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Objective To predict the effectiveness of nosocomial infection management and effectively control the risk of nosocomial infection. Methods In this study, with the population of ICU patients in a Grade A hospital , 345 ICU patients seen from June 2020 to June 2021 were included in the analysis to collect the infection data in the hospital. Based on the use of the decision tree model to analyze the influencing factors of nosocomial infection, the neural network model was also used to predict the risk of developing nosocomial infection. Results The decision tree model showed that advanced age (age> 80 years) influenced the root node. Type 2 diabetes, gender by male, and BMI level were child nodes, which had different synergistic effects on the occurrence of nosocomial infection. At the same time, random forest (RF), support vector machine (SVM), logical regression (LR) and K nearest neighbor (KNN) algorithms were used to construct a neural network prediction model of nosocomial infection risk, suggesting that the condition, sex and body size of basic diseases are related to the occurrence of nosocomial infection. The combined use of the above model in parallel can effectively increase the specificity and reduce the missed diagnosis. Conclusion The neural network model joint decision tree model in parallel and joint early warning of nosocomial infection risk have excellent effect, and can effectively provide information support for the prevention, management and disposal of nosocomial infection.
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Objective:To evaluate the impact of artificial intelligence continuous bowel sound auscultation recorder on enhanced recovery after surgery for patients with Crohn's disease.Methods:60 patients with Crohn's disease who underwent surgery in Sir Run Run Shaw Hospital , Zhejiang University School of Medicine in 2021 were enrolled in this trial prospectively. They were rendered to oral nutritional supplements (ONS) after surgery according to the hint given by artificial intelligence continuous bowel sound auscultation recorder or doctor's experience. In order to investigate the clinical value of artificial intelligence continuous bowel sound auscultation recorder.Results:the first postoperative flatus was earlier in the intervention group compared with control group [(58.3±1.5) h vs. (63.5±1.2) h, t=3.025, P=0.036], and the first ONS time was (18.3±0.3) h vs. (22.1±0.7) h, t=3.521, P=0.026; the incidence of postoperative complications in the intervention group was lower than that in the control group (3% vs. 7%, t=1.954, P=0.048) and the postoperative hospital stay was shorter [(7.2±0.4) d vs. (8.5±0.4) d, t=2.954, P=0.030]. The incidence of postoperative abdominal pain, abdominal distension, nausea, vomiting and fatigue in the intervention group was slightly lower than that in the control group, without statistically significant difference. Conclusion:In patient with Crohn's disease, the artificial intelligence continuous bowel sound auscultation recorder picks up accurate postoperative exhaust time, indicates the time of fist ONS after surgery, and shorten the postoperative hospital stay, without increase postoperative complication such as abdominal pain distension, accelerates postoperative recovery.
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OBJECTIVE To study the improvement effects and its mechanism of catalpol on testicular lesions in KK-Ay spontaneous diabetic mice on the basis of glycolysis process mediated by advanced glycation end products （AGEs） and their receptors （RAGE）. METHODS KK-Ay spontaneous diabetic mice fed with high-fat diet were used as diabetic model， and then randomly divided into model group， catalpol group （100 mg/kg）， aminoguanidine group （AGEs inhibitor， 100 mg/kg） and FPS- ZM1 group （RAGE inhibitor， 1 mg/kg）， and C57BL/6J mice fed in the same period were set as normal group， with 6 mice in each group. The catalpol group and aminoguanidine group mice were given relevant medicine intragastrically， normal group and model group mice were given constant volume of normal saline intragastrically， and FPS-ZM1 group mice were given relevant medicine 1 mL/g intraperitoneally， for consecutive 8 weeks. After the last administration， the body mass， fasting blood glucose， 24-hour food intake， water consumption， urine volume， testicular organ coefficient， and sperm motility of the mice were measured； pathological morphology and ultrastructural structure of testicular tissue were observed； the levels of reduced glutathione （GSH）， superoxide dismutase （SOD）， lactate dehydrogenase （LDH） and sugar metabolites in testicular tissue