Medicine
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The MYOC gene is associated with juvenile open-angle glaucoma (JOAG). This study aims to provide genetic counseling for a Chinese JOAG family by detecting MYOC mutations to identify high-risk individuals for early JOAG intervention. It also supplements the clinical characteristics of glaucoma patients with MYOC gene mutations. ⋯ MYOC c.1099 G > A was identified as a pathogenic gene of JOAG in this pedigree. The addition of the MYOC mutant spectrum to JOAG in the Chinese population facilitates a complete understanding of the molecular pathogenesis and clinical diagnosis of MYOC.
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Warfarin is the most commonly used drug in patients with mechanical valve replacement. Acute liver damage after warfarin is rare but potentially harmful. We present a case of warfarin-induced gastrointestinal bleeding with liver injury, pharmacy monitoring, and its therapy. ⋯ Close monitoring and immediate dose adjustment of warfarin and to avoid drug-drug interaction. Timely stopped warfarin, adjusted INR and anti-inflammatory liver therapy may reduce the occurrence of warfarin-induced liver failure.
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Studies have shown that gut microbiota (GM) and its metabolites, short-chain fatty acids (SCFAs), are associated with the development of postmenopausal osteoporosis (PMO). This study explored the clinical and laboratory evidence of the relationship of GM and SCFAs to PMO and attempted to determine the potential mechanism of action. 18 patients (Collected from the First Affiliated Hospital of Guangdong Pharmaceutical University between January 2021 and August 2021) were included in this retrospective study, including 10 PMO women and 8 healthy young women as the healthy control (HC) group from Guangzhou, China. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry. ⋯ Subdoligranulum and Norank_f_Muribaculaceae were also positively correlated BMD_F and propanoic acid, while Subdoligranulum is the only species that presented a strong correlation with the levels of acetic acid and butyric acid. Our findings indicated that, in postmenopausal women, there were evident changes in GM and SCFAs, and these changes were found correlated with patients' BMD. These correlations provide novel insights into the underlying mechanism of PMO development, representative of early diagnostic markers and therapeutic targets that may improve the bone health in postmenopausal women.
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Acute upper gastrointestinal bleeding (UGIB) is a critical emergency. Conventional scoring models for patients with UGIB have limitations; thus, more suitable tools for the Emergency Department are necessary. We aimed to develop a new model that can identify significant predictors of Intensive Care Unit (ICU) admission in Emergency Department patients with UGIB and to compare its predictive accuracy with that of existing models. ⋯ We implemented this model in a user-friendly calculator for clinical use. We identified key predictors of ICU admission that are crucial for hemodynamic stabilization in patients with UGIB. Our model, combined with this probability calculator, will enhance clinical decision-making and patient care for UGIB in emergency settings.
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Observational Study
Risk factors for the occurrence of arytenoid dislocation after major abdominal surgery: A retrospective study.
The incidence of arytenoid dislocation in abdominal surgery is relatively high, the cause is unknown, and it has not received sufficient attention. To identify the risk factors of arytenoid dislocation after abdominal surgery, and to establish a clinical prediction model based on relevant clinicopathological characteristics. We retrospectively collected the clinical data of 50 patients with arytenoid dislocation (AD) and 200 patients without AD after abdominal surgery with general anesthetic tracheal intubation in our Hospital from January 2013 to December 2019. ⋯ The calibration plot shows that the prediction curve was close to the ideal curve. Patients undergoing abdominal surgery with general anesthesia exhibit a significantly higher incidence of AD due to a combination of factors. Clinicopathological features can be used as an independent predictor of risk in patients with AD, and a clinical model has been developed that is a good predictor of AD.