ABSTRACT
Objective:To investigate the molecular genetic and clinical characteristics of MEF2D-BCL9 fusion gene-positive acute B-cell lymphoblastic leukemia (B-ALL), and to provide the reference for the diagnosis and treatment of the disease.Methods:The medical record and experimental examination data of a 18-year-old female MEF2D-BCL9 fusion gene-positive B-ALL patient were retrospectively analyzed. The clinical manifestations and biological characteristics of MEF2D-BCL9 fusion gene-positive B-ALL were summarized.Results:This 18-year-old female patient was treated in a local hospital in December 2018 and was diagnosed as B-ALL. She achieved complete remission after chemotherapy and recurred at 6 months after the initial onset, and then she was admitted to Hebei Yanda Ludaopei Hospital in the 9 months after the initial onset.MEF2D-BCL9 fusion gene was detected through RNA-sequencing (RNA-seq) and verified by using polymerase chain reaction and Sanger sequencing. Bone marrow cell morphology was similar to mature B cells with vacuoles but without characteristic chromosome karyotype abnormalities. The patient achieved remission after VLD regimen chemotherapy, chimeric antigen receptor T-cell (CAR-T) therapy and bridged to allogeneic hematopoietic stem cell transplantation (allo-HSCT). She has maintained complete remission for 2 years at the last follow-up in February 2022.Conclusions:MEF2D-BCL9 fusion gene-positive B-ALL is characterized with high risk, early relapse and poor prognosis. These patients may benefit from CAR-T and allo-HSCT. It further emphasizes the importance of taking MEF2D-BCL9 fusion gene into the detection or identification by using RNA-seq, particularly for those newly diagnosed B-ALL patients in children and adolescents with specific bone marrow morphology.
ABSTRACT
Objective:To investigate the clinical characteristics, diagnosis, treatment and outcome of patients with human herpesvirus 7 (HHV-7) viral encephalitis after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:The clinical manifestations, laboratory characteristics, diagnosis and treatment process and outcome of 3 patients with HHV-7 viral encephalitis after allo-HSCT in Hebei Yanda Lu Daopei Hospital from 2018 to 2020 were retrospectively analyzed, and the related literature was reviewed.Results:The clinical features of 3 patients with HHV-7 viral encephalitis after allo-HSCT included fever, headache, vomiting, apathy, etc., without specific symptoms or signs. The conventional white blood cell count in the cerebrospinal fluid was normal or slightly higher, mainly lymphocytes, and the cerebrospinal fluid protein was normal or slightly higher. The HHV-7 virus DNA in cerebrospinal fluid was positive, and the treatment with ganciclovir or foscarnet was effective. The prognosis was favorable in two mild cases, but one case with cerebral hemorrhage died eventually.Conclusions:HHV-7 viral encephalitis is a rare infection after allo-HSCT, and it can be easily misdiagnosed due to lack of typical symptoms and indications for routine laboratory tests. The detection of HHV-7 DNA in the cerebrospinal fluid can help confirm the diagnosis. Currently, there is no standard treatment programs, but ganciclovir and foscarnet are effective.
ABSTRACT
Objective:To investigate the early predictive factors of periprocedural thrombus migration and the relationship between periprocedural thrombus migration and prognosis after mechanical thrombectomy (MT) in stroke patients.Methods:The patients with anterior circulation acute large vessel occlusion stroke (ALVOS) who underwent MT in the Stroke Center of Yijishan Hospital of Wannan Medical College from May 2015 to December 2019 were retrospectively analyzed. The baseline characteristics, procedural and clinical outcomes were collected. Univariate and multivariate regression analysis was used to explore the risk factors of thrombus migration and the relationship between thrombus migration and prognosis of patients.Results:There were 302 ALVOS patients [(68.8±11.0) years old and 166 males (55.0%)] included, of whom thrombus migration was identified in 80 patients (26.5%), including 60 cases (75.0%) of proximal migration. Cardiogenic stroke ( OR=2.722, 95% CI 1.367-5.418, P=0.004) and clot burden score (CBS; OR=0.849, 95% CI 0.745-0.968, P=0.015) were independent risk factors of thrombus migration. Proximal migration ( OR=2.822, 95% CI 1.220-6.528, P=0.015) was an independent risk factor of 90-day clinical outcome, while the effect of distal migration on 90-day clinical outcome was not statistically significant. Conclusions:Cardiogenic stroke and lower CBS score are independent predictors of periprocedural thrombus migration in ALVOS patients who underwent MT. Proximal migration is an independent risk factor for the prognosis of patients, which has important clinical intervention significance.