of mice were detected； pathway enrichment analysis was performed； the level of AGEs in serum and testicular tissue， protein expressions of RAGE， B-cell lymphoma-2 （Bcl-2） and Bcl-2-associated X protein （Bax）， and mRNA expressions of key rate-limiting enzymes [hexokinase （HK）， phosphofructose kinase （PFK）， pyruvate kinase （PK）， LDH] in testicular tissue were alldetected. RESULT S Catalpol could significantly improve the general symptoms， testicular organ coefficients and motility ofsperm in KK-Ay spontaneous diabetic mice （P＜0.05 or P＜0.01）. The morphology and ultrastructure of spermatogenic cells in each layer of the seminiferous tubules were all improved. The levels of GSH， SOD and LDH in testicular tissue，the levels of the metabolic product glucose fructose-1，6-diphosphate， 3-phosphate glycerate， 3-phosphate glyceraldehyde， lactic acid and pyruvate， the expressions of HK， PFK， PK and LDH mRNA were all significantly increased（P＜0.05 or P＜0.01）； the levels of AGEs in serum and testicular tissue， the expression of RAGE protein and the ratio of Bax to Bcl-2 in testicular tissue were significantly decreased（P＜0.05 or P＜0.01）. Aminoguanidine and FPS-ZM1 could significantly improve the levels of most of above indicators in mice（P＜0.05 or P＜0.01）. CONCLUSIONS Catalpol shows significant improvement effects on testicular lesions of KK-Ay spontaneous diabetic mice， and its mechanism of action was associated with upregulation of AGEs/RAGE signaling pathway- mediated glycolysis.
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【Objective】 To genetically analyze the Del sample from a blood donor in Jiangyin and make clear the molecular basis of the serological phenotype. 【Methods】 The EDTA anticoagulant blood were collected: buffy coat were used for nucleic acid extract and cDNA analysis; red blood cells for serological test. Tube method and microcolumn gel were used for serological test. Genotyping kit were used for exon analysis. Gene mutation was analyzed using the sequence analyzer. 【Results】 Serological analysis demonstrated the sample′s RhD phenotype was Del. The phenotype of RhCE was CCEe. Real-time fluorescence quota PCR result demonstrated the existence of all exones. Weak D15 and RHD* DEL1 [RHD(1227G>A)], which had a high frequency of occurrence in China, were excluded according to real-time fluorescence quota PCR result. Sequence analyzing result verified RHD(28C>T) SNP mutation in cDNA. The genotype of this sample was RHD*01 W. 61[RHD(28C>T)]. 【Conclusion】 A weak D61 was found among blood donors in our city, Jiangyin.
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Objective:To summarize clinical characteristics of patients with Aspergillus fumigatus infection in a hospital in Nanjing, to preliminarily assess azole resistance in clinical isolates of Aspergillus fumigatus, and to investigate risk factors for the emergence of azole-resistant Aspergillus fumigatus. Methods:Clinical isolates of Aspergillus fumigatus were collected from inpatients in Department of Laboratory, Nanjing Drum Tower Hospital from March 2017 to February 2021. Clinical data on these infected patients were analyzed, azole sensitivity testing and mutation analysis of the cyp51A gene and its promoter region were performed for these Aspergillus fumigatus isolates. Results:A total of 201 strains of Aspergillus fumigatus were collected, and mainly isolated from sputum specimens. Among the infected patients, there were 131 males and 70 females, and their age were 64.2 ± 15.8 years. The patients were mainly collected from department of respiratory medicine (79 cases), department of intensive medicine (34 cases), department of rheumatology (19 cases), etc. Among these patients, common underlying diseases included interstitial pneumonia (32 cases), malignant tumors (18 cases), pneumonia (13 cases), trauma (12 cases), systemic lupus erythematosus (8 cases), etc. Drug susceptibility testing showed that 6 (2.99%) strains of Aspergillus fumigatus were resistant to itraconazole and posaconazole, and 3 patients infected with azole-resistant Aspergillus fumigatus had used antifungal drugs before testing. Sequencing was performed on the cyp51A gene and its promoter region in the 6 strains of azole-resistant Aspergillus fumigatus, and showed TR34/L98H/S297T/F495I mutation in 5 strains and TR34/L98H mutation in 1 strain. Conclusion:Compared with previously published data about azole resistance in China during 2010 -2015, the resistance of Aspergillus fumigatus to azoles in Nanjing Drum Tower Hospital did not increase from 2017 to 2021, and the mechanism of azole resistance was mostly associated with TR34/L98H/S297T/F495I mutation in the cyp51A gene and its promoter region.
