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Objective:To analyze 141 cases clinically misdiagnosed as melanoma, and to improve the understanding and diagnosis of diseases.Methods:Totally, 141 cases preliminarily diagnosed as melanoma, which was finally excluded according to histopathological examination results, were collected from the pathological database of Department of Dermatology, Xijing Hospital, The Fourth Military Medical University from November 2001 to September 2019, and their clinical and histopathological data were analyzed retrospectively.Results:Among the 141 cases clinically misdiagnosed as melanoma, 64 were males and 77 were females. Their median age at the time of misdiagnosis was 51 years, and the average disease duration was 103.4 months. The patients mainly presented with patches and papules, most of which were black in color. Based on histopathological manifestations, 35 patients were diagnosed with pigmented nevi, 29 with basal cell carcinoma, 15 with seborrheic keratosis, 7 with Bowen′s disease, 6 with nail melanin spots, 5 with epidermal cysts, 4 with poroma, 4 with hemorrhage, 4 with dermatofibroma, and 23 with other skin diseases.Conclusions:In clinical practice, some diseases with characteristics of melanoma are liable to be misdiagnosed. It is necessary to grasp their clinical features and actively carry out auxiliary examinations such as dermoscopy and histopathological examinations to confirm the diagnosis and reduce the misdiagnosis rate.
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Objective:To investigate the characteristics of obesity in adolescents with major depressive disorder (MDD) and its association with the depressed severity.Methods:A total of 278 adolescents with MDD were recruited according to the inclusion and exclusion criteria. Their demographic data were collected and 24-item Hamilton depression scale (HAMD-24) was used to evaluate their severity of depression. According to the body mass index (BMI) classification standard of adolescents in China, all subjects were classified into four groups(wasting group, normal BMI group, overweight group and obesity group). SPSS 26.0 statistical software was used for data analysis. The Kruskal-Wallis test and the Chi-square test were separately used for the comparison of the four groups.Spearman correlation was used to explore the relationship between BMI and HAMD-24 scores and severity.Results:Among 278 adolescents with MDD, the prevalence of body abnormality was 32.4% (90/278), among which wasting, overweight and obesity were 9.0% (25/278), 14.4% (40/278) and 9.0% (25/278) respectively. There were statistically differences in gender ( χ2=17.018, P<0.001), HAMD-24 scores ( H=9.427, P=0.024) and depressed severity( H=8.508, P=0.037) among the four groups. Multiple comparisons showed that there were only statistically differences between obesity group and normal BMI group, that was the prevalence of obesity in males was higher than that in females ( χ2=13.631, P<0.001), and the level in HAMD-24 scores ( Z=2.956, P=0.003) and depressed severity ( Z=2.832, P=0.005) was lower in obesity group than that in normal BMI group.Spearman correlation analysis showed that BMI was negatively correlated with HAMD-24 scores ( r=-0.162, P=0.007). Conclusion:There is gender difference in obesity rates among the adolescent patients with first-episode untreated MDD. And the obese patients are less depressed than those with normal BMI.
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Objective@#To investigate the changes of brain activity in adolescents with first-episode major depressive disorder (MDD) and its significance.@*Methods@#Totally 42 first-episode MDD patients with suicidal ideation (SU group), 17 MDD patients without suicidal ideation (NSU group) and 29 healthy controls (HC group) were examined by psychological assessment and resting-state functional magnetic resonance imaging (fMRI). The differences of brain functional activities between the three groups were compared by amplitude of low frequency fluctuation(ALFF). The relationship between the difference of zALFF value in brain regions and the severity of depression, intensity of suicidal ideation were further analyzed.@*Results@#The zALFF values in the left hippocampus(MNI: x=-21, y=-33, z=0) and left Frontal_Sup_Medial(MNI: x=3, y=33, z=63) of the three groups were significantly abnormal (P<0.001, k>20, uncorrected). The results of Post-hoc test showed that the zALFF value of left hippocampus increased significantly (F=28.931) and decreased significantly in left Frontal_Sup_Medial(F=16.648)in SU group , compared with NSU group and HC group(P<0.001, Bonferroni correction). There was no significant difference in zALFF value between HC group and NSU group(P>0.05). In SU group, the zALFF values of left hippocampus and left Frontal_Sup_Medial were not correlated with total scores of HAMD-24(r=-0.214, -0.103) and suicide ideation intensity factor scores(r=0.115, -0.055)(P>0.05).@*Conclusion@#Abnormal autonomic nervous activity exists in left hippocampus and left Frontal_Sup_Medial in adolescent MDD patients with suicidal ideation, which may be the neurological basis and biological index of suicidal ideation.