ABSTRACT
Objective:To observe the incidence, risk factors of malignant brain edema (MBE) and the influence of MBE on outcomes after early successful recanalization of acute large vascular occlusion stroke (ALVOS).Methods:A total of 149 patients (age (68±11) years, male 85 (57.0%)) with ALVOS who underwent early endovascular treatment and achieved successful recanalization at the First Affiliated Hospital of Wannan Medical College from July 2014 to February 2019 were retrospectively analyzed. Baseline data, perioperative data, and 90-day prognostic information were collected from patients enrolled in the study. Univariate and multivariate analyses were used to explore the relationship between MBE and outcomes, and the risk factors of MBE.Results:Among the 149 patients, baseline National Institutes of Health Stroke Scale score was 16 (13, 20), baseline Alberta Stroke Project early CT score was 9 (8, 10), the time of onset-to-puncture was (248.3±61.3) minutes, and the onset-to-recanalization time was (312.4±69.7) minutes. MBE occurred in 23 patients (15.4%, 23/149). The 90-day favorable outcome (90-day modified Rankin Scale score≤ 2) in patients with MBE was significantly lower than those without MBE (17.4% (4/23) vs 61.1% (77/126), χ 2=14.985, P<0.001), and the 90-day mortality in patients with MBE was significantly higher than those without MBE (43.5% (10/23) vs14.3% (18/126), χ 2=10.861, P=0.003). MBE was shown to be an independent predictor of 90-day poor outcome (adjusted OR=12.078, 95 %CI 1.934-75.443, P=0.008) and death (adjusted OR=4.146, 95 %CI 1.060-16.216, P=0.041). Multivariate Logistic regression analysis showed that the collateral circulation status was related to the incidence of MBE in patients with ALVOS after successful recanalization (level 2 vs level 0, adjusted OR=0.109, 95 %CI 0.021-0.563, P=0.008). Conclusions:MBE is an independent risk factor of ALVOS patients with poor outcome or death in 90 days. For patients with ALVOS, even if the occlusive vessels have been successfully recanalized after early endovascular treatment, MBE is still not uncommon. The collateral circulation state is an independent predictive factor of the development of MBE after recanalization by early endovascular treatment in patients with ALVOS.
ABSTRACT
Objective:To investigate the infection spectrum revealed by metagenomics high-throughput next-generation sequencing (mNGS), and to provide a reference for infection diagnosis after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A total of 64 patients who developed systemic or local infection symptoms after allo-HSCT in Hebei Yanda Lu Daopei Hospital from January 2018 to November 2018 were enrolled. Gene sequences of pathogenic microorganisms in blood, cerebrospinal fluid and bronchoalveolar fluid specimens were detected by using mNGS. The pathogenic microorganisms or suspected pathogens were determined based on the clinical manifestations of patients.Results:There were 97 samples of mNGS detection for 64 patients who underwent allo-HSCT. The most common gram-positive bacteria were staphylococcus haemolyticus (19 times) and staphylococcus (14 times), and the most common gram-negative bacterium was acinetobacter baumannii (8 times). The most common viruses were cytomegalovirus, EB virus and Torque teno virus (35, 22 and 23 times, respectively), and the most common fungi were malassezia globus (14 times) and candida parapsilosis (8 times). There were 3 mycobacterium tuberculosis complexes detected in 3 patients with acute myeloid leukemia who received allo-HSCT. Mycoplasma orale was detected in one patient's sputum, and none parasite was detected.Conclusion:mNGS can comprehensively reveal the infection spectrum of hematologic diseases after allo-HSCT, especially for pathogenic microorganisms that are rare or difficult to cultivate, and it can effectively help the diagnosis of clinically infectious pathogens.
