We report an acute myocardial infarction patient with respiratory cardiac arrest in whom conventional cardiopulmonary resuscitation was invalid and extracorporeal cardiopulmonary resuscitation (ECMO) was performed. During ECMO, bloodstream infections caused septic shock. With the assistance of ultrasound and other techniques, cardiac function and volume status were evaluated, which provided a basis for making rational clinical decision. After shock resuscitation and anti-infection treatment, the patient's condition improved.

Objective

Toevaluatetheeffectivenessofcase-basedcollaborativelearning（CBCL）teaching mode in clinical teaching of coronary atherosclerotic disease complicated with chronic kidney disease.

Methods

Medical students with bachelor degree or above who received standardized training in nephrology department of our hospital from December 2022 to May 2024 were randomly divided into an observation group and a control group. The CBCL teaching mode was used in the observation group， while conventional teaching methods were used in the control group. After the same training period， the examination results of the two groups of students were analyzed and compared， and the effects of the two teaching methods were evaluated. And the satisfaction levels of the participating medical students with the training were collected through a questionnaire survey.

Results

A total of 30 medical students were included， with 15 in the observation group and 15 in the control group. Both the theoretical ［（95.29±2.99）vs （85.13±4.74）， P＜0.001］and operational ［（94.07±1.98） vs （86.47±6.49）， P＜0.001］assessment scores of the observation group students were higher than those of the control group. The observation group students showed higher satisfaction with the overall course （93.3%）， and the teaching mode （86.7%） （P＜0.05）. In terms of theoretical knowledge understanding and clinical thinking cultivation， the satisfaction of the observation group was also higher than that of the control group （P＜0.05）.

Conclusion

The application of CBCL teaching mode in the clinical teaching of coronary atherosclerotic disease complicated with chronic kidney disease could improve the theoretical and operational scores of the medical students as well as satisfaction from them.

Objective

To analyze the clinical phenotypes and renal transplantation outcomes in children with Papillorenal syndrome (PAPRS) caused by PAX2 gene variations, and to propose strategies for pre-transplant risk assessment and post-transplant management strategies.

Methods

A retrospective analysis was performed on the clinical data of four pediatric patients diagnosed with PAPRS at 900th Hospital of PLA Joint Logistic Support Force between 2018 and 2024. These patients underwent kidney transplantation at other medical institutions and were subsequently followed up at our hospital. Clinical data, including genetic variant types, clinical manifestations, postoperative complications, and multi-system abnormalities, were systematically evaluated.

Results

All patients carried novel heterozygous variations in the PAX2 gene (NM_000278.5), including c.221_226dup(p.E74_T75dup), c.185A＞G (p.H62R) (not previously reported in global or domestic databases),and c.76dup (p.V26Gfs*28) (two cases). These variations were located within a hotspot mutation domain. All patients were female and were diagnosed with abnormal renal function during school age,progressing to end-stage renal disease, leading to renal transplantation during adolescence.Postoperatively, all patients experienced varying degrees of infection and exhibited extrarenal manifestations, including ocular lesions such as refractive errors, visual field abnormalities,reproductive system abnormalities such as fallopian tube or ovarian lesions, and central nervous system abnormalities such as intellectual disability, mood disorders.

Conclusions

Variations in the PAX2 gene not only impair renal function, but also result in multi-systemic involvement, with a particular focus on neuropsychological assessment. Early psychological intervention is conducive to improving adherence to long-term follow-up management after renal transplantation.

Objective

To investigatethe clinical characteristics of local cases of severe fever with thrombocytopenia syndrome (SFTS) in Beijing.

Methods

The general condition, epidemiology, clinical symptoms and laboratory indicators of indigenous patients with SFTS admitted to Beijing Ditan Hospital,Capital Medical University from January 2023 to December 2024 were analyzed, retrospectively.

Results

Total of 15 local patients with severe fever complicated with thrombocytopenia syndrome (SFTS) were admitted, comprising 8 males and 7 females.Among these patients, 12 cases recovered, while 3 cases unfortunately died.In 2023, 6 patients were admitted, and all of them recovered.In 2024, 9 patients were admitted, 3 cases of whom died.The average age was (61.0 ± 8.7) years old.The onset of the disease was concentrated from May to September.The main residence areas for the patients included Pinggu, Tongzhou and Mentougou Districts, with 80% (12 cases) being farmers.Three patients (20%) had a clear history of being bitten by ticks, while 4 patients (26.6%) had contact with pet dogs that had been bitten by ticks and 2 patients (13.3%) had contact with sick camels.Among the patients who recovered, 50% (6 cases) had no underlying health conditions, all 3 dead patients had cardiovascular diseases.All 15 patients experienced fever and fatigue, and 73.3% (11 cases) reported digestive symptoms, while 53.3% (8 cases) underwent muscle pain.All 3 dead patients exhibited apparent neurological abnormalities, with 2 of them (66.7%) also showing signs of bleeding.The white blood cell (WBC) ranged (1.0-3.0) × 10⁹/L, one case with the WBC count deceased to 0.9 × 10⁹/L.All patients exhibited thrombocytopenia, and the platelet (PLT) count of 2 patients were less than 30 × 10⁹/L.Additionally, all 15 patients showed varying degrees of organ damage； the urine protein levels of the 3 dead patients ranged from 3+ to 4+, and all had urine occult blood at 3+.The creatinine (Cr) and blood urea nitrogen (BUN) levels were signiflcantly elevated in 2 dead patients.Furthermore, all 15 patients displayed coagulation dysfunction, primarily indicated by elevated D-dimer levels.

Conclusions

The local cases in Beijing were mainly middle-old farmer patients, with the onset of disease from May to September.Their residence was concentrated in the peripheral areas of Beijing.Some patients were in contact with infected animals, such as domestic pet dogs.Patients with old age, cardiovascular underlying disease, abnormal neurological manifestations, bleeding tendency and severe renal impairment may have a poor prognosis.

Objective

To investigate the clinical manifestations, diagnosis, differential diagnosis and treatment of cat scratch disease (CSD).

Methods

A 62-year-old male patient, having a history of cat scratching, admitted to the Department of Infection, Southern University of Science and Technology Hospital in August 15, 2024 with “fever with left upper arm elbow and left axillary lymph node enlargement for 5 days” was reported.Lymph node ultrasound indicated that cat scratch disease was waiting to be diagnosed,and was clinically diagnosed by metagenomic sequencing (MetaCAP).

Results

Once Hanssebardia detected by MetaCAP, the patient underwent active anti-infective therapy, resulting in alleviation of fever and a reduction in the size of the enlarged lymph nodes in the left upper arm and axilla compared to previous measurements.The size of the enlarged lymph nodes in the left upper arm decreased from 23 mm × 12 mm to 21 mm ×10 mm, while those in the axilla diminished from 27 mm × 11 mm to 20 mm × 8 mm.

Conclusions

Patients with unexplained fever accompanied by lymphadenopathy, a history of scratches from cats or dogs should be considered the possibility of cat scratch disease.MetaCAP plays a signiflcant role in the diagnosis of cat scratch disease.

拉考沙胺为新型第三代抗癫痫药，主要通过选择性增强电压门控钠离子通道的慢失活来稳定神经细胞膜。临床常见的不良反应为头晕、头痛、恶心、呕吐，对心血管系统的不良反应报道较少。本文报道1例拉考沙胺致二度Ⅰ型窦房传导阻滞，旨在提高拉考沙胺对心血管系统不良反应的识别，避免误诊。