Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is defined as an acute and clinically significant respiratory deterioration characterized by evidence of new, widespread alveolar abnormality. In the past, AE-IPF was considered to be idiopathic, which was hard to be prevented and its prognosis was hard to be obviously improved; the latest researches have shown that AE-IPF can be triggered by known causes, including pulmonary infection, aspiration, etc. This review summarizes the etiology or risk factors, treatment and prevention of AE-IPF according to the latest researches.
Objective To investigate the etiological distribution of the patients with optic neuritis in China and compare the results with those in western countries. Methods Ophthalmological and neurological detailed clinical and laboratorial examinations were performed on 204 patients with primarily diagnosed optic neuritis (ON). We determined the etiologies using international accepted diagnostic criteria. Results Among 113 patrents with ON, 83(73.5%) were considered as with idiopathic demyelinating optic neuritis ( IDON). Sinusitis was common in these patients but was considered to be the probable cause of ON only in 4. Tuberculo-meningitis caused ON was found in 2 cases and syphilitic ON in 1. The causes of 23 cases (20.4%) were unknown. Conclusions Idiopathic demyelinating ON is the most common pathogeny of ON. Despite of some minor differences of causes and prognosis, the etiology of presumed ON in our population is similar to that reported in western countries. (Chin J Ocul Fundus Dis,2006,22:367-369)
Objective To investigate the causes of chronic cough in Chongqing City and assess the efficacy of specific therapy. Methods A total of 233 consecutively non-selected referred patients ( 136 females) whose cough duration more than eight weeks were studied. Their age[ median ( range) ] was 44. 5( 15-78) yrs and cough duration was 2. 6 ( 0. 2-30) yrs. They were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association and American College of Chest Physicians. The etiological diagnosis was made according to clinical manifestations, lab examinations, and response to specific therapy. The effects was assessed four weeks after the drug withdraw. Results The cause of chronic cough was confirmed in 216 patients ( 92. 7% ) . Seventeen patients( 7. 3% ) had not been definitely diagnosed. Cough due to a single cause was found in 163 patients ( 75. 45% ) , and due to multiple causes in 53 patients ( 24. 53% ) . The causes included upper airway cough syndrome ( UACS) in 127 patients( 44. 4% ) , cough variant asthma ( CVA) in 73 patients( 25. 5% ) , gastro-esophageal reflux cough ( GERC) in 26 patients( 9. 1%) , postinfectious cough and angiotensin converting enzyme ( ACE) inhibitor-induced cough in 6 patients( 2. 1% ) , atopic cough in 5 patients( 1. 7% ) , chronic bronchitis in 3 patients ( 1. 0% ) , respectively. After specific therapy based on diagnosis, cough cured in 59 patients ( 25. 3% ) , and alleviated in 114 patients ( 49. 3% ) , no response in 40 patients( 17. 1% ) . Conclusion The causes of chronic cough in different areas maybe variant. UACS, CVA and GREC are the main causes of chronic cough in Chongqing City. Specific therapy is effective in majority of patients with chronic cough.
Objective To review the recent research progress on relationshi p between subchondral bone and cartilage degeneration in osteoarthritis (OA), and to predict future research directions. Methods Recent l iteratures about the pathological changes of subchondral bone in OA were reviewed and analyzed in terms of biomechanics, bone remodel ingand biological factors. Results Subchondral bone sclerosis or softening was the result of osteoarthritis and also closely related to the occurrence and development of OA. Inhibiting the bone metabol ism of subchondral bone could slow the degeneration of articular cartilage. Conclusion For the treatment of OA, it is necessary to pay close attention to cartilage changes and the prevention of subchondral bone degeneration.
Adenoid hypertrophy in children with epilepsy is rarely reported. This paper analyzes the clinical characteristics and incidence of adenoid hypertrophy in children with epilepsy.Methods The clinical data in children with epilepsy from December 2014 to April 2020 in Shenzhen Children's hospital were analyzed retrospectively.Results There were 449 cases diagnosed with adenoid hypertrophy (2.74%) in 16387 children with epilepsy. Among 449 cases of adenoid hypertrophy, 276 males (61.47%) and 173 females (38.53%). The age distribution was: 28 days to 1 year old, 8 cases (2%); 1-3 years old, 78 cases (17%); 3-6 years old 167 cases (37%); 6-12 years old, 153 cases (34%); 12-18 years old, 43 cases (10%). In 40 patients the IgG antibody were positive for EB capsid antigen in 25 (62.5%). In 56 cases of EB virus DNA were detected by fluorescence quantitative PCR, 25 (44.64%) positive, and 21/44 cases (47.72%) were positive by general nucleic acid detection of enteroviruses. The neutrophil reduction rate in peripheral blood was 42.19% in 673 tests, lymphocyteincreased in 292 (43.38%), platelet count increased in 307 (45.61%), abnormal in platelet hematocrit in 311 (46.21%); the mean volume of RBC was decreased in319 (47.39%) tests. The content of \begin{document}${\rm{HCO}_3^-} $\end{document} was reduced in 20/55 cases (36.36%). 25-hydroxy vitamin D was 33 (44.5%) decreased in 74 cases. The blood glucose was measured in 146 cases, 60 (41.09%) increased, total cholesterol was 31 (40.78%) increased in 76 cases, serum C peptide was 12 (29.26%) increased in 41 cases.Conclusion Adenoid hypertrophy in children with epilepsy may be related to infection, inflammation or immune disorder, which may cause nutritional, metabolic or internal environment disorders. Therefore, there is need of nursing and health education, transferring to specialized centers for diagnosis and treatment.
