Hematogenous dissemination mediastinitis: case report / Mediastinitis de diseminación hematogena: Reporte de un caso

Abstract Background: Acute mediastinitis is the inflammation of the connective tissue and fat surrounding the mediastinal structures. It is a high-mortality entity and its most frequent causes include sternotomy infections from cardiovascular surgery, esophageal perforation and extension of head and neck infections. Isolated cases of acute mediastinitis from hematogenous spread are described in the literature. Case presentation: 58 year-old man, with history of gouty arthritis managed with steroids, diagnosed with acute mediastinitis by S. aureus, secondary to septic arthritis of the ankle, managed with drainage of mediastinal collections by thoracoscopy and antibiotic therapy, with satisfactory evolution. Conclusions: In patients with acute mediastinitis, hematogenous dissemination should be considered when the etiologies most frequently associated with the entity are ruled out. Early surgical treatment derived from a multidisciplinary diagnostic approach improves the prognosis of these patients.

Resumen Antecedentes: la mediastinitis aguda es la inflamación del tejido conectivo y la grasa que rodea las estructuras mediastínicas. Es una entidad de alta mortalidad y sus causas más frecuentes incluyen infecciones de la esternotomia de la cirugía cardiovascular, perforación esofágica y extensión de infecciones de cabeza y cuello. Casos aislados de mediastinitis aguda por diseminación hematógena se describen en la literatura. Caso: Hombre de 58 años, con antecedente de artritis gotosa manejado con esteroides, diagnosticado de mediastinitis aguda por S. aureus, secundaria a artritis séptica de tobillo, manejada con drenaje de colecciones mediastínicas por toracoscopia y antibioterapia, con evolución satisfactoria. Conclusiones: En pacientes con mediastinitis aguda, se puede considerar la diseminación hematógena cuando las etiologías más frecuentemente asociadas a la entidad están descartados. El tratamiento quirúrgico precoz derivado de un abordaje diagnóstico multidisciplinar mejora el pronóstico de estos pacientes.

Mechanism of Chinese Herbal Compounds Capable of Invigorating Qi and Activating Blood in Intervention of Hematogenous Metastasis of Malignant Tumors： A Review / 中国实验方剂学杂志

Metastasis is the main cause of poor prognosis of malignant tumors， and intervention with metastasis is the key measure in the treatment of malignant tumors. Hematogenous metastasis， the most common tumor metastasis， falls into the category of "Chuanshe" in traditional Chinese medicine （TCM）， with Qi deficiency and blood stasis as the critical pathogenesis. In the fight against malignant tumors， TCM emphasizes the reinforcement of healthy Qi and the elimination of pathogenic factors， exhibiting its action advantages of multiple targets， multiple mechanisms， and multiple levels. Extensive clinical evidence has shown the exact efficacy of Chinese herbal compounds designed for invigorating Qi and activating blood in delaying the progression of tumor disease and prolonging the survival period of patients. In view of the important role of hematogenous metastasis in the prognosis of tumors， more and more studies have explored the effects and mechanisms of Chinese herbal compounds capable of invigorating Qi and activating blood in intervening in hematogenous metastasis. This paper summarized the relevant literature reports in China and abroad on the intervention of Chinese herbal compounds capable of invigorating Qi and activating blood in the hematogenous metastasis of malignant tumors， in order to provide a theoretical basis for the clinical application of Qi-invigorating and blood-activating therapy in the treatment of malignant tumors. It has been found that Chinese herbal compounds formulated for invigorating qi and activating blood are effective in hindering several key steps in hematogenous metastasis through various mechanisms， including regulating the expression of cell adhesion molecules， inhibiting extracellular matrix degradation and angiogenesis， enhancing the killing effect of immunity， and improving blood hypercoagulability and hyperviscosity. Furthermore， the combination of invigorating Qi and activating blood targets the pathogenesis essence （Qi deficiency and blood stasis， characterized by sthenia in origin and asthenia in superficiality） of malignant tumor much better. Some comparative studies have demonstrated that the anti-metastasis effect of Qi-invigorating and blood-activating therapy is significantly stronger than that of the Qi-invigorating or blood-activating therapy alone， and such combination avoids the possible risk of the metastasis of malignant tumors triggered by the use of either of them. This study has provided some reference for the current clinical application of TCM for improving the prognosis of malignant tumors.

