目的 探究艾滋病(AIDS)合并马尔尼菲青霉病(PSM)的感染率，以及常规实验室检查结果和5种抗真菌药物对马尔尼菲青霉菌(PM)的体外抗菌活性。 方法 2006年1月-2009年11月间确诊AIDS患者326例，从其血液、骨髓培养出65株PM，检测该65例患者的血常规、肝功能和肾功能，并对20株酵母相PM进行体外药敏进行分析。 结果 AIDS合并PSM的感染率为19.94%；外周血常规：WBClt;4.0×109/L者48例，HBlt;100 g/L者51例，PLTlt;100×109/L者46例。肝功能检查：ALTgt;40 U/L者49，ASTgt;40 U/L者51例，GGTgt;60 U/L者44例，ALPgt;150 U/L者36例，ALBlt;35 g/L者53例，A/G倒置者50例。肾功能检查：BUNgt;7.2 mmol/L者9例，Crgt;150 μmol/L者4例。20株酵母相PM对5-氟胞嘧啶(5FC)、两性霉素B(AMB)、氟康唑(FCA)、伊曲康唑(ITR)、伏立康唑(VRC)的敏感率分别为75%、90%、80%、90%、90%。 结论 AIDS合并PSM感染率较高；患者感染后外周血WBC、HB、PLT通常低于正常人，肝功能多表现异常，肾功能的改变较少；对PM的治疗以AMB、ITR、VRC为首选。
Cryptogenic stroke (CS) accounts for 25% of ischemic stroke. The etiology of undetermined stroke is unclear leading to untargeted secondary prevention, high recurrence rate, so the clinical burden of cryptogenic stroke is substantial. Cardiac magnetic resonance (CMR) imaging can identify more occult cardiac embolism that cannot be identified by standard cardiac assessment based on its excellent spatial resolution and contrast, three-dimensional imaging capacity and ability to depict soft tissues, to accelerate the initiation of optimal secondary prevention and improve the prognosis of patients. This review summarizes the application of CMR in the field of CS in recent years. Based on the latest evidence of diagnosis and management strategies, this paper proposes a cardiac diagnostic examination plan for CS patients, thereby improving the secondary prevention strategy of CS patients and improving their quality of life.
ObjectiveTo summarize the relationship between Kupffer cells (KCs) and liver diseases.MethodsThe related literatures about the research progress of KCs in liver diseases in recent years were collected and analyzed.ResultsKCs were an important component of the monocyte-macrophage system. In a specific environment, activated KCs participated in a variety of inflammatory reactions, immune tolerance, and damage to hepatocytes by presenting antigens, secreting cytokines and chemokines, phagocytosis, and so on. KCs could not only be activated into M1 to promote inflammatory reaction and aggravate hepatocyte injury, but also could be activated to M2 to play an anti-inflammatory effect and improve liver injury. The role of KCs in liver diseases was very complex, but it also had potential research value.ConclusionKCs can affect the progression of liver diseases through many mechanisms and can provide new ideas for the prevention and treatment of liver diseases.
Heart transplantation remains the most effective treatment for patients with end-stage heart failure. Over the past decade, significant advancements have been made in the field of heart transplant surgery. However, the enormous demand from heart failure patients and the severe shortage of available donor hearts continue to be major obstacles to the widespread application of heart transplantation. With the development of donor heart recovery, preservation, and evaluation techniques, the use of extended criteria donors and donation after circulatory death has increased. These technological advancements have expanded the safe ischemic time and geographic range for donor heart procurement, significantly enlarging the donor pool and driving a rapid increase in heart transplant cases. Concurrently, many new techniques have emerged in heart transplant surgery and perioperative management, particularly the rapid advancements in mechanical circulatory support and artificial intelligence, which hold the potential to revolutionize the field. This article reviews and discusses the current status and major surgical advancements in adult heart transplantation in the United States, aiming to provide insights and stimulate ongoing exploration and innovation in this field.