass on the right maxillofacial region.The mass was tense and had prominent surface telangiectasias.Laboratory investigations revealed reduced hemoglobin and platelet count,and increased activated partial thromboplastin time,prothrombin time,and thrombin time.International normalized ratio,fibrin degradation products,and D-Dimer levels were significantly increased.Thromboelastography showed increased alpha angle,mean amplitude,and the clot formation speed.Thyroid-stimulating hormone level was significantly elevated.The patient was administered prednisone,propranolol,euthyrox,vitamin K1,milrinone,and digoxin.After operation,cefepime was administered for anti-infection and propranolol was prescribed at discharge.CONCLUSION We report a rare case of CH in the right maxillofacial region causing thrombocytopenia and heart failure.展开更多
Ischemic stroke has the characteristics of high morbidity and high mortality,which seriously endanger human health.According to the statistics,ischemic stroke in China accounts for about 80% of stroke cases,and its mo...Ischemic stroke has the characteristics of high morbidity and high mortality,which seriously endanger human health.According to the statistics,ischemic stroke in China accounts for about 80% of stroke cases,and its mortality rate is as high as 50%,but most of the ischemic stroke patients who survive have sequelae,such as hemiplegia,aphasia and so on.In recent years,people have continuously studied the pathological cascade of ischemic stroke,and also achieved some good results in animal model experiments,however,the clinical results are not satisfactory.Nowadays,the better clinically effective therapeutic drug is tissue plasminogen activator,but due to the limited time window,only a small number of patients can apply this drug in time to achieve the effect.Therefore,it is essential to study drugs that are definitive and can benefit a large number of patients with ischemic stroke.The development of traditional medicines is not as fast as the development of new drugs.For ischemic stroke,we can also turn from the study of the pathogenesis of ischemic stroke to the study of traditional drugs for the endogenous neuroprotection of ischemic stroke,and look for effective targets for neuroprotection based on traditional medicine.The multi-targets and multi-effects for the acute and convalescent phases of ischemic stroke is a direction explored by researchers,which also provides some evidence for more effective drugs for the treatment of ischemic stroke.展开更多
Background：Myocarditis is an inflammatory disease of the myocardium that may lead to cardiac death in some patients.However,little is known about the predictors of in-hospital mortality in patients with suspected myo...Background：Myocarditis is an inflammatory disease of the myocardium that may lead to cardiac death in some patients.However,little is known about the predictors of in-hospital mortality in patients with suspected myocarditis.Thus,the aim of this study was to identify the independent risk factors for in-hospital mortality in patients with suspected myocarditis by establishing a risk prediction model.Methods：A retrospective study was performed to analyze the clinical medical records of 403 consecutive patients with suspected myocarditis who were admitted to Ningbo First Hospital between January 2003 and December 2013.A total of 238 males （59%） and 165 females （41%） were enrolled in this study.We divided the above patients into two subgroups （survival and nonsurvival）,according to their clinical in-hospital outcomes.To maximize the effectiveness of the prediction model,we first identified the potential risk factors for in-hospital mortality among patients with suspected myocarditis,based on data pertaining to previously established risk factors and basic patient characteristics.We subsequently established a regression model for predicting in-hospital mortality using univariate and multivariate logistic regression analyses.Finally,we identified the independent risk factors for in-hospital mortality using our risk prediction model.Results：The following prediction model for in-hospital mortality in patients with suspected myocarditis,including creatinine clearance rate （Ccr）,age,ventricular tachycardia （VT）,New York Heart Association （NYHA） classification,gender and cardiac troponin T （cTnT）,was established in the study：P =ea/（1 ＋ ea） （where e is the exponential function,P is the probability of in-hospital death,and a =-7.34 ＋ 2.99× [Ccr 〈60 ml/min =1,Ccr ≥60 ml/min =0] ＋ 2.01 × [age ≥50 years =1,age 〈50 years =0] ＋ 1.93 × [VT =1,no VT =0] ＋ 1.39 × [NYHA ≥3 =1,NYHA 〈3 =0] ＋ 1.25 × [male =1,female =0] ＋ 1.13 × [cTnT ≥50 μg/L 1,cTnT 〈50 μg/L =0]）.The area under the receiver operating characteristic curve was 0.96 （standard error =0.015,95% confidence interval [CI]：0.93-0.99）.The model demonstrated that a Ccr 〈60 ml/min （odds ratio [OR] =19.94,95% CI：5.66-70.26）,an age ≥50 years （OR =7.43,95% CI：2.18-25.34）,VT （OR =6.89,95% CI：1.86-25.44）,a NYHA classification ≥3 （OR =4.03,95% CI：1.13-14.32）,male gender （OR =3.48,95% CI：0.99-12.20）,and a cTnT level ≥50 μg/L （OR =3.10,95% CI：0.91-10.62） were the independent risk factors for in-hospital mortality.Conclusions：A Ccr 〈60 ml/min,an age ≥50 years,VT,an NYHA classification ≥3,male gender,and a cTnT level ≥50 μg/L were the independent risk factors resulting from the prediction model for in-hospital mortality in patients with suspected myocarditis.In addition,sufficient life support during the early stage of the disease might improve the prognoses of patients with suspected myocarditis with multiple risk factors for in-hospital mortality.展开更多
文摘BACKGROUND We report a rare case of a large congenital hemangioma(CH)in the maxillofacial region in a female neonate that caused thrombocytopenia and heart failure.With close multidisciplinary collaboration,the congenital hemangioma was successfully resected with good results.CASE SUMMARY The patient was delivered at gestational age of 36 wk by cesarean section due to cephalopelvic disproportion and lack of onset of labor(birth weight:2630 g).A right-sided facial tumor was detected in the fetus during routine antenatal ultrasound examination of the mother at 32 wk of gestation.Physical examination revealed a 7 cm×7 cm×3 cm hard,dull purple-colored mass on the right maxillofacial region.The mass was tense and had prominent surface telangiectasias.Laboratory investigations revealed reduced hemoglobin and platelet count,and increased activated partial thromboplastin time,prothrombin time,and thrombin time.International normalized ratio,fibrin degradation products,and D-Dimer levels were significantly increased.Thromboelastography showed increased alpha angle,mean amplitude,and the clot formation speed.Thyroid-stimulating hormone level was significantly elevated.The patient was administered prednisone,propranolol,euthyrox,vitamin K1,milrinone,and digoxin.After operation,cefepime was administered for anti-infection and propranolol was prescribed at discharge.CONCLUSION We report a rare case of CH in the right maxillofacial region causing thrombocytopenia and heart failure.
