BACKGROUND Amiodarone is a Class III antiarrhythmic drug,which has been adopted for the treatment of atrial fibrillation and ventricular arrhythmia.However,the use of amiodarone can cause lower limb muscle tremors,whi...BACKGROUND Amiodarone is a Class III antiarrhythmic drug,which has been adopted for the treatment of atrial fibrillation and ventricular arrhythmia.However,the use of amiodarone can cause lower limb muscle tremors,which is recognized as a rare side effect of this medication.CASE SUMMARY An 84-year-old female was administrated with amiodarone for paroxysmal supraventricular tachycardia and frequent ventricular tachycardia.The patient developed a bilateral gastrocnemius tremor in the course of medication,and the strength of the patient’s bilateral knee flexor and extensor reached 4/5 and 3/5,respectively.After the use of amiodarone was stopped,and the patient was given a small dose of levetiracetam,the lower limb tremor symptoms were significantly mitigated,along with activity and function.CONCLUSION Attention should be paid to the significance of the side effects of drugs in the elderly,which may be atypical in the elderly.The relevant side effects of drugs may not be as rare as reported due to individual differences and different pharmacokinetics.If the side effects are generated,the medication should be adjusted in time,and the progress of the side effects should be intervened.展开更多
BACKGROUND As a rare anomaly,congenital absence of the right coronary artery(RCA)occurs during the development of coronary artery.Patients with congenital absence of the RCA often show no clinical symptoms,and this di...BACKGROUND As a rare anomaly,congenital absence of the right coronary artery(RCA)occurs during the development of coronary artery.Patients with congenital absence of the RCA often show no clinical symptoms,and this disease is considered benign.The left coronary artery gives blood supply to the whole myocardium.The prevalence of congenital absence of the RCA is approximately 0.024%-0.066%.There are few cases reported as for this disease.In this work,a patient,with congenital absence of the RCA diagnosed by coronary angiography(CAG),was described.CASE SUMMARY A 41-year-old man arrived at our hospital for treatment,due to the repeated palpitations for a duration of one year.Considering the possibility of coronary heart disease,the patient underwent CAG that indicated the congenital absence of the RCA.Unfortunately,the patient refused to accept computed tomography coronary angiography(CTCA),to further confirm the congenital absence of the RCA.CONCLUSION Single coronary artery is a rare type of coronary artery abnormality,which usually has no obvious clinical manifestations and is considered as a benign disease.CAG is the main means by which congenital absence of the RCA can be diagnosed,and the disease can also be further confirmed by CTCA.展开更多
BACKGROUND Currently,the implantation of permanent cardiac pacemakers entails mostly subclavian vein puncture,which is relatively simpler and easier to master.However,due to individual differences,some patients carry ...BACKGROUND Currently,the implantation of permanent cardiac pacemakers entails mostly subclavian vein puncture,which is relatively simpler and easier to master.However,due to individual differences,some patients carry a narrow space between the clavicle and the first rib.If the range of activity of the upper limb is increased,the friction between the electrode wire and the bone gap leads to the breakage of the electrode wire,which is manifested by poor pacemaker perception and pacing.CASE SUMMARY A 68-year-old woman underwent permanent pacemaker implantation in our hospital because of third-degree atrioventricular block 6 years ago.At that time,the patient was recommended to have a dual-chamber permanent pacemaker implantation,and finally chose a single-chamber permanent pacemaker because she could not afford the cost.The patient has repeatedly lost consciousness for no obvious reason in the past 3 d,and went to our hospital for treatment.The chest X-ray showed that the pacemaker electrode was broken.After the patient was given a pacemaker electrode replacement,the patient did not continue to lose consciousness.CONCLUSION Because the electrodes implanted in the subclavian approach are close to the clavicle and the first rib,the pacemaker electrodes may wear out.If the patient loses consciousness again after the pacemaker is implanted,we should consider whether there is a pacemaker.The possibility of electrode breakage,and timely help the patient to replace the new pacemaker electrodes.展开更多
Objective:Villoglandular papillary adenocarcinoma(VGPA)of the uterine cervix is a subtype of cervical adenocarcinoma.In the present study,we summarized the clinical features of VGPA of the uterine cervix and discussed...Objective:Villoglandular papillary adenocarcinoma(VGPA)of the uterine cervix is a subtype of cervical adenocarcinoma.In the present study,we summarized the clinical features of VGPA of the uterine cervix and discussed the potential indications for a conservative treatment.Methods:A retrospective review of clinical characteristics and treatment aspects of 10patients with VGPA at the Obstetrics and Gynecology Hospital of Fudan University was conducted between January 2007 and December 2016.Almost all of the existing 40 English papers on“villoglandular papillary adenocarcinoma[title/abstract]”identified from PubMed were obtained.Clinical data from these papers were analyzed in terms of age,International Federation of Gynecology and Obstetrics(FIGO)stage,recurrence rate,mortality,and conservation treatment aspects.Results:The median age of 10patients with VGPA was 40years.All cases had Stage IB 1 disease.Seven patients underwent human papillomavirus examinations,which revealed 6 positive and 1 negative case(s)of infection.Six patients underwent ThinPrep cytologic tests,which revealed 4patients with atypical glandular cells,1 with a high-grade squamous intraepithelial lesion,and 1 who tested negative for intraepithelial malignancy.None of the patients had lymph node metastases.During the 6-114months of follow-up,no disease recurrence or death occurred.Of note,one patient who received conservative treatment successfully became pregnant.Conclusions:VGPA can be detected at an early FIGO stage with excellent prognosis.For young patients who do not exhibit poor prognosis factors,conservative treatment may be the first treatment choice based on overall assessment of clinical conditions.展开更多
