May-Thurner syndrome(MTS) also termed iliocaval compression or Cockett-Thomas syndrome is a common, although rarely diagnosed, condition in which the patient has an anatomical variant wherein theright common iliac art...May-Thurner syndrome(MTS) also termed iliocaval compression or Cockett-Thomas syndrome is a common, although rarely diagnosed, condition in which the patient has an anatomical variant wherein theright common iliac artery overlies and compresses the left common iliac vein against the fifth lumbar spine resulting in increased risk of iliofemoral deep venous thrombosis. This variant has been shown to be present in over 23% of the population but most go undetected. We present a patient with MTS who developed high output cardiac failure due to an iatrogenic iliac fistula. The patient underwent an extensive workup for a left to right shunt including MRI and arterial duplex in the vascular lab. He was ultimately found to have a 2.1 cm left common iliac artery aneurysm and history of common iliac stent. We took the patient to the operating room for aortogram with placement of an endovascular plug of the left internal iliac artery and aorto-biiliac stent graft placement with CO2 and Ⅳ contrast. Subsequently the patient underwent successful stent placement in the area that was compressed followed by 6 mo of anticoagulation with warfarin. The flow from the fistula decreased significantly.展开更多
BACKGROUND Deep venous thrombosis(DVT)is a serious complication of lumbar spine surgery.Current guidelines recommend pharmacomechanical prophylaxis for patients at high risk of DVT after spine surgery.May-Thurner synd...BACKGROUND Deep venous thrombosis(DVT)is a serious complication of lumbar spine surgery.Current guidelines recommend pharmacomechanical prophylaxis for patients at high risk of DVT after spine surgery.May-Thurner syndrome(MTS),a venous anatomical variation that may require invasive intervention,is an often overlooked cause of DVT.To date,no case reports of symptomatic MTS caused by isthmic spondylolisthesis or subsequent acute DVT after posterior lumbar surgery have been published.CASE SUMMARY We here present a case of a patient who developed acute DVT 4 h after spondylolisthesis surgery,and MTS was only considered after surgery,during a review of a gynecological enhanced computed tomography image taken before the procedure.CONCLUSION In conclusion,clinicians should consider MTS in the presence of a dangerous triad:spondylolisthesis,elevated D-dimer levels,and sonographically indicated unilateral deep vein dilation.Consultation with a vascular surgeon is also essential to MTS management.展开更多
Skin ulceration syndrome(SUS)is the main diseases aff ected the development of sea cucumber(Apostichopus japonicus)culture industries.To better observe the changes in the sea cucumber A.japonicus with SUS and understa...Skin ulceration syndrome(SUS)is the main diseases aff ected the development of sea cucumber(Apostichopus japonicus)culture industries.To better observe the changes in the sea cucumber A.japonicus with SUS and understand the pathogenesis of the disease,activities of superoxide dismutase(SOD),catalase(CAT),and level of malondialdehyde(MDA)in coelomic fluid were detected using the Assay Kit and metabolites in the body wall were assessed using ultra-performance liquid chromatography and quadrupole-time of flight mass spectrometry.The results indicated that level of MDA was increased during SUS compared with healthy individuals(P<0.01),but activities of SOD and CAT were reduced(P<0.05).In metabolomics analysis,metabolites,such as adenosine,choline,betaine aldehyde,palmitic acid,and taurine,were found to be upregulated and 2-oxoadipic acid,anthranilic acid(vitamin L1),thioetheramide-PC,cholesterol-3-sulfate,and pentadecanoic acid were downregulated(VIP>1 and P<0.1).Pathway enrichment analysis indicated most enrichment of KEGG pathways were mainly related to energy metabolism,immunity,and osmoregulation such as ABC transporters,glycine,serine and threonine metabolism,tryptophan metabolism and neuroactive ligand-receptor interaction.Our study reflected the difference in enzyme activity and metabolites between A.japonicus with SUS and those without,which will provide reference data for investigating SUS.展开更多
目的探讨关节镜下采取保留喙肩韧带的肩峰下间隙减压手术方式治疗肩峰下撞击综合征的方法以及临床结果。方法2010年1月至2013年6月间，临床治疗肩峰下撞击综合征患者30例。手术过程：刨刀切除肩峰下滑囊；磨钻将肩峰的前缘磨平，术中注...目的探讨关节镜下采取保留喙肩韧带的肩峰下间隙减压手术方式治疗肩峰下撞击综合征的方法以及临床结果。方法2010年1月至2013年6月间，临床治疗肩峰下撞击综合征患者30例。手术过程：刨刀切除肩峰下滑囊；磨钻将肩峰的前缘磨平，术中注意保留喙肩韧带；探查肩锁关节并磨除骨赘；肩袖撕裂有手术指征者用锚钉修复。患者肩关节功能进行UCLA（University of California at Los Angeles）评分评估。结果平均随访时间16．8（7～25）个月，全部获得完整随访资料。术前UCLA评分平均为（16．15±2．13）分，术后平均为（31．85±2．57）分；和术前评分比较，两者差异有统计学意义（t＝36．09，P＜0．01）。结论保留喙肩韧带的关节镜下肩峰下间隙减压手术方式治疗肩峰下撞击综合征疗效满意，具有手术方式简单、花费少、出血少、创伤小、肩关节稳定性好、恢复快的优点。展开更多
文摘May-Thurner syndrome(MTS) also termed iliocaval compression or Cockett-Thomas syndrome is a common, although rarely diagnosed, condition in which the patient has an anatomical variant wherein theright common iliac artery overlies and compresses the left common iliac vein against the fifth lumbar spine resulting in increased risk of iliofemoral deep venous thrombosis. This variant has been shown to be present in over 23% of the population but most go undetected. We present a patient with MTS who developed high output cardiac failure due to an iatrogenic iliac fistula. The patient underwent an extensive workup for a left to right shunt including MRI and arterial duplex in the vascular lab. He was ultimately found to have a 2.1 cm left common iliac artery aneurysm and history of common iliac stent. We took the patient to the operating room for aortogram with placement of an endovascular plug of the left internal iliac artery and aorto-biiliac stent graft placement with CO2 and Ⅳ contrast. Subsequently the patient underwent successful stent placement in the area that was compressed followed by 6 mo of anticoagulation with warfarin. The flow from the fistula decreased significantly.