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Objective To study the resting-state functional connectivity( FC) changes of anterior cingulate cortex(ACC) and amygdala in adolescent patients with medication-naive first-episode major de-pressive disorder(MDD).Methods Medication-naive first-episode MDD adolescents( n＝30) and pair-wise matched healthy controls(HCs,n＝29) underwent resting-state functional magnetic resonance images(fM-RI).To study whether there were different in FC changes between amygdala and ACC and whole brain re-gions,and whether abnormal FC was related to clinical characteristics.Results Compared with HCs,the ado-lescent MDD patients showed decreased FC between the left amygdala and right thalamus( MNI x,y,z:15,－21,18)(t＝－2.85)and increased FC between the left amygdala and the bilateral temporal middle gyrus,left occipital gyrus,right medial prefrontal cortex(MPFC)(MNI x,y,z:9,66,15) ( t＝2.80).The right amygdale showed decreased FC with bilateral middle frontal gyrus,left caudate(MNI x,y,z:－15,－9,21)(t＝－2.53), right thalamus(MNI x,y,z:12,－36,12)(t＝－3.01),right cerebellum(MNI x,y,z:3,－84,－33)(t＝－2.45) and increased FC with right temporal middle gyrus,right MPFC( MNI x,y,z:6,69,12) ( t＝2.41).The left ACC showed decreased FC with left cerebellum( MNI x,y,z:12,－87,－24) ( t＝－2.36),left frontal inferior triangle gyrus,right frontal inferior orbital gyrus and increased FC with right frontal middle orbital gyrus.The right ACC showed decreased FC with left caudate(MNI x,y,z:－15,21,6)(t＝－2.29),right temporal middle gyrus,right MPFC(MNI x,y,z:9,54,36)(t＝－2.29),right frontal inferior orbital gyrus,right angular(MNI x,y,z:45,－51,21)(t＝－3.01),left dorsolateral prefrontal cortex(MNI x,y,z:－21,33,36) ( t＝－2.61).The increased FC between the left amygdale and bilateral temporal middle gyrus showed positive correlation with the score of HAMD(r＝0.50,P＜0.05;r＝0.45,P＜0.05).And the FC between the right amygdale and right middle frontal gyrus was positive correlation with duration of disease( r＝0.63,P＜0.05).Conclusion There is widespread FC disorder in amygdala and ACC in adolescents patients with first-episode depression.Abnor-mal FC changes may be the neuropathological mechanism of depression.
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CRISPR-based genome editing has been widely implemented in various cell types. In-silico single guide RNA (sgRNA) design is a key step for successful gene editing using CRISPR system. Continuing efforts are made to refine in-silico sgRNA design with high on-target efficacy and reduced off-target effects. In this paper, we summarize the present sgRNA design tools, and show that efficient in-silico models can be built that integrate current heterogeneous genome-editing data to derive unbiased sgRNA design rules and identify key features for improving sgRNA design. Our review shows that systematic comparisons and evaluation of on-target and off-target effects of sgRNA will allow more precise genome editing and gene therapies using the CRISPR system.
