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Reported One Case of the Renal Transplant between Identical Twins and Reviewed Literatures

摘要:目的: 报道同卵双生子间肾移植效果,探讨免疫抑制剂及激素的使用、鉴定同卵双生子的方法以及术后随访。 方法 :个案报道结合文献综述。 结果 :手术获得成功。术后随访8月,患者恢复良好。 结论 :同卵双生间的肾移植安全有效,术后不需要使用免疫抑制剂也能维持移植肾功能正常。Abstract: Objective: Reported the effects of renal transplantation between identical twins,explored the use of immunosuppressive drugs and glucocorticoid, identification method of the identical twins and postoperative followup . Methods :Combining case report and literature review. Results :The operation is success.Followup in 8 months,the patient recover well. Conclusion : The renal transplantation between identical twins is safe and effective,the immunosuppressant is not need for the postoperative patients to maintain the graft`s function.

One Case Report of MTX-Induced Aplastic Anemia and Literature Review

We reported one case of MTX-induced aplastic anemia and reviewed related literature to investigate the mechanism of action of MTX, and summarize the clinical feature, diagnostic criteria, risk factor, and interventions. These were hoped to arouse the attention of clinicians and clinical pharmacists, in order to effectively prevent, diagnose, and treat MTX-induced aplastic anemia.

原发性纵隔骨肉瘤一例

胰腺 Castleman 病 1 例报道并文献复习

目的 总结 1 例胰腺 Castleman 病患者的临床资料，并复习以往文献，总结该病的流行病学特点及诊治体会。 方法 回顾性分析 2016 年 1 月笔者所在医院收治的 1 例胰腺 Castleman 病患者的临床资料，进行文献复习及总结。 结果 该例患者无特殊临床表现，术前行 CT 检查发现胰腺占位，行手术切除，术后病理学诊断为胰腺 Castleman 病。术后 1 个月复查CT未见肿瘤复发及转移，已获访 6 个月，患者恢复良好。经查阅文献，共检索出胰腺 Castleman 病 32 例，男 11 例，女 21 例；年龄 23～74 岁，平均年龄为 46 岁；临床表现仅为腹部疼痛 7 例，腹痛伴发热 1 例，腹痛伴面部、双下肢水肿 1 例，腹痛伴乏力 1 例，腹胀 1 例，背部疼痛 1 例，颈部淋巴结肿大 1 例，吞咽困难 1 例，发热、乏力、体质量下降 1 例，无明显临床表现 17 例；肿瘤位于胰腺头部 9 例，胰腺颈部 3 例，胰腺体、尾部 16 例，胰周 4 例；肿瘤直径最小 1.5 cm，最大 7.2 cm；病理学分型为透明血管型（hyaline vascular，HV）19 例，浆细胞型（plasma cell，PC）4 例，混合型（mixed/HV-PC，MV）4 例，未给出明确病理分型 5 例。 结论 胰腺 Castleman 病是少见的淋巴组织增生性疾病，通常无特异临床表现，影像学检查也无特异性，目前仅能通过病理组织学检查确诊。胰腺 Castleman 病的治疗以手术为主，疗效较好。

Common Variable Immune Deficiency Combined with Celiac Disease: A Case Report and Literatures Review

ObjectiveTo enhance the understanding of common variable immune deficiency (CVID) combined with celiac disease in order to diagnose and treat the disease as early as possible and delay its complications through the treatment of the disease and study on related literatures. MethodThe experience of diagnosing and treating one case of CVID combined with celiac disease in November 2013 was reported in the present study, and the related literatures were reviewed. ResultsAfter strict gluten-free diet and infusion of intravenous immune globulin, the patient's diarrhea relieved and serum immunoglobulin elevated. ConclusionsCVID is the most frequent symptomatic primary immune deficiency which is related to celiac disease closely, a gluten-sensitive condition characterized by a variable degree of villous atrophy. Once diagnosed, gluten-free diet can alleviate the symptoms.

MDT discussion of 2 cases of hepatocellular carcinoma with bile duct tumor thrombus

Objective To discuss the clinical characteristics, radiological characteristics, diagnosis, and treatment of hepatocellular carcinoma with bile duct tumor thrombus (HCCBDTT), and to improve the level of diagnosis and treatment for it. Methods Clinical data of 2 cases of HCCBDTT admitted in March 2016 and July 2016 in our hospital were analyzed retrospectively, and the related literatures were reviewed. Results Two cases of HCCBDTT were misdiag- nosed as hilar cholangiocarcinoma before operation, and then proved to be HCCBDTT after operation. The 2 cases were both alive during the follow-up period (20 months and 13 months respectively). Conclusions HCCBDTT patients should be comprehensively analyzed basing on the clinical data for diagnosis, and avoiding misdiagnosis. Active surgical treatment can effectively improve the quality of life in HCCBDTT patients, and prolong the survival time.

