Advances in Clinical Medicine
ISSN / EISSN : 2161-8712 / 2161-8720
Published by: Hans Publishers (10.12677)
Total articles ≅ 3,341
Latest articles in this journal
Advances in Clinical Medicine, Volume 12, pp 2947-2952; https://doi.org/10.12677/acm.2022.124425
The digestive system provides energy for systemic metabolism and maintains life needs through digestion, absorption, material conversion and other functions. There is a physical barrier between the mucosal epithelium or endothelium of the digestive system. This physical barrier can prevent harmful substances from invading the digestive tract mucosa and reduce the occurrence of digestive system diseases. Its structure mainly includes tight junction, gap junction, adhesive junction and desmosomes. Tight junction plays a major role in maintaining the functional stability of mucosa. The translocation of pathogenic microorganisms, the invasion of endotoxin and macromolecular substances and drugs eventually lead to digestive system diseases by destroying the tight junction structure and function between two adjacent cells. Tight junction is a structural complex, including membrane proteins and cytoplasmic proteins. In recent years, there have been many studies on the relationship between tight junction related proteins and digestive system diseases. This paper mainly expounds the relationship between zonula occludens-1 (ZO-1) in tight junction and digestive system diseases.
Advances in Clinical Medicine, Volume 12, pp 3111-3116; https://doi.org/10.12677/acm.2022.124449
Macrolides are the first-line antibiotics for the treatment of Mycoplasma pneumoniae pneumonia. Resistance to macrolides is one of the main causes of refractory Mycoplasma pneumoniae pneumonia. In recent years, the resistance of macrolides has increased rapidly, especially in Asia, which produces great difficulties for clinical treatment. Fluoroquinolones and tetracyclines have shown benefits in shortening the duration of symptoms of Mycoplasma pneumoniae pneumonia. However, for the safety of second-line drugs in children, clinicians should balance the risks and benefits when choosing treatment options. This article will review the efficacy and safety of fluoroquinolone and tetracycline in the treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.
Advances in Clinical Medicine, Volume 12, pp 3060-3065; https://doi.org/10.12677/acm.2022.124441
Cockayne syndrome (CS) is an autosomal recessive genetic disease with various clinical manifestations. The main pathogenic genes are ERCC6, ERCC8. It’s associated with defects in transcription-coupled nucleotide excision repair (TC-NER), and may be related to defects in transcription, base excision DNA repair, mitochondrial functions, etc. The main clinical manifestations were growth failure, developmental retardation/regression, microcephaly, cutaneous photosensitivity, hearing and visual impairment, presenile face and so on. Neuroimaging shows characteristic performance including leukodystrophy, brain atrophy and intracranial calcification. Its clinical phenotype is divided into CS type I (classical), CS type II (severe) and CS type III (mild). Ultraviolet Susceptibility syndrome (UVSS) and Cerebro-oculo-facio-skeletal Syndrome (COFS) are its variants. It is a rare disease, with a prevalence of approximately 2.7 per million. At present, there are mostly case reports about this disease in China. This article reviews the clinical manifestations, molecular genetics, diagnosis and treatment of the CS in order to improve the knowledge of the disease.
Advances in Clinical Medicine, Volume 12, pp 3047-3052; https://doi.org/10.12677/acm.2022.124439
The YY1 protein is a multifunctional DNA-binding protein with a zinc-finger structure, the present study found that it’s closely related to the occurrence and development of hematological malignancies. YY1 protein binds to the target genes or protein factors of tumor cells, and plays a dual role of activation or inhibition in a series of biological processes, such as tumor proliferation, transcriptional regulation, metabolic reprogramming, and drug resistance. In recent years, hematological malignancies have become one of the most common malignancies, so this paper summarizes the biological function of YY1 protein in hematological malignancies, expounds the correlation of YY1 protein in hematological malignancies, and summarizes the research progress of YY1 protein in hematological malignancies.
Advances in Clinical Medicine, Volume 12, pp 3073-3078; https://doi.org/10.12677/acm.2022.124443
Patients with chronic kidney disease are prone to cardiovascular system involvement, which can cause changes in left ventricular function. Echocardiography has become the most commonly used non-invasive evaluation of cardiac function technology, bringing many conveniences in clinical work.
Advances in Clinical Medicine, Volume 12, pp 3087-3092; https://doi.org/10.12677/acm.2022.124445
The number of patients with severe burns is increasing. The treatment and prognosis of severe burns are very important. Severe burns can often lead to the destruction of the patient’s immune system, systemic multiple organ failure, and severe stress, inflammation, and negative nitrogen balance which can cause infection and fever on the wound. After burn, catabolism is enhanced and protein decomposition is accelerated, resulting in increased consumption of muscle, fat and other tissues of the whole body. Recombinant human growth hormone (rhGH) can regulate and increase collagen deposition on wound surface, speed up wound healing, increase nitrogen, phosphorus and potassium reserves, inhibit protein decomposition, promote protein synthesis, thus correcting negative nitrogen balance and hypoproteinemia in burn patients. It can also inhibit the inflammatory response and thereby inhibit intestinal infections.