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Objective To study the correlation between 5-serotonin transporter ( 5-HTT) gene pol-ymorphism and the first episode major depressive disorder ( MDD ) and cognitive function in adolescent. Methods 5-HTT genotype and allele were detected by polymerase chain reaction ( PCR) amplification of 76 patients with first episode of MDD and 73 normal controls. Case control method was used to analyze the correlation between different genotypes and the onset, the clinical features, and cognitive function. Result-s There was no significant difference between 5-HTTLPR genotype frequencies for the 41 cases of type S/S (53.9%),27 cases of type L/S(35.5%),8 cases of type L/L(10.5%)of case group and 5-HTTLPR geno-type frequencies for the 38 cases of type S/S(52.1%),18 cases of type L/S(24.7%),17 cases of type L/L (23.3%) of control group(P>0.05).Patients with S/S type,L/S type had significantly higher sleep scores than those of patients with type L/L(P=0.005,P=0.001). Agitation score in patients with S/S type group was significantly higher than that in patients with S/L,L/L(P=0.000,P=0.001);patients with S/S inferior-ity scores were significantly lower than those of patients with S/L,L/L(P=0.002,P=0.006). There was no significant difference in cognitive function among three groups. Conclusions In Chinese Han population, there may be no direct association between 5-HTTLPR gene polymorphism and susceptibility to MDD and its cognitive function in adolescents. S/S and L/S patients may be prone to sleep problems,type S/S patients may be prone to irritability and type L/L patients may be prone to inferiority.
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Objective To analyze the early clinical efficacy of alendronate sodium on residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.Methods By drug single treatment method,a total of 30 elderly patients with residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures were included.Patients were randomly divided into 2 groups:the treatment group and the control group.All patients were given calcium carbonate D3 treatment,and the treatment group was given alendronate sodium treatment additionally.6 weeks after the treatment,visual analogy score (VAS) was used for the evaluation of pain relief.Results All patients were followed up for 6 weeks.At the end of follow-up,the rates of pain relief were 86.8％ in treatment group and 13.2％ in control group.There was a significant difference in visual analogy scores between the treatment group and the control group[(0.51±0.32),(1.59±1.21) ; t=3.4,P＜0.001],which showed the degree of pain relief was higher in the treatment group than in control group.Conclusions Alendronate sodium is effective and reliable for the treatment of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.This study provides the scientific reference for the treatment and research of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.
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Objective To investigate the expression and significance of super oxide dismutase activity and malondialdehyde concentration in the serum and adrenal grands of patients with adrenocortica diseases. Methods 12 patients with adrenal hyperplasia and 10 patients with adrenal adenoma which were carried out hospital surgery and confirmed by pathology, and 11 cases of normal as controls were selected.The serum level of Cu/Zn-SOD, Mn-SOD and MDA before operation, and Cu/Zn-SOD and Mn-SOD positive cells percentage of adrenal tissue were compared between three groups. Results Before adrenalectomy SOD activity was lower(P <0.05)and MDA concentration was higher in serum(P<0.05)than the control group.Cu/Zn-SOD positive cell was lower in adrenocortical adenoma tissue than that of adrenocorticohyperplasia and normal cortex(P <0.05).Mn-SOD positive cell had a significant difference among adrenocortical hyperplasia, adrenocortical adenoma and normal adrenal cortex tissue(P <0.05).Both SOD positive cell in adrenocortical adenoma tissue were the lowest of all.In addition,the expression of SOD in tissue had a significant positive correlation with serological expression in study group. Conclusion The superoxide dismutase activities and malondialdehyde concentration seemed to change with adrenocortica diseases.The detection of superoxide dismutase activities and malondialdehyde concentration in the serum and adrenal grands could be the potential methods for the diagnosis and differential diagnosis of adrenocortica diseases.
