| 1 | Disabling portosystemic encephalopathy in a non-cirrhotic patient: successful endovascular treatment of a giant inferior mesenteric-caval shunt via the left internal iliac vein显示文摘Hepatic encephalopathy is suspected in non-cirrhotic cases of encephalopathy because the symptoms are accompanied by hyperammonaemia. Some cases have been misdiagnosed as psychiatric diseases and consequently patients hospitalized in psychiatric institutions or geriatric facilities. Therefore, the importance of accurate diagnosis of this disease should be strongly emphasized. A 68-year-old female patient presented to the Emergency Room with confusion, lethargy, nausea and vomiting. Examination disclosed normal vital signs. Neurological examination revealed a minimally responsive woman without apparent focal deficits and normal reflexes. She had no history of hematologic disorders or alcohol abuse. Her brain TC did not demonstrate any intracranial abnormalities and electroencephalography did not reveal any subclinical epileptiform discharges. Her ammonia level was > 400 mg/d L(reference range < 75 mg/d L) while hepatitis viral markers were negative. The patient was started on lactulose, rifaximin and low-protein diet.On the basis of the doppler ultrasound and abdomen computed tomography angiography findings, the decision was made to attempt portal venography which confirmed the presence of a giant portal-systemic venous shunt. Therefore, mechanic obliteration of shunt by interventional radiology was performed. As a consequence, mesenteric venous blood returned to hepatopetally flow into the liver, metabolic detoxification of ammonia increased and hepatic encephalopathy subsided. It is crucial that physicians immediately recognize the presence of non-cirrhotic encephalopathy, in view of the potential therapeutic resolution after accurate diagnosis and appropriate treatments. | Luca de Martinis Gloria Groppelli Riccardo Corti Lorenzo Paolo Moramarco Pietro Quaretti Pasquale De Cata Mario Rotondi Luca Chiovato | 2017 | World Journal of Gastroenterology2017，23，47： | 3 |
| 3 | 生物可降解多聚体biolimus洗脱支架与不可降解多聚体西罗莫司洗脱支架用于冠状动脉血运乖建(LEADERS):一项随机非劣效性试验显示文摘背景初步研究表明,从生物可降解多聚体中释出biolimus(西罗莫司类似物)的一种新型洗脱支架有望获得良好的临床效果。本研究比较了biolimus洗脱支架(具有生物可降解多聚体)和西罗莫司洗脱支架(具有不可降解多聚体)的安全性和疗效。方法作者在欧洲的10个研究中心进行了一项多中心、评估音设盲的非劣效性研究。1707例年龄≥18岁、患有慢性稳定性冠心病或急性冠状动脉综合征的患者经计算机产生的一组随机分配序列进行集中随机分组,分别接受biolimus,先脱支架(n=857)或西罗莫司洗脱支架(n=850)植入主要终点是在9个月内心脏性死亡、心肌梗死或具有临床指征的靶血管血运重建(TVR)的复合事件、采用意向治疗分析法对结果进行分析、随机抽取427例患者接受血管造影随访,主要结果指标为9个月时史巢内直径狭窄的百分比。本临床试验在ClinicalTrials.gov网站上注册,注册号为NCT00389220。结果对研究中所有随机分组的患者进行了分析。9个月时biolimus洗脱支架组在主要终点指标上并不劣于西罗莫司洗脱支架组[79例(9%)vs89例(11%),RR0.88,95%CI0.64~1.19,非劣效P=0.003,优势P=0.39]。心脏性死亡发生率[14例(1.6%)vs21例(2.5%),优势P=0.22]、心肌梗死发生率[49例(5.7%)vs39例(4.6%),P=0.30]以及具有临床指征的TVR实施率[38例(4.4%)vs547例(5.5%),P=0.29]在两组中相似.Biolimus洗脱支架组有168例(79%)患者的资料可用于血管造影随访,西罗莫司洗脱支架组有167例(78%)Biolimus洗脱支架组在支架内直径狭窄百分比上不劣于西罗莫司洗脱支架组(20.9%vs 23.3%,差值-2.2%.95%CI-6.0%~1.6%,非劣效P=0.001,优势P=0.26)、结论研究结果表明,从生物可降解多聚体中释出biolimus的洗脱支架安全有效,在对慢性稳定性冠心病或急性冠状动脉综合征患者进行治疗时,它可以取代从不可降解多聚体中释出西罗莫司的洗脱支架。 | Stephan Windecker Patrick W Serruys Simon Wandel Pawel Buszman Stanislaw Trznadel Axel Linke Karsten Lenk Thomas Ischinger Volker Klauss Franz Eberli Roberto Corti William Wijns Marie-Claude Morice Carlo di Mario Simon Davies Robert-Jan van Geuns Pedro Eerdmans Gerrit- Anne van Es Bernhard Meier Peter Jüni 刘少伟(译) | 2009 | 世界临床医学2009，3，3： | 0 |
| 5 | Anomalous Sorption Kinetics of Self-Interacting Particles by a Spherical Trap显示文摘In this paper we propose a computational framework for the investigation of the correlated motion between positive and negative ions exposed to the attraction of a bubble surface that mimics the(oscillating)cell membrane.Specifically we aim to investigate the role of surface traps with substances freely diffusing around the cell.The physical system we want to model is an anchored gas drop submitted to a diffusive flowof charged surfactants(ions).When the diffusing surfactantsmeet the surface of the bubble,they are reversibly adsorbed and their local concentration is accurately measured.The correlated diffusion of surfactants is described by a Poisson-Nernst-Planck(PNP)system,in which the drift term is given by the gradient of a potential which includes both the effect of the bubble and the Coulomb interaction between the carriers.The latter term is obtained from the solution of a self-consistent Poisson equation.For very short Debye lengths one can adopt the so called Quasi-Neutral limit which drastically simplifies the system,thus allowing for much faster numerical simulations.The paper has four main objectives.The first one is to present a PNP model that describes ion charges in presence of a trap.The second one is to provide benchmark tests for the validation of simplified multiscale models under current development[1].The third one is to explore the relevance of the term describing the interaction among the apolar tails of the anions.The last one is to quantitatively explore the validity of the Quasi-Neutral limit by comparison with detailed numerical simulation for smaller and smaller Debye lengths.In order to reach these goals,we propose a simple and efficient Alternate Direction Implicit method for the numerical solution of the non-linear PNP system,which guarantees second order accuracy both in space and time,without requiring solution of nonlinear equation at each time step.New semi-implicit scheme for a simplified PNP system near quasi neutrality is also proposed. | Antonio Raudino Antonio Grassi Giuseppe Lombardo Giovanni Russo Clarissa Astuto Mario Corti | 2022 | Communications in Computational Physics2022，31，3： | 0 |
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