ABSTRACT
Objective:To investigate the association between split foot and electrophysiology in patients with amyotrophic lateral sclerosis (ALS).Methods:The clinically definite or clinically probable ALS patients hospitalized in the Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital from April 2021 to December 2022 were prospectively collected. From April 2021 to December 2022, patients who visited the Chinese People′s Liberation Army General Hospital for other reasons without abnormal electrophysiological examination were collected as the control group. The incidence of split leg [the limb whose modified Medical Research Council Muscle Strength Scale (mMRC) score of ankle dorsiflexors was lower than that of ankle plantarflexors] in ALS patients was calculated, and the incidence of split foot (the limb whose mMRC score of hallux dorsiflexors was lower than that of hallux plantarflexors) in ALS patients was calculated. The amplitude of compound muscle action potential (CMAP) of common peroneal nerve and tibial nerve was detected to observe the involvement of motor neurons innervating ankle dorsiflexors and ankle plantarflexors. The characteristics of split leg and split foot in ALS patients were analyzed from the perspective of muscle strength, and the characteristics of split foot in ALS patients were analyzed from the perspective of electrophysiology. Receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of peroneal nerve/tibial nerve CMAP amplitude ratio in distinguishing ALS patients from controls.Results:A total of 101 ALS patients with lower limb involvement and 110 controls with normal lower limb muscle strength were collected. Among the 101 ALS patients with lower limb involvement, strength of ankle plantarflexors was greater than that of ankle dorsiflexors in 35.64% (36/101) patients, strength of ankle dorsiflexors was greater than that of ankle plantarflexors in 5.94% (6/101) patients, and strength of ankle plantarflexors and ankle dorsiflexors was equal in 58.42% (59/101) patients. Strength of hallux dorsiflexors was lower than that of hallux plantarflexors in 53.47% (54/101) patients, strength of hallux dorsiflexors was greater than that of hallux plantarflexors in 1.98% (2/101) patients, and the strength of hallux dorsiflexors and hallux plantarflexors was equal in 44.55% (45/101) patients. The incidence of split leg was negatively correlated with age ( OR=0.25, 95% CI 0.16-0.40, P<0.05), course of disease ( OR=0.52, 95% CI 0.38-0.80 P<0.05) and ALS functional revised scores ( OR=0.29, 95% CI 0.12-0.67, P<0.05). The incidence of split foot was negatively correlated with the onset time of lower limb symptoms ( OR=0.96, 95% CI 0.93-0.99, P<0.05). Compared with the control group, the differences of the decrease of CMAP amplitude in the common peroneal nerve and tibial nerve [the common peroneal nerve (6.45±2.56) mV vs (3.63±1.83) mV, tibial nerve (12.87±4.72) mV vs (9.18±6.22) mV] were statistically significant ( t=-4.65, t=-3.44, both P<0.001) and the differences of the peroneal nerve/tibial nerve CMAP amplitude ratio (0.54±0.24 vs 0.36±0.18) decrease was statistically significant ( t=-4.31, P<0.001) in patients with split foot. ROC curve analysis showed that the area under the ROC curve of CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot was 0.70, indicating that the accuracy of CMAP amplitude of common peroneal nerve/tibial nerve in distinguishing ALS patients from controls was low. Conclusions:In ALS patients with lower limb involvement, strength of ankle dorsiflexors is weaker than that of ankle plantarflexors, and strength of hallux dorsiflexors is weaker than that of hallux plantarflexors. At the diagnostic level, the CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot has a lower accuracy in the diagnosis of ALS.
ABSTRACT
Objective:Charcot-Marie-Tooth disease (CMT) comprises a group of clinically and genetically heterogeneous inherited neuropathies with an estimated prevalence of 1 in 2500. This study aimed to analyze the clinical and mutational characteristics of Chinese CMT patients with MFN2, BSCL2 and LRSAM1 variants.Methods:In this study, genetic analysis was performed in 206 Chinese patients at Chinese PLA General Hospital from December 2012 to March 2020 with clinical diagnosis of CMT, and reported variants of MFN2, BSCL2 and LRSAM1 related to CMT2.Results:We reported ten MFN2 mutations in ten unrelated patients (7 male, 3 female), two of whom had positive family history. Three novel mutations were detected including c.475-2A>G (splicing); c.687dupA (p.E230Rfs*16) and c.558dupT (p.S186fs). We reported three BSCL2 mutations of four unrelated patients, including c.461C>G (p.S154W), c.461C>T(p.S154L), and novel variants of c.1309G>C (p.A437P) and c.845C>T (p.A282V). Furthermore, two novel variants of LRSAM1, including c.1930G>T (p.G644C) and c.1178T>A (p.L393Q) were detected in two unrelated patients.Conclusion:Mutational spectrum of MFN2-, BSCL2-and LRSAM1-related CMT disease is expanded with the identification of novel variants in Chinese patients.
