In the cool and crisp autumn,Meigu county,a beautiful but remote place with rivers and rolling mountains at the western foot of the Huangmaogeng Ridge of Daliang Mountain,greeted some special guests——a medical group...In the cool and crisp autumn,Meigu county,a beautiful but remote place with rivers and rolling mountains at the western foot of the Huangmaogeng Ridge of Daliang Mountain,greeted some special guests——a medical group from the Bethune Baiqiuen Canadian Alliance.展开更多
泰国在1932年就以法律形式规定polygamy(一夫多妻制)为非法,但是,目前的实际情况是:One in four Thai men have more than one wife despitethe ban on polygamy.记得梁实秋曾经说过,一个人要一天不得安宁,请客;一个人要一年不得安宁,造...泰国在1932年就以法律形式规定polygamy(一夫多妻制)为非法,但是,目前的实际情况是:One in four Thai men have more than one wife despitethe ban on polygamy.记得梁实秋曾经说过,一个人要一天不得安宁,请客;一个人要一年不得安宁,造屋;一个人要一辈子不得安宁,讨小老婆。此文的主人公,57岁的Supat,家有7妻,同住一幢三层楼房。不知此君家中是否相安无事。展开更多
Giardiasis is the most common waterborne parasitic infection of the human intestine worldwide.The etiological agent,Giardia duodenalis(syn.G.intestinalis,G.lamblia),is a flagellated,binucleated protozoan parasite whic...Giardiasis is the most common waterborne parasitic infection of the human intestine worldwide.The etiological agent,Giardia duodenalis(syn.G.intestinalis,G.lamblia),is a flagellated,binucleated protozoan parasite which infects a wide array of mammalian hosts.Human giardiasis is a true cosmopolitan pathogen,with highest prevalence in developing countries.Giardiasis can present with a broad range of clinical manifestations from asymptomatic,to acute or chronic diarrheal disease associated with abdominal pain and nausea.Most infections are self-limiting,although re-infection and chronic infection can occur.Recent evidence indicating that Giardia may cause chronic post-infectious gastrointestinal complications have made it a topic of intense research.The causes of the post-infectious clinical manifestations due to Giardia,even after complete elimination of the parasite,remain obscure.This review offers a state-of-the-art discussion on the long-term consequences of Giardia infections,from extra-intestinal manifestations,growth and cognitive deficiencies,to post-infectious irritable bowel syndrome.The discussion also sheds light on some of the novel mechanisms recently implicated in the production of these postinfectious manifestations.展开更多
The early detection of focal liver lesions,particularly those which are malignant,is of utmost importance.The resection of liver metastases of some malignancies(including colorectal cancer)has been shown to improve th...The early detection of focal liver lesions,particularly those which are malignant,is of utmost importance.The resection of liver metastases of some malignancies(including colorectal cancer)has been shown to improve the survival of patients.Exact knowledge of the number,size,and regional distribution of liver metastases is essential to determine their resectability.Almost all focal liver lesions larger than 10 mm are demonstrated with current imaging techniques but the detection of smaller focal liver lesions is still relatively poor.One of the advantages of magnetic resonance imaging(MRI)of the liver is better soft tissue contrast(compared to other radiologic modalities),which allows better detection and characterization of the focal liver lesions in question.Developments in MRI hardware and software and the availability of novel MRI contrast agents have further improved the diagnostic yield of MRI in lesion detection and characterization.Although the primary modalities for liver imaging are ultrasound and computed tomography,recent studies have suggested that MRI is the most sensitive method for detecting small liver metastatic lesions,and MRI is now considered the pre-operative standard method for diagnosis.Two recent developments in MRI sequences for the upper abdomen comprise unenhanced diffusion-weighted imaging(DWI),and keyhole-based dynamic contrast-enhanced(DCE)MRI(4D THRIVE).DWI allows improved detection(b=10 s/mm2)of small(<10 mm)focal liver lesions in particular,and is useful as a road map sequence.Also,using higher b-values,the calculation of the apparent diffusion coefficient value,true diffusion coefficient,D,and the perfusion fraction,f,has been used for the characterization of focal liver lesions.DCE 4D THRIVE enables MRI of the liver with high temporal and spatial resolution and full liver coverage.4D THRIVE improves evaluation of focal liver lesions,providing multiple arterial and venous phases,and allows the calculation of perfusion parameters using pharmacokinetic models.4D THRIVE has potential benefits in terms of detection,characterization and staging of focal liver lesions and in monitoring therapy.展开更多
