Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic reso...Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence. Methods Nine patients with refractory temporal lobe epilepsy, 21 patients with non-refractory temporal lobe epilepsy, and 13 normal volunteers underwent FAIR MR scanning. The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured. And we also calculated the asymmetry index (AI) values. Results The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P=0.012 and 0.029, respectively). There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P=0.049), while no significant difference between refractory epilepsy patients and volunteers. Conclusions The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients. Although the hypoperfusion tends to extend out of temporal lobes in all patients, the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion, which may be valuable for evaluating prognosis.展开更多
Objective:The enhanced recovery after surgery(ERAS)program is less implemented in gastric cancer patients.The purpose of this survey is to investigate the implementation status of ERAS in perioperative period in gastr...Objective:The enhanced recovery after surgery(ERAS)program is less implemented in gastric cancer patients.The purpose of this survey is to investigate the implementation status of ERAS in perioperative period in gastric cancer.Methods:This clinical observational study enrolled 329 patients between January 2020 and August 2020 in a single gastric cancer center.The questionnaire consisted of 4 par ts:basic information,preoperative status,intraoperative status,and postoperative status of ERAS implementation in gastric cancer surgery.Results:In the preoperative period,patients'education and counseling(100%)were well adopted.Smoking cessation(34.6%),drinking cessation(36.9%),avoidance of preoperative mechanical bowel preparation(24.3%),respiratory function training(11.2%),and administration of carbohydrate-rich drink before surgery(0.6%)were relatively not well adopted.During the operation,maintenance of intraoperative normothermia and fluid management(100%),as well as epidural analgesia(81.5%),were well adopted.Thromboprophylaxis was performed in 133(40.4%)patients.In the postoperative period,early active mobilization was implemented about 9.5 h,and early ambulation was implemented about 39.5 h,after surgery.A total of 140(42.5%)patients received prolonged prophylactic antibiotics;268(81.5%)patients were provided diet upon gas passage;and 320(97.3%)patients received intravenous fluid administration more than 5 d after surgery.The practice rate of early removal of urinary catheter(0%)and nasogastric tube(15.5%)was relatively low.A total of 11(3.3%)patients experienced postoperative complication,and 1(0.3%)patient received unplanned reoperation.The average costs were￥59,500,and the average hospital stay was 12(5,36)d.Conclusions:Standard perioperative management of ERAS program in gastric cancer surgery in China still requires improvement.展开更多
AIM: To evaluate the value of endoscopic ultrasonography (EUS) in the choice of endoscopic therapy strategies for mesenchymal tumors of the upper gastrointestinal tract. METHODS: From July 2004 to September 2010, 1050...AIM: To evaluate the value of endoscopic ultrasonography (EUS) in the choice of endoscopic therapy strategies for mesenchymal tumors of the upper gastrointestinal tract. METHODS: From July 2004 to September 2010, 1050 patients with upper gastrointestinal mesenchymal tumors (GIMTs) were diagnosed using EUS. Among them, 201 patients underwent different endoscopic therapies based on the deriving layers, growth patterns and lesion sizes. RESULTS: Using EUS, we found 543 leiomyomas and 507 stromal tumors. One hundred and thirty-three leiomyomas and 24 stromal tumors were treated by snare electrosection, 6 leiomyomas and 20 stromal tumorswere treated by endoloop, 10 stromal tumors were treated by endoscopic mucosal resection and 8 stromal tumors were treated by endoscopic submucosal dissection. Complete resection of the lesion was achieved in all cases. Of the mesenchymal tumors, 90.38% diagnosed by EUS were also identified by pathohistology. All wounds were closed up nicely and no recurrence was found in the follow-up after 2 mo. CONCLUSION: EUS is an effective means of diagnosis for upper GIMTs and is an important tool in choosing the endoscopic therapy for GIMTs, by which the lesions can be treated safely and effectively.展开更多
