A 48-year-old Indian male with alcoholic liver cirrhosis was admitted after being found unresponsive. He was hypotensive and had hematochezia. Esophagogastroduodenoscopy (EGD) showed small esophageal varices and a cle...A 48-year-old Indian male with alcoholic liver cirrhosis was admitted after being found unresponsive. He was hypotensive and had hematochezia. Esophagogastroduodenoscopy (EGD) showed small esophageal varices and a clean-based duodenal ulcer. He continued to have hematochezia and anemia despite blood transfusions. Colonoscopy was normal. Repeat EGD did not reveal any source of recent bleed. Twelve days after admission, his hematochezia ceased. He refused further investigation and was discharged two days later. He presented one week after discharge with hematochezia. EGD showed non-bleeding Grade 1 esophageal varices and a clean-based duodenal ulcer. Colonoscopy was normal. Abdominal computed tomography (CT) showed liver cirrhosis with mild ascites, paraumbilical varices, and splenomegaly. He had multiple episodes of hematochezia, requiring repeated blood transfusions. Capsule endoscopy identified the bleeding site in the jejunum. Concurrently, CT angiography showed paraumbilical varices inseparable from a loop of small bowel, which had herniated through an umbilical hernia. The lumen of this loop of small bowel opacified in the delayed phase, which suggested variceal bleeding into the small bowel. Portal vein thrombosis was present. As he had severe coagulopathy and extensive paraumbilical varices, surgery was of high risk. He was not suitable for transjugular intrahepatic porto-systemic shunt as he had portal vein thrombosis. Percutaneous paraumbilical embolization via caput medusa was performed on day 9 of hospitalization. Following the embolization, the hematochezia stopped. However, he defaulted subsequent follow-up.展开更多
With properties of complete degradation and favorable mechanical behavior, Mg and its alloys are regarded as the next generation medical metal materials. However, fast degradation and poor surface biocompatibility hin...With properties of complete degradation and favorable mechanical behavior, Mg and its alloys are regarded as the next generation medical metal materials. However, fast degradation and poor surface biocompatibility hinder their clinical applications. Inspired by the ＂petal effect＂, we successfully constructed a superhydrophobic and highly adhesive coating on pure Mg via a simple hydrothermal treatment in a solution containing sodium oleate. The superhydrophobicity of the fabricated coating results from its flake-like micro-nanostructure and the low-surface-energy oleate group. Water droplet on the superhydrophobic coating cannot roll off even when the sample is turned upside down, owing to the sealed air-pockets and the van der Waals’ attraction at the solidliquid interface, indicating a highly adhesive force. The chemical and mechanical stability of the superhydrophobic coating were measured. Potentiodynamic polarization and electrochemical impedance spectroscopy measurements suggest enhanced corrosion resistance of the as-prepared sample.Furthermore, cell cytotoxicity, migration and adhesion data of human umbilical vein endothelial cells（HUVECs） reveal an improved cytocompatibility of the modified surface. Finally,hemolysis assay and platelet adhesion assay suggest an improved hemocompatibility. It is believed that the facile and low-cost method can expand the new application of superhydrophobic surface with highly adhesive on Mg in biomedical fields.展开更多
文摘A 48-year-old Indian male with alcoholic liver cirrhosis was admitted after being found unresponsive. He was hypotensive and had hematochezia. Esophagogastroduodenoscopy (EGD) showed small esophageal varices and a clean-based duodenal ulcer. He continued to have hematochezia and anemia despite blood transfusions. Colonoscopy was normal. Repeat EGD did not reveal any source of recent bleed. Twelve days after admission, his hematochezia ceased. He refused further investigation and was discharged two days later. He presented one week after discharge with hematochezia. EGD showed non-bleeding Grade 1 esophageal varices and a clean-based duodenal ulcer. Colonoscopy was normal. Abdominal computed tomography (CT) showed liver cirrhosis with mild ascites, paraumbilical varices, and splenomegaly. He had multiple episodes of hematochezia, requiring repeated blood transfusions. Capsule endoscopy identified the bleeding site in the jejunum. Concurrently, CT angiography showed paraumbilical varices inseparable from a loop of small bowel, which had herniated through an umbilical hernia. The lumen of this loop of small bowel opacified in the delayed phase, which suggested variceal bleeding into the small bowel. Portal vein thrombosis was present. As he had severe coagulopathy and extensive paraumbilical varices, surgery was of high risk. He was not suitable for transjugular intrahepatic porto-systemic shunt as he had portal vein thrombosis. Percutaneous paraumbilical embolization via caput medusa was performed on day 9 of hospitalization. Following the embolization, the hematochezia stopped. However, he defaulted subsequent follow-up.
基金financially supported by the Distinguished Young Scholars of China(51525207)the National Natural Science Foundation of China(31570973)+1 种基金the National Key Research and Development Program of China(2016YFC1100604)Shanghai Committee of Science and Technology,China(15441904900)
文摘With properties of complete degradation and favorable mechanical behavior, Mg and its alloys are regarded as the next generation medical metal materials. However, fast degradation and poor surface biocompatibility hinder their clinical applications. Inspired by the ＂petal effect＂, we successfully constructed a superhydrophobic and highly adhesive coating on pure Mg via a simple hydrothermal treatment in a solution containing sodium oleate. The superhydrophobicity of the fabricated coating results from its flake-like micro-nanostructure and the low-surface-energy oleate group. Water droplet on the superhydrophobic coating cannot roll off even when the sample is turned upside down, owing to the sealed air-pockets and the van der Waals’ attraction at the solidliquid interface, indicating a highly adhesive force. The chemical and mechanical stability of the superhydrophobic coating were measured. Potentiodynamic polarization and electrochemical impedance spectroscopy measurements suggest enhanced corrosion resistance of the as-prepared sample.Furthermore, cell cytotoxicity, migration and adhesion data of human umbilical vein endothelial cells（HUVECs） reveal an improved cytocompatibility of the modified surface. Finally,hemolysis assay and platelet adhesion assay suggest an improved hemocompatibility. It is believed that the facile and low-cost method can expand the new application of superhydrophobic surface with highly adhesive on Mg in biomedical fields.
