Spontaneous pneumomediastinum due to paralytic rabies

Rabies is a fatal disease resulting from rabies virus infection, causing severe neurological symptoms and ultimately death by destroying the nervous system. In general, a patient tends to see a neurologist or an infectious diseases physician, with very common and typical discipline-related signs and symptoms, such as hydrophobia, aerophobia, and mental disorders. However, we reported a rabies patient who was first admitted to see a thoracic surgeon with spontaneous pneumomediastinum.

The relationship between the waist-to-height ratio and glucose and lipid metabolism in han adolescents.

Objective. To evaluate the relationship between waist-to-height ratio (WHtR) and glucose and lipid metabolism in Han adolescents aged 13-15 years. Methods. A study was conducted on 1665 Han adolescents aged 13-15 years. Measurements included height, weight, waist circumference, fasting plasma glucose(FPG), triglyceride and high-density lipoprotein cholesterol. The subjects were divided into two groups according to WHtR. Results.Compared with the control group (n=1340,WHtR<0.46), the abdominal obesity group(n=325,WHtRe”0.46) had significantly higher levels of body mass index (BMI) (26.3±3.6 vs 18.9±2.3), WHtR (0.51±0.04 vs 0.40±0.03), FPG (4.99±0.48 vs 4.86±0.46), and triglyceride (1.21±0.62 vs 0.87±0.41), and a lower level of high-density lipoprotein cholesterol (1.26±0.27 vs 1.46±0.30) (P<0.01). Logistic regression analysis showed that after controlling for age, sex and BMI, the elevated FPG and dyslipidemia risk odds ratios of the abdominal obesity group were 1.954 (95% CI :1.250~3.054) and 2.012 (95% CI:1.204~3.362) (P<0.01) respectively. When clustered, the odds ratio of elevated FPG and dyslipidemia was 6.659 (95% CI: 1.337~33.159) (P<0.01). Conclusions. The waist-to-height ratio is an appropriate measure to assess dyslipidemic-diabetic adolescents and should be used to guide early intervention with the aim of future prevention of these linked diseases.

Clinical features of primary Sj(o)gren syndrome complicated with liver damage and its related factors / 中华全科医师杂志

Objective To study clinical features of liver damage in primary Sj(o)gren syndrome (pSS) and its related factors.Methods One hundred and forty-nine patients of confirmed pSS hospitalized at Peking University People's Hospital were analyzed retrospectively.Results Seventeen of 149 patients of pSS (11.4%) showed liver damage,10 diagnosed as autoimmune hepatitis and seven as primary biliary liver cirrhosis.Increased serum levels of IgG,IgM and γ-globulin accounted for 88.2% and 50.8%,35.3% and 5.3%,and 94.1% and 47.7% of those complicated with and without liver damage,respectively,with statistically significant difference (P ＜ 0.05).Positive serum anti-mitochondria antibody subtype M2 (AMA-M2) was 35.3% in pSS patients with liver damage,significantly higher than that in those without liver damage (1.5%) (P ＜ 0.05).Independent risk factors significantly associated with liver damage included age (OR = 1.013,95% CI 0.971-1.058),course of illness (OR = 1.089,95% CI 1.032-1.150),serum level of γ-globulin (OR = 4.021,95% CI 1.246-12.982),positive AMA-M2 (OR = 11.82,95% CI 0.005-0.157),and positive anti-SSA (OR = 101.333,95% CI 12.653-811.560).Conclusions Liver damage occurred rather high in pSS patients and increased serum levels of IgG,IgM,γ-globulin and anti-SSA can be used to predict their complication with liver damage.Age,course of illness,serum level of γ-globulin,positive AMA-M2 and positive anti-SSA are all significantly associated with liver damage in pSS patients.