ABSTRACT
@# Sarcopenia is a component of malnutrition in patients with liver cirrhosis. Studies have shown that both sarcopenia and hepatic encephalopathy can reduce quality of life and increase the risk of adverse events, including death, in patients with liver cirrhosis. This article reviews the association between sarcopenia and hepatic encephalopathy and the advances in treatment, so as to provide a reliable basis for the treatment of patients with sarcopenia and liver cirrhosis, prevent the development of hepatic encephalopathy, and thereby improve the quality of life and prolong the survival time of patients with liver disease.
ABSTRACT
Objective@#To investigate the application of metagenomic next-generation sequencing (mNGS) in detection of the rare or difficult-to-cultivate pathogens.@*Methods@#One patient with acute lymphoblastic leukemia who went through allogeneic hematopoietic stem cell transplantation (allo-HSCT) developed symptoms of infection after transplantation. Conventional microbial culture, polymerase chain reaction (PCR), and mNGS combined with biological information analysis were performed with plasma and cerebrospinal fluid samples, the anti-infective treatment was adjusted according to the test results, and the efficacy was assessed.@*Results@#No suspected pathogens were detected by microbial culture and PCR in the cerebrospinal fluid and plasma samples since the patient developed infection symptoms. However, Legionella pneumophila was analyzed by mNGS in the cerebrospinal fluid specimen on day 23 after allo-HSCT (reads count: 19 655), and it was considered as the principal pathogen after comprehensively evaluating the patient's clinical manifestations and the test results. Then the antimicrobial treatments were adjusted according to the patient's clinical manifestations and laboratory test results, and the number of gene sequences of Legionella pneumophila was monitored by mNGS method. Azithromycin, tigecycline, and other antibiotics effective for Legionella pneumophila were used after detecting this pathogen. A total of 15 mNGS analysis were performed during the 5-month period, and the highest number of Legionella pneumophila sequences monitored in the cerebrospinal fluid was 2 226, the lowest was 253 and eventually turned negative. The clinical symptoms and treatment outcomes were consistent with the mNGS monitoring results.@*Conclusions@#The mNGS technology has significant value in detection of the rare and difficult-to-cultivate pathogens. The mNGS technology provides a valuable supplement to microbial culture and PCR methods.
ABSTRACT
Transcriptome sequencing (RNA-seq) has unique advantages in analyzing gene fusion, splicing mutations, and gene expression profiles. Single-cell RNA-seq provides powerful tools to reveal cellular heterogeneity in normal and tumor tissues. With the widespread application of high-throughput gene sequencing technology and the rapid reduction in cost, RNA-seq is increasingly used in hematological malignancies research. This article introduces the related research progress in conjunction with reports at the 61st American Society of Hematology Annual Meeting.
ABSTRACT
Objective The aim of this study was to evaluate the effect of marriage quality intervention in peer education model among women with breast cancer.Methods Marginal quality questionnaire was used to assess in the intervention and control groups during the perioperative period.There had 120 breast cancer patients in the intervention group and 135 normal subjects for control group.The patients were followed by the peer education model and the marriage and quality education during the chemotherapy period.The marriage quality questionnaires were carried out one year after the operation.Results Marital satisfaction(38.73±7.45),couples communication(38.12±7.03)and sex life(36.77±6.96)were significantly higher than those of the patients who participated in the traditional health education group after 1 year of operation.The control subjects with traditional health education had lower satisfaction of marital life(32.59±9.29),husband and wife communication(34.41±7.39)and sexual life(32.59±6.59)in one year after surgery(P<0.001).The scores of marital satisfaction,husband and wife communication,and sex scores were significantly lower in patients with traditional health education after 1 year of operation(P<0.001).Conclusion Marriage quality interventions in the peer education model can effectively affect the marital quality of postoperative patients with breast cancer.