ABSTRACT
Objective:To investigate the curative efficacy of radical prostatectomy (RP) for T 4 stage prostate cancer invading bladder neck. Methods:The clinical data of 22 patients with T 4 stage prostate cancer invading bladder neck treated with RP from April 2013 to March 2021 were analyzed retrospectively. The mean age of the patients was (64.09±6.33) years, and the preoperative blood PSA was 57.70(39.40, 68.56) ng/ml. Preoperative MRI or PSMA-PET examination revealed bladder neck invasion, including 16 cases (72.73%) of urinary retention. Clinical stage of T 4N 0M 0 accounted for 40.91% (9/22), T 4N 1M 0 accounted for 45.45% (10/22), and T 4N 1M 1 accounted for 13.64% (3/22). Preoperative patients were not treated with neoadjuvant endocrine or chemotherapy. Laparoscopic or robotic assisted laparoscopic radical prostatectomy and pelvic lymph node dissection were performed. Results:The 22 operations were successfully completed without conversion. The operation time was(184.27±34.82) min, the amount of intraoperative bleeding was (210.91±83.03) ml, the retention time of drainage tube was (4.73 ± 1.03) days, the recovery of gastrointestinal function took 3 (2, 3) days, and the postoperative hospital stay was (6.68 ± 1.39) days. Postoperative pathology showed that the Gleason score of 7 points accounted for 4.54% (1/22), 8 points accounted for 13.64% (3/22), and 9 points accounted for 81.82% (18/22). The positive rate of margin was 81.82% (18/22). Pathological stage of T 4N 0M 0 accounted for 22.73% (5/22), T 4N 1M 0 accounted for 63.64% (14/22), and T 4N 1M 1 accounted for 13.64% (3/22), of which extracapsular or seminal vesicle invasion accounted for 90.91% (20/22). The incidence of postoperative complications above grade 3 was 9.09% (2/22), and the rate of urinary control recovery after 3 months of surgery was 90.91% (20/22). 16 patients with preoperative urinary retention were able to urinate normally after operation. All patients were treated with adjuvant androgen deprivation therapy (ADT) with or without antiandrogens, and 13 cases (59.09%) were treated with adjuvant radiotherapy. The postoperative PSA value before adjuvant treatment was 2.53 (0.51, 5.44) ng/ml. The median survival time was not reached. Two patients died of prostate cancer at 71 and 84 months and one patient died of heart disease at 28 months. Conclusions:RP surgery could effectively relieve the condition of urinary retention with low incidence of operative complications. Although the positive rate of surgical margin is high, RP could be used as one of the treatment options for T 4 stage prostate cancer invading bladder neck, while the long-term effect is still needed to be further analyzed.
ABSTRACT
Objective:To investigate the role and action mechanism of aquaporin 3 (AQP3) in skin photoaging.Methods:Normal human skin fibroblasts (NHDF) were divided into several groups: NHDF group receiving normal culture without transfection, AQP3 cDNA group transfected with AQP3 cDNA, AQP3 siRNA group transfected with AQP3 siRNA, heterogeneous nuclear ribonucleoprotein Q (hnRNPQ) cDNA group transfected with hnRNPQ cDNA, hnRNPQ siRNA group transfected with hnRNPQ siRNA, AQP3-hnRNPQ cDNA group transfected with AQP3 and hnRNPQ cDNAs, AQP3-hnRNPQ siRNA group transfected with AQP3 and hRNPQ siRNAs, cDNA empty vector group transfected with a cDNA empty vector, and siRNA empty vector group transfected with a siRNA empty vector. Transfected or untransfected NHDFs were irradiated with ultraviolet A (UVA) at a dose of 10 J·cm -2·d -1 for 3 consecutive days to establish a model of cellular senescence, and NHDF receiving no UVA irradiation served as a control. A cell counting method was used to evaluate the cellular proliferative activity, a senescence-related β-galactosidase staining kit to evaluate the senescence level of NHDFs in each experimental group, and luciferase reporter gene technology to assess the transcriptional regulation activity of p53. Western blot analysis was performed to determine the expression of AQP3, hnRNPQ and senescence-related proteins p53 and p21 in NHDFs. Two-independent-sample t test was used for comparisons between two groups, and one-way analysis of variance for comparisons among multiple groups. Results:After 3-day consecutive irradiation with UVA, the expression of p53 and p21 in NHDFs and the percentage of β-galactosidase-positive cells significantly increased compared with the unirradiated control group (all P < 0.05) , but the expression of AQP3 and cellular proliferative activity on days 5, 6 and 7 significantly decreased in the UVA group compared with the unirradiated control group (all P < 0.05) . After 3-day consecutive irradiation with UVA, aggravated senescence-related phenotypes of UVA-induced NHDFs were observed in the AQP3 siRNA group compared with the siRNA empty vector group, and there were significant differences in the expression of p53, p21 and hnRNPQ, percentage of β-galactosidase-positive cells, p53 