Infecciones osteoarticulares en niños / Osteoarticular infections in children

Las infecciones osteorticulares (IOA) en el niño son una causa importante de morbilidad y secuelas. Su pesquisa oportuna y el tratamiento eficiente pueden lograr excelentes resultados. La mejoría en las condiciones de salud de la población, y el cambio de los agentes etiológicos han variado la forma de presentación y tratamiento. La existencia de gérmenes como Kingella kingae y Staphilococcus aureus multiresistente, contribuyen a la variabilidad de presentación de las infecciones osteoarticulares.El manejo de estas patologías requiere de un conocimiento del cuadro clínico, de los métodos de diagnóstico y las herramientas terapéuticas. Para obtener buenos resultados es requisito básico el enfrentamiento de estos pacientes en un equipo multidisciplinario de especialistas.En este manuscrito revisaremos los aspectos fundamentales de las infecciones osteoarticulares, según el enfoque que aplicamos en nuestros pacientes.

Osteoarticular infections are a substantial cause of morbidity and sequelae in children. Early diagnosis and efficient treatment can achieve excellent results. The improvement in the health conditions of the population and the change in the etiological agents have produced changes in their presentation and their required treatment. The existence of germs like Kingella kingae and Staphilococcus aureus multiresistant contribute to the variability of presentation of osteoarticular infections.The appropriate management of these pathologies requires knowledge of the clinical picture, diagnostic methods, and therapeutic tools. To obtain good results, it is a basic requirement that these patients be confronted by a multidisciplinary team of specialists.In this manuscript we will review the most fundamental aspects of osteoarticular infections according to the approach we apply to our patients

Reliability of the Penny and Beit CURE Radiologic Classifications of Pediatric Patients with Chronic Hematogenous Osteomyelitis in the Philippine General Hospital

@#OBJECTIVE: This study aimed to evaluate the inter- and intraobserver reliability of the Penny and Beit CURE radiologic classifications of pediatric patients with Chronic Hematogenous Osteomyelitis (CHOM) in the Philippine General Hospital (PGH). METHODS: Thirty-four pre-operative radiographs of PGH pediatric patients with CHOM were classified by seven orthopedic surgeons using both Penny and Beit CURE Classification systems. Two sets of radiographs were sent to the surgeons twice, four weeks apart, to classify. The Fleiss and Cohen κ statistics were used to determine inter- and intraobserver reliabilities, respectively. RESULTS: The Penny Classification had a slight to fair interobserver reliability (Fleiss κ = 0.17 and 0.24) and a fair intraobserver reliability (Cohen κ =0.35) with a 49.58% average intraobserver agreement. The interobserver reliability when including all Beit CURE classification subtypes was fair (κ = 0.28 and 0.31). This improved to moderate (κ = 0.41 and 0.54) when using only the four main types of the Beit CURE classification with a 77.31% intraobserver agreement. CONCLUSION: The Beit CURE classification for pediatric CHOM had higher inter- and intraobserver agreement rates than the Penny classification. Further improvement in reliability can be made by combining B2 and B3 subtypes under the Beit CURE classification.

Study on molecular mechanism of circulating tumor cell clusters promoting hematogenous metastasis / 中国药理学通报

Tumor metastasis is an important cause of death in tumor patients. Once metastasis occurs, cancer will become more difficult to treat. Many studies have observed circulating tumor cells (CTCs) in the circulatory system of patients with metastasis. CTCs may occasionally appear in the form of clusters during the process of hematogenous metastasis. These aggregated tumor cell clusters have higher efficacy than the single CTC. The development of circulating tumor cell cluster capture technology provides new insights into tumor metastasis. The molecular mechanism of CTC clusters formation and their role in tumor hematogenous metastasis are discussed here, and their use as biomarkers and target in therapy is evaluated.

