Spinal cord injury (SCI) is a devastating type of neurological trauma with limited therapeutic op- portunities. The pathophysiology of SCI involves primary and secondary mechanisms of injury. Among all the secondary...Spinal cord injury (SCI) is a devastating type of neurological trauma with limited therapeutic op- portunities. The pathophysiology of SCI involves primary and secondary mechanisms of injury. Among all the secondary injury mechanisms, the inflammatory response is the major contrib- utor and results in expansion of the lesion and further loss of neurologic function. Meanwhile, the inflammation directly and indirectly dominates the outcomes of SCI, including not only pain and motor dysfunction, but also preventingneuronal regeneration. Microglia and macrophages play very important roles in secondary injury. Microglia reside in spinal parenchyma and survey the microenvironment through the signals of injury or infection. Macrophages are derived from monocytes recruited to injured sites from the peripheral circulation. Activated resident microglia and monocyte-derived macrophages induce and magnify immune and inflammatory responses not only by means of their secretory moleculesand phagocytosis, but also through their influence on astrocytes, oligodendrocytes and demyelination. In this review, we focus on the roles of mi- croglia and macrophages in secondary injury and how they contribute to the sequelae of SCI.展开更多
Objective:To look for secondary bacterial infections in bronchogenic carcinoma(BC<sub>A</sub>) with resistant organisms harboring bla genes considering the paucity of relevant studies.Methods: A total of...Objective:To look for secondary bacterial infections in bronchogenic carcinoma(BC<sub>A</sub>) with resistant organisms harboring bla genes considering the paucity of relevant studies.Methods: A total of 137 confirmed cases of BC<sub>A</sub> and 34 healthy volunteers were studied for the occurrence and prevalence of bla<sub>CTX-M</sub> and and bla<sub>AmpC</sub> harboring-enterobacteriaceae.A subset of these patients(n=69) was previously reported for the secondary infection with the Aspergillus species. Bronchoalveolar lavages(BAL) were subjected for bacterial and fungal cultures and the bacterial isolates were screened by multiplex PCRs for the presence of bla<sub>CTX-M</sub> and bla<sub>AmpC</sub>.The isolates were also screened for the association of insertion sequence(IS26) by PCR and characterized by RAPD for any clonal relatedness.Results:A total of 143 bacterial isolates were obtained from 137 BAL specimens of BC,patients.The Enterobacteriaceae-isolates were multidrug-resistant showing concomitant resistance to fluoroquinolones and aminoglycosides.Both bla<sub>CTX-M</sub> and bla<sub>AmpC</sub> of CIT family were detected in 77.4%and 27.4%isolates,respectively.Sequencing revealed the presence of bla<sub>CTX-M-15</sub> and bla<sub>CMY-6</sub>.Twenty one percent of the isolates were simultaneously harboring bla<sub>ampC</sub> and bla<sub>CTX-M-15</sub>.IS26 PCR and RAPD typing revealed the presence of diverse bacterial population but no predominant clone was identified.The present study also suggests strong association of aspergillosis with lung cancer and further strengthens the potential use of non-validated serological tests suggested earlier.Conclusions:We emphasize that all patients of bronchogenic carcinoma should also be screened for secondary bacterial infections,along with secondary fungal infections,so as to introduce early and specific antimicrobial therapy and to prevent unwanted deaths.展开更多
Müllerian adenosarcomas are rare mixed tumors with low malignant potential, and occur mainly in the uterus. Primary adenosarcomas arising in vaginal endometriosis are even more rarely reported. We report a very r...Müllerian adenosarcomas are rare mixed tumors with low malignant potential, and occur mainly in the uterus. Primary adenosarcomas arising in vaginal endometriosis are even more rarely reported. We report a very rare case with Müllerian adenosarcoma arising from vaginal endometriosis. A 43-year-old nulliparous woman has a history of endometriosis. Due to two parallel fistulas in cervix, severe endometriosis and adenosarcoma, she has undergone radical and multiple surgeries. After the surgery, persistent vaginal vault masses were noticed, and eight resections of the polyps at vaginal stump were performed. For the first six resections, all the pathological examinations showed endometriosis. And the last two resections demonstrated vaginal adenosarcoma. Transition between Müllerian adenosarcoma and endometriosis was gradual. Finally, adenosarcoma associated with endometriosis was diagnosed from recurrent vaginal masses. To our knowledge, this report is the sixth case that primary adenosarcomas arising in vaginal endometriosis. But chemo-therapy and radiation therapy were not taken and the patient remained in a good condition throughout the 9-year follow-up period. In addition, we present a review of the literature. The diagnosis and treatment of the tumor are also discussed.展开更多
