简介：InternationalJournalofClinicalCaseReports(IJCCR,ISSN1927-579X)isaninternational,openaccess,peerreviewedjournalpublishedonlinebyBioPublisher.Thejournalisconsideringallthelatestandoutstandingresearcharticles,lettersandreviewsinallaspectsofclinicalcase,containingclinicalmedicinewhichadvancegeneralmedicalknowledge;theeventinthecourseofobservingortreatingapatient;newvariationsindiseaseprocesses;aswellastheexpandsthefieldofclinicalrelatingtocasereports.Authorsfromlow-incomecountriesandareasorhavingfinancialdifficultiescanapplythediscountforAPCuponsubmission,andiftheauthorsarequalifiedtobewaivedtheydon’tnecessarilypaytheAPC.Wedonotwantfeestopreventthepublicationofworthy

简介：BackgroundPregnancycomplicatingpulmonaryarterialhypertension(PAH)isalife-threateningobstetricalcomplication.FewstudieshavereportedtheclinicalcharacteristicsandoutcomesofpregnantwomenwithPAH.MethodsRetrospectivelyanalysiswasconductedon86casesofpregnantwomenwithPAHattheDepartmentofObstetricinGuangdongGeneralHospitalbetween2009and2014.Dataincludedpatients'age,theetiologiesofPAH,clinicalclassificationoftheNewYorkHeartAssociation(NYHA),gestationalweeks,deliverymode,maternalandfetaloutcomes.Results1Therewere2casesofidiopathicpulmonaryarterialhypertension(IPAH)and84casesofsecondarypulmonaryarterialhypertension.Thelatterwascomposedby40(47.61%)casesofcongenitalheartdisease(CHD),38(45.23%)casesofrheumaticheartdisease(RHD),3(3.57%)casesofsystemiclupuserythematosus(SLE)and1(1.19%)caseofpartialhydatidiformmole.ThenumberofpatientsclassifiedinNYHAI~IVwere8(9.30%),41(47.67%),26(30.23%)and11(12.7%),respectively.Andthemortalitywas3.48%(3/86).2Amongthe86patients,31(36.04%)womengavebirthattermand36(41.86%)hadprematuredelivery.Inaddition,16(18.6%)womenhadanabortionlessthan28weeks.Therewereatotalof65(75.58%)livebirths,61(93.84%)ofwhomweredeliveredviacesareansection,whiletheother4(6.15%)werevaginaldeliveries.3Patientsweredividedinto3groups,12ofmild(<40mmHg),35ofmoderate(40~70mmHg)and39ofsevere(≥70mmHg)regardingthepulmonaryarterysystolicpressure(sPAP)measuredbyultrasound.WedefinedtheformertwoasgroupAandthelatterasgroupB.Thesignificancewasseenstatisticallyingestationalweeks(32.86±8.86gvs28.76±9.84),therateoftransferringtoICU(19.14%vs53.84%),neonatalbirth-weight(2725.69±467.43vs2044.82±665.75g),APGARscoring(9.97±0.16vs8.68±2.08),maternalstatusofheartfunctionandadversepregnantoutcomes,whencomparedgroupAwithB.AlltheP-valuesmentionedabovew

简介：Transforminggrowthfactor-β(TGF-β)isakeyfactorincancerdevelopmentandprogression.TGF-βcansuppresstumorigenesisbyinhibitingcellcycleprogressionandstimulatingapoptosisinearlystagesofcancerprogression.However,TGF-βcanmodulatecancer-relatedprocesses,suchascellinvasion,distantmetastasis,andmicroenvironmentmodificationthatmaybeusedbycancercellstotheiradvantageinlatestages.Correspondingmechanismsincludeangiogenesispromotion,anti-tumorimmunitysuppression,andepithelial-to-mesenchymaltransition(EMT)induction.ThecorrelationbetweenTGF-βexpressionandcancerprognosishasalsobeenextensivelyinvestigated.ResultssuggestthatTGF-βpathwaycanbetargetedtotreatcancer;assuch,thefeasibilityofthistreatmentisinvestigatedinclinicaltrials.