Axillary lymph node metastasis and prognosis of triple-negative invasive ductal breast cancer patients in different age groups / 中华内分泌外科杂志

Objective To investigate the metastasis and the prognosis of the axillary lymph nodes in triple-negative and invasive ductal breast cancer patients of different ages.Methods 321 female breast cancer patients diagnosed as triple-negative and invasive ductal carcinoma from Jan.1,2008 to Dec.31,2017 were selected as the samples,all of whom were treated with regular surgical treatment and postoperative radiotherapy and chemotherapy,and were divided into three groups according to their ages,including the younger group(＜40 years old),the middle age group (40 to 60 years old),and the elder group(≥60 years).We compared the metastasis of axillary lymph node,the disease-free survival rate after 1 to 5 years of the operations and the prognostic factors of the three groups.Results Among the 321 patients,there were 94 young patients,151 middle-aged patients and 76 elder patients.Among the three groups,the rate of axillary lymph nodes metastasis was the lowest in the elderly group(11.8％),the highest in the middle-aged group(17.2％)and middle in the young group(13.8％).The patients were followed up for 1 to 5 years.The recurrence rate of the young,middle-aged and elder groups was 56.4％,53.6％ and 17.1％ respectively.There was a significant difference between the three groups (P＜0.05).Conclusion ①he frequency of LN transfer in patients of TNBC is lower in the younger and the elder patients than in the middle-aged patients.②The younger patients of TNBC have a higher recurrence rate and poor prognosis,while the elder patients of TNBC have the lowest recurrence rate and good prognosis.(③The prognosis of TNBC may be related to metabolism,which,of course,needs to be further verified with the proof of blood and cell test.(④The younger patients of TNBC are more likely to suffer blood metastasis,and adjuvant systemic therapy in early period may be more beneficial than local radiotherapy and early axillary dissection.

Experience in rescue treatment of severe hematogenous Staphylococcus aureus pneumonia / 中国中西医结合急救杂志

The clinical characteristics of the pneumonia includes hyperthermia, cough and pectoralgia, etc with simultaneous mixed signs of inflammatory infiltration, consolidation, cavity/air sac and abscess in pulmonary CT scan, and these signs change rapidly. Respiratory failure and septic shock frequently occur in severe such patients, resulting in refractory management and relatively long therapeutic course. The timely diagnosis, use of sensitive antibiotics, respiratory and nutritional support, etc comprehensive effective measures can elevate the rescue success rate with severe hematogenous staphylococcus aureus pneumonia.

Acute osteomyelitis

Acute osteomyelitis requires careful clinical evaluation, a high index of suspicion as it is an uncommon but devastating disease that affects largely previously healthy children. Management of osteomyelitis is a formidable challenge as success of antibiotics in soft tissues has not been replicated in bony tissue due to peculiar anatomy and physiology of the bone. Illness, malnutrition and decreased immunity predispose children to develop acute osteomyelitis. Absence of phagocytic cells in the metaphysis may explain predilection in children. Recently the trend in treatment strategy includes a rapid transition from intravenous to oral antimicrobial therapy and a shortened overall course of therapy. Many new therapeutic options are on the horizon that will likely impact the management of this and other childhood bacterial infections. This review will focus on recent advances in the management of acute hematogenous osteomyelitis in children.

Splenic tuberculosis caused by hematogenous pulmonary tuberculosis: a case report and literature review / 中国感染与化疗杂志

Objective To understand the clinical features of splenic tuberculosis. Methods The clinical manifestations, laboratory tests, treatment outcomes of a case of splenic tuberculosis caused by hematogenous pulmonary tuberculosis were analyzed. Related literatures about splenic tuberculosis were also reviewed. Results The patient was a 19-year-old male. Cough, fever, night sweats, and weight loss were the main manifestations. Thoracoscopy revealed tuberculosis and imaging suggested splenic tuberculosis and tuberculosis in multiple body sites. Anti-tuberculosis treatment was effective in improving patient conditions. According to literature review, there are two types of splenic tuberculosis: primary splenic tuberculosis or as part of hematogenous pulmonary tuberculosis.The clinical manifestations of primary splenic tuberculosis are usually atypical. Immune deficiency is a significant risk factor of splenic tuberculosis. The main clinical manifestations of splenic tuberculosis are splenomegaly, fever, digestive system symptoms, and occasionally spontaneous splenic rupture (3/32). Most of the patients with splenic tuberculosis (28/32) were cured or improved by anti-tuberculosis treatment and/or splenectomy. Conclusions The onset of splenic tuberculosis is mostly insidious and clinical symptoms usually atypical. The diagnosis relies on radiographic findings, biopsy and pathological examination. Anti-tuberculosis and selective splenectomy are the effective treatment. The outcome of splenic tuberculosis is good in most patients.