BACKGROUND The co-existence of Waldenstr?m’s macroglobulinemia(WM) with internodal marginal zone lymphoma(INMZL) is rare and often associated with poor prognosis.CASE SUMMARY We present a Chinese female patient who d...BACKGROUND The co-existence of Waldenstr?m’s macroglobulinemia(WM) with internodal marginal zone lymphoma(INMZL) is rare and often associated with poor prognosis.CASE SUMMARY We present a Chinese female patient who developed secondary light chain amyloidosis due to WM and INMZL and provides opinions on its systemic treatment.A 65-year-old woman was diagnosed with WM 6 years ago and received Bruton tyrosine kinase inhibitor monotherapy for two years.Her INMZL was confirmed due to left cervical lymphadenopathy.The patient presented with oedema in both lower limbs one year ago,and was diagnosed with secondary light chain amyloidosis.Treatment with the BC regimen(rituximab 375 mg/m~2 monthly for 6-8 courses,and bendamustine 90 mg/m~2 per day × 2,monthly for six courses) was initiated,but not tolerated due to toxic side effects.Bortezomibbased therapy was given for two months,including bortezomib,dexamethasone,and zanubrutinb.Oedema in both lower limbs was relieved and treatment efficacy was evaluated as partial remission.CONCLUSION A detailed clinical evaluation and active identification of the aetiology are recommended to avoid missed diagnosis and misdiagnosis.展开更多
<strong>Introduction:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Mullerian malformations are a group of malformations that r...<strong>Introduction:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Mullerian malformations are a group of malformations that result from an alteration of embryonic development. Most cases are asymptomatic, however, in pregnant </span><span style="font-family:Verdana;">patients</span><span style="font-family:Verdana;"> it has been associated with recurrent abortion or premature delivery. </span><b><span style="font-family:Verdana;">Case presentation:</span></b><span style="font-family:Verdana;"> 12 + 2 weeks pregnant woman consulted for abdominal pain, vomiting </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> fever. During the study, a transvaginal ultrasound was performed, where two </span><span style="font-family:Verdana;">endometric</span><span style="font-family:Verdana;"> cavities and </span></span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">pregnancy</span><span style="font-family:Verdana;"> in the right horn were observed. The evolution of the patient was torpid, reaching hypovolemic shock, resolved by an emergency laparotomy where the rupture of the right horn was found. </span><b><span style="font-family:Verdana;">Discu</span></b><b><span style="font-family:Verdana;">s</span></b><b><span style="font-family:Verdana;">sion</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">The bicornuate uterus is the consequence </span><span style="font-family:;" "=""><span style="font-family:Verdana;">of a partial fusion of the paramesonephric ducts </span><span><span style="font-family:Verdana;">during </span><span style="font-family:Verdana;">the fetal</span><span style="font-family:Verdana;"> development, resulting in two functional uterine horns. Pa</span></span><span style="font-family:Verdana;">tients with bicornuate uterus may be asymptomatic</span></span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> a uterine rupture is a rare but potentially severe complication of the bicornuate uterus and is usually presented during </span><span style="font-family:Verdana;">first</span><span style="font-family:Verdana;"> and second trimester. </span><b><span style="font-family:Verdana;">Conclusions: </span></b></span><span style="font-family:Verdana;">Pregnancy with Mullerian anomalies often ha</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""> <span style="font-family:Verdana;">preterm</span><span style="font-family:Verdana;"> delivery, IUGR </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> malpresentation, and even </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">more severe complication as uterine </span><span style="font-family:Verdana;">ruptura</span><span style="font-family:Verdana;">, so, require</span></span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> proper </span><span style="font-family:Verdana;">counselling</span><span style="font-family:Verdana;"> and close monitoring during </span><span style="font-family:Verdana;">antenatal</span><span style="font-family:Verdana;"> period.</span></span>展开更多