transcriptional regulation activity and cellular proliferative activity between the 2 groups (all P < 0.05) . Further silencing of the hnRNPQ gene could reverse the above effects. Compared with the siRNA empty vector group, the senescence-related phenotypes of UVA-induced NHDFs were attenuated in the hnRNPQ siRNA group, and significant differences were observed between the 2 groups in terms of the expression of p53, p21 and hnRNPQ, percentage of β-galactosidase-positive cells, p53 transcriptional regulation activity and cellular proliferative activity (all P < 0.05) . After 3-day consecutive irradiation with UVA, the senescence-related phenotypes of UVA-induced NHDFs were significantly attenuated in the AQP3 cDNA group compared with the cDNA empty vector group (all P < 0.05) , manifesting as significantly decreased expression of p53 (0.25 ± 0.06 vs. 0.56 ± 0.08) , p21 (0.23 ± 0.06 vs. 0.70 ± 0.07) and hnRNPQ (0.82 ± 0.09 vs. 0.92 ± 0.03) , percentage of β-galactosidase-positive cells (31.23% ± 6.54% vs. 81.53% ± 7.62%) and p53 transcriptional regulation activity (2.52 ± 0.36 vs. 7.16 ± 0.25) , but increased cellular proliferative activity ([2.93 ± 0.33]× 10 6/ml vs.[2.15 ± 0.23]× 10 6/ml) , and further overexpression of hnRNPQ could reverse the above effects. After 3-day consecutive irradiation with UVA, the expression of p53, p21, percentage of β-galactosidase-positive cells, p53 transcriptional regulation activity and cellular proliferative activity in the hnRNPQ cDNA group were 1.41 ± 0.09, 1.42 ± 0.06, 91.06% ± 4.24%, 12.35 ± 0.88 and (1.23 ± 0.41) × 10 6/ml respectively, and the senescence-related phenotypes of UVA-induced NHDFs were significantly aggravated in the hnRNPQ cDNA group compared with the cDNA empty vector group (all P < 0.05) . Conclusion:AQP3 may alleviate the UVA-induced senescence of NHDFs by regulating hnRNPQ and downregulating p53 expression.
ABSTRACT
Objective:To study and train urological resident's laparoscopic operation skills based on retroperitoneal laparoscopic adrenalectomy.Methods:From January 2011 to January 2020, 121 urology residents were selected to complete the basic skills training including laparoscopic simulator, and gradually engaged in and operated laparoscopic minimally invasive surgery for adrenal tumor. The training stage included training and examination of laparoscopic simulator module, establishment of lateral position and puncture hole in lumbar surgery, anatomy of kidney at three levels and exposure and removal of adrenal tumor. The training of four stages was completed by step-by-step advanced assessment.Results:Fifteen doctors could complete laparoscopic adrenalectomy operation under the supervision and guiding of teachers (12.4%), 71 residentss could independently complete the operation requirements in the first three stages (58.7%).Conclusion:The study has proved that the main factors affecting the advanced training of retroperitoneal laparoscopic adrenalectomy were the operation assessment score of laparoscopic simulator, the duration of the standardized residency training in urology department, the case number of participating in retroperitoneal laparoscopic adrenalectomy, and the times that teachers and training residents exchanged the positions of main knife and assistant during the operation.
ABSTRACT
Objective@#To compare the carcinogenic abilities of CD133+CD44+ laryngeal cancer stem cells and general laryngeal cancer stem cells and to identify the mechanism underlying the action of miRNAs.@*Methods@#Solid tumor-derived laryngeal carcinoma stem cells and Hep-2-derived laryngeal carcinoma stem cells were cultured, and CD133+CD44+ laryngeal cancer stem cells were sorted by flow cytometry. Boden chamber invasion assay, cell migration assay and tumor formation assay were then performed to compare the invasion, migration and tumorigenic abilities of CD133+CD44+ laryngeal cancer stem cells and general laryngeal cancer stem cells. And then, miRNAs isolated from two laryngeal cancer stem cells were detected and analysed with miRNA chip.@*Results@#(1)In Boyden chamber invasion assay, the cell invasion rate of CD133+CD44+ laryngeal cancer stem cells was obviously higher (80.2%±2.3% vs. 63.9%±3.2%, t=5.011, P=0.027); (2)CD133+CD44+ laryngeal cancer stem cells also had higher mobility in cell migration assay (82.9%±1.1% vs. 70.9%±0.6%, t=4.514, P=0.031); (3)In tumor formation assay, the tumor formation rate of CD133+CD44+ laryngeal cancer stem cells was also higher (80% vs. 50%). What′s more, we identified 15 miRNAs that were significantly upregulated in CD133+CD44+ laryngeal cancer stem cells and 3 miRNAs that were significantly downregulated in CD133+CD44+ laryngeal cancer stem cells, compared with normal laryngeal cancer stem cells.@*Conclusions@#CD133+CD44+ laryngeal cancer stem cells have stronger invasion, migration and tumorigenic abilities compared with normal laryngeal cancer stem cells, and the difference of miRNAs′ expression is one of the possible causes.