ABSTRACT
Objective To investigate the clinical characteristics of the infections caused by carbapenem-resistant Pseudomonas aeruginosa (CRPA) for better prevention and treatment of CRPA infections. Methods A retrospective study was conducted to compare the features of CRPA infections (n=85) and carbapenem-susceptible P. aeruginosa (CSPA) infections (n=94) treated in Huashan Hospital from January 1, 2013 to December 31, 2013. Results? The?proportion?of?CRPA?infections?was?significantly?higher?than CSPA in Neurosurgery (40.0% versus 16.0%) and Intensive Care Unit (22.4%, 9.6%). Traumatic brain injury (30.6%) and vascular accidents (21.2%) were the main underlying diseases in CRPA patients, which was higher than in CSPA patients (11.7%and?8.5%,?respectively).?CRPA?infection?was?associated?with?significantly?higher?incidence?of?fever,?altered?mental?status,?and?severe hypoproteinemia than CSPA infection. Multiple bacterial infection was found in more CRPA patients (45.9%, 39/85) than in CSPA patients (24.5%, 23/94). Fewer CRPA patients showed positive treatment response (44.7%, 38/85) than CSPA patients (78.7%, 74/94). CRPA was associated with significantly more cases of disease progression (55.3%, 47/85) and more deaths (16.5%, 14/85) than CSPA (21.3% and 1.1%, respectively). Logistic regression analysis indicated that stay in Department of Neurosurgery, prior carbapenem use, peripherally inserted central catheter, nasal feeding, and mechanical ventilation were the risk factors for CRPA infection. Conclusions No specific clinical manifestation is associated with CRPA infection, which poses a therapeutic challenge and results in unfavorable prognosis. Rational use of antibacterial agents and appropriate supporting treatments are essential for control of CRPA in Huashan Hospital.
ABSTRACT
Objective To investigate the antibiotic resistance pattern and molecular epidemiology of carbapenem-resistant Pseudomonas aeruginosa.Methods The antimicrobial susceptibility was measured by agar dilution method for the 104 strains of carbapenem-resistant P.aeruginosa (CRPA) collected from Huashan Hospital.The homology between these strains was evaluated by pulsed field gel electrophoresis (PFGE).Results Of thel04 CRPA strains,85.6％ were resistant to meropenem and 98.1％ to imipenem.These strains also showed various percentages of resistance to amikacin (18.3％),gentamicin (40.4％),ceftazidime (26.9％),cefepime (21.2％),ciprofloxacin (44.2％),levofloxacin (50.0％),piperacillin-tazobactam (19.2％),cefoperazone-sulbactam (26.9％),ticarcillin-clavulanic acid (52.9％),aztreonam (26.9％),and colistin (5.8％).PFGE analysis showed that these strains were divided into 48 types,belonging to 9 clones.Only 3 strains were non-typeable.Clone A was the primary epidemic strain (41.6％,42/101),which was mainly isolated from Neurosurgery,Geriatrics and General Ward.Clone B accounted for 5.9％ (6/101) of the strains.Conclusions Multiple clones of carbapenem resistant Pseudomonas aeruginosa were prevalent in Huashan hospital.Effective infection control approaches should be adopted to prevent the development and the further spreading of antimicrobial resistance.