In recent years,an increasing number of young women have been diagnosed with cancer,including some nulliparous women.Therefore,many young patients with early-stage cancer desire to preserve fertility after cytotoxic o...In recent years,an increasing number of young women have been diagnosed with cancer,including some nulliparous women.Therefore,many young patients with early-stage cancer desire to preserve fertility after cytotoxic oncological treatments.It is important to develop a multidisciplinary approach to achieve the best outcomes for each patient.On the other hand,there has been a sharp increase in microRNAs(miRNAs)as potential biomarkers for the diagnosis,prognosis,and evaluation of treatment efficacy of several diseases.MiR-543 has been reported to affect the pathogenesis and progression of diseases via complex mechanisms.Understanding the regulatory role of miR-543 may aid comprehension of the pathogenesis and treatment of a broad range of diseases.Therefore,we provide an overview of the biogenesis,function,and role of miR-543 in various systems.These results shed light on the anticancer and endometrial protection role of miR-543 in young patients with gynecologic tumors and highlight the clinical potential of miR-543-based applications and related challenges.展开更多
Follicle-stimulating hormone(FSH), as the main indicator of ovarian function, plays an important role in the clinical activities of gynecologic endocrinology. Although anti-Miillerian hormone and antral follicle count...Follicle-stimulating hormone(FSH), as the main indicator of ovarian function, plays an important role in the clinical activities of gynecologic endocrinology. Although anti-Miillerian hormone and antral follicle count are also the indictors evaluating ovarian function, many clinicians are still relentless in their decision to impose the death penalty of ovaries when high FSH levels(especially more than 40 IU/L) are observed.We recently encountered four patients whose FSH levels were inconsistent with actual fertility because all patients had successfully conceived after treatment. In our study, we found the culprit(macro-FSH) of false-positive FSH levels by applying the polyethylene glycol protein precipitation technique. The biological functions of macro-FSH were further evaluated by using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis. This study suggests that ovarian reserve function should be comprehensively assessed in clinic, and the causes of serum test indicators inconsistent with clinic should be identified.展开更多
Considering that tungsten(W)materials served as the plasma-facing material in the fusion reactor would be exposed to edge-localized modes(ELMs)-like thermal shock loading accompanied with He-ion irradiation,the W-TiC ...Considering that tungsten(W)materials served as the plasma-facing material in the fusion reactor would be exposed to edge-localized modes(ELMs)-like thermal shock loading accompanied with He-ion irradiation,the W-TiC composite produced with a wet-chemical method was conducted by the dual effects from the laser beam thermal shock first and He-ion irradia-tion later in this work.The microstructure changes of the W-TiC composite before and after two tests were characterized by scanning electron microscopy or transmission electron microscopy.After the laser beam thermal shock test,there was an obvious interface on the exposed surface of the W-TiC composite.Several main cracks and melting areas could be found nearby the interface and center,respectively.Furthermore,a mixture of tungsten oxide and TiC was easy to aggregate and form into circle areas surrounding the melting area.The thermal shock tested that W-TiC composite was then subjected to the He-ion irradiation.The typical features of fuzz structures could be detected on the surface of the W-TiC composite apart from the center of the melting area.Notably,several nano-sized He bubbles deeply distributed at grain boundaries in the melting area,owing to the grain boundary functioning as the free path for He diffusion.展开更多
To the Editor： A 38-year-old male presented with chest pain for coronary angiography to exclude coronary heart disease in the Second Affiliated Hospital of Nanchang University. During coronary angiography, a 6 Fr she...To the Editor： A 38-year-old male presented with chest pain for coronary angiography to exclude coronary heart disease in the Second Affiliated Hospital of Nanchang University. During coronary angiography, a 6 Fr sheath was inserted without any difficulty after right radial artery access was obtained. However, the Loach guidewire could only be advanced to the descending aorta, and repeated attempts failed to enter the ascending aorta. Therefore, an abnormal origin of the right subclavian artery （aberrant right subclavian artery [ARSA]） was suspected. This had been confirmed by performing angiography near the origin of the right subclavian artery, which showed the right subclavian artery arising from the descending aorta.展开更多
文摘BACKGROUND Amiodarone is a Class III antiarrhythmic drug,which has been adopted for the treatment of atrial fibrillation and ventricular arrhythmia.However,the use of amiodarone can cause lower limb muscle tremors,which is recognized as a rare side effect of this medication.CASE SUMMARY An 84-year-old female was administrated with amiodarone for paroxysmal supraventricular tachycardia and frequent ventricular tachycardia.The patient developed a bilateral gastrocnemius tremor in the course of medication,and the strength of the patient’s bilateral knee flexor and extensor reached 4/5 and 3/5,respectively.After the use of amiodarone was stopped,and the patient was given a small dose of levetiracetam,the lower limb tremor symptoms were significantly mitigated,along with activity and function.CONCLUSION Attention should be paid to the significance of the side effects of drugs in the elderly,which may be atypical in the elderly.The relevant side effects of drugs may not be as rare as reported due to individual differences and different pharmacokinetics.If the side effects are generated,the medication should be adjusted in time,and the progress of the side effects should be intervened.