ABSTRACT
Objective To comparatively analyze the image characteristic of contrast-enhanced ultrasound(CEUS)and contrast-enhanced computed tomography(CECT),and explore the diagnostic value of the two methods in benign and malignant lesions of gallbladder.Methods comparative analysis the image characteristic of CEUS and CECT,the preoperative diagnostic results of 86 cases of gallbladder diseases were confirmed by pathology.Results The enhancement patterns of CEUS and CECT in benign and malignant lesions of gallbladder are similar.The sensitivity,specificity and accuracy of CEUS were 77.9%(53/68),77.8%(14/18),77.9%(67/86),respectively.The sensitivity,specificity and accuracy of CECT were 75%(51/68),55.6%(10/18),70.9%(61/86),respectively.The sensitivity,specificity and accuracy of the combination of CEUS and CECT were 83.8%(57/68),55.6%(10/18),77.9%(67/86),respectively.The accuracy of the combination of CEUS and CECT was higher than that of CECT in the diagnosis of malignant gallbladder lesions [(53.9±10.00)s vs(35.50±6.72)s],the differences were statistically significant(t=6.729,P＜0.001).Conclusions The enhancement patterns of CEUS and CECT in benign and malignant gallbladder lesions are similar.The combination of CEUS and CECT is helpful for improving the diagnostic accuracy of malignant gallbladder lesions.CEUS and CECT could corroborate and complement each other,and provide more valuable information for the differential diagnosis of benign and malignant gallbladder lesions.
ABSTRACT
Objective To analyze the clinical characteristics and enhancement pattern on contrast-enhanced ultrasound (CEUS) of combined hepatocellular-cholangiocarcinoma (cHCC-CC).Methods A total of 49 patients who were pathologically confirmed as cHCC-CC by surgery and underwent CEUS examination in Southwest Hospital Affiliated to Third Military Medical University from January 2005 to February 2015 were retrospectively enrolled.There were 3 enhancement patterns on CEUS:hepatocellular carcinoma (HCC) pattern,cholangiocarcinoma (CC) pattern and indeterminate pattern.The proportions of HCC pattern and CC pattern of cHCC-CC were compared by x2 test.And the proportions of tumour maker elevation [(alpha-fetoproteins,AFP) and/or (carbohydrate antigen,CA19-9)] in accordance or discordance with enhancement patterns were compared by x2 test.Results Among the 49 cHCC-CC patients,44 were male and 5 were female.Mean age was (52.3 ± 9.8) years old (range:28-74 years old).Of all cases,41 (83.7％,41/49) patients had single nodule.Mean size of nodule was (5.3 ± 3.5) cm (range:1.5-13.8 cm),and the size of 51.0％ (25/49) lesions were ＜ 5 cm.Totally 34 (69.4％,34/49) patients had pathologically diagnosed cirrhosis.AFP elevation was found in 31 (63.3％,31/49) patients,CA19-9 elevation was found in 12 (24.5％,12/49) patients,simultaneous elevation of both AFP and CA19-9 was found in 9 (18.4％,9/49) patients.The percentages of CC pattern and HCC pattern were 51.0％ (25/49) and 44.9％ (22/49) respectively.And there was no significant difference between the two patterns (x2=0.368,P=0.544).In 9 patients with simultaneous elevation of both AFP and CA19-9,CC pattern was observed in 5 patients and HCC pattern was noted in 4 patients.There were 12 (24.5％,12/49) patients with tumor marker elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS.Among the 12 cases,9 cases with AFP elevation were CC patterns on CEUS and 3 cases with CA19-9 elevation were HCC patterns on CEUS.Simultaneous elevation of tumor makers (AFP and CA19-9) or tumor mark elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS was found in 21 (42.9％,21/49) patients,which was significantly more than simultaneous elevation of AFP and CA19-9 alone (18.4％,9/49) (x2=6.918,P=0.009).Conclusions Clinical characteristics of patients with cHCC-CC were similar to that of patients with HCC.The proportion of HCC pattern and CC pattern was comparable.Combination of test of tumor makers (AFP and CA19-9) and enhancement pattern on CEUS maybe helpful for the diagnosis of cHCC-CC.