Objective To evaluate metabolic abnormalities in patients with mesial temporal lobe epilepsy （MTLE） with proton magnetic resonance spectroscopy （MRS） using a 3.0T MR scanner. Methods Sixty-three patients （32 wom...Objective To evaluate metabolic abnormalities in patients with mesial temporal lobe epilepsy （MTLE） with proton magnetic resonance spectroscopy （MRS） using a 3.0T MR scanner. Methods Sixty-three patients （32 women and 31 men） with diagnosed MTLE underwent diagnostic MR imaging （MRI） and proton MRS using a 3.0T MR scanner. The clinical history and interictal epileptiform discharges （IEDs） were recorded. Sixteen healthy volunteers served as control. The results of proton MRS were compared with the findings of electroencephalogram and structural MRI findings. Results Twenty-seven of the 63 patients with MTLE showed unilateral hippocampal sclerosis, and 9 showed bilateral hippocampal sclerosis. The concentration ratio of N-acytelaspartate （NAA） / [ creatine （ Cr ） ＋ choline （Cho） ] in the hippocampal region of MTLE patients （0. 64±0. 07） was significantly lower than control （0. 80±0. 05, P = 0.023）. In the patients with unilateral hippocampal sclerosis, NAA/（Cr ＋ Cho） in the hippocampal region ipsilateral to the sclerotic hippocampus （0.56±0.06） was significantly lower than the ratio in the contralateral hippocampal region （0.69±0.07, P 〈 0. 001 ）. There was significant difference in hippocampal NAA/（ Cr ＋ Cho） between the refractory patients and the non-refractory patients （0. 64±0. 05 vs.0.71±0. 07, P =0. 04）. Forty-five patients were lateralized by IEDs, while 49 patients were lateralized by metabolite ratio. And lateralization determined by proton MRS and IEDs was concordant in 33 patients. Conclusions MRS as a noninvasive tool adds helpful metabolite information to routine MRI in evaluation of MTLE. The method is well established and should be a routine clinical application in the investigation of epilepsy.展开更多
BACKGROUND The relationship between C-reactive protein(CRP)levels and prolonged intensive care unit(ICU)length of stay(LoS)has not been well defined.AIM To explore the association between CRP levels at ICU admission a...BACKGROUND The relationship between C-reactive protein(CRP)levels and prolonged intensive care unit(ICU)length of stay(LoS)has not been well defined.AIM To explore the association between CRP levels at ICU admission and prolonged ICU LoS in gastrointestinal cancer(GC)patients after major surgery.METHODS A retrospective study was performed to quantify serum CRP levels and to establish their association with prolonged ICU LoS(≥72 h)in GC patients admitted to the ICU.Univariate and multivariate regression analyses were conducted,and restricted cubic spline curves with four knots(5%,35%,65%,95%)were used to explore non-linearity assumptions.RESULTS A total of 408 patients were enrolled.Among them,83(20.3%)patients had an ICU LoS longer than 72 h.CRP levels were independently associated with the risk of prolonged ICU LoS[odds ratio(OR)1.47,95%confidence interval(CI)1.00–2.17].Restricted cubic spline analysis revealed a non-linear relationship between CRP levels and OR for the prolonged ICU LoS(P=0.035 for nonlinearity).After the cut-off of 2.6(log transformed mg/L),the OR for prolonged ICU LoS significantly increased with CRP levels.The adjusted regression coefficient was 0.70(95%CI 0.31–1.57,P=0.384)for CRP levels less than 2.6,whereas it was 2.43(95%CI 1.39–4.24,P=0.002)for CRP levels higher than 2.6.CONCLUSION Among the GC patients,CRP levels at ICU admission were non-linearly associated with prolonged ICU LoS in survivors.An admission CRP level>2.6(log transformed mg/L)was associated with increased risk of prolonged ICU LoS.展开更多
Objective: To explore the correlation between the genetic polymorphism of vitamin D binding protein gene (GC) and allergic rhinitis in Hainan population. Methods: 94 cases of patients with allergic rhinitis (AR) who v...Objective: To explore the correlation between the genetic polymorphism of vitamin D binding protein gene (GC) and allergic rhinitis in Hainan population. Methods: 94 cases of patients with allergic rhinitis (AR) who visit a hospital between March 2017 and December 2017 and 113 cases of healthy controls specimen (HCs) were chosen for the research. We analyzed the 222016 and rs7041 polymorphism in the vitamin D-binding protein gene (GC) by snapshot method. Four kinds of hereditary models including co-dominant, dominant, recessive and super dominant were used to identify the significant SNPs by the online analysis software SNPStats. The statistical analysis was done by SPSS25.0. Results: As rs7041 polymorphisms loci is mentioned, the frequency of TT, GT and GG genotypes of in CR group and HC group is 40.4% VS 42.5%, 44.7% VS 42.5%, 14.9% VS 15%, respectively. Statistical analysis showed that there was no significant difference between the two groups. Three genotype were detected for rs222016 loci which is AG, GG and AA. The frequency of AG, GG and AA in CR group and HCs group is 44.8% VS 40.7%, 12.8% VS 25.7% and 40.4% VS 33.6%, with a P value of 0.062, which is close to significance. The frequency of allele G for rs222016 in the HC group was significantly higher than that in the CR group. Conclusion: There was no significant correlation between the polymorphism of rs7041 and the incidence of allergic rhinitis in Hainan population, and GG genotype and allele G of rs222016 loci was likely to be a protective factor from allergic rhinitis in Hainan.展开更多