ABSTRACT
Objective To observe the effects of long-term low dose arsenic exposure through drinking water on learning ability of different generations of C3H and Balb/c mice.Methods Mice (C3H and Balb/c) were exposed to arsenic at 0 mg/L (control) and 85 mg/L (20 female mice and 10 male mice per group).The control group and F1,F2,F3 and F4 mice were selected and divided into 5 experimental groups,8 mice in each group.Their offsprings were detected by the Morris water maze test (the average escape latency of 1 to 5 days) and spatial probe test (the times of through target area on the sixth day).Statistical analysis was performed with SPSS 18.0 software.Results The average escape latencies of 1 to 5 days in C3H control group were (48.09 ± 2.63),(46.09 ± 3.27),(42.72 ± 3.29),(39.31 ± 2.69) and (36.75 ± 3.92) s,F1 were (49.59 ± 3.29),(47.34 ± 3.01),(44.28 ± 6.58),(44.50 ±1.67) and (42.16 ± 2.27) s,F2 were (51.41 ± 0.78),(48.88 ± 1.45),(45.54 ± 1.46),(43.94 ± 1.69) and (42.22 ± 3.27) s,F3 were (50.91 ± 4.20),(49.78 ± 5.18),(48.03 3.45),(46.16 ± 4.42) and (44.06 ± 1.04) s,F4 were (52.66 ± 4.60),(52.38 ± 5.78),(49.06 ± 1.22),(47.69 ± 2.34) and (46.47 ± 1.56) s.The average escape latencies of Balb/c control group were (50.91 ± 2.84),(47.03 ± 4.22),(45.56 ± 4.53),(39.72 ± 5.90) and (36.22 ± 4.85) s,F1 were (50.47 ±3.20),(48.25 ± 6.53),(47.13 ± 1.25),(43.72 ± 4.27) and (40.66 ± 4.52) s,F2 were (51.31 ± 4.73),(48.88 ± 1.53),(46.56 ± 1.43),(44.25 ± 1.16) and (41.20 ± 3.79) s,F3 were (51.72 ± 3.54),(50.78 ± 4.45),(45.03 ± 3.56),(41.19 ±5.63) and (42.81 ± 6.29) s,F4 were (53.34 ± 4.60),(52.34 ± 2.77),(48.72 ± 5.92),(46.97 ± 7.38) and (44.94 ± 1.75) s.On the fourth and fifth days of F1,F2,F3 and F4 generations of C3H,the escape latencies between generations were significantly different (all P ＜ 0.05).The times of through target area in the sixth day of the C3H control group and F1,F2,F3 and F4 mice were 2.25,1.75,1.63,1.50 and 1.38,Balb/c were 2.13,1.75,1.63,1.38 and 1.13.Conclusion Arsenic accumulation due to serial passage of C3H and Balb/c through long-term low doses arsenic exposure through drinking water has resulted in decreased learning and memory ability.
ABSTRACT
Objective To observe the expression of heat shock protein 47 (HSP47) and transforming growth factor-β2 (TGF-β2) in vitreous specimens and epiretinal membranes of patients with proliferative vitreoretinopathy diseases.Methods Vitreous specimens and epiretinal membranes were obtained from 48 patients (48 eyes) with proliferative vitreoretinopathy (PVR) and 50 patients (50 eyes) with proliferative diabetic retinopathy (PDR).Vitreous specimens and internal limiting membranes were collected from 20 patients (20 eyes) with idiopathic macular hole (IMH) as control group.The expression of HSP47 and TGF-β2 in the vitreous specimens was evaluated using enzyme linked immunosorbent assay.The expression of HSP47,TGF-β2,types Ⅰ and Ⅲ collagen in epiretinal membrane and internal limiting membrane specimens were observed for immunohistochemical staining method.The correlation between the positive expression of HSP47 and TGF-β2,types Ⅰ and Ⅲ collagen in epiretinal membrane specimens of patients with PVR and PDR were analyzed.Results The expression of HSP47 in vitreous specimens of patients with PVR,PDR and IMH were (212.35±23.32),(231.30±26.79),(171.06±28.91) pg/ml,respectively.The