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Objective To establish a method for determining the content of Gd3+ in gadoteric acid meglumine salt injection. Methods ICP-MS was used. The separation column was a metal chelate column (1-ml Chelating Sepharose column), column temperature was normal temperature. Flow rate was 1 ml/min. Injection volume was 500 μl. Atoms were measured by ICP-MS with a molecular weight of 157 (The molecular weight of Gd was 157). The carrier gas was argon. Results The linear range of Gd3+ mass concentration was 0-500 ng/ml (r=1.000); The precision, stability and repeatability of the sample recovery test were all in accordance with the requirements. Conclusion The method was simple in operation, accurate in results and good in repeatability, which could be used to determine the content of Gd3+ in gadoteric acid meglumine salt injection.
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Objective:To explore features and clinical significance of motility characteristics, related clinical symptoms, 24-hour esophageal impedance-pH monitoring in patients with gastroesophageal reflux disease (GERD) complicated with esophagogastric junction outflow obstruction (EGJOO).Methods:From August 2014 to August 2019, a total of 512 GERD patients visited Zhuhai People′s Hospital were enrolled. All patients were divided into EGJOO group (85 cases) and non-EGJOO group (427 cases) according to the presence or absence of EGJOO. The patients were also divided into non-erosive reflux disease (NERD) group (393 cases) and reflux esophagitis (RE) group (119 cases) based on the endoscopic findings. The esophageal high resolution manometry (HRM) motility characterisrics, clinical symptoms, results of 24-hour esophageal impedance-pH monitoring of each group were analyzed. Fisher exact probability method, Wilcoxon rank sum test for comparison among groups and McNemar test for comparison of paired data were used for statistical analysis.Results:The lower esophageal sphincter (LES) resting pressure, integrated relaxation pressure (IRP), distal contractile integral (DCI), intrabolus pressure (IBP) and maximum IBP of EGJOO group were all higher than those of non-EGJOO group (30.70 mmHg, 22.50 mmHg to 40.75 mmHg (1 mmHg=0.133 kPa) vs. 19.90 mmHg, 14.50 mmHg to 26.20 mmHg; 17.80 mmHg, 16.20 mmHg to 22.85 mmHg vs. 7.80 mmHg, 5.20 mmHg to 10.20 mmHg; 1 282.80 mmHg·s·cm, 654.55 mmHg·s·cm to 2 563.20 mmHg·s·cm vs. 818.90 mmHg·s·cm, 495.10 mmHg·s·cm to 1 365.10 mmHg·s·cm; 7.00 mmHg, 4.40 mmHg to 11.65 mmHg vs. 3.60 mmHg, 1.10 mmHg to 5.80 mmHg; 14.90 mmHg, 11.50 mmHg to 18.80 mmHg vs. 10.40 mmHg, 8.10 mmHg to 13.10 mmHg, respectively), and the differences were statistically significant ( Z=-7.82, -14.57, -4.25, -7.16, and -6.27, all P<0.01). The LES resting pressure of NRED group was higher than that of RE group (21.70 mmHg, 15.65 mmHg to 29.40 mmHg vs. 19.40 mmHg, 13.60 mmHg to 25.10 mmHg), and the difference was statistically significant ( Z=-2.47, P=0.014). The DeMeeste score, episodes of long time (more than five minutes) acid reflux, the longest duration of reflux and the percentage of time pH<4 of EGJOO group were all higher than those of non-EGJOO group (6.60 points, 2.70 points to 11.20 points vs. 3.25 points, 1.30 points to 9.18 points; 1.00 times, 0.00 times to 1.00 times vs. 0.00 times, 0.00 times to 0.00 times; 6.50 s, 2.00 s to 15.00 s vs. 1.00 s, 0.00 s to 5.00 s; 1.70%, 0.30% to 2.30% vs. 0.30%, 0.00% to 1.63%, respectively), and the differences were