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Objective@#The features of clinical, laboratory and radiologic examinations of an adult patient with Japanese encephalitis (JE) were analyzed to understand the differences in clinical characteristics between adult and children patients, and to investigate the method of etiological tests.@*Methods@#The clinical, laboratory tests and radiographic data of an adult case with JE requiring hospitalization were analyzed retrospectively and the related literature was reviewed.@*Results@#The clinical presentation of patients with JE was nonspecific, the patient presented with fever, consciousness and cognitive impairment, convulsion and meningeal irritation. Its main test indicator is IgM antibody of Japanese encephalitis virus(JEV) in acute cerebrospinal fluid and serum specimens.Craniocerebral MRI is an important auxiliary examination for JE, the common sites involved are thalamus, basal ganglia and cerebral cortex, of which thalamus is almost 100% affected.@*Conclusions@#The clinical presentation of patients with JE was nonspecific. Clear diagnosis should be accompanied by the combination of epidemiology, laboratory tests and specific antibodies detection. Neural damages commonly occur in thalamus.
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Accurate segmentation of pulmonary nodules is an important basis for doctors to determine lung cancer. Aiming at the problem of incorrect segmentation of pulmonary nodules, especially the problem that it is difficult to separate adhesive pulmonary nodules connected with chest wall or blood vessels, an improved random walk method is proposed to segment difficult pulmonary nodules accurately in this paper. The innovation of this paper is to introduce geodesic distance to redefine the weights in random walk combining the coordinates of the nodes and seed points in the image with the space distance. The improved algorithm is used to achieve the accurate segmentation of pulmonary nodules. The computed tomography (CT) images of 17 patients with different types of pulmonary nodules were selected for segmentation experiments. The experimental results are compared with the traditional random walk method and those of several literatures. Experiments show that the proposed method has good accuracy in the segmentation of pulmonary nodule, and the accuracy can reach more than 88% with segmentation time is less than 4 seconds. The results could be used to assist doctors in the diagnosis of benign and malignant pulmonary nodules and improve clinical efficiency.
Subject(s)
Humans , Algorithms , Cluster Analysis , Lung Neoplasms , Multiple Pulmonary Nodules , Radiographic Image Interpretation, Computer-Assisted , Tomography, X-Ray ComputedABSTRACT
Objective To observe the clinical efficacy of scalp acupuncture combined with electroacupuncture in the treatment of aphasia after ischemic stroke. Methods Totally 90 patients with aphasia after ischemic stroke were randomly divided into the control group and the treatment group, with 45 cases in each group. The control group received Schuell language training, 30 min each time, while the treatment group received scalp acupuncture plus electroacupuncture (Yifeng, Baihui, Houxi and Tongli), 20 min each time. The treatment for both group was 5 times a week and lasted for 16 weeks. The clinical efficacy was evaluated by aphasia degree, Chinese functional communication profile (CFCP) score and Western aphasia battery (WAB). Results There was statistical significance between the treatment group and the control group in the level of aphasia degree (P＜0.05). Compared with before treatment, the total scores of CFCP and WAB in both groups increased, with statistical significance (P＜0.05). The total scores of CFCP and WAB in treatment group were higher than control group, with statistical significance (P＜0.05). The total effective rate of the therapeutic effect was 91.11% (41/45) in the treatment group and 75.56% (34/45) in the control group, with statistical significance (P＜0.05). Conclusion Scalp acupuncture combined with electroacupuncture can obviously improve the language understanding and expression ability and language communication ability of aphasic patients after ischemic stroke.