成人胰腺体尾部海绵状血管瘤1例报道并文献复习

目的总结胰腺海绵状血管瘤的影像学表现及其相关临床特征。 方法回顾性分析四川省人民医院收治的经病理学检查确诊的1例胰腺海绵状血管瘤患者的临床及CT资料，分析其影像学表现及特点，并进行文献复习。 结果本例胰腺海绵状血管瘤患者的病灶位于胰腺体尾部，CT增强后其内分隔中度强化，并可见液-液平面，经病理学检查诊断为海绵状血管瘤。文献复习结果示：成人胰腺海绵状血管瘤好发于女性（14/19，占73.68%），发病年龄为23～79岁，平均49岁；最常见的症状为腹痛（12/18，占66.67%），发病部位最常见于胰头（8/19，占42.11%）；通常为较大的囊性病灶，最大径从3～20 cm不等。胰腺海绵状血管瘤的诊断方法从20世纪60年代的腹部X线平片发展到现在应用较多的MRI及CT检查，最常用的检查方法仍然是CT检查（13/18，占72.22%）。 结论胰腺海绵状血管瘤是一种少见的囊性肿瘤，CT检查时动脉期并不一定会出现显著强化，并可因伴有囊内出血而出现液-液平面。

腹膜前间隙法修补复合疝 3 例报道并文献复习

目的 探讨腹膜前间隙法修补复合疝的临床诊疗经验。 方法 回顾性分析笔者所在医院于 2011 年 7 月至 2015 年 10 月期间收治的 3 例复合疝病例的临床资料和诊疗过程，并进行相关文献复习。 结果 3 例患者均行择期局麻下疝修补术，1 例患者术前诊断为腹股沟疝合并股疝，余 2 例患者术前均诊断为腹股沟疝。3 例患者均经术中探查确诊为复合疝。结合文献复习，复合疝的发生率极低，临床症状隐匿，故容易被混淆及漏诊。对于术前有腹股沟区多个包块病史者及体质消瘦者，应高度警惕复合疝可能，术中应仔细探查腹股沟管及股管，以防遗漏疝。应用大网片行腹膜前间隙修补可同时修补 3 个疝，且操作简便、效果良好，同时降低了医疗费用。 结论 复合疝是一种少见的疝类型，术前诊断较困难，术中易漏诊。通过不断积累病例，完善修补技术，对术前明确诊断、及时治疗及提高患者满意度均大有裨益。

The Mounier-Kuhn syndrome: three cases report and literature review

Objective To summarize the etiology and clinical features of Mounier-Kuhn syndrome (MKS) so as to enhance the acknowledgement of MKS. Methods Three cases of MKS were reported and the keywords with " Tracheobronchomegaly”, " Mounier-Kuhn syndrome” were analyzed through the mode of literature retrieval in CNKI, VIP and Pubmed databases. Results There were 214 cases around the world including 14 cases of MKS in China. With unknown etiology and non-specific clinical feature, MKS is characteristic with congenital absence of tracheal or bronchial elastic tissue. MKS is diagnosed with remarkably dilated trachea and bronchus through chest CT or bronchofibroscope, accompanied with genetic defects. The ratio of men to women is 8.5 to 1. There is no radical cure. Symptomatic treatment and surgical treatment when necessary could be available. Conclusions MKS is a rare progressive hereditary disease, irrelevant to smoking and sharing a similar cause with generalized elastolysis, which need pay much attention to the physical examination of skin or elastic tissue. The diagnosis of MKS should be based on not merely airway diameter but also the overall clinical, pathologic, and radiologic profile.

Influenza A H1N1 virus infection: literature review of clinical and epidemiological features for 881 patients in China in the past thirty years

ObjectiveTo analyze the clinical features, laboratory examination, imaging findings, treatment and outcome of influenza A H1N1 virus infection in China, so as to improve the clinicians' understanding of the disease.MethodsOne patient with influenza A H1N1 pneumonia was reported in this hospital. The databases of CNKI, VIP network and Wanfang data were systematically consulted. After removing the duplicate and deleting the incomplete literature published between January 1989 and August 2019, 62 literatures were included, involving 880 patients. Hence, 881 patients in total were included. The clinical manifestations, laboratory examination, imaging manifestations, treatment and prognosis were analyzed.ResultsThere were 477 males and 404 females, aged from 50 days to 86 years old, with an average age of (20.4 ±10.0) years. The most common clinical symptoms were fever (99.4%, 876/881), followed by cough (85.0%, 749/881), expectoration (38.1%, 336/881), sore throat (37.0%, 326/881) and dyspnea (33.7%, 297/881), asthenia and general pain (33.5%, 295/881) and so on. Laboratory examination in the leukocyte decreased in 249 patients (28.3%), neutrophil increased in 143 patients (16.2%) and leukocyte increased in 141 patients (16.0%). Myocardial injury was found in 370 patients (42.0%), liver injury in 303 patients (34.4%) and renal insufficiency in 84 patients (9.5%). The main imaging manifestations were spotted, patchy or flaky shadows (41.8%, 362/866) in varying degrees, with consolidation shadows (19.3%, 167/866), thickening of lung texture (11.3%, 98/866), ground glass shadows (4.5%, 39/866), and pleural effusion (5.5%, 48/866). The most common treatments were anti-virus, anti-infection, anti-inflammation, mechanical ventilation and symptomatic support. Comprehensive treatment resulted good effects. There were 37 deaths and the mortality rate was 4.2%. The main cause of death was respiratory failure.ConclusionsInfluenza A H1N1 virus infection is a preventable, controllable and treatable infectious disease, which is similar to the general influenza virus. After active comprehensive treatment, most of the influenza A (H1N1) can be cured and the prognosis is benign.