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Objective:To investigate patients' compliance of endoscopic surveillance after endoscopic submucosal dissection (ESD) and the influencing factors.Methods:This study was a cross-sectional survey. The data of patients who underwent ESD in Xijing Digestive Hospital of Air Force Military Medical University from January 2014 to December 2015 were collected through questionnaire and telephone call. The questionnaire survey was conducted from May 1, 2019 to July 31, 2020. Patients' compliance for endoscopic surveillance and influencing factors were evaluated. Logistic regression model was used for multivariate analysis to determine independent risk factors affecting compliance of endoscopic surveillance.Results:A total of 413 questionnaires were collected, of which 331 (80.1%) patients were well complied with endoscopic surveillance, and 82 (19.9%) were not. Univariate analysis showed that gender ( χ2=4.68, P=0.034), lesion type ( χ2=10.10, P=0.002), educational background ( χ2=4.00, P=0.049), disposable income ( χ2=7.00, P=0.009), employment ( χ2=11.29, P=0.004) and medical insurance ( χ2=13.59, P=0.001) affected patients' endoscopic surveillance compliance. Logistic regression analysis indicated that patients with submucosal lesions were less likely to be compliant than patients with mucosal lesions with the same type of medical insurance ( P<0.001, OR=0.383, 95% CI: 0.227-0.644); and with the same lesion type, patients with urban medical insurance were more likely to be compliant than those with rural cooperative medical insurance ( P<0.001, OR=2.938, 95% CI: 1.696-5.090). Conclusion:The endoscopic surveillance compliance for post-ESD patients is related to the lesion type, the type of medical insurance, and the awareness of the disease. More attention should be paid to those with submucosal lesions and rural cooperative medical insurance due to their poor compliance. And it is necessary to improve health education on the disease for better surveillance compliance.
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Objective:To explore the accuracy of 18F-fluorodeoxyglucose (FDG) PET/MR in preoperative localization of refractory epilepsy patients with conventional MRI negative. Methods:From August 2016 to December 2018, 57 refractory epilepsy patients (36 males, 21 females, age (24.0±10.3) years) with conventional MRI negative who underwent surgery in Xuanwu Hospital were retrospectively enrolled. All patients received interictal 18F-FDG PET/MR before surgery and the epileptogenic foci were determined by using visual and semi-quantitative methods. Patients were followed up for 1 year and the surgical outcome was evaluated according to Engel classification. The sensitivity, specificity and accuracy of 18F-FDG PET/MR in locating epileptogenic foci were calculated according to surgical resection and followed-up results as the " gold standard" . Results:Of 57 patients, 51(89.5%, 51/57) showed single or multiple hypo-metabolism focus on 18F-FDG PET/MR, and 6(10.5%, 6/57) showed no abnormal metabolism changes. The microstructure abnormality was found in 18 patients (31.6%, 18/57) on 18F-FDG PET/MR images. Follow-up results were obtained from 46 patients, and 84.8%(39/46) with seizure improvement (Engel Ⅰ-Ⅲ). The sensitivity, specificity and accuracy of 18F-FDG PET/MR in preoperative localization of epileptic foci was 90.0%(27/30), 3/16 and 65.2%(30/46), respectively. Conclusion:18F-FDG PET/MR is helpful for the detection of epileptic foci in patients with MRI-negative refractory epilepsy, and can provide reliable information for further surgical treatment.