statistically significant ( Z=-2.04, -2.94, -3.98 and -2.42, all P<0.05). Before treatment, the percentage of dysphagia of EGJOO group was higher than that of non-EGJOO group (9.4%, 8/85 vs. 2.1%, 9/427), and the difference was statistically significant (Fisher exact test, P=0.01). The percentage of heartburn, belching, abdominal pain, abdominal distention and chest pain of EGJOO group and non-EGJOO group after treatment were all significantly lower than those before treatment (EGJOO group: 11.8%, 10/85 vs. 34.1%, 29/85; 34.1%, 29/85 vs. 51.8%, 44/85; 4.7%, 4/85 vs. 20.0%, 17/85; 3.5%, 3/85 vs. 22.4%, 19/85; 4.7%, 4/85 vs. 21.2%, 18/85. Non-EGJOO group: 14.8%, 63/427 vs. 33.0%, 141/427; 36.8%, 157/427 vs. 51.5%, 220/427; 5.4%, 23/427 vs. 26.5%, 113/427; 6.6%, 28/427 vs. 21.1%, 90/427; 2.8%, 12/427 vs. 18.3%, 78/427), and the differences were statistically significant (all McNemar test, all P<0.05). Conclusions:In EGJOO patients with LES dysfunction, the symptoms are more severe, acid reflux is more obvious, and the efficacy of conventional prokinetic therapy is poor. The occurrence of esophageal erosion is not only due to acid reflux and acid exposure time, but also to esophageal motility disorder and local mucosal barrier function.
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Objective:To analyze the clinical characteristics, severity of disease and treatment response of different anti-arrhythmic drugs in children with supraventricular tachycardia (SVT) hospitalized in PICU, providing few empirical messages for pediatricians.Methods:A retrospective study was conducted in children of different ages with SVT admitted to PICU at Shengjing Hospital of China Medical University from January 2012 to December 2019, collecting data regarding patients′ clinical features and curative effect of different drugs.Results:Among seventy-three cases, 53 cases(72.6%) were male and 20 cases(27.4%)were female, including 31 infant cases(42.5%), 15 toddler cases(20.5%), and 27 elderly children(37.0%). Main clinical manifestations for initially complains in sequence included: 36 cases(49.3%) with findings of fast heart rate, 12 cases(16.4%) with poor or rejective feeding with milk, 11 cases(15.1%)with discomfort of the precordial area, and 13 cases(17.8%) with fever or cough.By comparative of the clinical manifestations of patients, poor or rejective feeding with milk was more in infants group than the other two groups, findings of fast heart rate was more in toddler and elderly groups compared with infant group, and more elderly children with discomfort of the precordial area compared with the other two groups, which showed significant differences( P<0.05). Eighteen cases(24.7%)developed to congestive heart failure and six cases(8.2%)of them diagnosed with cardiac shock.Ratio of congenital heart disease and percentile of complicated with heart failure were higher in infant group compared with the other two groups, with significant difference( P<0.05). Fifty-four cases(74.0%)were successful turnover.Six cases(8.2%)were turnover with assistance of synchronized cardioversion.Five cases(6.8%)were failed in turnover, and four cases(5.5%)died. Conclusion:Children grouped with ages admitted to PICU with SVT show different clinical manifestations, variant electrocardiograms and underline diseases.Not all of SVT could successfully turnover with medications and synchronized cardioversion.Some cases would developed to life-threatening heart failure or cardiogenic shock, even death.