BACKGROUND Congenital tufting enteropathy(CTE)is a rare cause of diarrhea in children.However,it can result in early-onset of chronic diarrhea and failure to thrive.Children with this disease have to depend on total p...BACKGROUND Congenital tufting enteropathy(CTE)is a rare cause of diarrhea in children.However,it can result in early-onset of chronic diarrhea and failure to thrive.Children with this disease have to depend on total parenteral nutrition(TPN),and eventually small intestine transplantation.The epithelial cell adhesion molecule(EPCAM)gene was identified to be associated with CTE.Here,we present a case of an infant with CTE due to a mutation not reported in the literature before.CASE SUMMARY A 1-year and 7-mo infant boy exhibited intractable watery diarrhea and mushy stool within 1 wk after birth,for which he had required medical treatment and hospitalization several times.His sister presented similar symptoms and died at the age of two.On admission,his body weight was 5700 g(-4.8 SDS)and measured 66 cm(-5.4 SDS)in height.Meanwhile,he cannot speak or climb.He exhibited mild anemia,hypocalcemia,hypomagnesemia,and an infection in the upper respiratory tract.Microvilli sparse and vacuolar degeneration of epithelial cells were reported by small intestine biopsy.Whole-exome sequencing showed a novel homozygous splice mutation(c.657+1[IVS6]G>A)in the EPCAM gene.He was treated with TPN and recombinant human growth hormone.After 2 mo,his body weight was up to 8500 g and he has been waiting for small bowel transplantation.CONCLUSION CTE is rare but fatal.Patients with CTE require rapid diagnosis and therapy to improve their survival.展开更多
Background:Congenital heart disease(CHD)is a chronic medical condition often diagnosed at birth and requires surgical intervention,multiple hospitalizations,and lifelong care.This can put significant stress on the fami...Background:Congenital heart disease(CHD)is a chronic medical condition often diagnosed at birth and requires surgical intervention,multiple hospitalizations,and lifelong care.This can put significant stress on the family,leading to altered maternal mental health,bonding and attachment issues,and the potential for child abuse.The purpose of this study is to explore the characteristics of a sample of young children with CHD who experienced hospitalization with concurrent concern for child abuse in a free-standing pediatric tertiary care hos-pital.Methods:Electronic medical records were reviewed for children aged 0–5 years old who were hospitalized with concern for child abuse between 2016 and 2020.Variables were extracted related to the history of presenta-tion,and sociodemographics including SDOH,admission,and discharge condition/follow-up.Descriptive statis-tics were used to characterize the sample and correlations to identify an association with abuse type.Results:Out of 251 hospitalizations involving concern for child abuse,49(19.5%)had a diagnosis of CHD.The majority of cases were neglect(51%),<1 year of age(80%),male(57%),Hispanic ethnicity(45%),and publicly insured(90%).CHD severity was moderate to severe(71%)with multiple co-occurring medical conditions(genetic syn-drome,failure to thrive(FTT),prematurity,history of a feeding tube,developmental delay,and intrauterine drug exposure).Correlations associated with physical abuse were age,maternal mental health,head injury,and history of Child Protective Services(CPS)involvement.Neglect correlated with age,FTT,head injury,history of a feeding tube,previous CPS involvement,and substance use.Correlates specifically related to prenatal substance use included age,maternal mental health status,history of domestic violence,CPS involvement,feeding tube,FTT,lack of housing,employment status,and public insurance.Conclusions:Our study highlights the risk for abuse in children with CHD,regardless of defect severity.The most common abuse type was neglect(mostly prenatal substance use)which was associated with few child characteristics,but many parent/caregiver and neighborhood factors.This underscores the need for individual and/or family-based screening and approaches to provide psy-chological support and needed resources to assist parents of children with CHD to prevent abuse.Interventions should focus on families of low socioeconomic status with limited support and/or resources.展开更多
"Private enterprises must have internal impetus to grow. If you have strong internal impetus driving physical growth, you will have strong hematopoietic function. If you only rely on blood transfusion, you cannot..."Private enterprises must have internal impetus to grow. If you have strong internal impetus driving physical growth, you will have strong hematopoietic function. If you only rely on blood transfusion, you cannot stay healthy,” said Ma Yushan, chairman of Ningxia Wuzhong Instrument Co., Ltd., on March 6.“Internal impetus is the foundation of enterprise survival, and innovation is the only way for enterprise development.”展开更多
The 9-day China Fashion Week 2019 S/S Collection,themed with“Thriving Towards the Sun”,came to a successful close on November 2nd,2018,attracting more than 150 Chinese and foreign designers from over 140 brands to h...The 9-day China Fashion Week 2019 S/S Collection,themed with“Thriving Towards the Sun”,came to a successful close on November 2nd,2018,attracting more than 150 Chinese and foreign designers from over 140 brands to hold over 130 collection shows,professional design contests,press release,salon and forum as well as lectures in the Bird’s Nest Culture Center,the Banquet Hall of Beijing Hotel,751D?PARK,etc.The numbers of shows and designers,and the internationalized brands in this fashion week was the highest on record,showing its strong influence and attraction of the 21-year-old China Fashion Week in the new era that welcomes a promising contemporary Chinese fashion and Chinese creativity and a prosperous Chinese fashion industry development.展开更多
文摘In the cool and crisp autumn,Meigu county,a beautiful but remote place with rivers and rolling mountains at the western foot of the Huangmaogeng Ridge of Daliang Mountain,greeted some special guests——a medical group from the Bethune Baiqiuen Canadian Alliance.