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Increasing evidence suggests that hepatocellular carcinomas (HCCs) are sustained by a distinct subpopulation of self-renewing cells known as cancer stem cells (CSC). However, our understanding of their regulation is limited. Rapid reversible changes of CSC-like cells within tumors may result from the effect of biological mediators found in the tumor microenvironment. This paper aims to explore how nitrite, a key cellular modulator whose level is elevated in many tumors, affects CSC-like phenotypes of human hepatoma cells SMMC-7721 cells. The SMMC-7721 cell line was cultured under serum-free conditions to produce floating spheres. The distribution of cell cycle was analyzed by flow cytometry, the capability of cells self-renew was detected by colony-forming capabilities and spheroid-formation assay, the expression of stemness protein such as CD133, CD90 and EpCAM were determined by flow cytometry and Western blot, cell invasion was analyzed by transwell assay, and viability of SMMC-7721 parental cells and spheroids cancer cells was determined by the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Xenograft tumor models were established by subcutaneously injecting SMMC-7721 spheroids cancer cells, the transplanted tumor tissue ROS levels was detected by reactive oxygen species (ROS) test kits, the expression of HIF-1α was observed by immunofluorescence. Our results showed that the SMMC-7721 spheroid cells were enriched with CSCs properties, indicated by the ability to self-renew, increased expression of CSCs markers, and increased resistance to chemotherapeutic drugs. Additionally, SMMC-7721 parental cells and spheroids cancer cells were treated with 150 μmol·L-1 sodium nitrite for 6 days, compared with control cells, an increased accumulation of G0/G1 phase cells was observable in treatment cells. Indeed, our data demonstrated that in parent cells and spheres cells that were treated with sodium nitrite for different time, the cells' ability to chemoresistance and invasion, clone-forming efficiencies and the spheres forming ability were significantly higher than that of control cells. Exposure of sodium nitrite regulated CSC-like phenotype, indicated by increased expression of known CSC markers, CD133, CD90 and EpCAM in the exposed parental cells, as well as in dormant spheroids cancer cells. Compared with the parent cells, the above effects of nitrite on the spheres cells were significantly enhanced. In vivo data also presented a more significant promotion of tumor xenograft growth from the nitrite treatment than from either of the control. Mechanistic analysis indicated that nitrite induced the upregulation of HIF-1α as well as the downregulation of ROS in the tumor microenvironment. These results suggest that nitrite increases the invasiveness of SMMC-7721 cells through up-regulation of tumor stemness.
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Recent studies have demonstrated that nitrite and ammonia levels are higher in the tumor environment, but their effects on cancer cells remains unclear. The present study was designed to determine the effects of nitrite and ammonia on tumor invasion and the role of reactive oxygen (ROS)/ornithine decarboxylase (ODC) pathway. SMMC-7721 cells were treated with sodium nitrite, ammonium chloride, sodium nitrite and ammonium chloride mixture for 24 h, the cell viability was analyzed using the MTT assay, cell invasion was analyzed with the transwell assay, the intracellular ROS levels were detected with a reactive oxygen species (ROS) test kits, the expression of intracellular ODC was examined with immunofluorescence and Western blot, the expression of matrix metallopeptidase-2(MMP-2) and MMP-9 were analyzed by Western blot. Compared with the control group, SMMC-7721 cells exhibited an increase in cell viability, invasion ability, ROS levels and ODC protein after exposure to 150 μmol·L-1 sodium nitrite and ammonium chloride mixture for 24 h. The invasive activity was reduced by ROS scavenger N-acetycysteine (NAC) in SMMC-7721 cells. The specific ODC inhibitor difluoromethylornithine (DFMO) increased ROS levels and weakened the ability of sodium nitrite and ammonium chloride mixture in the regulation of invasion of SMMC-7721 cells. These data demonstrated that sodium nitrite and ammonium chloride mixture promote invasion of SMMC-7721 cells by enhancing ROS/ODC pathway.