ABSTRACT
Objective To analyze the effect of endophytic renal tumor growth characteristic on the short-term outcomes of robot-assisted laparoscopic partial nephrectomy (RALPN).Methods From March 2015 to October 2016,23 RALPN cases of endophytic renal masses and 68 RALPN cases of intermediate and exophytic renal tumors were retrospectively analyzed.There were no significant differences in age,gender,tumor side,history of abdominal surgery,benign and malignant cases of the two groups of patients (P ＞ 0.05).Patients with a completely endophytic mass had smaller tumors [(2.4 ± 0.5) cm vs.(3.9 ± 1.1) cm],and higher overall R.E.N.A.L.score (P ＜ 0.05).The differences of perioperative period and postoperative follow-up results were analyzed.Results All 91 RALPN cases were successfully done without conversion to open or radical nephrectomy.There were no significant differences in intraoperative blood loss,postoperative Hb decrease,intraoperative and postoperative blood transfusion rate,hospital days,positive tumor margins,and the incidence of Clavien-Dindo grade Ⅲ or above in the two groups (P ＞ 0.05).The endophytic group showed longer operative time [(95.6 ± 19.4) min vs.(75.3 ± 16.9) min],and longer renal warm ischemia [(25.2 ±5.4)min vs.(17.6 ±7.0)min].In the postoperative follow-up of 3 months to 22 months,all patients got disease-free survival.Conclusions RALPN for completely intraparenchymal renal tumors can be safely and effectively performed in experienced institutes.However,the long-term period of follow-up is still missing.
ABSTRACT
Ten patients diagnosed with multifocal motor neuropathy ( MMN) were recruited in the Department of Neurology at Chinese PLA General Hospital from January 1, 2009 to August 31, 2015.The clinical and electrophysiological features were analyzed retrospectively .All patients complained of progressive asymmetric limb weakness , which was more severe in distal than in proximal . Five presented muscle atrophy.None had sensory disturbances .All suffered diminished or disappeared tendon reflex , whereas Babinski signs were negative .Multi-focal conduction block ( CB) was confirmed by nerve conduction studies ( NCS) in all patients and 7 showed spontaneous potentials in needle electrode electromyography .Abnormal sensory nerve conduction was seen in 3 patients.Laboratory test revealed anti-ganglioside GM1 antibody in cerebrospinal fluid (CSF) in 6 cases and elevated CSF protein in 7 cases.Limb weakness alleviated greatly in 9 cases after intravenous immunoglobulin ( IVIg) treatment.But the other one reported poor response , who had long course of disease , serious limb weakness and obvious muscle atrophy .Motor nerve damage is the most important manifestation of MMN and sensory nerve damage may also appear .NCS is essential to the diagnosis of this disease , with CB as the characteristic electrophysiological feature .IVIg is an effective treatment.
ABSTRACT
Objective:To evaluate the clinical efficacy of tendon-regulating manipulation plus kinesiotherapy in treating low back pain. Methods:Sixty patients were randomized into a treatment group and a control group by using the random number table, 30 cases in each group. The treatment group was intervened by tendon-regulating manipulation plus kinesiotherapy, while the control group was by the tendon-regulating manipulation alone. The lumbar lordosis was measured by X-ray (side view), the pain was evaluated by analgesy meter, the lumbar range of motion was by using goniometer, and the function was judged by Oswestry disability index (ODI) before and after treatment, and the therapeutic efficacy was also observed. Results:After treatment, the pain level was significantly reduced, lumbar lordosis was significantly increased, the lumbar range of motion was markedly improved, and the ODI score significantly dropped (allP<0.05) in both groups; the improvement of each item in the treatment group was more significant than that in the control group (allP<0.05). The total effective rate was 90.0% in the treatment group versus 63.3% in the control group, and the difference was statistically significant (P<0.05). Conclusion:In the treatment of low back pain, tendon-regulating manipulation plus kinesiotherapy can mitigate topical pain, improve the motion of low back, enhance the quality of life, and produce a more significant therapeutic efficacy compared to tendon-regulating manipulation alone.
