BACKGROUND Frostbite is becoming increasingly common in urban environments,and severe cases can lead to tissue loss.The treatment goal is to preserve tissue and function;the sooner appropriate treatment is administere...BACKGROUND Frostbite is becoming increasingly common in urban environments,and severe cases can lead to tissue loss.The treatment goal is to preserve tissue and function;the sooner appropriate treatment is administered,the more tissue can be saved.However,not every patient with deep frostbite seeks medical care promptly.CASE SUMMARY We report the case of a 73-year-old male patient who was lost in the wilderness for 2 d due to trauma and confusion.He experienced deep frostbite on multiple fingers.Treatment should not be discontinued for patients with deep frostbite who present after the optimum treatment timing.Bullae that no longer form(bloody)blisters within 24 h of aspiration should be removed.Mucopolysaccharide polysulfate cream has clinical value in frostbite treatment.The patient was transferred to Chinese Academy of Medical Sciences and Peking Union Medical College Hospital 12 h after being rescued.The patient had contraindications for thrombolysis,the most effective treatment,due to intracranial hemorrhage and presenting past the optimum treatment timing.We devised a comprehensive treatment plan,which involved delayed use vasodilators and high-pressure oxygen therapy at day 49 post-injury.We experimented with mucopolysaccharide polysulfate cream to treat the frostbite.The aim of the treatment was to safeguard as much tissue as possible.In the end,the fingers that suffered from frostbite were able to be partially preserved.CONCLUSION The case indicated that patients with severe frostbite who missed the optimal treatment time and had contraindications for thrombolysis could still partially preserve the affected limbs through comprehensive treatment.展开更多
Aim： To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin. Methods： One thousand two hundred patients between the ...Aim： To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin. Methods： One thousand two hundred patients between the age of 5 and 95 years underwent circumcision using this procedure in the 2-year period between October 2005 and September 2007. Of these cases, 904 had excess foreskin and 296 were cases of phimosis. Results： In 96.33% of the cases the incision healed, leaving a minimal amount of the inner foreskin with no scarring and producing good cosmetic results. There were no incidents of device dislocation or damage to the frenulum. The average operative time was 2.5 min for excess foreskin, and 3.5 min for phimosis. During the 7 days of wearing the device, mild to moderate edema occurred in 10.08 % of cases with excess foreskin and in 2.58 % of those with phimosis. Edema in the frenulum was seen in 1.67% of patients, and only 0.67% had an infection of the incision. A total of 86.25% of patients reported pain due to penile erection. After removal of the device, 0.58% of the cases had minimal bleeding around the incision, and 2.42% had wound dehiscence. Conclusion： The new device can be applied to an overwhelming majority of patients with phimosis and excess foreskin. This technique is relatively simple to perform, and patients who underwent this surgery had very few complications. Antibiotics were not required and patients reported less pain than those who were circumcised using conventional methods. Circumcision with this device requires minimal tissue manipulation, and is quicker and safer than circumcision using conventional techniques.展开更多
The interplay between host cell genetics and Epstein-Barr virus(EBV) infection contributes to the development of nasopharyngeal carcinoma(NPC). Understanding the host genetic and epigenetic alterations and the influen...The interplay between host cell genetics and Epstein-Barr virus(EBV) infection contributes to the development of nasopharyngeal carcinoma(NPC). Understanding the host genetic and epigenetic alterations and the influence of EBV on cell signaling and host gene regulation will aid in understanding the molecular pathogenesis of NPC and provide useful biomarkers and targets for diagnosis and therapy. In this review, we provide an update of the oncogenes and tumor suppressor genes associated with NPC, as well as genes associated with NPC risk including those involved in carcinogen detoxification and DNA repair. We also describe the importance of host genetics that govern the human leukocyte antigen(HLA) complex and immune responses, and we describe the impact of EBV infection on host cell signaling changes and epigenetic regulation of gene expression. High-power genomic sequencing approaches are needed to elucidate the genetic basis for inherited susceptibility to NPC and to identify the genes and pathways driving its molecular pathogenesis.展开更多
基金National High Level Hospital Clinical Research Funding,No.2022-PUMCH-C-005.