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Objective To discuss the treatment of urethral stricture after hypospadias reDair.Methods Thirty-seven cases of urethral stricture after hypospadias repair from 1999 to 2006 were ret-rospectively analyzed. Of 37 patients,the stricture was located at the distal end of urethra in 7 cases.There were 3 1 cases with anastomotic stricture.There was 1 case with distal urethral stricture and anastomotic structure.There were 1 3 patients with the simple urethral stricture and the complicated 24 cases.Of 13 simple urethral stricture patients,4 patients were repaired with urethro-meatomy,6 patients with shelf operation and 3 patients with transurethral holmium laser urethrotomy.Eight Pa-tients with complicated urethral fistula,6 patients with urethral diverticula,4 patients with phallo-campsis and 6 patients with many times of postoperative urethral stricture were repaired with shelf op-eration or penis skin flap or septum of scrotum skin flaps urethroplasty. Results The simple stric-tures of 1 2 patients were cured by stage 1 operation,the other one cured after second surgery.Of 8 patients with fistula,7 were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with diverticulum,all were cured at stage 1.Of 4 patients with phallocampsis,3 cases were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with recurrent strictures,all were cured at stage 1.A1l patients were followed up 1 2 to 24 months.The micturition was without difficuItv at stand position. Conclusions Urethral stricture is one of the most common complications after hypos-padias repair.The simple urethral stricture could be repaired with urethro-meatomy or sheIf operation or transurethral holmium laser urethrotomy.The complicated urethral stricture could be reDaired with shelf operation or penis skin flaps or septum of scrotum skin flaps urethroplasty and overjetted with dortos of scrotum flaps.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of intraprostatic injection of Chuanshentong in the treatment of chronic abacterial prostatitis/chronic pelvic pain syndrome(CAP/CPPS).</p><p><b>METHODS</b>Randomized, double blinded, placebo controlled trials were carried out from September 2002 to March 2003. A total of 38 patients with diagnosed CAP/CPPS, 24 experimental and 14 controls, were analyzed. In the trial group, 6 ml of mixed solution of Chuanshentong and lidocaine was transperineally injected into one lobe of the prostate, once a day for 6 days. Likewise, the control group was treated with placebo containing lidocaine. The efficacy was evaluated by the NIH Chronic Prostatitis Symptom Index(CPSI) after a 6-week follow-up. The main semen parameters before and after 3-month treatment were compared.</p><p><b>RESULTS</b>In the trial group, 13 cases (56.5%) were completely cured, 5 cases(21.7%) showed remarkable effect, and 4 cases (17.4%) were improved. While in the control group, effectiveness was shown in only 2 cases (15.4%), and improvement in 3 cases (23%). CPSI scores decreased significantly after treatment(95% of confidence interval: 17.97-23.08). Chuanshentong solution had no obvious impact on the main semen parameters. No severe adverse effects were observed.</p><p><b>CONCLUSION</b>Transperineal intraprostatic injection of Chuanshentong is a safe and effective method for the treatment of CAP/CPPS.</p>
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Adult , Humans , Male , Middle Aged , Chronic Disease , Double-Blind Method , Drugs, Chinese Herbal , Therapeutic Uses , Injections , Pelvic Pain , Drug Therapy , Prostatitis , Drug TherapyABSTRACT
Objective To improve the diagnosis and differential diagnosis of adrenal incidentalomas for the optimal management of adrenal masses. Methods The clinical data of 52 cases (35 men and 17 women;mean age,42 years;age range,23-65 years) of adrenal incidentalomas was reviewed.Among them, 33 cases had tumors ≥ 3.0 cm in diameter.None of 52 cases had clinical symptoms and signs of hypertension and endocrine dysfunction.All of the tumors were incidentally found by ultrasonography or CT on regular physical examination.A series of blood chemical examinations (including electrolytes,adrenal cortical and medullary metabolic biochemistry),abdominal ultrasound and CT were performed in all 52 cases;and MRI,PET and 131 I-MIBG imaging were performed in 6,2 and 1 cases,respectively.Surgery and postoperative pathological study were performed in all. Results Postoperative pathology showed adrenocortical adenoma in 27 cases,adrenal metastatic carcinoma in 7,adrenal pheochromocytoma in 5,adrenal cyst in 4,primary aldosteronoma in 3,adrenal neurinoma in 2,adrenocortical carcinoma in 1,retroperitoneal neuroblastoma in 1,retroperitoneal primary lymphoma in 1 and adrenal ganglionic fibroma in 1.Diagnoses based on the results of imaging examinations and laboratory tests were correct in 14 cases (27%).Of the 10 patients with malignancies,5 with primary diseases died 6-10 months after chemotherapy and 5 were lost to follow-up.The remaining 42 patients were followed up for 6 months to 9 years with no evidence of recurrence. Conclusions Multidisciplinary approaches are required to identify and differentiate adrenal incidentalomas, and early surgical treatment is suggested.
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Objective To study the effect of finasteride on hematuria associated with benign prostate hyperplasia. Methods We evaluated 61 patients with intermittent hematuria who were randomized to a finasteride treated group or control group.Routine urinoscopy was carried out once a week in all the 61 patients. Results In the untreated control group hematuria recurred in 20/31 within a year but in only 7/28 in the finasteride group,which was a statistically significant difference (P