BACKGROUND Giant paraesophageal hiatal hernias (HH) are very infrequent,and their spectrum of clinical manifestations is large.Giant HH mainly occurs in elderly patients,and its relationship with anemia has been repor...BACKGROUND Giant paraesophageal hiatal hernias (HH) are very infrequent,and their spectrum of clinical manifestations is large.Giant HH mainly occurs in elderly patients,and its relationship with anemia has been reported.For the surgical treatment of large HH,Nissen fundoplication is the most common antireflux procedure,and the reinforcement of HH repair with a patch (either synthetic or biologic) is still debatable.CASE SUMMARY We report on a case of giant paraesophageal HH in a middle-aged male patient with reflux symptoms and severe anemia.After performing a series of tests and diagnostic approaches,results showed a complete intrathoradc stomach associated with severe iron deficiency anemia.The patient underwent successful laparoscopic hernia repair with mesh reinforcement and Nissen fundoplication.Postoperatively,reflux symptoms were markedly relieved,and the imaging study showed complete reduction of the hernia sac.More importantly,anemia was resolved,and hemoglobin,serum iron and ferritin level were returned to the normal range.The patient kept regular follow-up appointments and remained in a satisfactory condition.CONCLUSION This case report highlights the relationship between large HH and iron deficiency anemia.For the surgical treatment of large HH,laparoscopic repair of large HH combined with antireflux procedure and mesh reinforcement is recommended.展开更多
Zhang et al.[1]reported the first direct detection of the natural supercritical CO_(2)(scCO_(2);critical point:31.1℃and 72.9 atm)in a deep-sea hydrothermal system.In their study,they measured in situ the Raman bands ...Zhang et al.[1]reported the first direct detection of the natural supercritical CO_(2)(scCO_(2);critical point:31.1℃and 72.9 atm)in a deep-sea hydrothermal system.In their study,they measured in situ the Raman bands of scCO_(2)bubbling from an approximately 95℃hydrothermal vent.The Raman spectra indicated that the scCO_(2)bubbles also trapped N2 and CH4 gases and unidentified organic carbons.This discovery suggests a scenario that a layer of scCO_(2)might have existed in the Hadean atmosphere between the young ocean and the gaseous CO_(2)-dominated upper layers.Such a layer of scCO_(2)in the atmosphere should have been highly active in trapping energetic small molecules and catalytic transition metals and polymerizing organic matters,thereby aiding the creation of a favorable planetary environment for prebiotic evolution toward life.展开更多
文摘BACKGROUND Giant paraesophageal hiatal hernias (HH) are very infrequent,and their spectrum of clinical manifestations is large.Giant HH mainly occurs in elderly patients,and its relationship with anemia has been reported.For the surgical treatment of large HH,Nissen fundoplication is the most common antireflux procedure,and the reinforcement of HH repair with a patch (either synthetic or biologic) is still debatable.CASE SUMMARY We report on a case of giant paraesophageal HH in a middle-aged male patient with reflux symptoms and severe anemia.After performing a series of tests and diagnostic approaches,results showed a complete intrathoradc stomach associated with severe iron deficiency anemia.The patient underwent successful laparoscopic hernia repair with mesh reinforcement and Nissen fundoplication.Postoperatively,reflux symptoms were markedly relieved,and the imaging study showed complete reduction of the hernia sac.More importantly,anemia was resolved,and hemoglobin,serum iron and ferritin level were returned to the normal range.The patient kept regular follow-up appointments and remained in a satisfactory condition.CONCLUSION This case report highlights the relationship between large HH and iron deficiency anemia.For the surgical treatment of large HH,laparoscopic repair of large HH combined with antireflux procedure and mesh reinforcement is recommended.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB41000000 and XDA22050100)Qian Xuesen Laboratory,China Academy of Space Technology。
文摘Zhang et al.[1]reported the first direct detection of the natural supercritical CO_(2)(scCO_(2);critical point:31.1℃and 72.9 atm)in a deep-sea hydrothermal system.In their study,they measured in situ the Raman bands of scCO_(2)bubbling from an approximately 95℃hydrothermal vent.The Raman spectra indicated that the scCO_(2)bubbles also trapped N2 and CH4 gases and unidentified organic carbons.This discovery suggests a scenario that a layer of scCO_(2)might have existed in the Hadean atmosphere between the young ocean and the gaseous CO_(2)-dominated upper layers.Such a layer of scCO_(2)in the atmosphere should have been highly active in trapping energetic small molecules and catalytic transition metals and polymerizing organic matters,thereby aiding the creation of a favorable planetary environment for prebiotic evolution toward life.
