Brucellosis relapse causing thoracic aortic ulcers and aneurysm formation: a case report

Abstract

Background: Brucellosis is an infectious disease caused by Brucella spp, which can involve the cardiovascular, digestive, and respiratory systems. Cardiovascular involvement is a rare occurrence, it has an extremely high mortality rate.

Case presentation: A 67-year-old Chinese man presented with thoracic aortic multiple ulcers and partial aneurysm formation that caused symptoms of left waist and left buttock pain. The man was admitted to our hospital due to abdominal aorta pseudoaneurysms 5 years ago. The diagnosis was made by thoracic computed tomography angiography (CTA), previous history, and positive culture of Brucella, and the patient was successfully treated by thoracic aortic covered stent-graft implantation and specifc medical treatment.

Conclusions: People who have a history of contact with cattle and sheep, should beware of the possibility of Brucella infection. If chest and abdominal pain occur, timely medical treatment is recommended, aortic aneurysm, the disease with a high risk of death, can be identifed or excluded by CTA. Early treatment and prevention of disease progression are more benefcial to patients.

Keywords: Brucellosis, Relapse, Thoracic aortic ulcer, Aneurysm

心脏直视手术患者采取标准化防护流程降低 术中压疮发生率的效果研究

摘 要：目的：将标准化防护流程用于进行心脏直视手术患者中后，对其降低压疮发生率的效果进行探析。方法：本研究一共纳入90例实验对象，均为在蚌埠医学院第一附属医院进行心脏直视手术的患者，实验开展时间2019年10月至2020年08月。按随机法分为对照组与观察组，每组各45例患者，前者实施传统护理干预模式，后者实施标准化防护流程模式，对比两组患者术后不同时间段的压疮发生率。结果：观察组与对照组实施不同护理模式后，前者术后即刻与术后2d、4d压疮发生率2.22%、4.44%、8.89%均明显低于后者13.33%、17.78%、24.44%，前者均显著低于后者（P＜0.05）。结论：对进行心脏直视手术的患者应用标准化防护流程模式课后，能获得较为理想的护理效果，对降低患者发生压疮的风险具有非常积极的意义，值得临床应用。

关键词：心脏直视手术，标准化防护流程，压疮

协助偏瘫患者翻身预防压疮的护理研究进展

摘 要：偏瘫患者因肌力下降极易发生压疮，而翻身可间歇性减轻身体局部压力的压迫，是临床上最经济、有效的预防压疮的方法，故该文结合近年来护理人员帮助偏瘫患者翻身预防压疮的护理研究，从翻身的方法、翻身角度、翻身间隔时间及翻身辅助用具的使用等角度做出综述，为临床护理人员在有效预防压疮的基础上减轻翻身操作带来的职业性腰背痛提供一定的参考。

关键词：压力性损伤 偏瘫 护理 翻身

脉复生联合杏芎氯化钠注射液治疗下肢动脉硬化闭塞症的 临床研究

【摘 要】 目的 观察脉复生联合杏芎氯化钠注射液治疗下肢动脉硬化闭塞症患者的临床疗效。方法 将 206 例下肢动脉硬化闭塞症患者随机分为治疗组和对照组各 103 例。两组均在常规治疗基础上给予杏芎氯化钠注射液

( 100 mL 静滴，qd) ，治疗组加服用脉复生( 30 mL，bid) ，治疗 15 d 后，观察治疗前后患者创面愈合率、疼痛程度 VAS 评分、血脂水平、血液流变学、患肢经皮氧负压( TcPO2 ) 、踝肱指数( ABI) 的变化。结果 治疗组总有效率为 96. 11% ，显著高于对照组的 77. 1% ( P ＜ 0. 05) ; 治疗组疼痛减轻程度大于对照组( P ＜ 0. 05) ，经皮氧负压高于对照组( P ＜ 0. 05) 。结论 脉复生联合杏芎氯化钠注射液治疗下肢动脉硬化闭塞症患者有显著疗效，有助于减轻患者溃疡疼痛、提高患肢经皮氧分压、促进患肢溃疡愈合。

