Medicine
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Hypertension and insomnia are common diseases in the elderly. Oriental herbal medicine has been widely used in East Asia, and it has been considered as a promising alternative to conventional pharmacotherapy because of its efficacy in geriatrics. Moreover, since oriental herbal medicine acts on multiple targets, it may affect both hypertension and insomnia at the same time, which can reduce the risk of polypharmacy in this population. This systematic review will assess the efficacy and safety of oriental herbal medicine in the elderly with both insomnia and hypertension. ⋯ Our results will help clinicians and health policy makers take informed decisions regarding the use of oriental herbal medicine in the elderly. It will also provide evidence-based oriental herbal medicine data for elderly patients suffering from multiple diseases and their families.
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The clinical manifestations of VACTERL association include vertebral anomalies, anal atresia, congenital heart diseases, tracheoesophageal fistula, renal dysplasia, and limb abnormalities. The association of intrahepatic anomalies and VACTERL syndrome is a rare coincidence. VACTER syndrome and intrahepatic bile drainage anomalies might be genetically related. ⋯ Although hepatobiliary anomalies are not included in VACTERL association diagnostic criteria, detailed hepatobiliary work up is needed when gastrointestinal symptoms are present in VACTERL association patients.
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Case Reports
Α-fetoprotein producing hepatoid gastric adenocarcinoma with neuroendocrine differentiation: A case report.
Hepatoid gastric adenocarcinoma is a rare type of gastric cancer. The phenomenon of neuroendocrine differentiation (NED) in gastrointestinal tumor needs further research. Both hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. However, there is still no specific treatment. ⋯ Hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. It relapses easily. Long-term follow-up and regular examinations are necessary to detect relapses.
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Colonic lipomas are rare benign tumours, usually without any symptoms, and most occur in the caecum and ascending colon. We describe a patient with upper rectal intussusception caused by a giant rectal lipoma; no similar report of this type of case has been published. ⋯ Laparoscopic segmental resection of the rectum with LCA preservation is safe and feasible for the treatment of upper rectal intussusception caused by a giant rectal lipoma.
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Comparative Study Observational Study
Quantitative evaluation of myocardial layer-specific strain using two-dimensional speckle tracking echocardiography among young adults with essential hypertension in China.
The myocardial wall of the left ventricle is a complex, multilayered structure, which is altered in young adults with hypertension. The aim of this study was to define the characteristics of longitudinal and circumferential strain in young adults with hypertension. Two-dimensional speckle tracking echocardiography was used to analyze longitudinal and circumferential strain parameters in 67 young adults with hypertension, 70 older young adults with essential hypertension and 62 healthy adults. ⋯ This study provides reference values for layer-specific strain in young adults with hypertension. This detailed strain analysis provides layer-oriented information to reveal the different characteristics of circumferential and longitudinal strain in young adults with hypertension. This systolic dysfunction could be detected conveniently and accurately by 2DSTE.