expression of TGF β2 in vitreous specimens of patients with PVR,PDR and IMH were (1919.96 ± 318.55),(1939.39 ± 177.57),(1194.61 ± 234.20) pg/ml,respectively.The expression of HSP47,TGF-β2 in the vitreous specimens of patients with PVR and PDR were significantly increased compared with patients with IMH and the difference was statistically significant (F=12.952,34.532;P＜0.01).The epiretinal membrane of patients with PVR and PDR showed markedly increased expression of HSP47,TGF β2,types Ⅰ and Ⅲ collagen in the cytoplasm and extracellular matrix.The expression of HSP47 and type Ⅲ collagen was negative and the expression of TGF-β2 was weakly positive and the expression of types Ⅰ collagen was positive in internal limiting membrane of patients with IMH.The expression of HSP47,TGF β2,types Ⅰ and Ⅲ collagen in the epiretinal membrane of patients with PVR and PDR were significantly increased compared with patients with IMH and the difference was statistically significant (F=13.469,18.752,12.875,20.358;P＜0.01).The expression of HSP47 was positively correlated with thepositive expression of TGF-~,types Ⅰ and Ⅲ collagen in epiretinal membrane specimens of patients withPVR (r=0.475,0.556,0.468;P＜0.05) and PDR (r=0.484,0.589,0.512;P＜0.05).Conclusions This study showed increased consistent expression of HSP47 and TGF-β2 in vitreous and epiretinal membrane specimens of patients with PVR and PDR.Both HSP47 and TGF-β2 were expressed in the cytoplasm and extracellular matrix.HSP47 and TGF-β2 may be involved in the pathological process of PDR and PVR by promoting collagen synthesis.
ABSTRACT
Background:Visceral hypersensitivity is considered to be one of the major pathophysiological mechanisms of irritable bowel syndrome. Aims:To investigate the expression of TRPV1 and electrophysiological characteristics of colon-specific dorsal root ganglion( DRG)neurons in rat model of visceral hypersensitivity. Methods:Twenty 10-day-old rats were randomly divided into two groups. In model group,visceral hypersensitivity was induced by colorectal administration of acetic acid;while in control group the same amount of saline was administered. Colon-specific DRG neurons were labeled retrogradely by injection of DiI,a fluorochrome,into the colon wall. Expression of TRPV1 in DRG neurons was detected by immunofluorescence and the electrophysiological characteristics of DRG neurons was detected by using patch-clamp technique. Results:In model group,the expression rate of TRPV1 in colon-specific DRG neurons was significantly higher than that in controls(46. 1% vs. 36. 6% ,P <0. 01),the average rheobase was significantly decreased[(57. 80 ±1. 32)pA vs.(73. 45 ± 4. 51)pA,P < 0. 05],while the frequency of action potentials(APs)in response to doubling rheobase stimulation was significantly increased[(8. 20 ± 1. 10)Hz vs. (4. 54 ± 0. 66)Hz,P < 0. 05]. Score of abdominal withdrawal reflex(AWR)under a 60 mm Hg colorectal distention was positively correlated with the expression rate of TRPV1 and the frequency of APs in response to doubling rheobase stimulation(r = 0. 87 and r = 0. 73,P < 0. 01),but was negatively correlated with the rheobase(r = - 0. 81,P < 0. 01)in model group. Conclusions:Increased expression of TRPV1 and excitability in colon-specific DRG neurons might be a crucial step in formation of visceral hypersensitivity.
