Background: MYRF -related mild encephalopathy with reversible myelin vacuolization (MMERV) is an inherited neurological disorder characterized by dysfunction in the central nervous system and widespread reversible leukoencephalopathy. This paper presents a confirmed case of familial MMERV and summarizes pertinent features to offer guidance for future diagnosis and treatment of MMERV. Case Introduction: We have diagnosed a case of MMERV based on a history of seizures during early childhood and recurrent speech fluency issues in adulthood, reversible abnormal intensities in bilateral white matter in the centrum semiovale and corpus callosum, and the identification of myelin regulatory factor ( MYRF ) heterozygous variants. Conclusion: MYRF -related mild encephalopathy with reversible myelin vacuolization is a rare autosomal dominant genetic disease, with early clinical manifestations often being seizures. The definitive diagnosis of MMERV can be confirmed through genetic analysis. Minimizing infections can help reduce disease recurrence. However, future research should explore the impact of MYRF heterozygous variants in the wider MMERV population.
Biliary obstruction is one of the most important biliary complications after liver transplantation, with high incidence and high mortality. Prevention and timely treatment is very important for long-term survival of patients. Magnetic resonance cholangiography (MRCP), as a reliable and non-invasive tool for detecting biliary complications, has been widely accepted. Endoscopic retrograde cholangiopancreatography (ERCP) is the first choice for non-operative biliary obstruction after liver transplantation. The patients with invalid endoscopic treatment or severe obstruction symptom should have surgical therapy or liver re-transplantation.
Key words:
Cholestasis; Liver transplantation; Cholangiopancreatography, magnetic resonance; Cholangiopancreatography, endoscopic retrograde
Objective
To explore the effects of vascular risk factors on cognitive function among the elderly in community.
Methods
A cross-sectional study was conducted in 1 269 elderly people (aged 65 and over) who were randomly selected from three communities.Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE), and blood samples were collected for laboratory examination.Logistic regression analysis was used to analyze the vascular risk factors affecting cognitive function.
Results
Age ((73.1±6.6), (71.3±4.9), t=4.603, P<0.05), education level (χ2=12.727, P<0.05), hypertension (χ2=9.106, P<0.05) and LDL-C (χ2=5.157, P<0.05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age, gender and education, the logistic regression analysis showed that hypertension(β=0.378, P=0.006, OR(95%CI)=1.44(1.10-1.91)), systolic blood pressure ≥140 mmHg(β=0.350, P=0.011, OR(95%CI)=1.42(1.08-1.86), 1 mmHg=0.133 kPa), and high LDL-C(β=0.355, P=0.014, OR(95%CI)=1.43(1.08-1.89)) were the risk factors of MCI in the elderly in the community.Hypertension alone or high LDL-C (β=0.365, P=0.029, OR(95%CI)=1.44(1.04-2.00)) alone was risk factor for mild cognitive impairment in the elderly in the community.The risk of mild cognitive impairment in the elderly with hypertension and high LDL-C was 2.00 times higher than that in the healthy elderly (β=0.696, P<0.05, OR(95%CI)=2.00(1.36-2.97)).
Conclusion
Mild cognitive impairment in the elderly is closely related to hypertension and elevated LDL-C levels.Multiple vascular risk factors can further increase the risk of cognitive impairment.
Key words:
Cognitive impairment; Vascular risk factors; Hypertension; Elderly
Bisdemethoxycurcumin (BDMC) is a demethoxy derivative of curcumin. In this study, a human gastric adenocarcinoma xenograft model was generated in vivo using nude mice and BDMC was observed to suppress the growth and activity of tumors, in addition to improving the physical and mental capacity of the mice. An increased number of apoptotic cells, decreased ratio of B‑cell lymphoma 2 (Bcl‑2)/Bcl‑2‑associated X protein and increased caspase‑3 expression was also observed following treatment with BDMC, indicating that BDMC may promote apoptosis in tumors via mitochondrial modulation. The growth of SGC 7901 gastric cancer cells was inhibited and arrested at G1 phase. Specific indicators of mitochondrial dysfunction, a reduction in adenosine triphosphate generation, the inner mitochondrial membrane potential, augmentation of reactive oxygen species production and cytochrome c were also detected in the mitochondria following treatment with BDMC. These results indicate that BDMC attenuates gastric adenocarcinoma growth by inducing mitochondrial dysfunction.
Hiatal hernia (HH) is a common gastrointestinal disorder characterized by the displacement of abdominal contents, particularly the stomach, into the thoracic cavity. This condition is frequently associated with gastroesophageal reflux disease (GERD) and can lead to various symptoms, including chronic cough and respiratory issues. Despite its prevalence, the mechanisms linking psychological factors to HH are not well understood. Observational studies have suggested correlations between mental health issues – such as stress, anxiety, and depression – and gastrointestinal disorders, indicating that emotional states may influence the development of HH. This study aims to clarify the causal relationships between mood swings, depression, and the risk of developing HH using Mendelian randomization (MR), a robust method that utilizes genetic variants as instrumental variables (IVs) to infer causality. Data for this MR analysis were obtained from publicly available genome-wide association studies (GWAS). We employed a bidirectional, 2-sample MR approach, using IVs associated with mood swings, depression, feelings of tension, and feelings of misery as exposures, with HH as the outcome. A reverse MR analysis was also conducted, treating HH as the exposure and the aforementioned emotional states as outcomes. The primary analytical method used was inverse variance weighting (IVW), supplemented by sensitivity analyses, including MR-Egger and weighted median methods. Our analysis revealed significant associations: mood swings (OR = 1.014; 95% CI = 1.001–1.027; P = .032), depression (OR = 1.019; 95% CI = 1.006–1.033; P = .003), feelings of tension (OR = 1.012; 95% CI = 1.004–1.020; P = .001), and feelings of misery (OR = 1.007; 95% CI = 1.003–1.010; P = .0001) significantly increased the risk of HH. Importantly, reverse MR analysis indicated no causal influence of HH on these emotional states. This study provides evidence that mood swings, depression, feelings of tension, and feelings of misery are significant risk factors for developing HH. These findings highlight the need to address psychological factors in the clinical management and prevention strategies for HH, potentially improving patient outcomes.
Abstract Background Pancreatic fistula is a common complication after pancreaticoduodenectomy, which could be caused by: soft pancreatic tissue, pancreatic duct diameter < 3 mm and body mass index ≥25 kg/m 2 . Here we report a case of pancreatic fistula due to obstruction of the jejunal loop due to compression of the jejunal loop by the superior mesenteric vessels. Case presentation A 68-year-old man was admitted to our ward due to intermittent epigastric distension and pain. After various examinations and treatments, he was diagnosed with middle bile duct cancer. Pancreaticoduodenectomy was performed, and pancreaticojejunostomy and hepaticojejunostomy were completed by lifting the jejunal loop from behind the superior mesenteric vessels to the upper region of the colon. On postoperative day 9, the patient developed acute diffuse peritonitis, and on postoperative day 10, the patient underwent a second exploratory laparotomy, during which it was confirmed that the pancreatic fistula was caused by obstruction of the jejunal loop due to compression of the jejunal loop by the superior mesenteric vessels, then the patient recovered and was discharged alive after retrograde drainage in the jejunum. Conclusions The superior mesenteric vessels after pancreaticoduodenal surgery can compress the jejunal loop and cause obstruction leading to serious complications, and it is recommended that general surgeons should avoid lifting the jejunal loop from the posterior aspect of the superior mesenteric vessels to complete the anastomosis.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)