ABSTRACT
Objective To analyze the features of nerve conduction in patients with amyotrophic lateral sclerosis (ALS),and explore the correlation between compound muscle action potential (CMAP)amplitude and disease duration and revised amyotrophic lateral sclerosis functional rating scale (ALSFRSR).Methods Standard motor and sensory nerve conduction studies were performed in 154 patients with ALS.The following parameters were collected including CMAP amplitude,distal motor latency (DML),motor conduction velocity,sensory conduction velocity and sensory nerve action potential amplitude.Regression study was done to explore the correlation between CMAP amplitude and disease duration and ALSFRS-R.Results Motor nerve conduction abnormalities were presented in a majority of the patients with prolonged DML in the tibial nerve,median nerve and ulnar nerve as the most common form (61.06％-81.42％),followed by decreased CMAP amplitude (30.12％-53.98％),decreased MCV (12.05％-16.81％) and absence of CMAP (2.65％-9.73％).Sensory nerve conduction abnormalities were detected in a small proportion of patients and the decreased SCV,decreased SNAP amplitude and absence of SNAP in the sural nerve,median nerve and ulnar nerve were found in 1.22％-2.73％,0-1.82％ and 0-1.22％patients respectively.No correlation was found between CMAP of the common peroneal nerve,tibial nerve,median nerve and ulnar nerve and the disease duration (P ＞ 0.05),while significant positive correlation was established between CMAP amplitude of the median nerve and ulnar nerve and ALSFRS-R (r =0.273,P =0.016;r =0.357,P =0.001).Conclusions Motor nerve conduction is abnormal in a majority of ALS patients with prolonged DML as the most common form,while abnormal sensory nerve conduction is only found in a few of ALS patients.CMAP amplitude of the median nerve and ulnar nerve might be of certain clinical value in evaluating the severity of ALS.
ABSTRACT
BACKGROUND:Fracture healing mechanism is complex and affected by many factors, and delayed fracture healing or nonunion often occurs. How to promote fracture healing has become a serious problem. OBJECTIVE:To observe the effect of local application of nerve growth factor on early fracture healing after peripheral nerve injury. METHODS:Thirty-six healthy male Wistar rats were selected to establish tibial fracture models, which were randomly divided into four groups, with 18 limbs in each group. Group A: tibial fracture+normal saline injectionvia bilateral gastrocnemius muscles; group B: tibial fracture+nerve injury+normal saline injection; group C: tibial fracture+local injection of nerve growth factor; group D: tibial fracture+nerve injury+local injection of nerve growth factor. Calus metrology results were compared among different groups. RESULTS AND CONCLUSION:The calus volume was the most in the group B at 4 weeks of intervention, but there were no different among the other three groups (P > 0.05). At 2 weeks of intervention, the bone resorption area was significantly larger in the group B than the group D (P < 0.05), and the osteoclast index was significantly higher in the group A than the group C (P < 0.05); while at 4 weeks of intervention, the mineralized bone trabecular width was significantly lower in the group A than the group C (P < 0.05) as wel as lower in the group C than the group D (P < 0.05). These findings indicate that after peripheral nerve injury, local application of nerve growth factor can enhance the osteogenic ability, effectively inhibit osteoclast activity, and promote the early healing of fracture.
ABSTRACT
BACKGROUND:For patients with degenerative mitral annulus dilatation complicated by atrial fibrilation, atrial fibrilation is needed to be treated concomitant with artificial valve ring implantation. Although Cox maze III procedure is the gold standard for treatment of atrial fibrilation, its safety has been questioned. OBJECTIVE:To evaluate the safety of artificial valve rings implantation and Cox Maze III procedure for treatment of degenerative mitral annulus dilatation complicated by atrial fibrilation. METHODS: A total of 43 patients with degenerative mitral annulus dilatation and atrial fibrilation were enroled and were randomly divided into test group (n=21) and control group (n=22). Patients in the test group were treated with mitral valvuloplasty and Cox Maze III procedure. Patients in the control group were only treated with mitral valvuloplasty. RESULTS AND CONCLUSION: (1) Intraoperative safety indexes: the durations of cardiopulmonary bypass and aortic clamping. and the incidence of hemoglobinuria in the test group were higher than those in the control group (P < 0.001). There was no significant difference in the urine output between these two groups. (2) Postoperative safety indexes: the incidence of atrial dysrhythmia (i.e., any atrial dysrhythmia other than atrial fibrilation), proportion of patients requiring a temporary pacemaker and hospital stays in the test group were higher than those in the control group (P < 0.05). There were no significant differences in the secondary-thoracotomy bleeding rate and incidence of stroke between these two groups. (3) Postoperative outcomes: the rates of cardioversion to achieve sinus rhythm at the day of surgery and at discharge in the test group were significantly higher than those in the control group (P < 0.001). At discharge, patients in both groups were al at NYHA functional class Ior II. Echocardiography showed trace to mild mitral regurgitation and complete closure of the tricuspid valve. There were no significant differences in the left atrial diameter, left ventricular diameter, left ventricular volume, and ejection fraction between these two groups. However, the proportions of mitral and tricuspid valve peak A-waves were significantly higher than those in the control group (P < 0.001). These results show that artificial valve ring implantation and Cox Maze III procedure is a safe and effective method for treating degenerative mitral annulus dilatation complicated by atrial fibrilation during operation.