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Objective:To explore a scoring system of preoperative evaluation for high-risk gastric stromal tumors.Methods:A total of 275 consecutive patients with gastric stromal tumors of diameter ≤5 cm who underwent surgical or endoscopic resection at Xijing Hospital between 2008 and 2018 were retrospectively enrolled in the study. Multivariate logistic regression analysis was performed to investigate independent risk factors for high-risk gastric stromal tumors.Weighted points was proportionally assigned based on β regression coefficient value to establish the scoring system. The receiver operator characteristic (ROC) curve was plotted, the scoring system as the test variable, and the area under curve (AUC) was calculated.Results:Multivariate analysis revealed tumor size>1.75 cm ( OR=6.474, 95% CI: 2.335-17.948), irregular tumor shape ( OR=3.548, 95% CI: 1.745-7.216) and mucosal ulceration ( OR=2.412, 95% CI: 1.154-5.041) were independent risk factors for high-risk gastric stromal tumors of diameter ≤5 cm ( P<0.05). These risk factors for high-risk gastric stromal tumors were weighted with value: one point for mucosal ulceration, two points for irregular tumor shape and three points for tumor size>1.75 cm. The AUC value of the scoring system was 0.781, of which the cut-off value was 4. According to the cut-off value, 0-3 points was categorized as the low risk group and 4-6 points as the high risk group for gastric stromal tumors. The incidence of high-risk gastric stromal tumors of the low risk group and the high risk group were 13.3% (26/196) and 48.1% (38/79), respectively, with significant difference ( χ2=38.266, P<0.001). Conclusion:Tumor size larger than 1.75 cm, irregular tumor shape and mucosal ulceration can be applied to establish a preoperative scoring system to predict high-risk gastric stromal tumors of diameter ≤5 cm.
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Objective To summarize the clinicopathological features of cystic meningioangiomatosis.Methods The clinical manifestations,imaging characteristics and pathological features of a case of cystic meningioangiomatosis were analysed,and the relevant literature was reviewed.Results A 16-year-old male patient from Xuanwu Hospital,Capital Medical University had a history of epileptic seizures for more than three months.Magnetic resonance imaging (MRI) demonstrated a cystic mass in the left frontal lobe with long T1 and long T2 signals.Extensive resection of the upper frontal gyms was performed.The excised lesion presented with a cystic shape after incision and contained colorless translucent liquid.Microscopic examination of the lesion showed that the number of blood vessels in the local cortex of the brain tissue was increased and the vessels appeared to be branching.The blood vessel walls were surrounded by proliferative spindle cells,which were arranged in concentric circles.Immunohistochemical study revealed that those spindle cells and the cyst wall were vimentin positive.These cells had a rich reticular fibers.Ten months after the operation,the general condition of the patient was good,no epileptic seizure was observed,and the follow-up MRI did not reveal any residual lesion.Conclusions MRI of cystic meningioangiomatosis shows cystic space occupying.Pathological findings show typical features of meningioangiomatosis and cystic space formation.Cystic meningioangiomatosis has good prognosis after surgical resection.
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Objective@#To summarize the clinicopathological features of cystic meningioangiomatosis.@*Methods@#The clinical manifestations, imaging characteristics and pathological features of a case of cystic meningioangiomatosis were analysed, and the relevant literature was reviewed.@*Results@#A 16-year-old male patient from Xuanwu Hospital, Capital Medical University had a history of epileptic seizures for more than three months. Magnetic resonance imaging (MRI) demonstrated a cystic mass in the left frontal lobe with long T1 and long T2 signals. Extensive resection of the upper frontal gyrus was performed. The excised lesion presented with a cystic shape after incision and contained colorless translucent liquid. Microscopic examination of the lesion showed that the number of blood vessels in the local cortex of the brain tissue was increased and the vessels appeared to be branching. The blood vessel walls were surrounded by proliferative spindle cells, which were arranged in concentric circles. Immunohistochemical study revealed that those spindle cells and the cyst wall were vimentin positive. These cells had a rich reticular fibers. Ten months after the operation, the general condition of the patient was good, no epileptic seiƶure was observed, and the follow-up MRI did not reveal any residual lesion.@*Conclusions@#MRI of cystic meningioangiomatosis shows cystic space occupying. Pathological findings show typical features of meningioangiomatosis and cystic space formation. Cystic meningioangiomatosis has good prognosis after surgical resection.
