系统性红斑狼疮(SLE)是一种影响多个器官的全身性自身免疫疾病,其特点是免疫细胞、免疫因子和免疫途径的复杂相互作用导致各种临床表现。抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)是一组以中小血管坏死性炎症和外周血中出现ANCA为特征的自身免疫综合征。SLE/AAV重叠综合征(overlap syndrome, OS)一种混合表现的炎症性疾病,具有SLE和AAV的临床特征。在极少数情况下,SLE和AAV同时发病表现出更严重的临床症状。缺血性结肠炎(IC)是一组存在血管闭塞性或非闭塞性疾病的临床综合征,以结肠供血不足为特征。本文报告了1例SLE/AAV OS伴随缺血性结肠炎患者。经过血浆置换、足量激素冲击、免疫抑制剂环磷酰胺和硫酸羟氯喹、抑酸药、生长激素抑制类药物等治疗后,患者病情缓解。Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that affects multiple organs and is characterized by a complex interplay of immune cells, immune factors, and immune pathways leading to a variety of clinical manifestations. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune syndromes characterized by necrotizing inflammation of small and medium-sized blood vessels and the presence of ANCA in the peripheral blood. Overlap syndrome (OS) is a mixed manifestation of inflammatory disease with clinical features of SLE and AAV. In rare cases, the concurrent onset of SLE and AAV results in SLE/AAV OS, which exhibits more severe clinical symptoms. Ischemic colitis (IC) is a group of clinical syndromes in the presence of vaso-occlusive or non-occlusive disorders characterized by inadequate blood supply to the colon. In this article, we report a patient with SLE/AAV OS combined with ischemic colitis. After treatment with adequate hormonal shocks, the immunosuppressants cyclophosphamide and hydroxychloroquine sulfate, plasma exchange, acid-suppressing drugs, and anti-growth hormone analogs, the patient's condition resolved.
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.
原发性胆汁性肝硬化(Primary Biliary Cholangitis, PBC)和自身免疫性肝炎(Autoimmune Hepatitis, AIH)是不同的自身免疫性慢性肝病,这2种疾病在同一患者中共存称为重叠综合征。干燥综合征(Sjögren Syndrome, SS)是自身免疫性肝病(Autoimmune Liver Disease, AILD)最常并发的肝外自身免疫病。本文报告了一例AIH-PBC重叠综合征合并SS的病例,探讨其临床表现、诊断和治疗策略。Autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) are two common clinical autoimmune liver diseases, and some patients have both diseases;this feature is called AIH-PBC overlap syndrome. Sjögren syndrome is one of the most common extrahepatic autoimmune diseases among patients with autoimmune liver diseases. This article presents the case report of an elderly female patient who was diagnosed with AIH-PBC overlap syndrome combined with Sjögren syndrome, and discusses its clinical presentation, diagnosis and treatment strategies.
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