文摘Ischemic stroke has the characteristics of high morbidity and high mortality,which seriously endanger human health.According to the statistics,ischemic stroke in China accounts for about 80% of stroke cases,and its mortality rate is as high as 50%,but most of the ischemic stroke patients who survive have sequelae,such as hemiplegia,aphasia and so on.In recent years,people have continuously studied the pathological cascade of ischemic stroke,and also achieved some good results in animal model experiments,however,the clinical results are not satisfactory.Nowadays,the better clinically effective therapeutic drug is tissue plasminogen activator,but due to the limited time window,only a small number of patients can apply this drug in time to achieve the effect.Therefore,it is essential to study drugs that are definitive and can benefit a large number of patients with ischemic stroke.The development of traditional medicines is not as fast as the development of new drugs.For ischemic stroke,we can also turn from the study of the pathogenesis of ischemic stroke to the study of traditional drugs for the endogenous neuroprotection of ischemic stroke,and look for effective targets for neuroprotection based on traditional medicine.The multi-targets and multi-effects for the acute and convalescent phases of ischemic stroke is a direction explored by researchers,which also provides some evidence for more effective drugs for the treatment of ischemic stroke.
文摘Background：Myocarditis is an inflammatory disease of the myocardium that may lead to cardiac death in some patients.However,little is known about the predictors of in-hospital mortality in patients with suspected myocarditis.Thus,the aim of this study was to identify the independent risk factors for in-hospital mortality in patients with suspected myocarditis by establishing a risk prediction model.Methods：A retrospective study was performed to analyze the clinical medical records of 403 consecutive patients with suspected myocarditis who were admitted to Ningbo First Hospital between January 2003 and December 2013.A total of 238 males （59%） and 165 females （41%） were enrolled in this study.We divided the above patients into two subgroups （survival and nonsurvival）,according to their clinical in-hospital outcomes.To maximize the effectiveness of the prediction model,we first identified the potential risk factors for in-hospital mortality among patients with suspected myocarditis,based on data pertaining to previously established risk factors and basic patient characteristics.We subsequently established a regression model for predicting in-hospital mortality using univariate and multivariate logistic regression analyses.Finally,we identified the independent risk factors for in-hospital mortality using our risk prediction model.Results：The following prediction model for in-hospital mortality in patients with suspected myocarditis,including creatinine clearance rate （Ccr）,age,ventricular tachycardia （VT）,New York Heart Association （NYHA） classification,gender and cardiac troponin T （cTnT）,was established in the study：P =ea/（1 ＋ ea） （where e is the exponential function,P is the probability of in-hospital death,and a =-7.34 ＋ 2.99× [Ccr 〈60 ml/min =1,Ccr ≥60 ml/min =0] ＋ 2.01 × [age ≥50 years =1,age 〈50 years =0] ＋ 1.93 × [VT =1,no VT =0] ＋ 1.39 × [NYHA ≥3 =1,NYHA 〈3 =0] ＋ 1.25 × [male =1,female =0] ＋ 1.13 × [cTnT ≥50 μg/L 1,cTnT 〈50 μg/L =0]）.The area under the receiver operating characteristic curve was 0.96 （standard error =0.015,95% confidence interval [CI]：0.93-0.99）.The model demonstrated that a Ccr 〈60 ml/min （odds ratio [OR] =19.94,95% CI：5.66-70.26）,an age ≥50 years （OR =7.43,95% CI：2.18-25.34）,VT （OR =6.89,95% CI：1.86-25.44）,a NYHA classification ≥3 （OR =4.03,95% CI：1.13-14.32）,male gender （OR =3.48,95% CI：0.99-12.20）,and a cTnT level ≥50 μg/L （OR =3.10,95% CI：0.91-10.62） were the independent risk factors for in-hospital mortality.Conclusions：A Ccr 〈60 ml/min,an age ≥50 years,VT,an NYHA classification ≥3,male gender,and a cTnT level ≥50 μg/L were the independent risk factors resulting from the prediction model for in-hospital mortality in patients with suspected myocarditis.In addition,sufficient life support during the early stage of the disease might improve the prognoses of patients with suspected myocarditis with multiple risk factors for in-hospital mortality.
