Journal of the Chinese Medical Association : JCMA
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In late December 2013, a deadly infectious epidemic, Ebola virus disease (EVD), emerged from West Africa and resulted in a formidable outbreak in areas including Guinea, Liberia, Sierra Leone and Nigeria. EVD is a zoonotic disease with a high mortality rate. ⋯ Currently, there is no standard treatment for EVD. To promptly identify patients and prevent further spreading, physicians should be aware of travel or contact history for patients with constitutional symptoms.
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Surgery is the main treatment for curing gastric cancer. Early diagnosis provides an excellent survival outcome via an improved detection of early gastric cancer and an improved resection rate. The extent of lymphadenectomy surgery has been under debate for a long time. ⋯ Adjuvant or perioperative chemotherapy should be prescribed for gastric cancer with Stage II or III disease, due to its marked benefits of reducing disease recurrence and increasing long-term survival. Patients with inoperable advanced gastric cancer should receive chemotherapy to improve their survival and quality of life if an acceptable performance status can be achieved. Targeted therapy with trastuzumab should be considered in patients with HER-2/neu overexpression who have a higher response rate and a longer survival.
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Chronic visceral pain is the predominant symptom of functional gastrointestinal disorders and chronic pancreatitis. Such pain can impair the patients' quality of life, and can also serve as one of the principal reasons for these patients to seek medical help. Nevertheless, the underlying mechanisms of chronic visceral pain have remained unclear, and much of what we know about visceral pain has been derived from studies of somatic nociception. ⋯ Minocycline (a microglia inhibitor) reversed the hyperalgesia in rat models of chronic visceral pain, whereas fractalkine (FKN, a microglia activator) reproduced the visceral nociception in naïve rats. These preliminary results support the pronociceptive role of spinal microglia in mediating visceral hyperalgesia. Consequently, spinal microglia may serve as a promising target for controlling the chronic visceral pain.
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Contrast-induced nephropathy (CIN) is a common hospital-acquired acute kidney injury. Published studies on this condition have dramatically increased in recent years. This article aims to provide a brief literature review. ⋯ The other medications or techniques for reducing CIN risk are still unclear. CIN is a potentially preventable clinical condition. A careful review of published reports gives us a deeper understanding of CIN and a greater chance of decreasing its risk.
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Transesophageal echocardiography (TEE) is not only an invaluable diagnostic tool for cardiac patients, but also is essential for cardiac monitoring in critically ill patients in cardiac and non-cardiac surgery settings and in the differential diagnosis of unexplained hemodynamic collapse. The advantage of TEE over transthoracic echocardiography (TTE) is usually clearer images, especially when viewing structures that are difficult to see transthoracically. ⋯ Although TEE is considered to be relatively safe and noninvasive, TEE-associated complications, such as esophageal laceration, must be taken seriously. Recently, real-time three-dimensional (3D) TEE imaging has played an important role defining valvular and congenital abnormalities and aiding in operative and percutaneous repair.