进行性面部偏侧萎缩的临床和血清学特征:12例病例系列研究

Background: Progressive facial hemiatrophy (PFH) is characterized by a slowly progressive atrophy of soft tissues and in some cases bony structures. Coexisting features of localized scleroderma (LS) are commonly observed, indicating the close nature of both disorders. Objective: We sought to investigate clinical, serological, and radiographic findings in PFH from 278 patients with LS and to discuss the relationship to linear scleroderma en coup de sabre (LSCS). Method: A total of 12 patients with PFH were retrospectively evaluated on the basis of clinical, serological, and radiographic findings. Results: Five patients (42% ) presented with complete PFH, and 7 patients (58% ) with partial PFH involving either cheek or forehead. Five of the patients (42% ) had a coexisting LSCS lesion, and 3 of them (25% ) had concomitant LS of the trunk. Intraoral involvement was present in 6 cases. Neurological involvement was common, in particular, epileptic seizures. Serologic investigations showed neither evidence for infection with Borrelia burgdorferi nor any other indication of underlying systemic immunological disorders. Limitations: There were a relatively small number of patients in a retrospective study. Conclusion: The reported cases suggest a close relationship between PFH and LSCS. PFH might appear as two different subtypes,one involving cutaneous structures and presenting with clinical features similar to LSCS, one being strictly restricted to subcutaneous structures, primarily affecting the cheek area. The manifold clinical features of central nervous system involvement indicate the pathogenetic importance of neurological involvement in the development of PFH. Magnetic resonance imaging should be included in the tools of standard diagnostic procedures in patients with PFH. The etiologic relevance of autoimmunity as well as preceding trauma should be investigated in larger collective studies.

Peritoneal dialysis associated infections: An update on diagnosis and management

Peritoneal dialysis （PD） is associated with a high risk of infection of the peritoneum, subcutaneous tunnel and catheter exit site. Although quality standards demand an infection rate 〈 0.67 episodes/patient/year on dialy-sis, the reported overall rate of PD associated infection is 0.24-1.66 episodes/patient/year. It is estimated that for every 0.5-per-year increase in peritonitis rate, the risk of death increases by 4% and 18% of the episodes resulted in removal of the PD catheter and 3.5% re-sulted in death. Improved diagnosis, increased aware-ness of causative agents in addition to other measures will facilitate prompt management of PD associated infection and salvage of PD modality. The aims of this review are to determine the magnitude of the infection problem, identify possible risk factors and provide an update on the diagnosis and management of PD as-sociated infection. Gram-positive cocci such as Staphy-lococcus epidermidis , other coagulase negative staphy-lococcoci, and Staphylococcus aureus （S. aureus ） are the most frequent aetiological agents of PD-associated peritonitis worldwide. Empiric antibiotic therapy must cover both gram-positive and gram-negative organ-isms. However, use of systemic vancomycin and cip-rofoxacin administration for example, is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis - success rate of 77%. However, for fungal PD peritonitis, it is now standard practice to remove PD catheters in addition to antifungal treatment for a minimum of 3 wk and subsequent transfer to hemodi-alysis. To prevent PD associated infections, prophylactic antibiotic administration before catheter placement, adequate patient training, exit-site care, and treatment for S. aureus nasal carriage should be employed. Mupi-rocin treatment can reduce the risk of exit site infection by 46% but it cannot decrease the risk of peritonitis due to all organisms.

Intensity of parasitic infestation in silver carp,Hypophthalmichthys molitrix

Silver carp,Hypopthalmichthys molitrix is one of the most economically valuable fish species in Bangladesh.However,its production is often hindered by parasite-induced mortality.The present study reports the intensity of parasitic infestation in 216 specimens of H.molitrix collected from different fish markets in Rajshahi City,Bangladesh.Nine different parasite species (Trichodina pediculatus,Dactylogyrus vastator,Ichthyophthirius multifilis,Gyrodactylus elegans,Lernaea sp.,Apiosoma sp.,Myxobolus rohitae,Camallanus ophiocephali,and Pallisentis ophiocephali) were recovered from the gill,skin,stomach,and intestine of host fish.The highest level of infection was observed for host skin,while lower levels were observed for host gill,stomach,and intestine.The results also revealed that the intensity of parasite infection in different organs of H.molitrix varied with the season.In particular,the highest levels of infection were recorded during the winter period (November-February),when fish are most susceptible to parasites.The findings of the study will help in the management and conservation of H.molitrix.