Analysis on curative effect of new type irrigation pump use in acute hematogenous osteomyelitis / 重庆医学

Objective To investigate the curative effect of using new irrigation pump in acute hematogenous osteomyelitis.Methods Forty patients with acute hematogenous osteomyelitis were divided into the control group and observation group,20 cases in each group.The control group adopted the conventional lavage for drainage,while the observation group used self-made irrigation pump.Then the clinical curative effect and cure time were compared between the two groups.Results The total effective rate in the observation group was 100.00 ％,which was significantly higher than 80.00 ％ in the control group(P＜0.05),and the difference was statistically significant(P＜0.05).The cure time in the observation group was(10.13 ± 8.03)d,which was significantly shorter than (18.14-±5.43)in the control group,and the difference was statistically significant(P＜0.05).Conclusion The curative effect of new type irrigation pump in acute hematogenous osteomyelitis is more acurate than that of conventional lavage for vacuum darianage.

Abscesso espinhal epidural por disseminação hematogênica: relato de caso / Spinal Epidural Abscess by Hematogenous Spread: Case Report

Abscesso espinhal epidural é uma doença rara de diagnóstico difícil, sendo que o principal fator prognóstico é o diagnóstico breve. A maioria dos pacientes, porém, tem o diagnóstico tardio, quando já existem sintomas neurológicos que podem permanecer após o tratamento. Na maioria dos casos, os sintomas iniciais são dor nas costas, febre e paralisia. O tratamento é feito à base de antibioticoterapia empírica e, caso não haja contraindicação, descompressão e drenagem cirúrgica. Relata-se o caso de uma paciente que sofreu paralisia súbita nos membros inferiores. Inicialmente, havia suspeita de mielite transversa, mas a evolução do caso permitiu o diagnóstico de abscesso espinhal epidural emT6, T7 e T8, causada por disseminação hematogênica de Staphylococcus aureus.

Spinal epidural abscess is a rare and difficult disease to diagnose, and the main prognostic factor is the early diagnosis. Most patients, however, have their diagnosis delayed to when they already have neurological symptoms that may remain after treatment. In most cases, the initial symptoms are back pain, fever and paralysis. Treatment is based on empirical antibiotic therapy and, if there is no contraindication, decompression and surgical drainage. We report the case of a patient who suffered sudden paralysis of the inferior members. Initially suspected as transversemyelitis, the case evolved, allowing the diagnosis of spinal epidural abscess in T6, T7 and T8, caused by hematogenous spread of Staphylococcus aureus.

Effect of metabolic tumor volume on the prognosis of patients with colorectal cancer / 重庆医学

Objective To investigate the predictive value of metabolic tumor volume (MTV) in angiogenesis and hematoge‐nous metastasis of patients with colorectal cancer .Methods Totally 108 patients with colorectal cancer from January 2011 to De‐cember 2015 were enrolled into the study and divided into metastasis group (n=42) and non‐metastasis group (n=66) according to whether combining with hematogenous metastasis .All patients received 18 F‐2‐fluoro‐D‐glucose positron emission tomography/com‐puted tomography (18F‐FDG PET/CT) before operation ,then used the PET VERA software to automatically calculate MTV ac‐cording to the 40% of standard uptake value max(SUVmax ) as the threshold .The blood vessels were identified with CD34+ immu‐nohistochemical staining ,then measured the microvessel density (MVD) .The clinical pathologic data ,SUVmax ,MTV and MVD were compared between metastasis group and non‐metastasis group .The area under the receiver‐operating characteristic curve (AUC) was performed to evaluate the predictive value of MTV on hematogenous metastasis .Results SUVmax ,MTV and MVD in metastasis group were significantly higher than that in non‐metastasis group (P0 .05) ,MVD and SUVmax (r=0 .179 ,P=0 .064>0 .05) .AUC of MTV was 0 .736 ,and the best threshold value was 15 .016 cm3 ,whose sensitivity ,specificity ,positive predictive value ,negative predictive value and Youden index were 83 .3% ,63 .6% , 59 .3% ,85 .7% and 47 .0% respectively .Conclusion Compared with SUVmax ,MTV of colorectal cancer is associated with angio‐genesis and hematogenous metastasis ,so as to predict the prognosis of colorectal cancer ,which is worthy of clinical application .