文摘BACKGROUND Deep venous thrombosis(DVT)is a serious complication of lumbar spine surgery.Current guidelines recommend pharmacomechanical prophylaxis for patients at high risk of DVT after spine surgery.May-Thurner syndrome(MTS),a venous anatomical variation that may require invasive intervention,is an often overlooked cause of DVT.To date,no case reports of symptomatic MTS caused by isthmic spondylolisthesis or subsequent acute DVT after posterior lumbar surgery have been published.CASE SUMMARY We here present a case of a patient who developed acute DVT 4 h after spondylolisthesis surgery,and MTS was only considered after surgery,during a review of a gynecological enhanced computed tomography image taken before the procedure.CONCLUSION In conclusion,clinicians should consider MTS in the presence of a dangerous triad:spondylolisthesis,elevated D-dimer levels,and sonographically indicated unilateral deep vein dilation.Consultation with a vascular surgeon is also essential to MTS management.
基金Supported by the National Natural Science Foundation of China(No.31772849)the Scientific Research Funding Project of Liaoning Provincial Department of Education in 2019(No.DL201901)the Program for Liaoning Innovative Research Team in University(No.LT2019003)。
文摘Skin ulceration syndrome(SUS)is the main diseases aff ected the development of sea cucumber(Apostichopus japonicus)culture industries.To better observe the changes in the sea cucumber A.japonicus with SUS and understand the pathogenesis of the disease,activities of superoxide dismutase(SOD),catalase(CAT),and level of malondialdehyde(MDA)in coelomic fluid were detected using the Assay Kit and metabolites in the body wall were assessed using ultra-performance liquid chromatography and quadrupole-time of flight mass spectrometry.The results indicated that level of MDA was increased during SUS compared with healthy individuals(P<0.01),but activities of SOD and CAT were reduced(P<0.05).In metabolomics analysis,metabolites,such as adenosine,choline,betaine aldehyde,palmitic acid,and taurine,were found to be upregulated and 2-oxoadipic acid,anthranilic acid(vitamin L1),thioetheramide-PC,cholesterol-3-sulfate,and pentadecanoic acid were downregulated(VIP>1 and P<0.1).Pathway enrichment analysis indicated most enrichment of KEGG pathways were mainly related to energy metabolism,immunity,and osmoregulation such as ABC transporters,glycine,serine and threonine metabolism,tryptophan metabolism and neuroactive ligand-receptor interaction.Our study reflected the difference in enzyme activity and metabolites between A.japonicus with SUS and those without,which will provide reference data for investigating SUS.
文摘目的探讨关节镜下采取保留喙肩韧带的肩峰下间隙减压手术方式治疗肩峰下撞击综合征的方法以及临床结果。方法2010年1月至2013年6月间，临床治疗肩峰下撞击综合征患者30例。手术过程：刨刀切除肩峰下滑囊；磨钻将肩峰的前缘磨平，术中注意保留喙肩韧带；探查肩锁关节并磨除骨赘；肩袖撕裂有手术指征者用锚钉修复。患者肩关节功能进行UCLA（University of California at Los Angeles）评分评估。结果平均随访时间16．8（7～25）个月，全部获得完整随访资料。术前UCLA评分平均为（16．15±2．13）分，术后平均为（31．85±2．57）分；和术前评分比较，两者差异有统计学意义（t＝36．09，P＜0．01）。结论保留喙肩韧带的关节镜下肩峰下间隙减压手术方式治疗肩峰下撞击综合征疗效满意，具有手术方式简单、花费少、出血少、创伤小、肩关节稳定性好、恢复快的优点。
