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Androgen insensitivity syndrome(AIS)with bilateral testicular malignant transformation is very rare,and its diagnosis should be based on clinical manifestations,physical examination,serological findings,karyotype analysis,and pathological findings.This study reported a case of complete androgen insensitivity syndrome among Tibetan in Tibet.It took 17 years from the discovery of congenital absence of uterus to bilateral pelvic mass resection.Pathological examination confirmed that bilateral pelvic space occupying lesions were dysplastic testicular tissue with seminoma and sertoli cell adenoma-like nodules.This study summarized the clinicopathological features to deepen the understanding of the disease.
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Female , Humans , Male , Androgen-Insensitivity Syndrome/surgery , Cryptorchidism , Seminoma/pathology , Testicular Neoplasms/pathology , TibetABSTRACT
Objective:To evaluate the association between thrombus composition and mechanical recanalization,operation procedure and clinical outcome.Methods:One hundred and ninety-two consecutive stroke patients with large-vessel occlusion treated by mechanical thrombectomy using a stent retriever and (or) aspiration catheter in the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University between January 2018 and January 2020 were collected. The retrieved thrombi were quantitatively analyzed for red blood cells, white blood cells, platelets, and fibrin. The patients were divided into two groups, a erythrocyte-rich group and a fibrin-rich group based on the predominant composition in the clot. The clinical prognosis, CT value of thrombus, procedure time,number of recanalization maneuvers, and degree of vascular recanalization were compared between the two groups.Results:The retrieved clot from 138 patients with acute ischemic stroke from internal carotid artery occlusion ( n=56), middle cerebral artery occlusion ( n=62), intracranial segment of vertebral artery or basilar artery occlusion( n=20) were histologically analyzed. Erythrocyte-rich clots were present in 59 cases, while fibrin-rich clots were present in 79 cases. Cardioembolic thrombi had higher proportions of fibrin/platelets [77.2%(61/79)], less erythrocytes than noncardioembolic thrombi [45.8%(27/59), χ2=8.115, P=0.004]. Patients with erythrocyte-rich thrombi had a smaller number of recanalization maneuvers [2 (1, 2) vs 3 (2, 4), Z=-7.613, P<0.001], shorter procedure time [45 (30, 60) min vs 80 (60, 90) min, Z=-6.944, P<0.001], higher thrombus CT value [42 (32, 53) vs 36 (31, 41), Z=-2.003, P=0.045], good clinical prognosis (the ratio of modified Rankin Scale score ≤2, 62.7% (37/59) vs 39.2% (31/79), χ2=7.444, P=0.006). There was no significant difference in the location of vascular occlusion between the two groups. Conclusion:For patients whose thrombotic components are mainly red blood cells, the cause of stroke may be non cardiogenic cerebral embolism, the CT value of embolus is relatively high, the embolus is easy to remove, and the clinical prognosis is relatively good.
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Objective Toevaluatetheclinicaleffectofinterventionaltreatmentfordelayedhemorrhageinpatientsafterabdominal surgery.Methods Dataof76patients,undergoingangiographyduetodelayedpostoperativehemorrhage,wereanalyzedretrospectively. Theexclusioncriteriaincludedpositiveangiographywithoutembolizationorhaemorrhagecausedbyothercauses(urologicaland reproductivesystemdiseases).Basedonendovascularprocedures,thepatientsweredividedintoembolizedgroup (positiveangiography withembolization)andnon-embolizedgroup(negativeangiographywithoutembolization).Theoutcomesoftreatmentwerecompared betweentwogroupsandfactorsassociatedwithrebleedingwerealsoanalyzed.Results Angiogramswerepositivein70% (53/76)of patients,andintravascularembolizationswereperformed.Intheembolizationgroup,technicalsuccessrateandclinicalsuccessrate were98.1%(52/53)and71.7%(38/53),respectively.Noseverecomplications,suchasgastrointestinalorhepaticischemicnecrosis wereobservedinallpatients.Therebleedingrateswere28.3%and52.2%intheembolizationgroupandthenon-embolizationgroup, respectively(P＝0.046).Multivariateanalysisshowedthatuseofvasopressoragentsbeforesurgerywasanindependentriskfactor forrebleeding (P＝0.022).Conclusion Intravascularinterventionaltherapyisasafeandeffectivemethodfordelayedhemorrhageafter abdominalsurgery.Useofvasopressoragentsbeforesurgerymayincreasetheriskofpostoperativerebleeding.