简介：AIM:Toevaluatetheclinicalusefulnessofendoscopicultrasonography(EUS)forthediagnosisoftheinvasiondepthofulcerativecolitis-associatedtumors.METHODS:Thestudygroupcomprised13patientswith16ulcerativecolitis(UC)-associatedtumorsforwhichthedepthofinvasionwaspreoperativelyestimatedbyEUS.Thelesionswerethenresectedendoscopicallyorbysurgicalcolectomyandwereexaminedhistopathologically.Themeanageofthesubjectswas48.2±17.1years,andthemeandurationofUCwas15.8±8.3years.Twolesionsweretreatedbyendoscopicresectionandtheother14lesionsbysurgicalcolectomy.ThedepthofinvasionofUCassociatedtumorswasestimatedbyEUSusinganultrasonicprobeandwasevaluatedonthebasisofthedeepestlayerwithnarrowingorruptureofthecolonicwall.RESULTS:ThediagnosisofUC-associatedtumorsbyEUSwascarcinomafor13lesionsanddysplasiafor3lesions.Theinvasiondepthofthecarcinomaswasintramucosalfor8lesions,submucosalfor2,themuscularispropriafor2,andsubserosalfor1.Eleven(69%)ofthe16lesionsaroseintherectum.Themacroscopicappearancewasthelaterallyspreadingtumor-non-granulartypefor4lesions,sessiletypefor4,laterallyspreadingtumor-granulartypefor3,semipedunculatedtype(Isp)for2,type1for2,andtype3for1.ThedepthofinvasionwascorrectlyestimatedbyEUSfor15lesions(94%)butwasmisdiagnosedasintramucosalfor1carcinomawithhigh-gradesubmucosalinvasion.The2lesionstreatedbyendoscopicresectionwereintramucosalcarcinomaanddysplasia,andbothwerediagnosedasintramucosallesionsbyEUS.CONCLUSION:EUSprovidesagoodestimationoftheinvasiondepthofUC-associatedtumorsandmaythusfacilitatetheselectionoftreatment.

简介：AIM:Tocomparetheconjunctivalepithelialtoxicitiesofthreenewer-generationfluoroquinoloneswithoutpreservatives.·METHODS:Inaprospective,randomized,doubleblindcomparativestudy,47eyesof47patientswithaprimarypterygiumwereenrolled,anddividedrandomlyintothreegroups(levofloxacin0.5%,gatifloxacin0.3%,andmoxifloxacin0.5%).Afterpterygiumsurgerywiththesameconjunctivalautografttechnique,eachpatientmaintainedaregimenwitharandomlyassignedfluoroquinoloneeyedrop.Patientswereexaminedeveryotherdayaftersurgeryuntiltheepitheliumhadcompletelyhealed.Photosweretakenandusedtomeasuretheareaofresidualepithelialdefects.Conjunctivalhealingtimeandspeed(initialdefectarea/healingtime(mm~2/d)comparedineachgroupusingKruskal-Wallistests.·RESULTS:Therewerenosignificantdifferencesinmeanage,gender,andconjunctivaldefectsizeofthedonorsitebetweenthesegroups.However,themeanofconjunctivalhealingtimeandspeedwerestatisticallydifferentineachgroup.Themeanofconjunctivalepithelialhealingtimewas8.93±2.69d(levofloxacingroup),10.31±2.96d(gatifloxacingroup),and13.50±4.10d(moxifloxacingroup),P=0.006.Themeanconjuctivalepithelialhealingspeedwas6.18±1.39mm~2/d(levofloxacingroup),5.52±1.68mm~2/d(gatifloxacingroup),and4.40±1.30mm~2/d(moxifloxacingroup),P=0.003.·CONCLUSION:Withouttheinfluenceofpreservatives,levofloxacinandgatifloxacinmightbelesstoxictotheregenerationofconjunctivalepithelialcellsandcauseafasterconjunctivalwoundhealingrelativetomoxifloxacin.

简介：

简介：Thisreviewstartswithabriefhistoryofdrugdiscovery&development,andtheplaceofAsiainthisworldwideeffortdiscussed.TheconditionsandconstraintsofasuccessfultranslationalR&DinvolvingacademicbasicresearchandclinicalresearcharediscussedandtheSingaporemodelforpursuitofopenR&Ddescribed.Theimportanceofwell-characterized,validateddrugtargetsforthesearchfornoveltargetedanti-canceragentsisemphasized,aswellasastructured,highqualitytranslationalR&D.Furthermore,thecharacteristicsofanattractivepreclinicaldevelopmentdrugcandidatearediscussedlayingthefoundationofasuccessfulpreclinicaldevelopment.Themostfrequentsourcesoffailuresaredescribedandriskmanagementateverystageishighlyrecommended.Organizationalfactorsarealsoconsideredtoplayanimportantrole.Thefactorstoconsiderbeforestartinganewdrugdiscovery&developmentprojectaredescribed,andanexampleisgivenofasuccessfulclinicalprojectthathashaditsrootsinlocaluniversitiesandwascarriedthroughpreclinicaldevelopmentintophaseIclinicaltrials.