Background： Helicohacterpylori （H. pylori） frequently colonizes the stomach. Gastroesophageal reflux disease （GERD） is a common and costly disease. But the relationship ofH. pylori and GERD is still unclear. This...Background： Helicohacterpylori （H. pylori） frequently colonizes the stomach. Gastroesophageal reflux disease （GERD） is a common and costly disease. But the relationship ofH. pylori and GERD is still unclear. This study aimed to explore the effect ofH. p.vlori and its eradication on reflux esophagitis therapy. Methods： Patients diagnosed with reflux esophagitis by endoscopy were enrolled; based on rapid urease test and Warth-Starry stain, they were divided into H. pylori positive and negative groups. H. pylori positive patients were randomly given H. pylori eradication treatment for 10 days, then esomeprazole 20 mg bid for 46 days. The other patients received esomeprazole 20 mg bid therapy for 8 weeks. After treatment, three patient groups were obtained： H. pylori positive eradicated, H. pylori positive uneradicated, and H. pylori negative. Before and after therapy, reflux symptoms were scored and compared. Healing rates were compared among groups. The x2 test and t-test were used, respectively, for enumeration and measurement data. Results： There were 176 H. pylori positive （with 92 eradication cases） and 180 negative cases. Healing rates in the H. pylori positive eradicated and H. pylori positive uneradicated groups reached 80.4% and 79.8% （P = 0.911）, with reflux symptom scores of 0.22 and 0.14 （P = 0.588）. Healing rates of esophagitis in the 14. pylori positive uneradicated and H. pylori negative groups were, respectively, 79.8% and 82.2% （P = 0.848）; reflux symptom scores were 0.14 and 0.21 （P = 0.546）. Conclusions： Based on esomeprazole therapy, H. pylori infection and eradication have no significant effect on reflux esophagitis therapy.展开更多
A 33-year-old woman, gravida 1, para 0, came to the hospital with the chief complaint of severe dysmenorrhea and infertility. Her menstrual cycle was regular, bleeding moderately for 3–5 days with an interval of 30 d...A 33-year-old woman, gravida 1, para 0, came to the hospital with the chief complaint of severe dysmenorrhea and infertility. Her menstrual cycle was regular, bleeding moderately for 3–5 days with an interval of 30 days. She was diagnosed with ectopic pregnancy and received the left salpingectomy in September 2014. Intraoperative exploration showed a slightly enlarged retroverted uterus with a wide fundus and a normal right fallopian tube. As a further examination of infertility, hysterosalpingography was done in January 2016, which showed a unicornuate uterus （left） with an obstructed unilateral fallopian tube. She was referred to the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital in February 2016. Her basic body temperature showed biphasic pattern. The sperm test of her husband was normal. Physical examination indicated two vaginal orifices in the vestibule, with a vertical septate lying in between. The left lateral vaginal lumen could be easily expanded and speculated, and a normal cervix was seen at its top. In contrast, the cervix was unable to be seen through the right lateral vaginal lumen, which was narrow and difficult to be exposed or inspected. Pelvic ultrasound scan showed that the uterus was 4.7 cm ×6.0 cm × 3.6 cm in size, along with the Y-shaped endometrium of 0.8 cm in thickness, and a normal echo in the muscular layer. No abnormalities were found at the bilateral adnexa areas or pelvic cavity. Besides, the bilateral renal areas and ureters were found normal in the ultrasound scan as well.展开更多
Psittacosis is a zoonosis caused by Chlamydia psittaci,a Gram-negative intracellular bacterium.This condition is caused by the ingestion of contaminated fecal matter and nasal secretions from infected birds.The severi...Psittacosis is a zoonosis caused by Chlamydia psittaci,a Gram-negative intracellular bacterium.This condition is caused by the ingestion of contaminated fecal matter and nasal secretions from infected birds.The severity of human psittacosis varies from mildflu-like symptoms to life-threatening severe pneumonia.[1]Given that C.psittaci is not a part of the traditional microbiological diagnosis’human psittacosis is often underreported,misdiagnosed,and inadequately diagnosed.In this study,the clinical data of C.psittaci pneumonia patients were retrospectively analyzed.展开更多
文摘Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence. Methods Nine patients with refractory temporal lobe epilepsy, 21 patients with non-refractory temporal lobe epilepsy, and 13 normal volunteers underwent FAIR MR scanning. The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured. And we also calculated the asymmetry index (AI) values. Results The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P=0.012 and 0.029, respectively). There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P=0.049), while no significant difference between refractory epilepsy patients and volunteers. Conclusions The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients. Although the hypoperfusion tends to extend out of temporal lobes in all patients, the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion, which may be valuable for evaluating prognosis.