ABSTRACT
BACKGROUND:Incidence of degenerative mitral regurgitation show a gradual increase tendency,but there is no report on degenerative mitral regurgitation due to pure mitral valve ring expansion in China.OBJECTIVE:To summarze the early and midterm outcomes of pure mitral valve annuloplasty in the treatment of degenerative mitral regurgitation due to pure mitral valve ring expansion. METHODS :Forty-eight patients with degenerative mitrlal regurgitation due to pure mitral valve ring expansion underwent pure mitral valve annuloplasty, including 23 cases treated with Carpentier-Edwards Physio ring and 23 with SJMTM rigid saddle ring.Affter discharge,echocardiography was used to evaluate heart function and mitral regurgitation degree during the follow-up.The outcomes were compared between the two groups. RWSULTS AND CONCLUSION:There was no early death after operation and all cases were cured and discharged.All patients were followed up for 3 months to 4years,and the cardiac function and mitral valve regurgitation were significantly improved (no mitral regurgitation in 36 cases,trivial regurgitation in 10 cases and mild mitral regurgitation in 2cases).According to NYHA grading,there were 32 cases of level 1 and 16 ceses of level Ⅱ. The echocardiography showed that postoperative left atrium diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, pulmonary artery systolic pressure and the ratio of regurgitation beam area to left atrial area were significantly lower than those before operation (P < 0.01). The left ventricular ejection fraction increased greatly (P < 0.01). There was no ring rupture, ring avulsion and hemolysis. Postoperative transvalvular pressure was less than 3 mm Hg. However, there were no significant differences in the above-mentioned parameters between the Carpentier-Edwards Physio ring and SJMTM rigid saddle ring groups. The results suggest that the pure mitral valve annuloplasty is excelent in the treatment of degenerative mitral regurgitation due to pure mitral valve ring expansion, through the right surgical techniques and the right choice of artificial valve ring.
ABSTRACT
Objective To explore contrast-enchancement ultrasound (CEUS) parameters of hepatocellular carcinoma (HCC) with different cytokeratin-19 (CK19) expression in the background of cirrhosis.Methods CEUS data of pathologically proven HCC in patients with cirrhosis in Southwest Hospital from June 2005 to October 2013 were collected in this retrospective study. Two groups were classified on the basis of different CK19 expression in HCC patients: CK19 positive group (seventy-nine patients) and CK19 negative group (eighty-ifve patients). DFY-II Ultrasound Imaging Analysis Software was utilized to measure and calculate CEUS paramrters, including the enhancement heterogeneity of the tumor and peak intensity in arterial phase, the enhancement intensity of tumor and the enhancement ratio of tumor/adjacent liver parenchyma in portal phase. The difference between the two groups was compared by statistics test. Results TThe arterial phase enhancement heterogeneity of tumor in CK19 positive group was higher than that of the negative group (2.64±0.64 vs 2.29±0.31). The arterial phase peak intensity of tumor in CK19 positive group was lower than that of the negative group [(102.83±29.78)dB vs (120.65±25.49)dB]. The portal phase enhancement intensity of tumor in CK19 positive group was lower than that of the negative group [(66.83±20.13) dB vs (79.99±27.15) dB ].The enhancement ratio of tumor/adjacent liver parenchyma in portal phase was lower in CK19 positive group than that in the negative group (0.74±0.03 vs 0.92±0.22). All above comparisons had significant differences between two group. Conclusions The CEUS enhancement parameters had signiifcant difference between the CK19 positive HCC and negative HCC in patient with background cirrhosis.