Advances in Clinical Medicine, Volume 12, pp 3855-3860; https://doi.org/10.12677/acm.2022.125557
A 60-year-old male patient was admitted to the Department of Cardiovascular Medicine of our hos-pital because of chest tightness and suffocation for more than half a year after emotional agitation, accompanied by palpitation, dizziness and headache. He has a history of hypertension for 13 years and has been regularly taking “valsartan amlodipine tablets” for hypotensive for many years. His blood pressure has never been well controlled during the medication, with the highest value being 200/100 mmHg, with 10 years after intracranial aneurysm embolization for subarachnoid hemor-rhage, and half a year after retinal detachment in the right eye. The patient denied smoking and drinking history, family history of cardiovascular disease and early onset hypertension. On admis-sion, heart rate was 65 times/min, blood pressure was 155/99 mmHg, general condition and con-ventional physical examination were negative. The results of blood potassium and blood sodium were 1.6 mmol/L and 147.8 mmol/L, respectively. Urine analysis showed PH 6.0, and plasma al-dosterone levels increased in vertical position 511 pg/mL and recubitus position 655 pg/mL re-spectively. The plasma renin activity was decreased by 0 ng/mL/hr in vertical position and 0 ng/mL/hr in recubitus position, and the aldosterone/renin activity ratio (ARR) was increased by 51.1 in vertical position and 65.5 in recubitus position. Dynamic enhanced adrenal CT scan showed low- density nodular opacity in both adrenal glands, which was considered as primary aldosteron-ism caused by adrenal cortical adenoma. Then, the patient was transferred to the urology depart-ment for retroperitoneal laparoscopic left adrenal gland resection, which was pathologically diag-nosed as adrenal cortical adenoma. The plasma aldosterone, blood potassium, blood sodium and other biochemical indexes were all in the normal range and blood pressure was normal 2 weeks af-ter surgery.
Advances in Clinical Medicine, Volume 12, pp 2940-2946; https://doi.org/10.12677/acm.2022.124424
Objective: To observe the changes of various bile acids level in bile within 7 days after liver transplantation, and to explore the predictive value of their changes in early allograft dysfunction (EAD) after liver transplantation. Methods: In this paper, 40 patients with orthotopic liver transplantation from July 2020 to December 2020 were selected retrospectively. According to the diagnostic criteria of EAD proposed by Olthoff et al. in 2010, the patients were divided into EAD group and non-EAD group. The bile of the patients was collected on the 1st, 3rd, 5th and 7th day after operation, and the changes of various bile acids in the bile of EAD group and non-EAD group were compared on the 1st, 3rd, 5th and 7th day after operation. ROC curve was used to evaluate the predictive value of the changes of bile acid levels in bile for EAD after liver transplantation. Results: According to the data, the GDCA level measured in EAD group was lower than that in non-EAD group on the 1st day after operation, the GCA and GDCA levels measured in EAD group were higher than that in non-EAD group on the 5th day after operation, and the TLCA, GCDCA and GDCA levels measured in EAD group were higher than that in non-EAD group on the 7th day after operation; it is compared between groups (P < 0.05). According to the ROC curve, on the 7th day after operation, the AUC of GCDCA in bile for judging the early postoperative EAD is 0.762, which is the same as the 7th day, the AUC of TLCA level in bile for judging the early postoperative EAD is 0.754, and on the 5th day after operation, the AUC of GCA level in bile for judging the early postoperative EAD is 0.721. Conclusion: The bile of patients on the 1st, 3rd, 5th and 7th days after liver transplantation was taken, and the contents of various bile acids in the bile were measured. The levels of GCDCA, GCA and TLCA in the bile within 7 days after liver transplantation will increase. The levels of GCDCA, GCA and TLCA have a certain predictive value for the early occurrence of EAD in patients after liver transplantation, to guide the early treatment.
Advances in Clinical Medicine, Volume 12, pp 6-12; https://doi.org/10.12677/acm.2022.121002
Infective endocarditis in children is more common in children with heart diseases. It is an endocardial inflammatory lesion caused by pathogenic infection, which can involve multiple systems of the whole body, complex and diverse clinical manifestations, difficult early diagnosis, long hospital stay, high hospitalization cost and a relatively high mortality rate. Blood culture and echocardiography are important basis for diagnosis. This paper reviews the etiology, diagnosis and treatment of infective endocarditis in children, so as to provide ideas for early diagnosis and reasonable treatment.
Advances in Clinical Medicine, Volume 12, pp 13-18; https://doi.org/10.12677/acm.2022.121003
The syndesmosis ligament is a soft tissue complex that provides flexibility and stability to the ankle joint. These ligaments maintain stability between the distal tibia and the fibula. When these ligaments break in a severe ankle sprain, the distal fibula migrates and can no longer provide a stable lateral support to the ankle. The importance of accurate simultaneous reduction and fixation after distal tibiofibular syndesmosis injury has been proven. The gold standard for surgical treatment of distal tibiofibular syndesmosis injury is still fixation of the fibula to the tibia with screws, but there are many controversies regarding the position, quantity, size and number of penetrating cortex of screws. With the development of finite-element technology, the reliability of the finite-element model of the ankle joint established by this technology has been widely confirmed. More and more scholars have applied this technology to study the condition of screw fixation of the tibiofibular syndesmosis injury. Therefore, this paper mainly reviews the study of screw fixation tibiofibular injury by finite element method.