简介：

简介：AIM:Todescribetheclinicalfeatures,systemicassociations,treatmentandvisualoutcomesinSaudipatientswithscleritis.·METHODS:AretrospectivechartreviewwasperformedforpatientswithscleritispresentingtotwotertiarycareeyehospitalsinRiyadh,SaudiArabia,from2001to2011.Datawerecollectedontheclinicalfeaturesofscleritis,subtypesofscleritis,associatedsystemicdisease,historyofpreviousocularsurgeryandmedicaltherapy,includingtheuseofimmunosuppressants.Treatmentoutcomeswereevaluatedbasedonbest-correctedvisualacuity(BCVA)andresponsetotreatment.·RESULTS:Ofthe52patientsincludedinthestudy,non-necrotizinganteriorscleritiswasthemostcommontypeofscleritisin22patients(42.3%),followedbyposteriorscleritisin14patients(26.9%).Themajorityofcases,31patients(59.6%),wereidiopathicinnature.Systemicassociationswerepresentin12patients(23.1%).Infectiousscleritiswasconfirmedin6patients(11.5%):3withbacterialscleritisafterpterygiumexcision,2patientswithscleritisrelatedtotuberculosisand1patientwithscleritisresultingfromherpessimplexinfection.Forthevarioussubtypesofscleritis,BCVAvaluesaftertreatmentandtimetoremissionsignificantlydiffered(P<0.05,allcases).Systemicimmunosuppressivetherapiesinadditiontosteroidswereadministeredto46.2%ofallpatients.TheT-signwaspresentonB-scanultrasonographyin9(64.3%)ofthe14posteriorscleritispatients.·CONCLUSION:Non-necrotizinganteriorscleritiswasthemostcommonsubtypeofscleritis.Finalvisualoutcomeandtimetoremissiondifferedamongthevariousscleritissubtypes.

简介：BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.

简介：Objective:Tostudythemainclinicalandhistopathologicalfeaturesof12patientswithHodgkin'slymphoma(HL)diagnosedprimarilyfrombonemarrow(BM)involvement.Methods:Weincluded12acquiredimmunodeficiencysyndrome(AIDS)patientswithHLassistedintheF.J.Mu?izInfectiousDiseasesHospitalsinceJanuary2002toDecember2013.ThediagnosisofHLwithprimaryBMinvolvementinpatientswasconfirmedbyclinical,histopathological,andimmunohistochemicalfindings.Results:Allpatientspresented'B'symptomsandpancytopenia.AllofthemhadstageIVneoplasmdiseasebecauseofBMinfiltration.ThemedianofCD4+T-cellcountswas114cells/μL,andmixedcellularity(MC)wasthemostfrequenthistopathologicalsubtypeof92%cases.Conclusion:Whenothercausesareexcluded,BMbiopsyshouldbeperformedinAIDSpatientswith'B'symptomsandpancytopeniatoevaluateBMinfiltrationbyatypicallymphocytes.

简介：摘要针对护理诊断制定护理计划，为提供持续护理、预防或减轻服务对象健康问题而制定护理对策或措施的过程。在计划阶段，护士分析社区存在的健康问题，按问题的严重程度排列顺序，制定护理目标，拟定适当的护理措施并书写护理计划。对制定的护理计划采取的行动，由目标制定者共同努力完成。明确护理活动的效果及服务对象是否朝向预期目标进展。检查护理活动十分恰当、合适。了解问题是否解决。

简介：

简介：

简介：

简介：

简介：

简介：摘要目的探讨妇产科护理工作风险，为护理措施的制定提供依据。方法在2013年1月至2015年6月期间我院收治的妇产科患者中，抽选500例作为研究对象。回顾分析产妇的一般资料、分娩方式、护理方法，总结风险事件发生原因，制定并实施针对性的护理措施。结果39例护理风险事件中，发生原因主要是服务观念问题（43.6%）、护理技术问题（28.2%）、护患沟通问题（17.9%）、制度管理问题（10.2%）。结论妇产科护理工作中存在较多风险因素，要求护理人员总结风险发生原因，实施护理措施，来改善护理服务质量，提高患者的护理满意程度。

简介：摘要临床路径是近几年来国外提出的一种诊疗护理新模式，它通过个性化、流程化、标准化的诊疗护理方案，兼顾效益—成本，达到预期的诊疗护理效果，控制病人的医疗费用。本文就临床路径对护理工作带来的积极影响作一探讨与分析。

简介：摘要目的为满足患者住院期间的各种需求，促进患者健康，改进我们现有的工作方法，夯实基础护理，提供优质护理服务。方法结合医院实际，在医院开展优质护理服务示范工程活动，注重夯实基础护理。结果患者对护理服务的满意率达98%，实现了护理零投诉，取得了良好的社会效益。结论夯实基础护理是实现优质护理服务的关键。