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China has entered an aging society.The situation of elderly-care has become immensely serious.The task of providing health care for the elderly demands immediate and urgent attention,in which traditional Chinese medicine plays unique advantages.Currently,with government support,elderly health care provided by TCM has achieved good results,and reached an unprecedented rapid rising stage of opportunities.However,there is still quite a gap between the elderly health care services provided by traditional Chinese medicine and the increasing demand.By examining the current situation of elderly health care provided by TCM,this paper reveals the difficulties and challenges faced by elderly health care provided by TCM,such as lack of TCM geriatric professionals,disconnection with the Internet,impairment of necessary facilities.By studying the current status,this paper proposes strategies to promote elderly health care provided by TCM as an active response to the call of the aging population.
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National health is the fundamental purpose of building a healthy China. This paper analyzes the development status and existing problems of informational TCM health care services for the elderly, and proposes development strategies for TCM health care services, including "Health Care Plus Intelligent Management, Platform Plus Tourism Support, Medical Network Integration, and Smoothening the Industry Chain" for the new era of "Internet Plus", with the purposes of realizing real-time disease detection and intelligent diagnoses, meeting the senior health care needs, responding proactively to the call of the aging population and promoting the development and revitalization of TCM in the field of senior care.
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Objective This paper reports a modified method for the isolation of rat thoracic aortic vascular smooth muscle cells based on combined enzyme double digestion.Methods An enzyme mixture containing collagenase II, soybean trypsin inhibitor and elastase was prepared and used to remove the aortic tunica intima and tunica adventitia, and then the tunica media was subjected to second digestion using the same enzyme mixture and to isolate vascular smooth muscle cells.Results The isolated VSMCs were cultured in vitro and the growing cells had an elongated spindle-shape, reached confluence within a week, and displaying a typical hill-and-valley pattern.After 1 week, the cells were passaged.Contractile smooth muscle markers(α-SMA, myosin-II and β-tubulin) were highly expressed in the isolated cells.More than 90% of the cells significantly expressed alpha smooth muscle actin and myosin-II.Conclusions Themethod established in this study has advantages of simple and easy to operate, and good reproducibility, with a high activity and purity of the separated cells.It can ensure to obtain a large amount of contraction-type vascular smooth muscle cells within a short time.
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Aim To investigate the effect that catalpol intervenes macrophage polarization mediated by mouse mesangial cells(MMCs) stimulated by advanced glycation end products(AGEs).Methods RAW264.7 macrophages and MMCs were co-cultured in vitro and divided into model group(100 mg·L-1 AGEs), control group(100 mg·L-1 BSA), catalpol(0.1, 1.0, 10.0 μmol·L-1) group, and aminoguanidine(1.0 μmol·L-1) group which was set as positive control.After being incubated with catalpol for 1 h, MMCs were stimulated by AGEs for 23 h.The proliferation-inhibition rate of MMCs was measured by MTT assay.MCP-1 in supernatant liquid of MMCs was detected by ELISA method.The expression of iNOS, CD16/32, TNF-α, COX-2, CD206 and Arg-1 was detected by Western blot.Simultaneously, the percentage of iNOS and CD206 was also measured by flow cytometry.Results AGEs could increase the level of MCP-1 secreted by MMCs.The expression of iNOS, TNF-α, CD16/32 and COX-2 protein of macrophage was up-regulated after MMCs stimulated by AGEs, while the expression of CD206 and Arg-1 was down-regulated.After being intervened by catalpol, these effects could be reversed.All the changes were concentration-related.Conclusions Catalpol can inhibit macrophages M1-type polarization process and promote M2-type polarization, which may be mediated through MCP-1 secreted by MMCs after AGEs stimulation.Catalpol can ameliorate inflammation and relieve diabetic kidney injury.
