Percutaneous transhepatic stenting for acute superior mesenteric vein stenosis after pancreaticoduodenectomy with portal vein reconstruction:A case report

BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/occlusion.It has been widely used after liver transplantation surgery;however,reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are rare.CASE SUMMARY Herein,we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic surgery.The patient was successfully treated using stent grafts.Although the stenosis resolved after stent placement,complications,including bleeding,pancreatic fistula,bile leakage,and infection,made the treatment highly challenging.The use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of bleeding.After careful treatment,the patient stabilized,and stent placement effectively managed postoperative PV/SMV stenosis.CONCLUSION Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.

Miniaturized time-of-flight neutron spin flipper using a high-TC superconductor

A miniaturized neutron spin flipper based on a high-TC superconductor film,developed at the China Spallation Neutron Source(CSNS),is presented.A neutron spin flipper is an essential component for performing polarized neutron experiments and,as such,constitutes a high priority for developing CSNS’s polarized neutron capability.To provide the beamlines with a universal neutron spin flipper operating over a wide wavelength band,the neutron spin flipper utilizes non-adiabatic spin flipping during transit through opposite magnetic fields that are mutually shielded by the superconductor Meissner effect.A compact vacuum heat shield and a low-power consumption sterling refrigerator maintained the superconducting condition while reducing the size and power input of the flipper.The prototype device was tested at the CSNS BL-20,which demonstrated a flipping efficiency of 99%at 4 A°.

Different effects of paliperidone and risperidone therapy on blood lipid and Hcy metabolism as well as endocrine hormones in patients with schizophrenia

Objective: To explore the different effects of paliperidone and risperidone therapy on blood lipid and Hcy metabolism as well as endocrine hormones in patients with schizophrenia. Methods: A total of 118 patients with schizophrenia who were treated in the hospital between December 2014 and February 2017 were collected as the research subjects and divided into control group and study group by random number table, each group with 59 cases. Control group received risperidone therapy, observation group received paliperidone therapy, and the differences in the levels of blood lipid indexes, Hcy metabolism indexes and endocrine hormones were compared between the two groups before and after treatment. Results:There was no statistically significant difference in the levels of blood lipid indexes, Hcy and endocrine hormones between the two groups before treatment. After treatment, lipid indexes TG and TC levels in peripheral blood of study group were lower than those of control group while HDL-C content was higher than that of control group;Hcy level in serum of study group was lower than that of control group;endocrine hormones FT3, FT4, T and E2 levels in serum of study group were higher than those of control group. Conclusion: paliperidone therapy for schizophrenia can be more effective than risperidone in regulating blood lipid metabolism, Hcy metabolism and endocrine hormones.

How should congenital absence of cruciate ligaments be treated? A case report and literature review

BACKGROUND Hypoplasia of bilateral cruciate ligaments is a rare congenital malformation.The diagnosis of such diseases and indications for the various treatment options require further analysis and discussion.CASE SUMMARY The patient is a 26-year-old Chinese woman who has been suffering from knee pain since the age of 8 years,2-3 episodes a year.Three years ago,due to the practice of advanced yoga poses,the frequency of left knee pain increased,requiring prompt medical treatment.Magnetic resonance imaging demonstrated an absence of both anterior and posterior cruciate ligaments of both knees with abnormal posterior tilting of the tibial plateau.Bilateral subluxation of the knee joint was also found,therefore tibial osteotomy was performed.The patient reported at the 24 mo follow-up that the frequency of pain and instability had been reduced and function restored.CONCLUSION Osteotomy may be an effective method to treat patients with congenital cruciate ligament deficiency with posterior tibial plateau tilting.The diagnosis of congenital cruciate ligament deficiency shall be based on the combination of patient’s medical history,clinical manifestations,and findings from imaging to avoid possible misdiagnosis.Based on the symptoms,frequency of attacks,and intent of the individual,appropriate treatment options shall be identified.

Trigger finger at the wrist caused by an intramuscular lipoma within the carpal tunnel:A case report

BACKGROUND Trigger finger at the wrist,which occurs with finger movement,is an uncommon presentation.Few reports describing cases of trigger finger at the wrist have been published.Thus,we present a case of an intramuscular lipoma arising from an anomalous flexor digitorum muscle belly in a 48-year-old female patient causing painful finger triggering at the wrist and carpal tunnel syndrome(CTS).CASE SUMMARY A 48-year-old woman with complaints of a catching sensation during wrist motion and a progressive tingling sensation on the palmar aspect of the right hand for approximately 2 years was referred to our hospital.Triggering of the index to middle finger was evident with a palpable and audible clunk over the carpal tunnel during passive motion.Tinel’s sign was positive over the carpal tunnel of the right wrist with a positive Phalen’s test.Nerve conduction studies of the median nerve demonstrated a right CTS.Ultrasound examination revealed a 2.5 cm×2.0 cm subcutaneous hyperechoic mass with no obvious blood flow at the wrist of the right arm.Surgical excision of the tumor and muscle mass led to a resolution of the patient’s symptoms,and any triggering or discomfort disappeared.The patient has had no evidence of recurrence at more than 1 year of follow-up.CONCLUSION Triggering of the fingers at the wrist is rare. It must be noted that there are manypossible causes and types of triggering or clicking around the wrist. Accuratediagnosis is mandatory to avoid inaccurate treatment of patients with triggerwrist. During the diagnosis and treatment of CTS, attention should be paid to thevariation of tendon tissue in the carpal tunnel, to avoid only focusing on therelease of transverse carpal ligament and ignoring the removal of anomalousmuscle belly.

女性泌尿生殖道瘘的单中心临床研究

目的探讨女性泌尿生殖道瘘的致病因素和手术效果。方法回顾性分析2003年1月—2018年6月昆明医科大学第二附属医院泌尿外科收治的166例女性泌尿生殖道瘘患者的临床资料。结果92.2%(153/166)患者发生于医源性损伤后,7.8%(13/166)患者为非医源性因素。150例患者行手术修补,一次手术修补总成功率和早期(漏尿病程<3个月)手术修补成功率分别为87.3%(131/150)和82.6%(19/23),差异无统计学意义(P>0.05);首诊首次手术和首诊再次手术的一次手术修补成功率分别为91.1%(113/124)和69.2%(18/26),差异有统计学意义(P<0.05)。16例患者保守治疗,其中9例保守治疗后自愈。结论医源性损伤是主要致瘘原因。早期修补不影响手术成功率,既往手术影响手术成功率。