Objective
To evaluate the efficiency and security of physical exercise with low intensity against malnutrition and sarcopenia in patients with cirrhosis.
Methods
Between December 2014 and October 2015, 37 patients with cirrhosis were divided into two groups according to their willings, with 19 in the exercise group and 18 in the control group. Endurance of the exercise for 3 months were recorded. Mid-arm circumference, " up and go” time, width of portal vein and Child-Pugh score were compared before and after the research between the two groups.
Results
Three months later, the mid-arm circumference and the " up and go” time of the exercise group [(33.99±2.15) cm, (9.17±0.35) s] were better than those before the exercise [(32.09±2.58) cm, (9.77±0.46) s] and those in the control group [(31.93±2.04) cm, (9.76±0.30) s], and the differences above were all statistically significant (P<0.05). The change of the width of portal vein was positively correlated with pre-exercise body mass index in overweight patients (r=0.93, P=0.007).
Conclusions
Physical exercise with low intensity is safe and effective against malnutrition and sarcopenia in patients with cirrhosis. Overweitht patiens or malnutrition at the early stage may benefit more.
【摘要】 目的 探討肝硬化食管靜脈曲張程度與門脾靜脈內徑、肝功能Child-Pugh分級間的關系。 方法 對2007年1月-2010年1月間56例肝硬化患者行增強CT，測量門靜脈主干及脾門部脾靜脈直徑，采用Child-Pugh分級標準進行肝功能分級，并行胃鏡了解食管靜脈曲張的程度。 結果 食管靜脈曲張程度與門、脾靜脈內徑呈正相關，而Child-Pugh分級與門脾靜脈內徑、食管靜脈曲張程度無相關性。 結論 根據門、脾靜脈內徑可預測肝硬化上消化道出血的可能性；在Child-Pugh分級基礎上對患者上消化道出血的風險進行評估顯得尤為重要。【Abstract】 Objective To discuss the relationship among the esophageal varices, the diameter of portal vein and spleen vein, and Child-Pugh score in patients with liver cirrhosis. Methods The study included 56 patients who had liver cirrhosis between January 2007 and January 2010. We measured their portal vein and spleen vein diameter with CT; used Child-Pugh score to grade their hepatic function; and detected the degree of the esophageal varices by endoscopy. Results There was a positive correlation between the degree of esophageal varices and diameter of portal vein and spleen vein, while no correlation showed between portal vein and spleen vein diameter, degree of esophageal varices, and Child-Pugh score. Conclusion The upper gastrointestinal bleeding in patients with liver cirrhosis can be predicted by the diameter of portal vein and spleen vein, assessment of upper gastrointestinal bleeding based on Child-Pugh score should also be taken into account.
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.
Objective
To enhance the understanding of the primary salivary glandtype lung cancer (PSGLC) and improve the diagnostic rate of the disease.
Methods
The clinical data of 41 patients with PSGLC pathologically confirmed in West China Hospital between October 2009 and October 2015 were analyzed in terms of clinical features, therapy and prognosis.
Results
All the 41 patients (21 males and 20 females) accounted for 0.22% (41/18 738) of the primary malignant lung tumor diagnosed in the same period. The patients aged from 16 to 72 with the median age of 43.6. The disease course was 1 month to 6 years, and 12 had smoking history. There were 23 cases of adenoid cystic carcinoma, 15 of mucoepidermoid carcinoma and 3 of acinic cell carcinoma. The symptoms, chest-computed tomography and fiberbronchoscopy examination had no specificity. There were 34 patients who had undergone surgery, in whom 3 had fiberbronchoscopy, 4 had oral traditional Chinese medicine treatment, 5 had chemotherapy and radiotherapy at the same time, 9 received chemotherapy only, and 4 recived radiotherapy only. Follow-up period lasted for 2-65 months, with the median time of 38 months. Two patients had recrudescence, 6 patients had distant metastasis and 1 patient died.
Conclusions
PSGLC have no specific clinical features; its diagnosis basically rely on pathological examination. After comprehensive treatment mainly on surgery, the prognosis of the disease is better than other malignant lung cancers.