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Systemic inflammatory response has a major role in the development and progression of cancer,and increased systemic inflammatory response usually correlates with poorer survival.Recently the evaluation index of systemic inflammatory response including neutrophil-lymphocyte ratio,C-reactive protein,glasgow prognostic score,platelet-lymphocyte ratio.Several previous studies show that these indexes are the independent prognostic factors for esophageal cancer.Research on the systemic inflammatory markers may also be valuable for the clinical treatment and prognosis of esophageal cancer.
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Aim To observe the protective mechanism of loganinand morroniside ( active components in Cornus officinalis) on HUVEC injury induced by advanced glycation end products ( AGEs ) .Methods HUVECs were cultured in vitro and divided into control group , model group ( AGEs group ) , loganin group , morroni-side group and aminoguanidine group ( set as positive control).After being incubated with loganin and mor-roniside( final concentrations were 100,10,1 μmol?L-1 ) for 1 h, HUVECs were stimulated by AGEs of 200 mg? L-1 for 24 h.Then, the cell viability was measured by using MTT method .The supernatant was extracted and the levels of NO ,ET-1,MCP-1,VCAM-1 were measured by the corresponding kits .Receptors of advanced glycation end products ( RAGE ) and NF-κB in HUVEC were detected by Western blot .Results Loganin and morroniside could inhibit HUVEC injury induced by AGEs .In model group ,the contents of ET-1,MCP-1,VCAM-1 increased(P<0.01),the content of NO decreased ( P <0.01 ) and the expression of RAGE and NF-κB increased(P<0.01); however,lo-ganin and morronside could reduce the ET-1,MCP-1, VCAM-1contents,increase the NO content and down-regulate the expression of RAGE and NF-κB to differ-ent extents .Conclusion Loganin and morroniside could ameliorate HUVEC injury , and its mechanism may be related to inhibit inflammation , the improve-ment of endothelial cell function , and the decrease of the expression of RAGE .
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Objective To investigate the clinical and pathological features and prognostic factors for thymoma with myasthenia gravis (MG).Methods The clinical and pathological data of 126 patients with thymoma and MG confirmed by postoperative pathological examination from 2008 to 2014 were analyzed retrospectively.The Kaplan-Meier method was used to calculate survival rates;the log-rank test was applied for univariate prognostic analysis;the Cox regression model was applied for multivariate prognostic analysis.Results The numbers of patients who received the follow-up visits at 3 and 5 years were 88 and 45,respectively (the patients who were admitted before the end of October 2011 and the end of October 2009).The 3-and 5-year survival rates were 97.9％ and 91.8％,respectively.The 3-and 5-year survival rates for patients with WHO types A+AB+B1 +B2 and B3 were 98.6％/95.2％ and 90.6％/92.9％,respectively (P=0.764),and those for patients with Masaoka stages Ⅰ-Ⅱ and Ⅲ-Ⅳ were 98.6％/95.2％ and 97.4％/72.7％,respectively (P=0.791).The 3-and 5-year survival rates for patients with complete and partial resection were 97.8％/91.7％ and 100.0％/50.0％,respectively (P=0.964),and those for patients with complete resection alone and complete resection+postoperative radiotherapy were 96.8％/93.1％ and 100.0％/94.7％,respectively (P=1.000).Conclusions The major treatment modality for thymoma with MG is complete resection followed by radiotherapy according to the specific circumstances after surgery.Complete resection,postoperative radiotherapy,WHO type,and Masaoka stage may be associated with prognosis.