文摘泰国在1932年就以法律形式规定polygamy(一夫多妻制)为非法,但是,目前的实际情况是:One in four Thai men have more than one wife despitethe ban on polygamy.记得梁实秋曾经说过,一个人要一天不得安宁,请客;一个人要一年不得安宁,造屋;一个人要一辈子不得安宁,讨小老婆。此文的主人公,57岁的Supat,家有7妻,同住一幢三层楼房。不知此君家中是否相安无事。
基金Supported by Grants from the Natural Sciences and Engineering Research Council of Canada(individual operating and CREATE),the France-Canada Research Fundthe"Ministère de l’enseignement supérieur et de la recherche",French Ministry of Secondary Education and Research
文摘Giardiasis is the most common waterborne parasitic infection of the human intestine worldwide.The etiological agent,Giardia duodenalis(syn.G.intestinalis,G.lamblia),is a flagellated,binucleated protozoan parasite which infects a wide array of mammalian hosts.Human giardiasis is a true cosmopolitan pathogen,with highest prevalence in developing countries.Giardiasis can present with a broad range of clinical manifestations from asymptomatic,to acute or chronic diarrheal disease associated with abdominal pain and nausea.Most infections are self-limiting,although re-infection and chronic infection can occur.Recent evidence indicating that Giardia may cause chronic post-infectious gastrointestinal complications have made it a topic of intense research.The causes of the post-infectious clinical manifestations due to Giardia,even after complete elimination of the parasite,remain obscure.This review offers a state-of-the-art discussion on the long-term consequences of Giardia infections,from extra-intestinal manifestations,growth and cognitive deficiencies,to post-infectious irritable bowel syndrome.The discussion also sheds light on some of the novel mechanisms recently implicated in the production of these postinfectious manifestations.
文摘The early detection of focal liver lesions,particularly those which are malignant,is of utmost importance.The resection of liver metastases of some malignancies(including colorectal cancer)has been shown to improve the survival of patients.Exact knowledge of the number,size,and regional distribution of liver metastases is essential to determine their resectability.Almost all focal liver lesions larger than 10 mm are demonstrated with current imaging techniques but the detection of smaller focal liver lesions is still relatively poor.One of the advantages of magnetic resonance imaging(MRI)of the liver is better soft tissue contrast(compared to other radiologic modalities),which allows better detection and characterization of the focal liver lesions in question.Developments in MRI hardware and software and the availability of novel MRI contrast agents have further improved the diagnostic yield of MRI in lesion detection and characterization.Although the primary modalities for liver imaging are ultrasound and computed tomography,recent studies have suggested that MRI is the most sensitive method for detecting small liver metastatic lesions,and MRI is now considered the pre-operative standard method for diagnosis.Two recent developments in MRI sequences for the upper abdomen comprise unenhanced diffusion-weighted imaging(DWI),and keyhole-based dynamic contrast-enhanced(DCE)MRI(4D THRIVE).DWI allows improved detection(b=10 s/mm2)of small(<10 mm)focal liver lesions in particular,and is useful as a road map sequence.Also,using higher b-values,the calculation of the apparent diffusion coefficient value,true diffusion coefficient,D,and the perfusion fraction,f,has been used for the characterization of focal liver lesions.DCE 4D THRIVE enables MRI of the liver with high temporal and spatial resolution and full liver coverage.4D THRIVE improves evaluation of focal liver lesions,providing multiple arterial and venous phases,and allows the calculation of perfusion parameters using pharmacokinetic models.4D THRIVE has potential benefits in terms of detection,characterization and staging of focal liver lesions and in monitoring therapy.
