Medicine
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Endo-bronchial ultrasound guided trans-bronchial needle aspiration (EBUS-TBNA) has been widely accepted as a safe and efficient technique for diagnosing patients with mediastinal/hilar lymphadenopathy and suspected cases of lung cancer. An effective anesthetic technique should provide comfort and quick recovery of patients while allowing the clinicians to obtain adequate tissue sample. Therefore we combined mask ventilation support (SIMV), BIS monitoring, and short-acting medication to achieve the effect mentioned above. ⋯ The obtained results showed that this anesthesia scheme can provide appropriate depth of anesthesia for patients undergoing EBUS-TBNA examination, while ensuring rapid and high-quality recovery of patients.
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Some acute myeloid leukemia (AML) patients present with features mimicking the classical hypergranular subtype of acute promyelocytic leukemia (APL) but without the typical promyelocytic leukemia/retinoic acid receptor α (PML/RARα) rearrangement. Herein, we report an AML patient resembling APL but with nucleoporin 98/retinoid acid receptor gamma gene (NUP98/RARG) fusion transcript and Runt-related transcription factor 1 (RUNX1) mutation. ⋯ Acute myeloid leukemia with the NUP98/RARG fusion gene and the RUNX1 mutation may be a special subtype of AML and may benefit from the alkaloid-based regimen.
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Case Reports
Late-onset anastomotic leak following sweet esophagectomy: A case report and review of the literature.
Late-onset anastomotic leak (AL) is an uncommon but potentially lethal complication after esophagectomy. ⋯ Late-onset AL should be kept in mind when the patient complained of chest distress and fever during the follow up after esophagectomy. In addition, naso-leakage extraluminal drainage could be considered for the treatment of AL. Further trials for better evidence are warranted.
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Observational Study
The ratio of estimated average glucose to fasting plasma glucose level as an indicator of insulin resistance in young adult diabetes: An observational study.
At present, glycated hemoglobin (HbA1c) and glycated albumin (GA) are used to evaluate glycemic control in diabetic patients, but they cannot reflect insulin deficiency and/or insulin resistance. We investigated the feasibility of using estimated average glucose to fasting plasma glucose ratio (eAG/fPG ratio) to estimate insulin resistance in young adult diabetes. A total of 387 patients with type 2 diabetes were included and were stratified into 2 groups based on median values of the glycemic index ratio: the GA/A1c ratio <2.09 (n = 91) and ≥2.09 (n = 296); the eAG/fPG ratio <1.69 (n = 155) and ≥1.69 (n = 232). ⋯ The ratio of GA to HbA1c was calculated, and the homeostasis model assessment of β-cell function and insulin resistance were determined. The homeostasis model assessment of insulin resistance level was significantly associated with the eAG/fPG ratio, but not with the ratio of GA to HbA1c, GA, HbA1c, and fructosamine levels. The ratio of estimated average glucose to fasting plasma glucose level correlates with insulin resistance in young adult diabetes.
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Intradural schwannomas can occur at any level of the spine. According to the literature, approximately 8% of intradural schwannomas occur in the atlantoaxial spine, and these tumors are usually located in the posterolateral or lateral spinal cord. In contrast, tumors in the ventral midline of the spinal cord are relatively rare. ⋯ In summary, for the tumors in the ventral midline of the atlantoaxial spinal cord, the preferred treatment is complete surgical resection by the posterior approach compared to the anterior approach, which often improves clinical symptoms or achieves a healing effect.