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Small Intestine Intussusception Induced by Juvenile Polyps：A Systematic Literature Review

目的　提高对幼年性息肉致小肠套叠的诊治水平。方法　按检索策略，检索PubMed、中国生物医学文献数据库（CBM）、中文科技期刊全文数据库（CSJD）、中国期刊全文数据库（CJFD）及CNKI数字图书馆的相关文献，并结合笔者所在医院于2011年收治的1例幼年性息肉致小肠套叠病例资料，对该病进行一系统的描述。结果　共检出相关文献65篇，按纳入及排除标准，最后纳入6篇文献。共7例患者，临床表现为腹痛、呕吐5例，便血2例，贫血3例；经超声检查诊断4例；全组均行小肠切除肠吻合术，其中1例为腹腔镜辅助手术；有1例患者共实施了3次手术，最后死于恶液质，其余患者恢复较好。结论　幼年性息肉致小肠套叠为临床罕见疾病，超声检查仍为首选诊断方法；提高医师对该病的认识，术中彻底探查肠道，必要时术中行快速冰冻切片病理学检查，有望减少息肉遗留，改善患者的预后。

原发性纵隔骨肉瘤一例

关于乳腺癌根治术后局部复发的一点思考（附1例报道）

目的探讨乳腺癌根治术后局部复发治疗方法的选择。 方法回顾性分析中国人民解放军空军总医院收治的1例乳腺癌根治术后局部复发患者的临床资料，并进行文献复习。 结果本例患者行左乳腺癌改良根治术后8年出现复发并转移，接受“化疗-放疗-化疗”综合治疗后，取得了良好的治疗效果，复查胸部CT检查示术区未见异常软组织影及肿瘤复发。 结论有多种因素影响乳腺癌局部复发患者治疗方法的选择，通过制定个体化治疗方案，可以局部控制局部复发乳腺癌，并减少肿瘤的远处转移，提高患者的生存率。

Fungal pulmonary embolism: two cases report and literature review

Objective To investigate the clinical characteristics and diagnosis and treatment of fungal pulmonary embolism, and to improve the understanding of this disease. Methods The diagnosis and treatment of two patients with fungal main pulmonary embolism in the First Affiliated Hospital of Guangzhou Medical University were summarized and analyzed. Literatures were retrieved from Wanfang database, China national knowledge internet database and Pubmed database with search terms of “pulmonary embolism AND mucor”, “pulmonary embolism AND aspergillus”, “pulmonary embolism AND fungi”, “pulmonary embolism AND Candida”, “pulmonary embolism AND cryptococcus”. Results Case 1, a 53-year-old female was referred, with cough, high fever, breathlessness for 2 years, chest pain for 1 year. The patient had rheumatoid arthritis and systemic lupus erythematosus history with long term prednisone treatment. Finally, the patient was diagnosed main pulmonary artery embolism (aspergillus) and disseminated aspergillosis. Although treatment with voriconazole, amphotericin B, and caspofungin were given for more than 1 year, the patient died with uncontrolled aspergillus infection. Case 2, a 67-year-old female was referred with cough, chest distress, chest pain for 8 months, breathlessness for 6 months. The patient had a history of chronic viral hepatitis C. Finally the patient was diagnosed as main pulmonary artery embolism and pulmonary valve endocarditis (aspergillus, mucor). The patient underwent pulmonary artery lesion resection and tricuspid valvuloplasty (DeVega method). After surgery, the patient was delivered with amphotericin B and posaconazole for 3 months. During the follow-up period of 1 year, the patient recovered almost totally without relapse signs. A total of 42 cases of fungal pulmonary embolism from 1980 to 2021 were retrieved (including 2 cases in this article), and 6 of these cases were main pulmonary artery embolism. Of all the cases, the median age was 49 years and 22 (54.3%) were males. 20 cases were immunocompromised. The infection pathogens included: Aspergillus (21, 50%), Candida (11, 26.2%), Mucor (7, 16.7%), and Aspergillus combined with Mucor (1, 2.5%), Coccidioides spp (1, 2.5%), and Cryptococcus (1, 2.5%). Fifteen cases were complicated with infection other than cardiopulmonary. Twenty-two cases were treated with surgery combined with antifungal medicine, and 9 cases with antifungal medicine alone. Twenty-two cases were dead and the overall mortality rate was 52.4%. There were statistically significant differences in the effects of fungal species, dissemination of other organs other than the heart and lung, and surgical treatment on the survival rate. The survival rate of different fungal species was significantly different. Dissemination to organs other than the heart and lungs reduces survival, whereas surgical treatment improves survival. Conclusions Fungal pulmonary embolism, a disease with high mortality, rarely involves the main pulmonary artery. The possibility of fungal pulmonary embolism should be considered when the cause of pulmonary thrombosis is unknown and the anticoagulant effect is poor. Although there is no unified treatment at present, early surgical combined with standard antifungal treatment may improve the prognosis of patients.

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.

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。

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.

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.

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.

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。