ABSTRACT
Objective To analyze the clinical characteristic,treatment and prognosis of traumatic macular holes resulted from ocular contusion.Methods The clinical data of 47 cases with traumatic macular hole was retrospectively reviewed.The general condition of the patients was summarized,optical coherence tomography and multifocal electroretinogram (mfERG) were used to evaluate anatomic and functional outcomes.The patients were divided into observation group and surgery group by the treatment they received,and the prognosis was evaluated.Results Traumatic macular hole occurs mainly in male.In the observation group,the mean diameter of macular hole was(490.0±86.9) μm.During the 12 month follow up,the holes in 7 cases (33.3％) were closed spontaneously,Vision and diameters of 14 cases (57.1％) maintained stable for a long time,the vision of 1 case (3.3 ％) declined mildly and the diameter of 1 case (3.3％) enlarged slightly.Visual acuity was improved significantly at last follow up (Z=-2.40,P＜ 0.05).The amplitudes of N1 wave of mfERG increased both in central fovea and macular area(t=13.30,5.06;P＜0.05).These data suggests that the macular function was recovered well.In the surgery group,the mean diameter of macular hole was (643.3 ± 125.0) μm and statistically larger than that of the observation group (t=-4.76,P＜0.05).At the last follow-up,visual acuity were not improved significantly (Z=-1.79,P＞0.05).The amplitudes of N1 wave in 6 cases (23.1 ％) improved merely and the difference was not statistically significant (t =1.98,P ＞ 0.05).These data suggests that the macular function was recovered slightly only in a few patients.Conclusions A part of the patients with smaller diameters of macular holes may close spontaneously,and they may get better visual acuity.Vitrectomy may help to close the macular holes in some severe cases,but the improvement of functional outcomes is not significant.
ABSTRACT
Objective To studying the MR findings and pathology of peripheral small intrahepatic cholangiocarcinoma and improving the understanding of peripheral small cholangiocarcinoma with no-bile duct dilatation. Methods A retrospective analysis of 12 patients with intrahepatic peripheral cholangiocarcinoma which were confirmed by surgery and pathology, all patients were examined by abdominal MRI without and with contrast. Correlation was made with gross pathology and surgical pathological specimen. Results On T1WI, there were 4 cases of complex low signal intensity and 8 cases of low signal intensity. On T2WI, there were 8 cases of high signal intensity and 4 cases of complex high signal intensity. Enhanced MRI showed: marked nidus enhancement on arterial phase in 1 case, and the pathological diagnosis was poorly differentiated adenocarcinoma. Inhomogeneous enhancement or annular enhancement were seen in 10 cases on arterial phase, 3 of these cases showed thin annular enhancement on arterial phase, low signalintensity on portal venous phase and isointensity on delayed phase. One case showed delayed enhancement. Thick circular enhancement correlated with pathological changes of survival of tumor cells, center areas correlated with fibrous connective tissue, and a small amount of necrotic tissue. Island-like enhancement or inhomogeneous enhancement were seen in 3 cases. Corresponding pathological changes consisted of tumor tissue and a small amount of fibrous connective tissue, as well as somenecrotic tissue. In 1 case, no enhancement was seen on all three phases and pathological changes showed cystic changes, hemorrhage, necrosis, with survival tumor cells seen between cyst and normal liver tissue. Conclusions MRI scanning of peripheral small cholangiocarcinoma lacked characteristic features, but dynamic contrast-enhanced MR had certain specific findings. Due to different pathology, the fibrous tissue, necrotic tissue and survival tumor tissue components were exhibited different imaging findings.
ABSTRACT
Objective To investigate the clinical effects of biofeedback therapy on constipation-predominant irritable bowel syndrome(IBS-C).Methods 30 patients with IBS-C were given to biofeedback therapy,5 times every treatment course.and then their clinical symptoms,mental state and quality of life before the treatment and at the end of treatment with biofeedback therapy were respectively evaluated by symptom scores,self-rating anxiety scale (SAS),self-rating depression scale (SDS),and short form 36 health survey questionnaire (SF-36).Results Post-treatment with biofeedback therapy,there were very significant decrease in total and subscales scores of bowel symptom including abdominal pain/discomfort,abdominal distension,abnormal appearance of defecation,abnormal process of defecation((12.31±2.01) vs (19.16±2.17),(2.95±0.57) vs (5.04±1.04),(2.64±0.92) vs (4.25±1.09),(3.66±1.09) vs (5.10±0.57),(3.06±1.08) vs (4.77±0.95) respectively,P＜0.01).The integration of SAS and SDS were obviously decreased after treatment((39.53±6.39) vs (44.43±7.89),P＜0.05;(40.70±8.38) vs (46.46±8.74),P＜0.05),the SF-36 scores were also improved in five dimensions including rolephysical,social-functioning,vitality,role-emotional and mental health((74.16±21.25) vs (57.0±39.40),(86.21±13.54) vs (75.54±20.96),(75.16±13.42) vs (64.66±20.54),(78.87±28.36) vs (57.76±46.26),(81.60±16.08) vs (71.20±22.04) respectively,P＜0.05).Conclusion Biofeedback therapy can improve the clinical symptoms,alleviate the moods of anxiety and depression,and improve the quality of life in patients with IBS-C.