ABSTRACT
<p><b>BACKGROUND</b>Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disease caused by abnormal expansion of cytosine-thymine-guanine (CTG) repeats in the myotonic dystrophy protein kinase gene. The clinical manifestations of DM1 are multisystemic and highly variable, and the unstable nature of CTG expansion causes wide genotypic and phenotypic presentations, which make molecular methods essential for the diagnosis. So far, very few studies about molecular diagnosis in Chinese patients with DM1 have been reported. Therefore, we carried out a study using two different methods in molecular diagnosis to verify the validity in detecting CTG expansion in Chinese patients showing DM signs.</p><p><b>METHODS</b>A total of 97 Chinese individuals were referred for molecular diagnosis of DM1 using conventional polymerase chain reaction (PCR) accompanied by Southern blotting and triplet primed PCR (TP-PCR). We evaluated the sensitivity and limitation of each method using percentage.</p><p><b>RESULTS</b>By conventional PCR 65 samples showed only one fragment corresponding to the normal allele and 62 out of them were correctly diagnosed as DM1 by TP-PCR and three homologous non-DM1 samples were ruled out; Southern blotting analysis successfully made 13 out of 16 correct diagnoses with a more sensitivity using α-(32)P-labeled probes than dig-labeled probes.</p><p><b>CONCLUSION</b>Molecular analysis is necessary for the diagnosis of DM1 and TP-PCR is a reliable, sensitive, and easily performed method in molecular diagnosis which is worthy to be popularized.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Blotting, Southern , Molecular Diagnostic Techniques , Methods , Myotonic Dystrophy , Diagnosis , Genetics , Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
BACKGROUND:Osteoarthritis animal models induced by papain are commonly used for studying osteoarthritis. OBJECTIVE:To observe the morphology of articular cartilage surface during early osteoarthritis process in rats induced by papain and L-cysteine under scanning electron microscope. METHODS:The right knees of Sprague-Dawley rats were given 0.15 mL mixed solution of 2%papain and 0.03 mol/L L-cysteine in the ratio of 2:1. The left knees were given injections of 0.15 mL 0.9%NaCl, as the control group. Another two rats (four knees) maintained untreated, as the normal control group. Al the rats were observed with scanning electron microscope at 2, 4, 6 weeks after injection, to explore the surface morphology of medial condyle of femur. RESULTS AND CONCLUSION:The condyles of normal and control groups revealed numerous shal ow pits on the surface of articular cartilage. At 2 weeks after injection, the surfaces of condyles were unsmooth, presenting the shrinkage and distortion. The thinner articular cartilage and local tiny cracks were seen at 4 weeks. The deep and great cracks and cartilage defect were observed on the surface of cartilage at 6 weeks. The time of 4-6 weeks is a reference point for establishing early osteoarthritis model in rats through injections of 2%papain and 0.03 mol/L L-cysteine.
ABSTRACT
Objective To explore the biomechanical property on Suture-Button and conventional screw fixating the distal tibiofibular syndesmosis injury.Methods The distal tibiofibular syndesmosis injury models were made by cutting the anteroinferior tibiofibular ligaments,posteroinferior tibiofibular ligaments,interosseous tibiofibular ligaments or deltoid ligaments of 8 fresh frozen calves.These models were randomly and equally divided into the two groups.The two groups were respectively fixed by Suture-Button and conventional screw.The contact area and peak intra-articular pressure of tibiatalar joint were measured by biomechanical testing methods and the stress and strain sensing technology.Results The maximal contact area and peak intra-articular pressure of Suture-Button fixation group had no significant differences with the conventional screw group by the four kinds of ankle flexion-extension angles in the sagittal plane (t =3.52,4.49,5.93,4.75,all P ＞ 0.05),peak intra-articular pressure was also similarly improved (t =3.61,3.97,4.68,2.41,all P ＞ 0.05).But biomechanical markers of two fixation groups had an improvement trend.Conclusion Suture-Button fixing the distal tibiofibular syndesmosis injury had similar biomechanical effect to compare with traditional conventional screw,and two fixation groups both improved trend to compare with ligament-cut group.
ABSTRACT
Objective To investigate the causes and treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Methods A retrospective analysis was conducted in 6 cases (5 males and 1 female,aged 11 to 53 years) of familial neurohypophyseal diabetes insipidus with hydronephrosis treated in our institute from June 2009 to December 2010.All cases had polydipsia and polyuria since their childhood.The daily output of urine ranged from 5,290 to 15,040 ml.The urine specific gravity was less than 1.005.The water deprivation and vasopressin injection test showed positive results,and MRI showed that the shape and size of pituitary gland were in normal range.Ultrasound and IVU showed that all cases had hydronephrosis.Five adult cases were administered with Desmopressin 0.2 mg three times a day,and 1 juvenile patient given half dosage of Desmopressin as in adult.The case No.1 underwent percutaneous nephrostomy and bilateral ureteral reimplantation.Case No.2 received urethral catheterization for 5 days and Tamsulosin.Three cases with urinary tract infection were given antibiotics on the base of urine culture and antibiotic sensitivity test results.Follow-up was undertaken every 3 mon for the duration of 18-36 mon.Results In 6 cases,polydipsia and polyuria were significantly improved after the treatment.Daily urine output dropped to 6000 ml in 5 adult cases and decreased to 2000 ml in the juvenile case.The flank sore of case No.1 was relieved after percutaneous nephrostomy,and hydronephrosis improved 6 mon after bilateral ureteral reimplantation.The residual urine volume of case No.2 was reduced to 40 ml,and no recurrence was observed after anti-infection therapy.During the follow-up,6 cases showed relieved hydronephrosis and no recurrent infection.Conclusions It is of important to reduce the urine volume for the treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Early diagnosis and treatment of the diseases is crucial for the improvement of renal function.