Objective To investigate the etiology, diagnosis, revascularization of upper l imb ischemia and the compl ications. Methods From March 2003 to February 2008, 72 cases of upper l imb ischemia were treated. There were 44males and 28 females, aged 19-90 years old (median 63 years old). The duration of the disease was 1 hour to 2 years. All cases had symptoms of l imb ischemia such as paleness, coldness, paralysis. According to individual condition, 72 patients accepted revascularizations including thromboembolectomy, reconstruction after traumatic injuries, pseudoaneurysm excision and angioplasty, balloon dilatation and stent implant, arterial repair, patch, vascular prosthesis or vein bypass/transplantation, and l igation or coarctation of fistula. Results Sixty patients (83.3%) recovered well after operation. Re-occlusion following thromboemboletomy was found in 6 patients (8.3%). And there were 4 patients (5.6%) with l imbs disturbance and muscles contracture and 2 patients (2.8%) with compartment syndrome in this series. The affected l imb had to be amputated in 2 patients (2.8%). And 1 patient (1.4%) died of cerebral hemorrhage because of anticoagulation 3 days after operation. All patients were followed up 1-6 years (mean 52 months) after operation. Four patients recurred and got improved after retreatments. The others got a good result with normal skin color and temperature, restoration of the radial and ulnar pulses, normal saturation of blood oxygen of finger ti p (gt; 90%) and patent blood flow of affected arteries was shown by color Doppler ultrasound. Conclusion The study indicates that identifying the etiology of upper l imb ischemia before operation and active revascularizations consistent with different causes are the key to treat the upper l imb ischemia.
Objective To investigate the diagnosis and treatment of pulmonary arterial hypertension ( PAH) due to rare causes. Methods The clinical presentation, laboratory testing, diagnosis and treatment of 4 patients with PAH associated with rare causes in Beijing Anzhen Hospital from January 2001 to March 2008 were analysed retrospectively. Results Primary biliary cirrhosis, hyperthyroidism, antiphospholipid syndrome and pulmonary artery sarcoma may cause PAH, which were improved after corresponding diagnosis and management. Conclusion PAH can result from rare causes. The enhancement of its recognition will help earlier diagnosis and treatment and improve the prognosis.
Objective To study the etiology of primary intrahepatic stones. MethodsThe literatures in the recent years on the etiology of intrahepatic stone were revieved. Results The formation of intrahepatic stone mainly caused by bacteria infection, parasitic infestation, bile stasis, congenital anatomic abnormalities and immunoreaction of bile tract. Further investigation found that metabolic, low protein diet, environment and ethnic factors and gene mutation were considered to play important roles in the formation of the intrahepatic stone. Conclusion The formation of intrahepatic stone is complex and are result of multiple factors. It closely related to the infection and stasis of the bile duct.
Atrial fibrillation (AF) as a most frequent arrhythmia has a high incidence of 79% in patients with mitral valve disease. Thrombosis, embolization and serious arrhythmia can be caused by AF. There is the recrudescent tendency in using drugs to recover the sinus rhythm, surgery and radio frequency ablation can only cure a part of patients. By now the pathogenesis of AF is not known clearly. The pathogenesis of AF from virulence gene, cardiac electrophysiology, connecxins, cell ultramicrostructure and cell signaling system are reviewed in this article.
ObjectiveTo summarize recent progress in surgical management of progressive hemifacial atrophy (PHA), to analyse the key features of various methods of treatment, and to define subjects worthy of further researches. MethodsThe publications concerning the etiology and surgical management of PHA were reviewed, analyzed, and summarized. ResultsSurgical management serves as the primary treatment, including flap transposition, tissue flap reconstruction, free tissue grafting, prosthetic implants, and other surgical treatments. Each method has its own advantages and limitations. At present, comprehensive treatment are considered to be the most commonly method for PHA. ConclusionThe combined use of various surgical methods is the trend of surgical management of PHA; effective treatments specific to the etiology and minimally invasive surgical methods are still to be developed.