基金supported by Program of Shanghai Shenkang Hospital Development Center (SHDC22020204)Nursing Science Support Program of Zhongshan Hospital,Fudan University (XK-082-007)Management Fund of Zhongshan Hospital,Fudan University (2022ZSGL01)。
文摘Objective:The enhanced recovery after surgery(ERAS)program is less implemented in gastric cancer patients.The purpose of this survey is to investigate the implementation status of ERAS in perioperative period in gastric cancer.Methods:This clinical observational study enrolled 329 patients between January 2020 and August 2020 in a single gastric cancer center.The questionnaire consisted of 4 par ts:basic information,preoperative status,intraoperative status,and postoperative status of ERAS implementation in gastric cancer surgery.Results:In the preoperative period,patients'education and counseling(100%)were well adopted.Smoking cessation(34.6%),drinking cessation(36.9%),avoidance of preoperative mechanical bowel preparation(24.3%),respiratory function training(11.2%),and administration of carbohydrate-rich drink before surgery(0.6%)were relatively not well adopted.During the operation,maintenance of intraoperative normothermia and fluid management(100%),as well as epidural analgesia(81.5%),were well adopted.Thromboprophylaxis was performed in 133(40.4%)patients.In the postoperative period,early active mobilization was implemented about 9.5 h,and early ambulation was implemented about 39.5 h,after surgery.A total of 140(42.5%)patients received prolonged prophylactic antibiotics;268(81.5%)patients were provided diet upon gas passage;and 320(97.3%)patients received intravenous fluid administration more than 5 d after surgery.The practice rate of early removal of urinary catheter(0%)and nasogastric tube(15.5%)was relatively low.A total of 11(3.3%)patients experienced postoperative complication,and 1(0.3%)patient received unplanned reoperation.The average costs were￥59,500,and the average hospital stay was 12(5,36)d.Conclusions:Standard perioperative management of ERAS program in gastric cancer surgery in China still requires improvement.
文摘AIM: To evaluate the value of endoscopic ultrasonography (EUS) in the choice of endoscopic therapy strategies for mesenchymal tumors of the upper gastrointestinal tract. METHODS: From July 2004 to September 2010, 1050 patients with upper gastrointestinal mesenchymal tumors (GIMTs) were diagnosed using EUS. Among them, 201 patients underwent different endoscopic therapies based on the deriving layers, growth patterns and lesion sizes. RESULTS: Using EUS, we found 543 leiomyomas and 507 stromal tumors. One hundred and thirty-three leiomyomas and 24 stromal tumors were treated by snare electrosection, 6 leiomyomas and 20 stromal tumorswere treated by endoloop, 10 stromal tumors were treated by endoscopic mucosal resection and 8 stromal tumors were treated by endoscopic submucosal dissection. Complete resection of the lesion was achieved in all cases. Of the mesenchymal tumors, 90.38% diagnosed by EUS were also identified by pathohistology. All wounds were closed up nicely and no recurrence was found in the follow-up after 2 mo. CONCLUSION: EUS is an effective means of diagnosis for upper GIMTs and is an important tool in choosing the endoscopic therapy for GIMTs, by which the lesions can be treated safely and effectively.
