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Objective:To investigate the clinical characteristics, imaging features, treatment, prognosis, and possible causes of myelodysplastic syndrome complicated by acute cerebral infarction.Methods:The clinical data of four patients with myelodysplastic syndrome complicated by acute cerebral infarction who received treatment at Peking University International Hospital and Beijing Jingcheng Boai Hospital from January to December 2021 were retrospectively analyzed.Results:All four patients experienced myelodysplastic syndrome complicated by acute cerebral infarction for the first time. They were aged 60-69 years, with a median age of 65 years. Bone marrow suppression occurred in the four patients with myelodysplastic syndrome after chemotherapy, resulting in a remarkable reduction in the number of platelets. All four patients had just been transfused with platelets before the onset of myelodysplastic syndrome complicated by acute cerebral infarction. The main clinical manifestations were dyskinesia, language disorder, paresthesia, and dizziness. Three patients had multiple foci, two of them involved bilateral cerebral hemispheres, and only one patient had a single focus. Circulation improvement and symptomatic treatment were given after admission. Two patients with cerebral hernia died, and two patients were discharged after improvement.Conclusion:The pathogenesis of myelodysplastic syndrome complicated by acute cerebral infarction is complex. It includes many causes rather than common risk factors for stroke. Myelodysplastic syndrome complicated by acute cerebral infarction is rare in the clinic. It is difficult to treat, is serious, and has a poor prognosis.
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The pathophysiology of allergic disease such as asthma and allergic rhinitis tell the similar story: when the endogenous and exogenous inflammatory mechanisms occur disorder, the body may begin with inflammatory cell activation, namely through the release of cytokine and inflammatory mediator role in the corresponding target cells, activate the sensory nerve fiber, acting on the cell organ specificity effect, clinical symptoms. This article is divided into the following five parts focused on the research progress of allergic inflammatory diseases: (1) inflammatory cells; (2) staphylococcus aureus superantigen; (3) small molecules (cytokines, inflammatory mediators, lipid classes medium); (4) nerve fibers and effect cells; (5) genetic and epigenetic factors.
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Humans , Asthma , Cytokines , Allergy and Immunology , Hypersensitivity , Inflammation , Respiratory System , Rhinitis, AllergicABSTRACT
Objective To determine the risk factors for postoperative respiratory complications and establish a preoperative risk scoring system.Methods Patients,aged ≥ 18 yr,scheduled for elective surgery or undergoing emergency operation under total intravenous anesthesia or field block anesthesia,were studied.The general data of patients,preoperative SpO2,and conditions of respiratory infection,anemia or cough tests within 1 month before surgery were recorded.The operative sites (thorax,upper abdomen,other sites),duration of operation,type of surgery (emergency operation/elective operation),and methods of anesthesia (general anesthesia/field block) were also recorded.According to the development of respiratory complications within 1-7 days after operation,the patients were divided into either postoperative respiratory complication group or non-postoperative respiratory complication group.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to pick out the risk factors for postoperative respiratory complications and to establish a preoperative risk scoring system.Results Two thousand and thirty-seven patients completed the study.A total of 493 patients developed postoperative pulmonary complications,and the incidence was 24.20％.Statistical analysis showed that the risk factors associated with postoperative respiratory complications included age ＞ 50 yr,preoperative SpO2 ≤90％,high ASA physical status,duration of smoking ＞ 1 yr,positive cough tests,respiratory infections at one month before operation,preoperative anemia,upper abdominal and intrathoracic operations,duration of operation ＞ 2 h.A preoperative risk scoring system was established for postoperative respiratory complications based on 6 independent risk factors:preoperative SpO2,anemia,respiratory infections,age,duration of operation and operative sites.The incidence of postoperative respiratory complications was 61.9 ％,52.8 ％ and 17.2 ％ in high-risk,medium-risk and low-risk groups,respectively,and there was significant difference between the three groups (P ＜ 0.01).Area under the ROC curve was 90％ for subsamples and 87％ for the validation subsamples.Conclusion Age ＞ 50 yr,high ASA physical status,duration of smoking ＞ 1 yr,positive cough tests,preoperative SpO2 ≤90％,anemia,respiratory infections at one month before operation,duration of operation ＞ 2 h,upper abdominal and intrathoracic operations are risk factors for postoperative respiratory complications.A preoperative risk scoring system is successfully established for postoperative respiratory complications based on preoperative SpO2,anemia,respiratory infections,age,duration of operation and operative sites.
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0.05),but it was significantly lower than that in LTP group (P