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Objective To construct a scientific behavioral research of pasta matrix reaching task (PMRT) and comprehensively evaluate sensory-motor dysfunction caused by brain injury.Methods Twenty-one SD rats were subjected to 14-days pasta matrix grasping training and then were randomly divided into model group (11 rats) and sham group (6 rats).Motor cortex ischemia was induced by injection of endothelin-1 in SD rats.The number of pasta grabed by the injured forelimb and the location in matrix were evaluated daily 7 days after surgery.The infarct volume was measured by Nissl staining at the 7 days,14 days,and 28 days after stroke.Results The number of pasta obtained by rats was reduced from (33.43± 1.02) to (20.57±0.57) at 7 days post stroke in model group,and then increased to (26.85±0.98) at 28 days post stroke,although there was a significant difference between sham group (32.33± 1.45) and ischemic group (t=3.198,P＜0.05).The frequency of retrieval from each slot of the pasta matrix represented that sham group demonstrated a significant gain in performance in the antero quadrant of the matrix compared to ischemic rats by the fourth week after stroke.The stroke volume was decreased from (37.82± 1.17)mm3 at 7 days post-stroke to (24.35±0.38)mm3 at 28 days post-stroke,indicating brain recovery from ischemic injury.Conclusion The pasta matrix reaching task can function as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies and focused rehabilitative training after stroke.
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Objective@#To construct a scientific behavioral research of pasta matrix reaching task (PMRT) and comprehensively evaluate sensory-motor dysfunction caused by brain injury.@*Methods@#Twenty-one SD rats were subjected to 14-days pasta matrix grasping training and then were randomly divided into model group (11 rats) and sham group (6 rats). Motor cortex ischemia was induced by injection of endothelin-1 in SD rats. The number of pasta grabed by the injured forelimb and the location in matrix were evaluated daily 7 days after surgery. The infarct volume was measured by Nissl staining at the 7 days, 14 days, and 28 days after stroke.@*Results@#The number of pasta obtained by rats was reduced from (33.43±1.02) to (20.57±0.57) at 7 days post stroke in model group, and then increased to (26.85±0.98) at 28 days post stroke, although there was a significant difference between sham group(32.33±1.45) and ischemic group (t=3.198, P<0.05). The frequency of retrieval from each slot of the pasta matrix represented that sham group demonstrated a significant gain in performance in the antero quadrant of the matrix compared to ischemic rats by the fourth week after stroke.The stroke volume was decreased from (37.82±1.17)mm3 at 7 days post-stroke to (24.35±0.38)mm3 at 28 days post-stroke, indicating brain recovery from ischemic injury.@*Conclusion@#The pasta matrix reaching task can function as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies and focused rehabilitative training after stroke.
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Objective To explore risk factors of influencing operating efficiency of endoscopic submucosal dissection (ESD) for gastric mucosal lesions. Methods The data of 304 cases with gastric mucosal lesion undergoing ESD in Xijing Hospital of Digestive Disease from April 2009 to February 2017 were retrospectively analyzed. The procedure time and complete resection rate ( R0 resection rate ) were regarded as indicators of ESD efficiency. Risk factors influencing procedure time and R0 resection rate were analyzed using Chi-square test and logistic regression. Results Using median procedure time of 45 min as the cutoff value, Chi-square test showed that specimen size ( P=0. 000) , lesion location ( P=0. 001) , and pathological type ( P=0. 003) affected the operation time. Further logistic regression analysis indicated that specimen size (≥40 mm/<40 mm, P<0. 001, OR=3. 748, 95％CI: 2. 247-6. 254) and lesion location (upper or middle 1/3 of stomach/lower 1/3 of stomach, P=0. 001, OR=2. 180, 95％CI: 1. 318-3. 606) were independent risk factors of procedure time. Using R0 resection as outcome measure, neither single nor multiple parameter analysis was statistically significant. Conclusion Specimen size and lesion location are independent risk factors influencing efficiency of gastric mucosal ESD, and could be possibly used to estimate the procedure time of ESD.