Medicine
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Case Reports
VV-ECMO combined with prone position ventilation in the treatment of Pneumocystis jirovecii pneumonia: A case report.
Pneumocystis jirovecii pneumonia (PJP) occurs in immunocompromised hosts. It is classified as PJP with human immunodeficiency virus (HIV) infection (HIV-PJP) and PJP without HIV infection (non-HIV PJP). Compared with HIV-PJP, non-HIV PJP is more likely to develop rapidly into respiratory failure, with difficult diagnosis and high mortality. ⋯ VV-ECMO combined with prone position ventilation could be a useful choice for respiratory assistance in non-HIV PJP patients.
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Studies on the thyroid disease risk in patients with rheumatoid arthritis (RA) associated with comorbidities are limited. This population-based retrospective cohort study investigated the hypothyroidism risk in patients with RA and the role of comorbidities. We used Taiwan National Health Insurance Research Database to identify 16,714 RA patients newly diagnosed in 2000 to 2008 and 66,856 control persons without RA, frequency matched by sex, age, and index year. ⋯ Among all comorbidities, stroke exerted the greatest impact in the RA group with an adjusted hazard ratio of 3.85 (95% confidence interval = 1.24-12.0). RA patients have an increased risk of developing hypothyroidism; this risk was pronounced in women and the elderly. RA patients should be closely monitored to prevent the development of hypothyroidism.
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The aim of this study was to investigate root canal curvature and direction of maxillary lateral incisors in Shandong, China. Cone beam computed tomography (CBCT) images of 176 maxillary lateral incisors of 88 patients were collected in Shandong Province, China. Software included with CBCT was used to measure the angle of root canal curvature of maxillary lateral incisors on the maximum bending plane. ⋯ The most curved root canal of maxillary lateral incisors oriented in the palato-distal direction. The maxillary lateral incisors were mainly curved root canals of which the proportion of moderate curvature was the largest. Software included with CBCT would provide some valuable information for root canal instrumentation of maxillary lateral incisors.
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To screen the prognosis-related autophagy genes of female lung adenocarcinoma by the transcriptome data and clinical data from The Cancer Genome Atlas (TCGA) database. In this study, screen meaningful female lung adenocarcinoma differential genes in TCGA, use univariate Cox proportional regression model to select genes related to prognosis, and establish the best risk model. In this study, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were applied for carrying out bioinformatics analysis of gene function. ⋯ At last, there is autophagy genes differentially expressed among various clinicopathological parameters: ATG4A, BAK1, CCR2, DLC1, ERO1A, FKBP1A, ITGA6. The risk score can be used as an independent prognostic indicator for female patients with lung adenocarcinoma. The autophagy genes ITGA6, ERO1A, FKBP1A, BAK1, CCR2, FADD, EDEM1, ATG10, ATG4A, DLC1, VAMP7, ST13 were identified as prognostic genes in female lung adenocarcinoma, which may be the targets of treatment in the future.
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Intraspinal gout tophus in the lumbar vertebral canal associated with gouty arthritis is rare. We present 2 cases with the first manifestations of a sequestrated intervertebral disc and an extradural tumor, and histopathologically proven to be gouty deposits in the lumbar vertebral canal. ⋯ Definitive diagnosis of intraspinal extradural gout tophus, mimicking a sequestrated intervertebral disc or an extradural tumor, may be difficult. The initial suspicion of intraspinal gouty deposits, based on the diagnostic/management algorithm, may effectively avoid incorrect diagnosis via a less invasive procedure than explorative laminectomy.