ABSTRACT
Objective To explore the impact of alcohol to attention networks.Methods The attention network test was performed in 33 alcoholics and 27 normal controls on the efficiency of three anatomically defined attentional networks:alerting,orienting and executive control.Results The orienting network function was significantly lower(t =-3.72,P ＜0.01 ) in alcoholics (26.7 ± 38.6) ms than that in normal controls (51.8 ± 22.3 ) ms.The executive networks effects was higher and the alerting networks effects was lower in alcoholics than in normal controls,however without significant difference ( P ＞ 0.05 ).Conclusion The parietal lobe and cholinergic system may be more significantly affected by the alcohol.
ABSTRACT
ObjectiveTo assess the effects and safety of glycoprotein Ⅱ b/Ⅲ a receptor inhibitors tirofiban( intracoronary administration and venous maintenance) combined with DIVERTM CE thrombus-aspiration catheter in the percutaneous coronary intervention (PCI)-treated patients with acute ST-segment elevation myocardial infarction (ST-EMI).Methods Sixty patients with ST-EMI who underwent PCI were randomized into two groups.Thirty-two patients in group A were treated with tirofiban,twenty-eight patients in group B were treated with tirofiban and thrombus-aspiration catheter.Between two groups,the thrombolysis in myocardial infarction (TIMI) risk score,hemorrhagic complications,and incidence of major adverse cardiovascular events (MACE) were compared.ResultsThe TIMI flow was improved in both groups,and it was better in group B than group A ( P ＜ 0.05 ).The incidence of MACE in group B was lower than group A (25.0％ vs 3.6％,P ＜0.05). No fatal hemorrhagic complications were found in both groups.ConclusionsApplication of tirofiban and DIVERTM CE thrombus-aspiration catheter is safe and effective in ST-EMI patients,which can greatly improve myocardial reperfusion and reduce incidence of MACE.
ABSTRACT
Objective To investigate the characteristics and plausible mechanisms of attention network impairments in hyperthyroid patients.Methods 34 hypertyroid patients and 33 normal controls performed the attention network test (ANT),which was used for assessing three components of attentional networks including alerting,orienting,and executive control.Results The mean scores for alerting and orienting networks were significantly shorter (P ＜ 0.01) in hyperthyroid patients (respectively,(20.00 ± 22.47) ms,(35.26 ± 22.65) ms)than those in normal controls (respectively,(35.70 ± 17.62) ms,(50.61 ± 23.66) ms).The mean reaction time for executive control network was significantly longer(P ＜ 0.01) in hyperthyroid patients((116.71 ± 40.36)ms)than those in controls ((93.00 ± 29.34)ms).Triiodothyronine(T3) and thyroxine(T4) were positively correlated with the scores for executive control network (respectively,r=0.350,P＜ 0.05; r=0.417,P＜ 0.05) in hyperthyroid patients,whereas no relationship was found between thyroid stimulating hormone(TSH) and the value of executive control network.T3,T4 and TSH were not correlated with the value of alerting and orienting network in hyperthyroid patients.Conclusion Hypertyroid patients have extensive impairments in various kinds of attentional network,rather than a specific deficit.The recession of executive control network accompanies with enhancement of serum levels of T3,T4 in hyperthyroid patients.