黄疸后遗症是新生儿时期发生高胆红素血症从而对大脑造成损害所致的临床后遗症,扭转痉挛作为黄疸后遗症的远期神经系统并发症较为罕见,对于该病的具体治疗方案报道较少。本案例报道1例黄疸后遗症引起的扭转痉挛的病例,患者紧张时头颈不自主向右扭转,伴有肌张力障碍和步态异常,通过予以药物、理疗、光照疗法等综合康复治疗后,症状较前缓解,为该病的临床治疗提供了新的思路。Sequelae of jaundice is a clinical sequela that arises from hyperbilirubinemia during the neonatal period, leading to cerebral impairment. Torsion spasms, a rare neurological complication of sequelae of jaundice, have been infrequently reported, and there is a paucity of literature addressing treatment options for this condition. In this case, we present a case of torsion spasm resulting from sequelae of jaundice, in which the patient exhibited involuntary right-sided rotation of the head and neck during tension, accompanied by dystonia and impaired gait. The symptoms were mitigated following a comprehensive rehabilitation treatment approach that incorporated medication, physical therapy, and light therapy, offering a novel approach for the clinical management of this condition.
卒中后抑郁是一种常见的卒中并发症,对患者的康复和生活质量有着显著影响。约三分一卒中患者伴有糖尿病,而糖尿病可加剧卒中后抑郁的风险,两者之间在病理生理学上存在相互促进的关系。本文将探讨糖尿病与卒中后抑郁之间的病理生理学联系,并从药物治疗的角度进行分析,旨在为合并糖尿病的卒中后抑郁患者提供预防和诊治参考。Post-stroke depression is a common complication of stroke, significantly affecting patients’ recovery and quality of life. Approximately one-third of stroke patients are diagnosed with diabetes, and diabetes can exacerbate the risk of post-stroke depression. There is a mutually reinforcing relationship between the two in terms of pathophysiology. This article will explore the pathophysiological connection between diabetes and post-stroke depression and analyze it from the perspective of drug therapy, aiming to provide prevention and treatment references for patients with post-stroke depression who also have diabetes.
腹膜炎是全球重症监护病房患者败血症的第二大死亡原因,脓毒血症的早期预测对于及时干预并最终改善预后至关重要。本研究基于新型的机器学习算法,建立并验证腹膜炎患者发展为脓毒血症的预测模型,研究结果提示机器学习模型可以成为预测腹膜炎患者预测脓毒血症的可靠工具,并且,随机森林算法模型具有最佳的预测性能,这种机器学习方法可用于帮助临床医生对于高风险因素的认识并早期干预以降低死亡率。Peritonitis is the second leading cause of sepsis-related mortality in intensive care unit (ICU) patients worldwide. Early prediction of sepsis is critical for timely intervention and ultimately improving prognosis. This study established and validated a predictive model for the development of sepsis in peritonitis patients using novel machine learning algorithms. The findings suggest that machine learning models can be a reliable tool for predicting sepsis in peritonitis patients. Among them, the random forest algorithm model showed the best predictive performance. This machine learning approach can help clinicians recognize high-risk factors and intervene early to reduce mortality.
目前,国内尚无关于九价人乳头瘤病毒疫苗导致药物性肝损伤的报道,但这一问题应引起临床医师的高度重视。现报道1例中年女性患者,在接种九价HPV疫苗第二针后出现乏力、纳差、巩膜及皮肤黄染,经护肝、利胆等对症支持治疗后症状好转,但临床医生未能及时说服患者完善相关检查进一步排查药物性肝损伤,致患者继续接种第三针,出现肝损慢性化、严重化。经进一步的护肝、利胆、营养支持等对症支持治疗并随访5个月,患者肝脏功能已恢复正常。通过该病例以期提高临床对药物性肝损伤的认知及诊治水平。At present, there is no report on drug-induced liver injury caused by nine-valent human papillomavirus vaccine in China, but this problem should be highly valued by clinicians. It is reported that a middle-aged female patient suffered from fatigue, poor appetite, yellow staining of sclera and skin after the second dose of nine-valent HPV vaccine. After symptomatic support treatment such as protecting the liver and promoting gallbladder function, the symptoms improved, but the clinician failed to persuade the patient to improve the relevant examination in time to further investigate the drug-induced liver injury, resulting in the patient continuing to receive the third dose, resulting in chronic and severe liver damage. After further symptomatic support treatment such as liver protection, choleretic and nutritional support and follow-up for 5 months, the liver function of the patient has returned to normal. Through this case, we hope to improve the clinical cognition, diagnosis and treatment of drug-induced liver injury.
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