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Objective To study predicting results of the back propagation (BP)neural network model for hematoma enlargement (HE)in patients with intracerebral hemorrhage. Methods The clinical data of 128 patients with cerebral hemorrhage admitted to the 309th hospital of People′s Liberation Army from January 2011 to December 2014 were analyzed retrospectively. The Matlab 7. 14 software was used to achieve BP neural network model for predicting hematoma enlargement within 24 hours in patients with intracerebral hemorrhage (HE ≥6. 0 ml and HE ≥12. 5 ml). The mean square error (MSE)of the model and the accuracy of the overall prediction were calculated. The receiver operation characteristic (ROC) curve was drawn for predicting HE. Results When the BP neural network predicted HE ≥6. 0 ml and HE ≥12. 5 ml,the mean square deviations of the training set,validation set,and test set were 0. 061, 0. 143,0. 052 and 0. 023,0. 057,and 0. 065,respectively. The best fitting performance verification of hematoma enlargement was as follows:≥ 6. 0 ml for network training 11 times and the error value 0. 224;≥12. 5 ml for network training 20 times,and the error value 0. 057. The overall accuracies of predicting HE ≥6. 0 ml and HE ≥12. 5 ml were 92. 2% (118/ 128)and 96. 9% (124/ 128)respectively. Conclusion The BP neural network model have no special limitation for data. It can accurately fit the hematoma expansion model of cerebral hemorrhage.
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@#Objective To investigate the effect of several types of cervical braces used for external immobilization on craniovertebral junction malformation. Methods 48 patients with craniovertebral junction malformation applied several types of cervical braces, including Philadelphia collar, sterno-occipito-mandibular immobilizer (SOMI) and Halo-vest, for the surgical treatment were retrospectively analyzed. Results The primary applications of external cervical brace after posterior internal craniovertebral fixation in this series were 20 cases of Philadelphia collar, 16 cases of SOMI and 12 cases of Halo-vest, with excellent or good results in 80%, 87.5% and 91.7%. The applications of external brace for post-hospital recovery were 16 cases of collar, 15 cases of SOMI and 17 cases of Halo-vest. 35 (72.9%) patients were followed-up for at least 4 months, with satisfying immobilization and duration which fulfilled the requirements for post-operative recovery. Conclusion The applications of the all of 3 kinds of external brace, including collar, SOMI and Halo-vest, have their important clinical value for peri-operational and post-operational recovery in the treatment of patients with craniovertebral junction malformation. To have a reasonable choice of these brace in different patients, the characteristics of pathology as well as the surgical stages should be taken into account.
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To evaluate the effect of papaverine administered via different routes following cerebral aneurysm operation, 43 cerebral aneurysm patients were divided randomly into two groups: A and B. Patients of group A were placed with a silicagel tube in cerebral ventricle and lavaged repeatedly with papaverine solution during operation and following 3 days after operation, those of group B were intramuscularly injected with papaverine 30mg, 3 times per day,for one week. By analysis of clinical features and TCD data, both A and B could cure cerebral vasospasm, but group A was obviously superior to group B. Our conclusion is that papaverine solution lavaged locally can effectively prevent cerebral vasospasm after cerebral aneurysm operation .
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Objective To observe the interaction between the extreme stress and mild traumatic brain injury in the patients surviving Wenchuan earthquake.Methods Forty survivors in Wenchuan earthquake were selected for the psychological status survey 2-30 days after the disaster,among them 20 survivors were suffering from mild traumatic brain injury,and the remainders were in normal physical conditions.The Symptom Checklist-90(SCL-90),which consisted of 90 items with 5 grades for each item(0-4 grade,grade zero as none and grade 4 as severe),including 9 symptom factors,was adopted to perform the evaluation for all the subjects in both groups,and the subscales were compared.Results Five subscales of SCL-90,including somatization,depression,anxiety,hostility and fear,which averaged 2.12?0.50,1.83?0.60,1.99?0.40,1.80?0.70 and 2.20?0.8,respectively,were significantly increased in mild traumatic brain injury group than that in control group(P0.05).Conclusions Mild traumatic brain injury occurred among survivors of severe earthquakes is strongly associated with psychological problems.A higher incidence of psychological disorder in survivors of earthquake with mild traumatic brain injury indicates that one must be cautious when attributing a health problem to mild traumatic brain injury,since the post-traumatic stress disorder and depression may be the primary problem.The high-risk population with psychological obstacle consists of the survivors with mild traumatic brain injury,and the interactions of both psychological stress and traumatic brain injury may lead to more complex clinical symptoms,so psychotherapy should be emphasized in the treatment of patients with mild traumatic brain injury.