Research progress on the role of platelet in mediating tumor metastasis by hematogenous spread and its mechanisms / 中国药理学通报

Tumor metastasis is one of the most important biologi-cal characteristics of malignant tumor, and it is also the main factors that cause treatment failure and poor prognosis. Clinical studies have shown that the number of platelets in patients with malignant tumor increased more significantly than that in benign tumor patients and healthy people, which indicate that platelet might be involved in the development process of tumor. Further study found that in the process of cancer spreading to blood, platelet could interact with tumor cells to form tumor emboli, helped tumor cells escape from immune surveillance, thus pro-moted the tumor metastasis. In recent years, related mechanisms on platelets in promoting tumor metastasis were revealed gradual-ly, and several targeted therapies based on platelets were also carried out. This paper reviews the role of platelet in mediating tumor metastasis by hematogenous spread and its mechanisms and discusses the therapy strategies that target platelet, which may provide references for follow-up research and clinical treat-ment.

Osteomielitis / Osteomyelitis

La osteomielitis es una infección de hueso y médula ósea, que se debe a la inoculación de un microorganismo ya sea por contigüidad, directa o hematógena. Esta genera inflamación aguda, aumento de la presión intraósea, trombosis e isquemia que derivan en necrosis ósea. Para establecer el diagnóstico son necesarios la historia clínica, el examen físico, estudios de gabinete así como de imagen, entre ellos rayos X, ultrasonido, TAC, RM y estudios de medicina nuclear.

Osteomyelitis is an infection of bone and bone marrow, which is caused by the inoculation of a microorganism, either contiguous, directly or by hematogenous dissemination. The infection creates acute inflammation, increased intraosseous pressure, thrombosis and ischemia that result in bone necrosis. To establish the diagnosis medical history, physical examination, imaging studies and imaging, including X-rays, ultrasound, CT, MRI and nuclear medicine studies are needed.

Integrin-mediated tumor cell-host cell interaction during hematogenous metastasis and their regulatory mechanisms / 医用生物力学

Hematogenous metastasis is one of the most important ways for metastasis of tumor cells and this is a complex pathophysiological process. Tumor cells enter the bloodstream and move with the blood circulation, meanwhile interact with leukocyte, platelets via integrins, or directly interact with endothelial cells to cause a series of biological behaviors and promote the metastasis of tumor cells. These activated integrins, collaborating with other molecules (e.g. integrins, selectins, cytokines and chemokines), will induce various signal cascades to mediate tumor cell adhesion and migration, and form a new metastatic foci. Hence, better understanding of hematogenous metastasis process is of great significance for treating malignant metastasis of tumor cells and improving life of tumor patients. In this review, the roles of integrins during hematogenous metastasis of tumor cells and their signal transduction were summarized, and new perspectives for future investigation were also discussed. The elucidation about the mechanism of hematogenous metastasis of tumor cells will help to provide a rational basis for anticancer drug development and drug target discovery.