基金supported by grants from National Institutes of Health(R01GM100474)the New Jersey Commission on Spinal Cord Research(CSCR13IRG006)
文摘Spinal cord injury (SCI) is a devastating type of neurological trauma with limited therapeutic op- portunities. The pathophysiology of SCI involves primary and secondary mechanisms of injury. Among all the secondary injury mechanisms, the inflammatory response is the major contrib- utor and results in expansion of the lesion and further loss of neurologic function. Meanwhile, the inflammation directly and indirectly dominates the outcomes of SCI, including not only pain and motor dysfunction, but also preventingneuronal regeneration. Microglia and macrophages play very important roles in secondary injury. Microglia reside in spinal parenchyma and survey the microenvironment through the signals of injury or infection. Macrophages are derived from monocytes recruited to injured sites from the peripheral circulation. Activated resident microglia and monocyte-derived macrophages induce and magnify immune and inflammatory responses not only by means of their secretory moleculesand phagocytosis, but also through their influence on astrocytes, oligodendrocytes and demyelination. In this review, we focus on the roles of mi- croglia and macrophages in secondary injury and how they contribute to the sequelae of SCI.
基金Department of Science & Technology,Ministry of Science & Technology,Government of India for awarding "Young Scientist Project Award"(FT/SR-L-111/2006)
文摘Objective:To look for secondary bacterial infections in bronchogenic carcinoma(BC<sub>A</sub>) with resistant organisms harboring bla genes considering the paucity of relevant studies.Methods: A total of 137 confirmed cases of BC<sub>A</sub> and 34 healthy volunteers were studied for the occurrence and prevalence of bla<sub>CTX-M</sub> and and bla<sub>AmpC</sub> harboring-enterobacteriaceae.A subset of these patients(n=69) was previously reported for the secondary infection with the Aspergillus species. Bronchoalveolar lavages(BAL) were subjected for bacterial and fungal cultures and the bacterial isolates were screened by multiplex PCRs for the presence of bla<sub>CTX-M</sub> and bla<sub>AmpC</sub>.The isolates were also screened for the association of insertion sequence(IS26) by PCR and characterized by RAPD for any clonal relatedness.Results:A total of 143 bacterial isolates were obtained from 137 BAL specimens of BC,patients.The Enterobacteriaceae-isolates were multidrug-resistant showing concomitant resistance to fluoroquinolones and aminoglycosides.Both bla<sub>CTX-M</sub> and bla<sub>AmpC</sub> of CIT family were detected in 77.4%and 27.4%isolates,respectively.Sequencing revealed the presence of bla<sub>CTX-M-15</sub> and bla<sub>CMY-6</sub>.Twenty one percent of the isolates were simultaneously harboring bla<sub>ampC</sub> and bla<sub>CTX-M-15</sub>.IS26 PCR and RAPD typing revealed the presence of diverse bacterial population but no predominant clone was identified.The present study also suggests strong association of aspergillosis with lung cancer and further strengthens the potential use of non-validated serological tests suggested earlier.Conclusions:We emphasize that all patients of bronchogenic carcinoma should also be screened for secondary bacterial infections,along with secondary fungal infections,so as to introduce early and specific antimicrobial therapy and to prevent unwanted deaths.
文摘Müllerian adenosarcomas are rare mixed tumors with low malignant potential, and occur mainly in the uterus. Primary adenosarcomas arising in vaginal endometriosis are even more rarely reported. We report a very rare case with Müllerian adenosarcoma arising from vaginal endometriosis. A 43-year-old nulliparous woman has a history of endometriosis. Due to two parallel fistulas in cervix, severe endometriosis and adenosarcoma, she has undergone radical and multiple surgeries. After the surgery, persistent vaginal vault masses were noticed, and eight resections of the polyps at vaginal stump were performed. For the first six resections, all the pathological examinations showed endometriosis. And the last two resections demonstrated vaginal adenosarcoma. Transition between Müllerian adenosarcoma and endometriosis was gradual. Finally, adenosarcoma associated with endometriosis was diagnosed from recurrent vaginal masses. To our knowledge, this report is the sixth case that primary adenosarcomas arising in vaginal endometriosis. But chemo-therapy and radiation therapy were not taken and the patient remained in a good condition throughout the 9-year follow-up period. In addition, we present a review of the literature. The diagnosis and treatment of the tumor are also discussed.