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Objective To research the clinical characteristics of cerebral infarction involving the anterior and posterior circulation in the same time. Methods Collected the clinical data of 11 patients with cerebral infarction involving the anterior and posterior circulation in the same time, who was confirmed by clinical and radiographic examination. Results In the majority of 11 patients, they had multiple risk factors in the same time. By Chinese Ischemic Stroke Subclassification (CISS) criteria, there were 3 patients with large-artery atherosclerotic brain infarction (aortic arch atherosclerosis and intracranial and extracranial large arteries atherosclerosis coexist), 3 patients with cardiogenic stroke, 3 patients with undetermined etiology (intracranial and extracranial large arteries atherosclerosis and cardiogenic stroke maybe coexist), 2 patients with other etiologies(1 patient with Moyamoya disease, 1 patient with polycythemia vera). There were multiple vascular stenosis in the 3 patients with large artery atherosclerosis, and the posterior communicating artery was open. Conclusions Cerebral infarction involving the anterior and posterior circulation in the same time is rare, cardiogenic stroke is more often, the relevant examinations should be perfect to definite the rare cause.
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Aim To explore the protective effect of lo-ganin ( an active component in Cornus officinalis ) on podocyte injury induced by advanced glycation end products ( AGEs) and its possible mechanism. Meth-ods Mouse podocytes were cultured in vitro and di-vided into Normal group, model group ( AGEs group) , loganin group and aminoguanidine group ( set as posi-tive control) . After being incubated with loganin( final concentrations are 0. 1, 1, 10 μmol · L-1 ) for 1 h, podocytes were stimulated by AGEs of 100 mg · L-1 for 24 h. Then, the cell viability was measured by u-sing MTT method. Podocytes apoptosis was evaluated by Hoechst33342/PI staining and flow cytometry. Re-ceptors of advanced glycation end products ( RAGE ) ,desmin and apoptosis-related protein like Bax, Bcl-2, cleaved caspase-3 in podocytes were detected by Western blot. Results Loganin ameliorated podocyte injury induced by AGEs, down-regulated the expression of desmin and RAGE. Loganin also reduced the apoptotic rate of podocytes and decreased the ratio of Bax/ Bcl-2 and the expression of pro-apoptotic protein cleaved caspase-3 in podocytes. Conclusion Loganin could ameliorate podocyte injury, and its mechanism may be related to the decrease of the expression of RAGE and inhibition of the apoptotic pathway.
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<p><b>OBJECTIVE</b>To investigate the influence of the local sensory abnormality in throat while the change of motility in the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), as well as the change of esophageal body in pharyngeal paraesthesia.</p><p><b>METHODS</b>From January 2014 to January 2015 there were sixty-four patients who had pharyngeal susceptible syndrome (PSS) but without confirmed organic disease were enrolled as the PSS group, forty healthy volunteers as the control group. High resolution manometry (HRM) was utilized to distinguish esophageal motility patterns of PSS, including the muscular tension of LES and UES, the integrity, adaptability, amplitude, speed and duration of esophageal peristalsis at 10 swallows.</p><p><b>RESULTS</b>The resting LES and UES pressures and the distal contractile integral (DCI) of esophagus in PSS group were lower than that in control group (P < 0.05). The esophageal peristalsis was decelerated and shortened in duration, and amplitude of contraction notably lower in PSS group compared with its counterpart (P < 0.05). The integrity of esophageal peristalsis was impaired in PSS with remarkable changes in motility patterns, involving ratio of major and minor interrupts, and synchronous contraction rate (P < 0.05). As for the time course from relaxation to the lowest pressure point of UES and time for restoration, no definite difference was noticed between the two groups (P > 0.05). The average peak pressure was similar in two groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Muscle tension around the UES has no obvious change when pharyngeal paraesthesia occurred, but the reduction of esophageal motor function, clearance ability, anti-reflux gastroesophageal junction, causing the abnormal reflux which hurt the pharyngeal surface mucosa maybe one of the most important reasons leading to pharyngeal paresthesia.</p>