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The industry of germ-free animals has been a hot spot in research along with the rapid development of studies on the relationship between microbiota and host diseases. Because it is pathogen?free, and the high degree of simi?larity in anatomy, physiology, pathogenesis to humans, germ?free pig is considered a clinical relevant model to be widely used in life science research. Based on the current state of research of germ?free pig cultivation at home and abroad and the experimental studies carried out in our laboratory as well, this article gives a simple discussion on germ?free technique of domestic pigs.
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In this study,the common critical medical cases were organically combined with SimMan simulation system,which enabled students to deeply understand the diagnosis,treatment of disease and clinical operation as consulting real patients.Also,it could improve their clinical thinking ability,clinical skills and operational level.
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This study compared the efficacy and safety of tiotropium bromide inhalation powder (spiriva) and doxofylline oral tablet (doxofylline) in the treatment of chronic obstructive pulmonary disease (COPD). A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder (18 μg/day) or oral doxofylline tablets (0.2 g/time, 2 times a day) for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV(1), FEV(1)/FVC% and 6-min walk distance were significantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases (9.9%) and 12 cases (12.9%), respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day (two times a day) are effective and safe for the treatment of COPD.
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<p><b>OBJECTIVE</b>To investigate the possible association between the glutamate-cysteine ligase catalytic subunit gene (GCLC) C-129T and modifier subunit gene (GCLM) G-23T polymorphisms with coronary heart disease (CHD) in Chinese population.</p><p><b>METHODS</b>GCLC C-129T and GCLM G-23T genotypes were determined in 212 CHD patients and 218 healthy individuals using a PCR-based restriction fragment length polymorphism (RFLP) method. Odds ratio (OR) for CHD and 95% confidence interval (CI) from unconditional logistic regression models were used to evaluate relative risks.</p><p><b>RESULTS</b>The T allele of the GCLC C-129T polymorphism was more frequently found in CHD cases than in controls (P < 0.01) and individuals with GCLC-129T allele had a significantly higher risk for CHD (OR = 2.38, 95% CI: 1.25 - 4.54) as compared to individuals with the -129C allele. When compared with CC homozygote, CT heterozygote had a 2.14-fold higher risk for CHD (95% CI: 1.08 - 4.24, P < 0.05) and carriers of the-129T allele (CT or TT genotype) also had a similarly 2.28-fold higher risk for CHD (95% CI: 1.16 - 4.49, P < 0.05). In contrast, the frequency of T allele of the GCLM G-23T polymorphism was lower in CHD patients than that of controls (0.174 vs. 0.264) and individuals with the GCLM-23T allele had a significantly lower risk for CHD (OR = 0.59, 95% CI: 0.42 - 0.82, P < 0.01) as compared to the -23G allele. When compared with GG homozygote, the OR of CHD for GT heterozygote was 0.71 (95% CI: 0.47 - 1.08, P > 0.05), for TT homozygote was 0.18 (95% CI: 0.06 - 0.55, P < 0.01), and for carriers of the -23T allele (GT or TT genotype) was 0.61 (95% CI: 0.42 - 0.92, P < 0.05).</p><p><b>CONCLUSION</b>The GCLC C-129T polymorphism may be one of the genetic risk factor while the GCLM G-23T polymorphism may be one of the genetic protective factors for CHD in this Chinese population.</p>
Subject(s)
Aged , Female , Humans , Male , Alleles , Coronary Disease , Genetics , Genetic Predisposition to Disease , Genotype , Glutamate-Cysteine Ligase , Genetics , Polymorphism, Single NucleotideABSTRACT
0.05), but the symptom of fever and character of respiratory tract's secretion of the patients in experiment group took turns for better obviously than the control group's ( P