基金Supported by Medical and Health Research Project of Hainan Province,No. 21A200197。
文摘BACKGROUND The co-existence of Waldenstr?m’s macroglobulinemia(WM) with internodal marginal zone lymphoma(INMZL) is rare and often associated with poor prognosis.CASE SUMMARY We present a Chinese female patient who developed secondary light chain amyloidosis due to WM and INMZL and provides opinions on its systemic treatment.A 65-year-old woman was diagnosed with WM 6 years ago and received Bruton tyrosine kinase inhibitor monotherapy for two years.Her INMZL was confirmed due to left cervical lymphadenopathy.The patient presented with oedema in both lower limbs one year ago,and was diagnosed with secondary light chain amyloidosis.Treatment with the BC regimen(rituximab 375 mg/m~2 monthly for 6-8 courses,and bendamustine 90 mg/m~2 per day × 2,monthly for six courses) was initiated,but not tolerated due to toxic side effects.Bortezomibbased therapy was given for two months,including bortezomib,dexamethasone,and zanubrutinb.Oedema in both lower limbs was relieved and treatment efficacy was evaluated as partial remission.CONCLUSION A detailed clinical evaluation and active identification of the aetiology are recommended to avoid missed diagnosis and misdiagnosis.
文摘<strong>Introduction:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Mullerian malformations are a group of malformations that result from an alteration of embryonic development. Most cases are asymptomatic, however, in pregnant </span><span style="font-family:Verdana;">patients</span><span style="font-family:Verdana;"> it has been associated with recurrent abortion or premature delivery. </span><b><span style="font-family:Verdana;">Case presentation:</span></b><span style="font-family:Verdana;"> 12 + 2 weeks pregnant woman consulted for abdominal pain, vomiting </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> fever. During the study, a transvaginal ultrasound was performed, where two </span><span style="font-family:Verdana;">endometric</span><span style="font-family:Verdana;"> cavities and </span></span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">pregnancy</span><span style="font-family:Verdana;"> in the right horn were observed. The evolution of the patient was torpid, reaching hypovolemic shock, resolved by an emergency laparotomy where the rupture of the right horn was found. </span><b><span style="font-family:Verdana;">Discu</span></b><b><span style="font-family:Verdana;">s</span></b><b><span style="font-family:Verdana;">sion</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">The bicornuate uterus is the consequence </span><span style="font-family:;" "=""><span style="font-family:Verdana;">of a partial fusion of the paramesonephric ducts </span><span><span style="font-family:Verdana;">during </span><span style="font-family:Verdana;">the fetal</span><span style="font-family:Verdana;"> development, resulting in two functional uterine horns. Pa</span></span><span style="font-family:Verdana;">tients with bicornuate uterus may be asymptomatic</span></span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> a uterine rupture is a rare but potentially severe complication of the bicornuate uterus and is usually presented during </span><span style="font-family:Verdana;">first</span><span style="font-family:Verdana;"> and second trimester. </span><b><span style="font-family:Verdana;">Conclusions: </span></b></span><span style="font-family:Verdana;">Pregnancy with Mullerian anomalies often ha</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""> <span style="font-family:Verdana;">preterm</span><span style="font-family:Verdana;"> delivery, IUGR </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> malpresentation, and even </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">more severe complication as uterine </span><span style="font-family:Verdana;">ruptura</span><span style="font-family:Verdana;">, so, require</span></span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> proper </span><span style="font-family:Verdana;">counselling</span><span style="font-family:Verdana;"> and close monitoring during </span><span style="font-family:Verdana;">antenatal</span><span style="font-family:Verdana;"> period.</span></span>