Aspergilosis nasosinusal con extensión intracraneal en una paciente inmunocompetente: una entidad infrecuente con características radiológicas típicas / Sinonasal aspergillosis with intracranial extension in an immunocompetent patient: a rare disease with typical imaging features

El aspergilo es un hongo ubicuo. Las localizaciones de infección primaria más comunes son el tracto respiratorio y los senos paranasales. La afectación intracraneal es rara y conlleva una alta mortalidad. Ocurre mayoritariamente por extensión hematógena desde el pulmón, pero en pacientes inmunocompetentes, la extensión directa desde los senos paranasales es más común. Describimos el caso de una mujer de 25 años originaria de India que se presentó en el servicio de urgencia de nuestro centro hospitalario con cefalea frontal crónica y progresiva. Los hallazgos en los estudios de imágenes sugirieron el diagnóstico de sinusitis fúngica con extensión intracraneal, siendo el patógeno más frecuente el aspergilo. El diagnóstico fue confirmado anátomo-patológicamente. Revisamos los hallazgos radiológicos típicos que deben ayudar al diagnóstico precoz de esta entidad, rara, pero potencialmente mortal.

Aspergillus is a ubiquitous fungus. The most common primary sites of infection are the respiratory tract and sinuses. Intracranial infection is rare and implies a high mortality. It occurs mainly by hematogenous extension from the lung, but in immunocompetent patients, direct extension from the sinuses is more common. We describe the case of a 25 year old woman from India who consulted in the emergency room of our hospital with chronic and progressive frontal headache. The findings in imaging studies suggested the diagnosis of fungal sinusitis with intracranial extension, being the most common pathogen of Aspergillus. The diagnosis was anatomically-pathologically confirmed. We review the typical radiological findings which should help in the early diagnosis of this rare but potentially fatal disease.

Discitis hematógena aguda en un adulto / Discite hématogène aiguë chez un adulte / Acute hematogenous discitis in an adult patient

Introducción: la discitis es una de las formas de presentación de los procesos infecciosos en el raquis. La de origen hematógeno es más frecuente en los niños y de modo raro aparece en el adulto asociada a una inmunodepresión, porque en esta edad ocurre generalmente como complicación de un proceder quirúrgico sobre el disco intervertebral. Objetivo: establecer las características clínicas e imaginológicas y el tratamiento de esta afección en el adulto. Descripción: se presentó un paciente masculino de 35 años de edad con antecedentes de salud anterior, que comenzó a presentar dolor en columna lumbar e impotencia funcional absoluta. Se realizaron estudios de laboratorio y de imágenes. Los parámetros hematológicos inclinaban al diagnóstico de un proceso infeccioso y la resonancia magnética nuclear evidenció una discitis. El tratamiento consistió en la administración de antibióticos e inmovilización. Conclusiones: el paciente presentó mejoría de los síntomas a las 72 h, con alivio total del dolor a las 2 semanas. Los resultados hematológicos mejoraron paulatinamente hasta alcanzar la normalidad a los 3 meses. Los estudios de imágenes fueron normales a los 6 meses y el paciente se incorporó a sus actividades habituales. la discitis hematógena en el adulto, aunque infrecuente, debe ser sospechada en todo paciente con síntomas dolorosos del raquis de posible origen infeccioso, que no responde a tratamiento médico y mucho más si concomita con algún grado de inmunodepresión(AU)

Introduction: Discitis is one of the forms of presentation of infectious processes of the spine. Discitis of hematogenous origin is more common in children. In adults it is a rare condition associated to immunosuppression, since it generally occurs as a complication of intervertebral disk surgery. Objective: Determine the clinical and imaging characteristics as well as the treatment of this condition in adults. Description: A male 35-year-old patient with a disease history presents with lumbar pain and total functional impotence. Laboratory and imaging studies were conducted. Hematological parameters pointed to an infectious process, and nuclear magnetic resonance imaging revealed a discitis. Treatment consisted of antibiotics and immobilization. Conclusions: The patient showed symptom improvement at 72 hours, with total pain relief at 2 weeks. There was gradual improvement in hematological results, which reached normal levels at 3 months. Imaging studies were normal at 6 months, and the patient resumed his daily routine. Adult hematogenous discitis, though infrequent, should be suspected in any patient with spinal pain symptoms of possible infectious origin not responding to clinical treatment, particularly when it is concomitant with some degree of immunosuppression(AU)

