ABSTRACT
Objective:To evaluate the predictive value of gait kinematic combined with total MRI burden for the risk of falls in patients with gait disorder in cerebral small vessel disease(CSVD)using logistic regression analysis and ROC curve. Method:Forty-three patients diagnosed with CSVD and presenting primarily with gait disorder at Rehabilitation Department of Gansu Province Hospital from March 1,2019 to March 30,2020 were selected.The statistical clinical data were collected,and according to the TUG test time,all patients were divided into a group with high risk of fall(high risk of falling,HRF,TUG≥15s)and a group of low risk of falls(low risk of falling,LRF,TUG＜15s).Logistic regression analysis and ROC curve were used to assess the predictive value of gait kinematic characteristic combined with total MRI burden for the risk of falls in CSVD patients. Result:A total of 43 patients were included with average age(71.07±8.17)years.Among them,there were 26 female(60.4％)and 30 hypertension patients(69.8％),After adjusting for age and TUG,the logistic regres-sion analysis showed that the step length(OR 0.821,95％CI 0.702-0.959,P=0.013)was an independent protec-tive factor against the risk of falls in CSVD patients,while the total MRI burden(OR 4.217,95％CI 1.444-12.317,P=0.009)was an independent risk factor for the falls in CSVD.The ROC curve analysis showed that the combination of step length and total MRI burden had a high predictive value for the risk of fall in CSVD patients with gait disorder(AUC=0.904),with a sensitivity of 82.6％and a specificity of 90％. Conclusion:Step length combined with total MRI burden has a high predictive value for the risk of falls in CSVD patients with gait disorder.
ABSTRACT
Objective To investigate the CT features of ovarian cystadenofibroma(CFA)and to improve the diagnostic accuracy. Methods The clinical data and CT images of 7 patients with ovarian CFA were retrospectively analyzed.All cases underwent non-enhanced and contrast-enhanced CT scan.Results Ovarian lesions were unilateral in 5 cases,bilateral in 2 cases and totally 9 lesions were found.6 lesions were cystic,2 lesions were mainly solid and 1 lesion was mixed components.The maximum diameter of lesions ranged from 4.7-21.5 cm with an average of 8.2 cm.Lesions had smooth margins,and solid portions had different size vesicles. Cyst walls or septa showed various degree of thickening with calcification in 1 lesion and mural nodules in 5 lesions,and a small vesicle was visualized in only 1 of the mural nodules.Cystic portions appeared as fluid density without enhancement.Solid portions,thickened cyst walls and septa appeared as slight enhancement or no enhancement.No regional lymph node metastasis was found,no ascites or peritoneal implants as well.Conclusion Ovarian CFA has some characteristic of CT findings that may improve clinical diagnosis and differential diagnosis.
ABSTRACT
Objective To screen the variation in NeuroD1 gene and to study its function in vitro and its clinical phenotypes and genetic characteristics in Chinese early-onset type 2 diabetic probands. Methods PCR-direct sequencing of NeuroD1 gene was performed in 85 early-onset type 2 diabetic probands, 95 late-onset type 2 diabetics with strong diabetic history and 87 non-diabetic control subjects. Distributions of the identified variation were calculated and compared among the three groups. Expression vectors with mouse NeuroD1 (mND1)cDNA wild type or mutant type and reporter vectors with human insulin promotor-linked luciferase were constructed. Then the above vectors were co-transfected into rat INS-1 cells. Relative luciferase activities were measured to compare transcriptional activities of insulin gene between WT and MT. Results S159P (T→C), a new mutation was identified in a proband, which was co-segregated with diabetes in 4 carriers from the paternal side. The functional study showed that the S159P mutant exhibited a 25% reduction in transcriptional activity of insulin gene as compared with the wild type. A45T (G→A), a common variation was identified. The AA + GA genotypic frequencies were markedly increased in early-onset type 2 diabetic probands as compared with late-onset type 2 diabetic probands and non-diabetic control subjects (P=0.006 and P=0.014, respectively). Conclusion The novel S159P mutation in the NeuroDl gene seems to contribute to the development of diabetes in the Chinese early-onset type 2 diabetic family. The A45T variation may increase susceptibility to or be in disequilibrium with early-onset type 2 diabetes mellitus in Chinese population. In addition, the A45T variation may affect the onset pattern of type 2 diabetes mellitns, such as early-onset but not late-onset type 2 diabetes mellitus.