文摘Objective To evaluate metabolic abnormalities in patients with mesial temporal lobe epilepsy （MTLE） with proton magnetic resonance spectroscopy （MRS） using a 3.0T MR scanner. Methods Sixty-three patients （32 women and 31 men） with diagnosed MTLE underwent diagnostic MR imaging （MRI） and proton MRS using a 3.0T MR scanner. The clinical history and interictal epileptiform discharges （IEDs） were recorded. Sixteen healthy volunteers served as control. The results of proton MRS were compared with the findings of electroencephalogram and structural MRI findings. Results Twenty-seven of the 63 patients with MTLE showed unilateral hippocampal sclerosis, and 9 showed bilateral hippocampal sclerosis. The concentration ratio of N-acytelaspartate （NAA） / [ creatine （ Cr ） ＋ choline （Cho） ] in the hippocampal region of MTLE patients （0. 64±0. 07） was significantly lower than control （0. 80±0. 05, P = 0.023）. In the patients with unilateral hippocampal sclerosis, NAA/（Cr ＋ Cho） in the hippocampal region ipsilateral to the sclerotic hippocampus （0.56±0.06） was significantly lower than the ratio in the contralateral hippocampal region （0.69±0.07, P 〈 0. 001 ）. There was significant difference in hippocampal NAA/（ Cr ＋ Cho） between the refractory patients and the non-refractory patients （0. 64±0. 05 vs.0.71±0. 07, P =0. 04）. Forty-five patients were lateralized by IEDs, while 49 patients were lateralized by metabolite ratio. And lateralization determined by proton MRS and IEDs was concordant in 33 patients. Conclusions MRS as a noninvasive tool adds helpful metabolite information to routine MRI in evaluation of MTLE. The method is well established and should be a routine clinical application in the investigation of epilepsy.
基金Supported by Youth Program of Zhongshan Hospital,Fudan University,No.2019ZSQN01Fuxing Nursing Program of Fudan University,No.FNF202007.
文摘BACKGROUND The relationship between C-reactive protein(CRP)levels and prolonged intensive care unit(ICU)length of stay(LoS)has not been well defined.AIM To explore the association between CRP levels at ICU admission and prolonged ICU LoS in gastrointestinal cancer(GC)patients after major surgery.METHODS A retrospective study was performed to quantify serum CRP levels and to establish their association with prolonged ICU LoS(≥72 h)in GC patients admitted to the ICU.Univariate and multivariate regression analyses were conducted,and restricted cubic spline curves with four knots(5%,35%,65%,95%)were used to explore non-linearity assumptions.RESULTS A total of 408 patients were enrolled.Among them,83(20.3%)patients had an ICU LoS longer than 72 h.CRP levels were independently associated with the risk of prolonged ICU LoS[odds ratio(OR)1.47,95%confidence interval(CI)1.00–2.17].Restricted cubic spline analysis revealed a non-linear relationship between CRP levels and OR for the prolonged ICU LoS(P=0.035 for nonlinearity).After the cut-off of 2.6(log transformed mg/L),the OR for prolonged ICU LoS significantly increased with CRP levels.The adjusted regression coefficient was 0.70(95%CI 0.31–1.57,P=0.384)for CRP levels less than 2.6,whereas it was 2.43(95%CI 1.39–4.24,P=0.002)for CRP levels higher than 2.6.CONCLUSION Among the GC patients,CRP levels at ICU admission were non-linearly associated with prolonged ICU LoS in survivors.An admission CRP level>2.6(log transformed mg/L)was associated with increased risk of prolonged ICU LoS.
基金Hainan Provincial Natural Science Foundation of China.Project No:817323,817145,818QN247.
