BACKGROUND Immune checkpoint inhibitors are one of the modern treatment methods for advanced malignancies.However,this group of medications is also associated with various immune-related adverse events,such as colitis...BACKGROUND Immune checkpoint inhibitors are one of the modern treatment methods for advanced malignancies.However,this group of medications is also associated with various immune-related adverse events,such as colitis or pneumonitis.Immune checkpoint inhibitor-induced gastritis is a less common adverse event.CASE SUMMARY We describe a 64-year-old woman presenting with diarrhea,nausea,and discomfort in the upper abdominal region.The patient had a history of metastatic lung cancer,which was treated with nivolumab.During the first endoscopy,an infiltrating gastric tumour was suspected.Later,based on endoscopic,histological and radiological findings,nivolumab-induced gastritis was diagnosed.The patient was successfully treated with three courses of omeprazole.CONCLUSION As a consequence of the increased use of immune checkpoint inhibitors,a growing number of reported immune-related adverse events could be expected.The diagnosis of immune checkpoint inhibitor-induced gastritis should be considered when assessing a patient treated with nivolumab with upper gastrointestinal distress.展开更多
Based on Darcy Gersevanov law concerning a flow relation between water and solids, we derive the horizontal movement of solid frame resulted from a discharging well in a Theis Thiem confined system, and further anal...Based on Darcy Gersevanov law concerning a flow relation between water and solids, we derive the horizontal movement of solid frame resulted from a discharging well in a Theis Thiem confined system, and further analyze the relations among the horizontal movements and pumped time t as well as radius r from the discharging well. As applications of the theory, we propose some new interperations for ground fissure activity and casing failures induced by groundwater withdrawal or injection.展开更多
BACKGROUND Functioning farnesoid X receptor(FXR;encoded by NR1H4)is key to normal bile acid homeostasis.Biallelic mutations in NR1H4 are reported in a few children with intrahepatic cholestasis.We describe a boy with ...BACKGROUND Functioning farnesoid X receptor(FXR;encoded by NR1H4)is key to normal bile acid homeostasis.Biallelic mutations in NR1H4 are reported in a few children with intrahepatic cholestasis.We describe a boy with progressive familial intrahepatic cholestasis and homozygous mutation in NR1H4.CASE SUMMARY A boy had severe neonatal cholestasis with moderate hypercholanemia and persistently elevated alpha-fetoprotein.Despite medical treatment,coagulopathy was uncontrollable,prompting liver transplantation at age 8 mo with incidental splenectomy.The patient experienced catch-up growth with good liver function and did not develop allograft steatosis.However,1 year after transplant,he died from an acute infection,considered secondary to immunosuppression and asplenia.A homozygous protein-truncating mutation,c.547C>T,p.(Arg183Ter),was subsequently identified in NR1H4,and both parents were shown to be heterozygous carriers.Absence of FXR and of bile salt export pump expression was confirmed by immunostaining of explanted liver.CONCLUSION Severe cholestasis with persistently high alpha-fetoprotein and modest elevation of serum bile acid levels may suggest FXR deficiency.Some patients with FXR deficiency may not develop allograft steatosis and may respond well to liver transplantation.展开更多
The rotary jet pumps, namely the pitot pumps, are composed of the rotating casing with the impeller channels and the stationary pick-up tube for discharging, are known as the one of high pressure pumps in the U.S. mar...The rotary jet pumps, namely the pitot pumps, are composed of the rotating casing with the impeller channels and the stationary pick-up tube for discharging, are known as the one of high pressure pumps in the U.S. market. The pumps, however, have been prepared experientially, because of poor knowledge for the flow conditions and the pump performances. Then, this paper discusses the pump performances and the internal flow conditions in the rotating casing. Three types of the pick-up tube were prepared for the experiments to know the pump performances and the flow conditions in the rotating casing. The flow in the rotating casing is nearly in the forced vortex type and gives the higher pressure at the pick-up tube inlet. The more cross-sectional area of the pick-up tube channel is large, the more head and discharge are higher with excellent efficiency. Moreover, the authors confirmed that the secondary flow runs toward the rotating center at the wake flow region behind the pick-up tube.展开更多
BACKGROUND Twin reversed arterial perfusion(TRAP) sequence is an extremely rare congenital anomaly in monochorionic(MC) twins.The condition is characterized by a malformed fetus(acardiac twin) without cardiac activiti...BACKGROUND Twin reversed arterial perfusion(TRAP) sequence is an extremely rare congenital anomaly in monochorionic(MC) twins.The condition is characterized by a malformed fetus(acardiac twin) without cardiac activities being perfused by a structurally normal one(pump twin) via an artery-to-artery anastomosis in a reverse direction.CASE SUMMARY We described the first case of TRAP to receive laser surgery in Vietnam.The 26-wk pregnancy was originally misdiagnosed in another hospital as MC twins with single intrauterine fetal death.Following admission to our center,the diagnosis was amended to a 26-wk TRAP sequence stage IIb.The acardiac twin was 7.5 cm at the longest length,the ratio of the weight of the acardiac twin to the weight of the pump twin was more than 90%,the pump twin showed fetal distress with absent diastolic flow in umbilical artery of pump twin,and the peak systolic velocity in the middle cerebral artery = 1.6 Mo M.We performed emergency laser photocoagulation of the acardiac twin’s umbilical cord.After surgery,we successfully maintained the pregnancy for 8 wk and ended it electively by cesarean section at 34 wk of gestation due to rupture of membranes.CONCLUSION TRAP should be appropriately diagnosed and treated early to avoid complications of the pump twin.Fetoscopic laser photocoagulation is a new and effective treatment for this condition.展开更多
文摘BACKGROUND Immune checkpoint inhibitors are one of the modern treatment methods for advanced malignancies.However,this group of medications is also associated with various immune-related adverse events,such as colitis or pneumonitis.Immune checkpoint inhibitor-induced gastritis is a less common adverse event.CASE SUMMARY We describe a 64-year-old woman presenting with diarrhea,nausea,and discomfort in the upper abdominal region.The patient had a history of metastatic lung cancer,which was treated with nivolumab.During the first endoscopy,an infiltrating gastric tumour was suspected.Later,based on endoscopic,histological and radiological findings,nivolumab-induced gastritis was diagnosed.The patient was successfully treated with three courses of omeprazole.CONCLUSION As a consequence of the increased use of immune checkpoint inhibitors,a growing number of reported immune-related adverse events could be expected.The diagnosis of immune checkpoint inhibitor-induced gastritis should be considered when assessing a patient treated with nivolumab with upper gastrointestinal distress.
