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Objective:To improve the understanding of hemodialysis complicated with mesenteric artery calcified stenosis and mesenteric ischemia through the analysis of the case and review of related literature.Methods:A case of hemodialysis with intractable abdominal pain as the main manifestation was reported, and its clinical features, diagnosis and treatment were summarized.Results:The case was a maintenance hemodialysis patient with persistent dull pain around the umbilicus, which worsens after meal and hemodialysis. The results showed multiple vascular calcification, superior mesenteric artery stenosis so the patient was diagnosed with chronic mesenteric ischemia. Mesenteric revascularization under intervention was planned but the guide wire failed to enter the superior mesenteric artery after repeated attempts during the operation. Surgical treatment was recommended, but the patient and family refused surgery and were discharged.Conclusions:Dialysis patients with intractable abdominal pain should be carefully identified and alert for mesenteric artery disease and mesenteric ischemia.
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Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.
Subject(s)
Female , Humans , Antibodies, Antineutrophil Cytoplasmic , Organizing Pneumonia , Autoantibodies , Glomerulonephritis , Anti-Glomerular Basement Membrane Disease , Pneumonia , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complicationsABSTRACT
Objective To improve vibration resistance of conventional blood transportation kits and mitigate hemolysis during transportation.Methods The structure of a blood transportation kit was modified.We installed a suspension brac-kets within the kit,added buffer material between the brackets,and tested the vibration-suppressing effect compared with the conventional blood transportation kit.Results Rubber and plastic materials between brackets were added,and double membrane suspension brackets were installed.After 4 and 6 min of vibration,free hemoglobin(FHb)[(1559.7 ±1038.5) and(1886.2 ±1023.8)mg/L],lactic dehydrogenase levels[(135.3 ±67.7)and(195.7 ±123.6)U/L]and hemolysis rate[(0.35 ±0.34)%and(0.42 ±0.38)%]in the conventional transportation kit were significantly higher than in the vibration-suppressing kit.K+did not change significantly,and was comparable in both groups at each time point.After 4 and 6 min of vibration, FHb in the conventional transportation kit exceeded the standard.However, after 12 min of vibration,FHb[(560.1 ±342.3)mg/L]in the vibration-suppressing kit were within the standard range.No bacterial growth was detected in either group.Conclusion The vibration-suppressing kit under research shows a better 1986vibration-suppressing effect,which could improve blood support capability in case of emergency.
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Objective To study the thermal insulation properties of vacuum insulated panel(VIP)used as materials for blood transportation kits.Methods A VIP transportation kit was taken as test group,and a conventional transportation kit was taken as control.Phase change cool storage materials of the same amount and 4℃water bags were put into both kits.A recordable electronic thermometer was used to record the temperature within the two kits,and free hemoglobin(FHb)and potassium ion concentration were measured at 0, 4, and 7 days after blood storage.Results The temperature in the conventional transportation kit increased faster after 36 h, and was significantly higher than in the VIP transportation kit until 60 h.Besides,the VIP transportation kit kept the temperature under 10℃ for(60.7 ±0.6)h, compared to (54.2 ±3.0)h in the conventional transportation kit.FHb concentration was significantly lower in the VIP transportation kit[(605.26 ±74.63)mg/L]than in the conventional transportation kit[(1327.60 ±187.41)mg/L]at day 7(d 7),so was the potassium ion concentration in the VIP transportation kit[(22.7 ±0.4)mmol/L]compared to[(24.6 ±0.6) mmol/L]in the transportation kit at d 7.Conclusion The VIP transportation kit keeps the temperature under 10℃ for a longer time,and the blood quality of preservation is better than that of the conventional transportation kit.Novel heat preservation material can improve health support ability,and is of great value and significance.
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<p><b>OBJECTIVE</b>To evaluate clinical effectiveness of total pelvic floor reconstruction surgery for repair of severe pelvic organ prolapse.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 21 patients with severe pelvic organ prolapse. The anatomical outcomes were evaluated by Pelvic Organ Prolapse Quantitation, functional effectiveness by Prolapse Quality of Life method, and sexual function and operation-related complications were also analyzed.</p><p><b>RESULTS</b>All surgical operations were accomplished successfully by the same surgeon. No impairment of bladder, urethra, rectum, or great vessels was noted, and no patient required blood transfusion. The mean operation duration was (63±19) minutes, and the mean intra-operative blood loss was (143±72) ml. One patients experienced post-operative urinary retention for 7 days, and the remaining 20 patients were able to micturate spontaneously 1-2 day after surgery. The post-operative morbidity rate was 14.3%. Three patients (14.3%) experienced mesh erosion. Of 12 patients who were sexually active, two patients suffered from algopareunia from dyspareunia, one from de novo overactive bladder, and one from stress urinary incontinence Questionnaire scores showed that the overall post operative quality of life was improved significantly (P=0.000), while quality of sexual life significantly degraded (P=0.044) The anatomic cure rate was 95.2% (20/21), and the patient subjective satisfaction rate was 85.7% (18/21)</p><p><b>CONCLUSIONS</b>The total pelvic floor reconstruction is a safe and effective approach for the repair of severe pelvic organ prolapse, although its functional effectiveness is not as notable as anatomical outcomes However, the complications such as mesh erosion, low urinary tract symptoms, algopareunia, and dyspareunia should be carefully managed.</p>
Subject(s)
Aged , Humans , Middle Aged , Pelvic Floor , General Surgery , Pelvic Organ Prolapse , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
High-density lipoprotein (HDL), an abundant plasma lipoprotein, has been thought to be anti-inflammatory in both health and infectious diseases. It binds lipopolysaccharide (LPS) and neutralizes its bioactivity. The present study aimed to investigate the potential role of HDL, which was separated from human plasma, in LPS-induced acute lung injury in mice. Kunming mice (18-22 g) were treated with either HDL (70 mg/kg body weight, via tail vein) or saline 30 min after LPS administration (10 mg/kg body weight, intraperitoneally) and were decapitated 6 h after LPS challenge. The arterial blood was collected and analyzed for blood gas variables (PaO(2), pH, and PaCO(2)). The bronchoalveolar lavage fluid (BALF) samples were analyzed for total protein concentration, lactate dehydrogenase (LDH) activity, and white blood cell (WBC) count. The lung samples were taken for histopathological evaluation and for determination of lung wet-to-dry weight ratio (W/D), malondialdehyde (MDA) content, myeloperoxidase (MPO) activity and tumor necrosis factor α (TNF-α) content. Arterial blood gas analysis showed that after LPS challenge, HDL-treated mice exhibited a higher PaO(2), and pH, but a lower PaCO(2) than HDL-untreated ones (P<0.01). LPS-induced increases in total protein concentration, WBC number and LDH activity in BALF were significantly attenuated in HDL-treated mice (P<0.01). HDL treatment also resulted in a significant protection of lung tissues against LPS-induced acute lung injury via decreasing W/D ratio, MPO activity, MDA content, and the content of the pro-inflammatory cytokine TNF-α (P<0.05, P<0.01). Histological examination revealed that HDL treatment resulted in significantly lower scores of acute lung injury induced by LPS, with reduced hemorrhage, intra-alveolar edema and neutrophilic infiltration (P<0.01). It is suggested that HDL plays a protective role in attenuating LPS-induced acute lung injury in mice.