Introduction: la discite est l'une des formes de présentation caractérisant les processus infectieux au niveau du rachis. L'infection hématogène est la plus fréquente chez les enfants, mais rare chez les adultes si associée à une immunodépression, car à l'âge adulte, elle survient généralement comme une complication d'un geste chirurgical sur un disque intervertébral. Objectif: établir les caractéristiques cliniques et par image, et le traitement de cette affection chez l'adulte. Description: un patient du sexe masculin, âgé de 35 ans, avec une histoire médicale connue, ayant une douleur lombaire et un dysfonctionnement absolu, s'est présenté en consultation. Des examens de laboratoire et d'imagerie ont été réalisés. Les résultats hématologiques ont évoqué une infection, et la résonance magnétique nucléaire a mis en évidence une discite. Le traitement a consisté à l'administration des antibiotiques et à l'immobilisation. Conclusion: les symptômes du patient ont résolu à 72 h, la douleur s'est atténuée à 2 semaines. Les résultats hématologiques ont amélioré peu à peu lors de 3 semaines. Les examens d'imagerie sont revenus à la normale à 6 mois, et le patient s'est réincorporé à sa vie quotidienne. La discite hématogène chez l'adulte, quoique rare, doit être soupçonnée chez tout patient ayant une douleur de possible origine infectieuse au niveau du rachis et ne répondant pas au traitement médical, nettement plus si une certaine immunodépression est concomitante(AU)

Surgical treatment of subacute hematogenous osteomyelitis in children

Background: Subacute hematogenous osteomyelitis is a rare disease and difficult to diagnose. Hematogenous osteomyelitis is an infection caused by bacterial seeding from the blood. Acute hematogenous osteomyelitis is characterized by an acute infection of the bone caused by the seeding of the bacteria within the bone from a remote source.\r\n', u"Objectives: The study had two purposes: (1) Remark of Clinical and Xray syndrome of Subacute hematogenous osteomyelitis, and (2) Evaluation of the surgical results. Subjects and method:We operated on 42 patients with Subacute hematogenous osteomyelitis during 18 years period ( from 1984, October to 2005 December). Included 11 female, 31 male at the age from 4 to 12 years old. A rontgenographic classification was described by Gledhill & Roberts. The surgical debridement and irrigated with the antibiotic. Results: The patient's temperature is mildly elevated or normal, the pain isn't remarked. The WBC is normal. The cultures obtained by biopsy are positive in 8/42 patients. The lesions of type 1 in (88.1 % and type 2 in 11.9%. The follow - up: Good in 61.7%,Fair in 32.4%, Poor in 5.9%. Conclusions: The diagnosis and treatment are usually delayed, sometimes must be established by an open biopsy and cultures. Treatment with curettage of the lesion and administration irrigated with the solution antibiotics.\r\n", u'

Studies on sLe~(a/x) and Hematogenous Metastasis of Cancer / 中国生物工程杂志

The expression of sLea/x which correlates with conventional histopathologic parameters serves as a useful indicator for the prognosis of metastatic disease. The bindings between sLea/x and their common ligand E-selectin initiate hematogenous metastasis of cancer. Certain bioactive conformation is crucial for the interaction between sLea/x and their ligands. Thus, a new class of compounds that mimic the structures of sLea/x can potently inhibit not only their functional bindings to selectins, but also the metastasis of cancer. This review is mainly on the sLea/x molecular structure,biosynthesis,distribution, especially the relationship between sLea/x and hematogenous metastasis of cancer and the design of drugs that mimic the structures of sLea/x.

Clinical study on anti-infective reconstituted bone xenograft for treatmeat of chronic hematogenous osteomyelitis / 中国矫形外科杂志

[Objective] To study the effect of anti-infective reconstituted bone xenograft(ARBX)on treating chronic hematogenous osteomyelitis as one-stage grafting.[Method]ARBX was used to treat 24 cases of chronic hematogenous osteomyelitis as one-stage grafting after debridement since September of 2001,17 cases of which were followed up for an average period of 34 months(range,12 to 79 months).[Result]Except 1 case failed to cure,and 1 resulted in recurrence of infection,and 1 with large segmental bone defect nonunion post-operatively,other 14 cases were cured,the cure rate was 82.4% which was better than traditional therapy.[Conclusion]ARBX has high osteoinductive activity and enhanced anti-infective capability,which enables it to be used as primary grafting to treat chronic hematogenous osteomyelitis.