文摘Based on Darcy Gersevanov law concerning a flow relation between water and solids, we derive the horizontal movement of solid frame resulted from a discharging well in a Theis Thiem confined system, and further analyze the relations among the horizontal movements and pumped time t as well as radius r from the discharging well. As applications of the theory, we propose some new interperations for ground fissure activity and casing failures induced by groundwater withdrawal or injection.
基金National Institutes of Health,No.R01DK094828and National Human Genome Research Institute,No.UM1 HG006493 and No.U24 HG008956.
文摘BACKGROUND Functioning farnesoid X receptor(FXR;encoded by NR1H4)is key to normal bile acid homeostasis.Biallelic mutations in NR1H4 are reported in a few children with intrahepatic cholestasis.We describe a boy with progressive familial intrahepatic cholestasis and homozygous mutation in NR1H4.CASE SUMMARY A boy had severe neonatal cholestasis with moderate hypercholanemia and persistently elevated alpha-fetoprotein.Despite medical treatment,coagulopathy was uncontrollable,prompting liver transplantation at age 8 mo with incidental splenectomy.The patient experienced catch-up growth with good liver function and did not develop allograft steatosis.However,1 year after transplant,he died from an acute infection,considered secondary to immunosuppression and asplenia.A homozygous protein-truncating mutation,c.547C>T,p.(Arg183Ter),was subsequently identified in NR1H4,and both parents were shown to be heterozygous carriers.Absence of FXR and of bile salt export pump expression was confirmed by immunostaining of explanted liver.CONCLUSION Severe cholestasis with persistently high alpha-fetoprotein and modest elevation of serum bile acid levels may suggest FXR deficiency.Some patients with FXR deficiency may not develop allograft steatosis and may respond well to liver transplantation.
文摘The rotary jet pumps, namely the pitot pumps, are composed of the rotating casing with the impeller channels and the stationary pick-up tube for discharging, are known as the one of high pressure pumps in the U.S. market. The pumps, however, have been prepared experientially, because of poor knowledge for the flow conditions and the pump performances. Then, this paper discusses the pump performances and the internal flow conditions in the rotating casing. Three types of the pick-up tube were prepared for the experiments to know the pump performances and the flow conditions in the rotating casing. The flow in the rotating casing is nearly in the forced vortex type and gives the higher pressure at the pick-up tube inlet. The more cross-sectional area of the pick-up tube channel is large, the more head and discharge are higher with excellent efficiency. Moreover, the authors confirmed that the secondary flow runs toward the rotating center at the wake flow region behind the pick-up tube.
文摘BACKGROUND Twin reversed arterial perfusion(TRAP) sequence is an extremely rare congenital anomaly in monochorionic(MC) twins.The condition is characterized by a malformed fetus(acardiac twin) without cardiac activities being perfused by a structurally normal one(pump twin) via an artery-to-artery anastomosis in a reverse direction.CASE SUMMARY We described the first case of TRAP to receive laser surgery in Vietnam.The 26-wk pregnancy was originally misdiagnosed in another hospital as MC twins with single intrauterine fetal death.Following admission to our center,the diagnosis was amended to a 26-wk TRAP sequence stage IIb.The acardiac twin was 7.5 cm at the longest length,the ratio of the weight of the acardiac twin to the weight of the pump twin was more than 90%,the pump twin showed fetal distress with absent diastolic flow in umbilical artery of pump twin,and the peak systolic velocity in the middle cerebral artery = 1.6 Mo M.We performed emergency laser photocoagulation of the acardiac twin’s umbilical cord.After surgery,we successfully maintained the pregnancy for 8 wk and ended it electively by cesarean section at 34 wk of gestation due to rupture of membranes.CONCLUSION TRAP should be appropriately diagnosed and treated early to avoid complications of the pump twin.Fetoscopic laser photocoagulation is a new and effective treatment for this condition.