文摘Objective: To explore the correlation between the genetic polymorphism of vitamin D binding protein gene (GC) and allergic rhinitis in Hainan population. Methods: 94 cases of patients with allergic rhinitis (AR) who visit a hospital between March 2017 and December 2017 and 113 cases of healthy controls specimen (HCs) were chosen for the research. We analyzed the 222016 and rs7041 polymorphism in the vitamin D-binding protein gene (GC) by snapshot method. Four kinds of hereditary models including co-dominant, dominant, recessive and super dominant were used to identify the significant SNPs by the online analysis software SNPStats. The statistical analysis was done by SPSS25.0. Results: As rs7041 polymorphisms loci is mentioned, the frequency of TT, GT and GG genotypes of in CR group and HC group is 40.4% VS 42.5%, 44.7% VS 42.5%, 14.9% VS 15%, respectively. Statistical analysis showed that there was no significant difference between the two groups. Three genotype were detected for rs222016 loci which is AG, GG and AA. The frequency of AG, GG and AA in CR group and HCs group is 44.8% VS 40.7%, 12.8% VS 25.7% and 40.4% VS 33.6%, with a P value of 0.062, which is close to significance. The frequency of allele G for rs222016 in the HC group was significantly higher than that in the CR group. Conclusion: There was no significant correlation between the polymorphism of rs7041 and the incidence of allergic rhinitis in Hainan population, and GG genotype and allele G of rs222016 loci was likely to be a protective factor from allergic rhinitis in Hainan.
文摘Background： Helicohacterpylori （H. pylori） frequently colonizes the stomach. Gastroesophageal reflux disease （GERD） is a common and costly disease. But the relationship ofH. pylori and GERD is still unclear. This study aimed to explore the effect ofH. p.vlori and its eradication on reflux esophagitis therapy. Methods： Patients diagnosed with reflux esophagitis by endoscopy were enrolled; based on rapid urease test and Warth-Starry stain, they were divided into H. pylori positive and negative groups. H. pylori positive patients were randomly given H. pylori eradication treatment for 10 days, then esomeprazole 20 mg bid for 46 days. The other patients received esomeprazole 20 mg bid therapy for 8 weeks. After treatment, three patient groups were obtained： H. pylori positive eradicated, H. pylori positive uneradicated, and H. pylori negative. Before and after therapy, reflux symptoms were scored and compared. Healing rates were compared among groups. The x2 test and t-test were used, respectively, for enumeration and measurement data. Results： There were 176 H. pylori positive （with 92 eradication cases） and 180 negative cases. Healing rates in the H. pylori positive eradicated and H. pylori positive uneradicated groups reached 80.4% and 79.8% （P = 0.911）, with reflux symptom scores of 0.22 and 0.14 （P = 0.588）. Healing rates of esophagitis in the 14. pylori positive uneradicated and H. pylori negative groups were, respectively, 79.8% and 82.2% （P = 0.848）; reflux symptom scores were 0.14 and 0.21 （P = 0.546）. Conclusions： Based on esomeprazole therapy, H. pylori infection and eradication have no significant effect on reflux esophagitis therapy.
文摘A 33-year-old woman, gravida 1, para 0, came to the hospital with the chief complaint of severe dysmenorrhea and infertility. Her menstrual cycle was regular, bleeding moderately for 3–5 days with an interval of 30 days. She was diagnosed with ectopic pregnancy and received the left salpingectomy in September 2014. Intraoperative exploration showed a slightly enlarged retroverted uterus with a wide fundus and a normal right fallopian tube. As a further examination of infertility, hysterosalpingography was done in January 2016, which showed a unicornuate uterus （left） with an obstructed unilateral fallopian tube. She was referred to the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital in February 2016. Her basic body temperature showed biphasic pattern. The sperm test of her husband was normal. Physical examination indicated two vaginal orifices in the vestibule, with a vertical septate lying in between. The left lateral vaginal lumen could be easily expanded and speculated, and a normal cervix was seen at its top. In contrast, the cervix was unable to be seen through the right lateral vaginal lumen, which was narrow and difficult to be exposed or inspected. Pelvic ultrasound scan showed that the uterus was 4.7 cm ×6.0 cm × 3.6 cm in size, along with the Y-shaped endometrium of 0.8 cm in thickness, and a normal echo in the muscular layer. No abnormalities were found at the bilateral adnexa areas or pelvic cavity. Besides, the bilateral renal areas and ureters were found normal in the ultrasound scan as well.
文摘Psittacosis is a zoonosis caused by Chlamydia psittaci,a Gram-negative intracellular bacterium.This condition is caused by the ingestion of contaminated fecal matter and nasal secretions from infected birds.The severity of human psittacosis varies from mildflu-like symptoms to life-threatening severe pneumonia.[1]Given that C.psittaci is not a part of the traditional microbiological diagnosis’human psittacosis is often underreported,misdiagnosed,and inadequately diagnosed.In this study,the clinical data of C.psittaci pneumonia patients were retrospectively analyzed.