文摘BACKGROUND As a rare anomaly,congenital absence of the right coronary artery(RCA)occurs during the development of coronary artery.Patients with congenital absence of the RCA often show no clinical symptoms,and this disease is considered benign.The left coronary artery gives blood supply to the whole myocardium.The prevalence of congenital absence of the RCA is approximately 0.024%-0.066%.There are few cases reported as for this disease.In this work,a patient,with congenital absence of the RCA diagnosed by coronary angiography(CAG),was described.CASE SUMMARY A 41-year-old man arrived at our hospital for treatment,due to the repeated palpitations for a duration of one year.Considering the possibility of coronary heart disease,the patient underwent CAG that indicated the congenital absence of the RCA.Unfortunately,the patient refused to accept computed tomography coronary angiography(CTCA),to further confirm the congenital absence of the RCA.CONCLUSION Single coronary artery is a rare type of coronary artery abnormality,which usually has no obvious clinical manifestations and is considered as a benign disease.CAG is the main means by which congenital absence of the RCA can be diagnosed,and the disease can also be further confirmed by CTCA.
文摘BACKGROUND Currently,the implantation of permanent cardiac pacemakers entails mostly subclavian vein puncture,which is relatively simpler and easier to master.However,due to individual differences,some patients carry a narrow space between the clavicle and the first rib.If the range of activity of the upper limb is increased,the friction between the electrode wire and the bone gap leads to the breakage of the electrode wire,which is manifested by poor pacemaker perception and pacing.CASE SUMMARY A 68-year-old woman underwent permanent pacemaker implantation in our hospital because of third-degree atrioventricular block 6 years ago.At that time,the patient was recommended to have a dual-chamber permanent pacemaker implantation,and finally chose a single-chamber permanent pacemaker because she could not afford the cost.The patient has repeatedly lost consciousness for no obvious reason in the past 3 d,and went to our hospital for treatment.The chest X-ray showed that the pacemaker electrode was broken.After the patient was given a pacemaker electrode replacement,the patient did not continue to lose consciousness.CONCLUSION Because the electrodes implanted in the subclavian approach are close to the clavicle and the first rib,the pacemaker electrodes may wear out.If the patient loses consciousness again after the pacemaker is implanted,we should consider whether there is a pacemaker.The possibility of electrode breakage,and timely help the patient to replace the new pacemaker electrodes.
文摘Objective:Villoglandular papillary adenocarcinoma(VGPA)of the uterine cervix is a subtype of cervical adenocarcinoma.In the present study,we summarized the clinical features of VGPA of the uterine cervix and discussed the potential indications for a conservative treatment.Methods:A retrospective review of clinical characteristics and treatment aspects of 10patients with VGPA at the Obstetrics and Gynecology Hospital of Fudan University was conducted between January 2007 and December 2016.Almost all of the existing 40 English papers on“villoglandular papillary adenocarcinoma[title/abstract]”identified from PubMed were obtained.Clinical data from these papers were analyzed in terms of age,International Federation of Gynecology and Obstetrics(FIGO)stage,recurrence rate,mortality,and conservation treatment aspects.Results:The median age of 10patients with VGPA was 40years.All cases had Stage IB 1 disease.Seven patients underwent human papillomavirus examinations,which revealed 6 positive and 1 negative case(s)of infection.Six patients underwent ThinPrep cytologic tests,which revealed 4patients with atypical glandular cells,1 with a high-grade squamous intraepithelial lesion,and 1 who tested negative for intraepithelial malignancy.None of the patients had lymph node metastases.During the 6-114months of follow-up,no disease recurrence or death occurred.Of note,one patient who received conservative treatment successfully became pregnant.Conclusions:VGPA can be detected at an early FIGO stage with excellent prognosis.For young patients who do not exhibit poor prognosis factors,conservative treatment may be the first treatment choice based on overall assessment of clinical conditions.