Subject(s)
Humans , Esophageal Motility Disorders , Diagnosis , Esophageal Sphincter, Lower , Esophageal Sphincter, Upper , Manometry , Muscle Tonus , Paresthesia , Peristalsis , Pharynx , PressureABSTRACT
<p><b>OBJECTIVE</b>To measure gray matter volume of whole brain with voxel-based morphometry (VBM) method and to study brain structures associated with gross motor function.</p><p><b>METHOD</b>Forty children with cerebral palsy were recruited in the authors' hospital from Oct. 2012 to Dec. 2013 (26 male, 14 female cases, average age (3.6 ± 2.0) years ). Gross motor function classification system (GMFCS) for children was used to obtain their motor function. The whole-brain three dimensional magnetic resonance imaging (MRI) was performed on a 3.0 T MRI scanner. The data were segmented by VBM 5, and the whole brain volumes of gray matter, white matter and cerebospinal fluid were produced. Correlation analysis was used to analyze the correlation of GMFCS with whole brain volumes using SPM 5 in Matalab 7.1.</p><p><b>RESULT</b>The volume in left meditemporal gyrus (Z=3.57) and inferior temporal gyrus (Z=3.40), right thalamus and pallidum (Z=3.36), left thalamus and pallidum (Z=2.76), left supramarginal gyrus (Z=3.14), left precuneus gyrus (Z=3.00), right dorsolateral superior frontal gyrus (Z=3.08), right superior and medial occipital gyrus (Z=2.84) significantly increased as aggravation of gross motor dysfunction. The volume of the left medial orbitofrontal lobe and anterior cingulate (Z=3.28,3.02), left medial superior frontal gyrus (Z=3.19), left caudate (Z=3.04, 2.94, 2.92), left cerebellum (Z=2.94), right cerebellum (Z=2.97), left parahippocampal (Z=3.94), right parahippocampal (Z=3.43, 3.00), left insula (Z=3.50), right insula (Z=3.41, 3.80), left lingual (Z=3.37), right lingual (Z=3.30), left post cingulum (Z=2.73), left midioccipital gyrus (Z=2.92) and right miditemporal gyrus (Z=3.05) significantly reduced as the aggravation of gross motor dysfunction (P all<0.005).</p><p><b>CONCLUSION</b>GMFCS in children with cerebral palsy is related to abnormalities of brain gray matter structure for motor, emotion, memory and default model network when examined with VBM method.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Cerebral Palsy , Gray Matter , Pathology , Magnetic Resonance ImagingABSTRACT
Objective To evaluate the therapeutic effects of thymectomy in myasthenia gravis (MG) patients with thymoma.Methods A total of 178 MG patients with thymectomy between July 2008 and December 2010 were included.All the subjects were received either cyclophosphamide alone or in combination with radiotherapeutic treatment after surgery.The MG absolute and relative clinical scores were used to assess the effectiveness of long-term trcatments.Clinical evaluations were conducted before,and at 1,6,12 and 24 months after operation.A comparative analysis on the inter-relationships among MG clinical presentation,WHO histology aud Masaoka stage was also conducted.Results (1) Of the 178 thymomapatients,103 were male and 75 were female,with a mean age of (43.7 ± 12.5)-years old.One hundred and twelve cases were taken cyclophosphamide,and 58 cases with invasive thymoma (stages Ⅱ,Ⅲ and Ⅳ or WHO type B3) were taken cyclophosphamide in combination with radiotherapy.Five patients refused cyclophosphamide or radiotherapy and 3 did not finish treatment.(2) The muscular strength improved obviously in 32.8％ (58/177) of the patients after 1 month after thymectomy,and 59.8％ (101/169),69.7％ (115/165) and 81.5％ (132/162) after 6 months,1 year and 2 years,respectively with MG score for disease severity decreased significantly with time.(3) No significant differences of the improvement rates were observed in patients within different WHO histology category.However,the rates were much higher in patients with Masaoka stage Ⅰ (91.4％) and stage Ⅱ (89.8％) than those in patients with stage Ⅲ (45.5％) and Ⅳ(28.6％) (all P＜0.001).Conclusions The remission rate of MG patients with thymomas increase after thymectomy plus cyclophosphamide or in combination with radiotherapy and reached 81.5％ after 2 years.The remission rate is associated with Masaoka stagc,but not with WHO histology.