【关键词】 下肢动脉硬化闭塞症; 脉复生; 杏芎氯化钠注射液; 下肢溃疡; 经皮氧分压 ABI

肠造口患者病耻感与出院准备度的关系肠造口患者病耻感与出院准备度的关系

【摘 要】目的: 调查肠造口患者病耻感与出院准备度现状，并探讨两者相关性。方法: 选取北京协和医院结直肠外科行肠造口术住院患者 124 例，采用出院准备度量表 ( RHDS) 评价出院准备度状况，用社会影响量表 ( SIS) 评价病耻感状况。结果: 居住在农村的患者 SIS 得分高于居住在城市的患者，家庭月均收入≤3000 元的患者 SIS 高于家庭月均收入 ＞ 3000 元的患者 ( 均 P ＜ 0. 05) 。患者 SIS 总分及各维度得分均与 RHDS 总分呈负相关 ( r = － 0. 35、 － 0. 31、 － 0. 26、 － 0. 32、 － 0. 36，均 P ＜ 0. 01) 。多重回归分析显示 SIS 的内在羞耻感维度得分与 RHDS 总分负向关联 ( β = － 3. 33，P ＜ 0. 05) 。结论: 肠造口患者病耻感与出院准备度密切相关。

【关键词】肠造口; 病耻感; 出院准备度

PFKP Activation Ameliorates Foot Process Fusion in Podocytes in Diabetic Kidney Disease

Background: Glycolysis dysfunction is an important pathogenesis of podocyte injury in diabetic kidney disease (DKD). Foot process fusion of podocytes and increased albuminuria are markers of early DKD. Moreover, cytoskeletal remodeling has been found to be involved in the foot process fusion of podocytes. However, the connections between cytoskeletal remodeling and alterations of glycolysis in podocytes in DKD have not been clarifified.

Methods: mRNA sequencing of glomeruli obtained from db/db and db/m mice with albuminuria was performed to analyze the expression profifiling of genes in glucose metabolism. Expressions of phosphofructokinase platelet type (PFKP) in the glomeruli of DKD patients were detected. Clotrimazole (CTZ) was used to explore the renal effects of PFKP inhibition in diabetic mice. Using Pfkp siRNA or recombinant plasmid to manipulate PFKP expression, the effects of PFKP on high glucose (HG) induced podocyte damage were assessed in vitro. The levels of fructose-1,6-bisphosphate (FBP) were measured. Targeted metabolomics was performed to observe the alterations of the metabolites in glucose metabolism after HG stimulation. Furthermore, aldolase type b (Aldob) siRNA or recombinant plasmid were applied to evaluate the inflfluence of FBP level alteration on podocytes. FBP was directly added to podocyte culture media. Db/db mice were treated with FBP to investigate its effects on their kidney.

Results: mRNA sequencing showed that glycolysis enzyme genes were altered, characterized by upregulation of upstream genes (Hk1, and Pfkp) and down-regulation of downstream genes of glycolysis (Pkm, and Ldha). Moreover, the expression of PFKP was increased in glomeruli of DKD patients. The CTZ group presented more severe renal damage In vitro, the Pfkp siRNA group and ALDOB overexpression group showed much more induced cytoskeletal remodeling in podocytes, while overexpression of PFKP and suppression of ALDOB in vitro rescued podocytes from cytoskeletal remodeling through regulation of FBP levels and inhibition of the RhoA/ROCK1 pathway. Furthermore, targeted metabolomics showed FBP level was signifificantly increased in HG group compared with the control group. Exogenous FBP addition reduced podocyte cytoskeletal remodeling and renal damage of db/db mice.

Conclusions: These fifindings provide evidence that PFKP may be a potential target for podocyte injury in DN and provide a rationale for applying podocyte glycolysis enhancing agents in patients with DKD.

Keywords: PFKP, diabetic kidney diseases, glycolysis, podocyte injury, cytoskeletal remodeling, FBP