基金This work was supported by grants from the National Basic Research Program of China(2015CB943304)National Natural Science Foundation ofChina(81671457 and 81871143 to X.YZ,31800768 to W.T.H.).
文摘In recent years,an increasing number of young women have been diagnosed with cancer,including some nulliparous women.Therefore,many young patients with early-stage cancer desire to preserve fertility after cytotoxic oncological treatments.It is important to develop a multidisciplinary approach to achieve the best outcomes for each patient.On the other hand,there has been a sharp increase in microRNAs(miRNAs)as potential biomarkers for the diagnosis,prognosis,and evaluation of treatment efficacy of several diseases.MiR-543 has been reported to affect the pathogenesis and progression of diseases via complex mechanisms.Understanding the regulatory role of miR-543 may aid comprehension of the pathogenesis and treatment of a broad range of diseases.Therefore,we provide an overview of the biogenesis,function,and role of miR-543 in various systems.These results shed light on the anticancer and endometrial protection role of miR-543 in young patients with gynecologic tumors and highlight the clinical potential of miR-543-based applications and related challenges.
基金supported by the National Natural Science Foundation of China(No.81471438 to Yingli Shi).
文摘Follicle-stimulating hormone(FSH), as the main indicator of ovarian function, plays an important role in the clinical activities of gynecologic endocrinology. Although anti-Miillerian hormone and antral follicle count are also the indictors evaluating ovarian function, many clinicians are still relentless in their decision to impose the death penalty of ovaries when high FSH levels(especially more than 40 IU/L) are observed.We recently encountered four patients whose FSH levels were inconsistent with actual fertility because all patients had successfully conceived after treatment. In our study, we found the culprit(macro-FSH) of false-positive FSH levels by applying the polyethylene glycol protein precipitation technique. The biological functions of macro-FSH were further evaluated by using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis. This study suggests that ovarian reserve function should be comprehensively assessed in clinic, and the causes of serum test indicators inconsistent with clinic should be identified.
基金the National Natural Science Foundation of China(Grant No.51574101)the Fundamental Research Funds for the Central Universities(Grant Nos.PA2018GDQT0010,PA2019GDZC0096,JZ2019HGTA0040)+2 种基金the Foundation of Laboratory of Nonferrous Metal Material and Processing Engineering of Anhui Province(15CZS08031)the Natural Science Foundation of Anhui Province(Grant Nos.201904b11020034,1908085ME115)the Foundation of Laboratory of Nonferrous Metal Material and Processing Engineering of Anhui Province,the Open Foundation of Key Laboratory of Advanced Functional Materials,Devices of Anhui Province and Double First Class enhancing independent innovation and social service capabilities of Hefei University of Technology(Grant No.45000-411104/011).
文摘Considering that tungsten(W)materials served as the plasma-facing material in the fusion reactor would be exposed to edge-localized modes(ELMs)-like thermal shock loading accompanied with He-ion irradiation,the W-TiC composite produced with a wet-chemical method was conducted by the dual effects from the laser beam thermal shock first and He-ion irradia-tion later in this work.The microstructure changes of the W-TiC composite before and after two tests were characterized by scanning electron microscopy or transmission electron microscopy.After the laser beam thermal shock test,there was an obvious interface on the exposed surface of the W-TiC composite.Several main cracks and melting areas could be found nearby the interface and center,respectively.Furthermore,a mixture of tungsten oxide and TiC was easy to aggregate and form into circle areas surrounding the melting area.The thermal shock tested that W-TiC composite was then subjected to the He-ion irradiation.The typical features of fuzz structures could be detected on the surface of the W-TiC composite apart from the center of the melting area.Notably,several nano-sized He bubbles deeply distributed at grain boundaries in the melting area,owing to the grain boundary functioning as the free path for He diffusion.
文摘To the Editor： A 38-year-old male presented with chest pain for coronary angiography to exclude coronary heart disease in the Second Affiliated Hospital of Nanchang University. During coronary angiography, a 6 Fr sheath was inserted without any difficulty after right radial artery access was obtained. However, the Loach guidewire could only be advanced to the descending aorta, and repeated attempts failed to enter the ascending aorta. Therefore, an abnormal origin of the right subclavian artery （aberrant right subclavian artery [ARSA]） was suspected. This had been confirmed by performing angiography near the origin of the right subclavian artery, which showed the right subclavian artery arising from the descending aorta.