文摘BACKGROUND Frostbite is becoming increasingly common in urban environments,and severe cases can lead to tissue loss.The treatment goal is to preserve tissue and function;the sooner appropriate treatment is administered,the more tissue can be saved.However,not every patient with deep frostbite seeks medical care promptly.CASE SUMMARY We report the case of a 73-year-old male patient who was lost in the wilderness for 2 d due to trauma and confusion.He experienced deep frostbite on multiple fingers.Treatment should not be discontinued for patients with deep frostbite who present after the optimum treatment timing.Bullae that no longer form(bloody)blisters within 24 h of aspiration should be removed.Mucopolysaccharide polysulfate cream has clinical value in frostbite treatment.The patient was transferred to Chinese Academy of Medical Sciences and Peking Union Medical College Hospital 12 h after being rescued.The patient had contraindications for thrombolysis,the most effective treatment,due to intracranial hemorrhage and presenting past the optimum treatment timing.We devised a comprehensive treatment plan,which involved delayed use vasodilators and high-pressure oxygen therapy at day 49 post-injury.We experimented with mucopolysaccharide polysulfate cream to treat the frostbite.The aim of the treatment was to safeguard as much tissue as possible.In the end,the fingers that suffered from frostbite were able to be partially preserved.CONCLUSION The case indicated that patients with severe frostbite who missed the optimal treatment time and had contraindications for thrombolysis could still partially preserve the affected limbs through comprehensive treatment.
基金Acknowledgment The project （The Fundamental Researches of the Reproductive Health） was supported by the National Natural Science Foundation of China （G1999055905, branch topic）.
文摘Aim： To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin. Methods： One thousand two hundred patients between the age of 5 and 95 years underwent circumcision using this procedure in the 2-year period between October 2005 and September 2007. Of these cases, 904 had excess foreskin and 296 were cases of phimosis. Results： In 96.33% of the cases the incision healed, leaving a minimal amount of the inner foreskin with no scarring and producing good cosmetic results. There were no incidents of device dislocation or damage to the frenulum. The average operative time was 2.5 min for excess foreskin, and 3.5 min for phimosis. During the 7 days of wearing the device, mild to moderate edema occurred in 10.08 % of cases with excess foreskin and in 2.58 % of those with phimosis. Edema in the frenulum was seen in 1.67% of patients, and only 0.67% had an infection of the incision. A total of 86.25% of patients reported pain due to penile erection. After removal of the device, 0.58% of the cases had minimal bleeding around the incision, and 2.42% had wound dehiscence. Conclusion： The new device can be applied to an overwhelming majority of patients with phimosis and excess foreskin. This technique is relatively simple to perform, and patients who underwent this surgery had very few complications. Antibiotics were not required and patients reported less pain than those who were circumcised using conventional methods. Circumcision with this device requires minimal tissue manipulation, and is quicker and safer than circumcision using conventional techniques.
基金supported by the Research Grants Council Area of Excellence grant (AoE/M-06/08)
文摘The interplay between host cell genetics and Epstein-Barr virus(EBV) infection contributes to the development of nasopharyngeal carcinoma(NPC). Understanding the host genetic and epigenetic alterations and the influence of EBV on cell signaling and host gene regulation will aid in understanding the molecular pathogenesis of NPC and provide useful biomarkers and targets for diagnosis and therapy. In this review, we provide an update of the oncogenes and tumor suppressor genes associated with NPC, as well as genes associated with NPC risk including those involved in carcinogen detoxification and DNA repair. We also describe the importance of host genetics that govern the human leukocyte antigen(HLA) complex and immune responses, and we describe the impact of EBV infection on host cell signaling changes and epigenetic regulation of gene expression. High-power genomic sequencing approaches are needed to elucidate the genetic basis for inherited susceptibility to NPC and to identify the genes and pathways driving its molecular pathogenesis.