基金Key Research and Development Program of Zhejiang Province,China,No.2020C03121。
文摘BACKGROUND Congenital tufting enteropathy(CTE)is a rare cause of diarrhea in children.However,it can result in early-onset of chronic diarrhea and failure to thrive.Children with this disease have to depend on total parenteral nutrition(TPN),and eventually small intestine transplantation.The epithelial cell adhesion molecule(EPCAM)gene was identified to be associated with CTE.Here,we present a case of an infant with CTE due to a mutation not reported in the literature before.CASE SUMMARY A 1-year and 7-mo infant boy exhibited intractable watery diarrhea and mushy stool within 1 wk after birth,for which he had required medical treatment and hospitalization several times.His sister presented similar symptoms and died at the age of two.On admission,his body weight was 5700 g(-4.8 SDS)and measured 66 cm(-5.4 SDS)in height.Meanwhile,he cannot speak or climb.He exhibited mild anemia,hypocalcemia,hypomagnesemia,and an infection in the upper respiratory tract.Microvilli sparse and vacuolar degeneration of epithelial cells were reported by small intestine biopsy.Whole-exome sequencing showed a novel homozygous splice mutation(c.657+1[IVS6]G>A)in the EPCAM gene.He was treated with TPN and recombinant human growth hormone.After 2 mo,his body weight was up to 8500 g and he has been waiting for small bowel transplantation.CONCLUSION CTE is rare but fatal.Patients with CTE require rapid diagnosis and therapy to improve their survival.
文摘Background:Congenital heart disease(CHD)is a chronic medical condition often diagnosed at birth and requires surgical intervention,multiple hospitalizations,and lifelong care.This can put significant stress on the family,leading to altered maternal mental health,bonding and attachment issues,and the potential for child abuse.The purpose of this study is to explore the characteristics of a sample of young children with CHD who experienced hospitalization with concurrent concern for child abuse in a free-standing pediatric tertiary care hos-pital.Methods:Electronic medical records were reviewed for children aged 0–5 years old who were hospitalized with concern for child abuse between 2016 and 2020.Variables were extracted related to the history of presenta-tion,and sociodemographics including SDOH,admission,and discharge condition/follow-up.Descriptive statis-tics were used to characterize the sample and correlations to identify an association with abuse type.Results:Out of 251 hospitalizations involving concern for child abuse,49(19.5%)had a diagnosis of CHD.The majority of cases were neglect(51%),<1 year of age(80%),male(57%),Hispanic ethnicity(45%),and publicly insured(90%).CHD severity was moderate to severe(71%)with multiple co-occurring medical conditions(genetic syn-drome,failure to thrive(FTT),prematurity,history of a feeding tube,developmental delay,and intrauterine drug exposure).Correlations associated with physical abuse were age,maternal mental health,head injury,and history of Child Protective Services(CPS)involvement.Neglect correlated with age,FTT,head injury,history of a feeding tube,previous CPS involvement,and substance use.Correlates specifically related to prenatal substance use included age,maternal mental health status,history of domestic violence,CPS involvement,feeding tube,FTT,lack of housing,employment status,and public insurance.Conclusions:Our study highlights the risk for abuse in children with CHD,regardless of defect severity.The most common abuse type was neglect(mostly prenatal substance use)which was associated with few child characteristics,but many parent/caregiver and neighborhood factors.This underscores the need for individual and/or family-based screening and approaches to provide psy-chological support and needed resources to assist parents of children with CHD to prevent abuse.Interventions should focus on families of low socioeconomic status with limited support and/or resources.
文摘"Private enterprises must have internal impetus to grow. If you have strong internal impetus driving physical growth, you will have strong hematopoietic function. If you only rely on blood transfusion, you cannot stay healthy,” said Ma Yushan, chairman of Ningxia Wuzhong Instrument Co., Ltd., on March 6.“Internal impetus is the foundation of enterprise survival, and innovation is the only way for enterprise development.”
文摘The 9-day China Fashion Week 2019 S/S Collection,themed with“Thriving Towards the Sun”,came to a successful close on November 2nd,2018,attracting more than 150 Chinese and foreign designers from over 140 brands to hold over 130 collection shows,professional design contests,press release,salon and forum as well as lectures in the Bird’s Nest Culture Center,the Banquet Hall of Beijing Hotel,751D?PARK,etc.The numbers of shows and designers,and the internationalized brands in this fashion week was the highest on record,showing its strong influence and attraction of the 21-year-old China Fashion Week in the new era that welcomes a promising contemporary Chinese fashion and Chinese creativity and a prosperous Chinese fashion industry development.
