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Objective:To compare and analyze the tremor characteristics between essential tremor (ET) with Parkinson disease (PD) and pure PD or pure ET.Methods:From January 2015 to June 2019 in Rizhao People′s Hospital of Shandong Province, 35 patients with PD and ET (observation group), 35 patients with pure PD (control group Ⅰ) and 35 patients with pure ET (control group Ⅱ) were selected. Tremor analysis were performed in all the patients, and the results of tremor analysis were compared statistically.Results:There were significant differences in the proportion of static tremor, postural tremor and the recurrence time of tremor among control group Ⅰ, control group Ⅱ and observation group: 80.0% (28/35) vs. 20.0% (7/35) and 65.7% (23/35), 65.7% (23/35) vs. 100.0% (35/35) and 88.6% (31/35), (10.2±2.6) s vs. (2.5 ± 1.3) s and (7.6 ± 2.9) s ( P < 0.05). The tremor frequencies of control group Ⅰ, control group Ⅱ and observation group at rest were (5.5 ± 0.7), (7.2 ± 1.3) and (6.2 ± 1.1) Hz, and at posture were (6.2 ± 2.0), (8.3 ± 1.9) and (6.5 ± 1.3) Hz, respectively, with statistically significant differences among the three groups ( F = 6.881 and 7.984, P < 0.05). The proportion of electromyography alternating contractions of the active and antagonistic muscles of control group Ⅰ, control group Ⅱ and observation group at rest were 76.7% (23/30), 0, 34.6% (9/26), and at posture were 53.3% (16/30), 20.0% (7/35), 26.9% (7/26), with statistically significant differences among the three groups ( χ2 = 16.186 and 7.650, P < 0.05). The above data of the observation group were in the middle level. The working characteristic curve was used to analyze the efficacy of PD with ET, PD and ET, and the area under the curve was 0.654, 0.756 and 0.771, respectively. Conclusions:ET with PD has both the characteristics of pure PD or pure ET and the unique characteristics. Tremor analysis can objectively identify the electromyography alternating contractions at rest of PD with ET.
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A young female patient with acute necrotizing encephalopathy (ANE) is reported,who aged 15 years,with a history of upper respiratory tract infection,main clinical manifestations of seizures and consciousness disorders,and brain MRI examination showing characteristic symmetrical bilateral abnormal signals at both thalamic area,pons,and cerebellar hemisphere.Imaging changes corresponded to pathophysiological changes.The initial manifestations were found to be brain swelling and edema.In the acute phase,hemorrhage and necrosis of the affected brain tissues were observed.The recovery period was characterized by hemosiderin deposition and cystic space formation,which was consistent with ANE diagnosis.By early use of high-dose gammaglobulin and methylprednisolone,the prognosis of the patient was good,proving that immunosuppressive therapy by corticosteroids and gammaglobulin is effective for ANE.
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Objective To determine the accuracy and accuracy of 4 cystatin C (CysC) reagents,to initially select a suitable detection system according to the Six Sigma parameters for the new development projects,and to evaluate the selected reagents comprehensively.Methods Imprecision (CV％) of 4 kinds of CysC reagents (A,B,C,D) were evaluated with mixed fresh serum of patients,the bias of each kit (Bias％) was evaluated by measuring 5 specimens of the CysC project 2016 Health Planning Commission interventricular quality assessment,the total allowable error (TEa) from Health Planning Commission interventricular quality assessment was used to calculate the Sigma value and quality target index (QGI),sigma verification diagram was rendered,and the results were compared.The linear range verification,interference experiment,clinical reporting range verification and biological reference interval validation were carried out for the highest sigma kit.Results The CV value of four kinds of CysC reagents(A,B,C,D)were 6.11％,5.39％,3.13％ and 3.66％.The value of bias were 4.63％,4.42％,5.38％ and 1.09％.The sigma value were 4.15σ,4.75σ,7.87σ and 7.90σ.The quality target index(QGI) of A and B were 0.50 and 0.55,The sigma performance verification diagrams indicated that the reagent A and B were at good performance level and reagent C and D were at the world class level,D was the best one.The linear range validation,interference test,clinical reportable range validation and biological reference interval validation of D reagent were carried out,which all accorded with the declaration and clinical needs of the instructions.Conclusion The performance verification of Sigma can directly reflect the difference of performance between different reagents,and can be used for the preliminary screening of the kit.
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Purpose Polypoid endometriosis is an uncommon and distinctive variant of endometriosis, and its detailed histopathological features have been investigated and analysed. Methods A retrospective analysis was performed in 10 cases with polypoid endometrio-sis by comparing clinical data, histopathologic and immunohistochemical changes. Results The patients were 27 to 54 years ( mean 39. 4 years) of age. The most common clinical presentations were a pelvic mass. The intraoperative findings suggested a neoplasm. Sites of involvement in order of frequency included ovary, uterine serosa and cervix. Polypoid, pink, gray or tan masses ranged up to 9 cm in maximal dimension. On microscopic examination, the polypoid masses were composed of an admixture of endometriotic glands and stroma. Most commonly glandular architectural patterns were simple hyperplasia. Tubal epithelial metaplasia was common. The stroma was fibrous, resembling to some extent the stroma of the endometrial polyp and atypical stromal cells can be seen. Nine cases were associated with usual endometriosis. Follow-up data in nine patients indicated that all of patients were alive without evidence of re-sidual disease. The main lesion in the differential diagnosis is a mullerian adenosarcoma. Conclusion Polypoid endometriosis is a rare manifestation of endometriosis, and probably is overgrowth of local ectopic endometrium based on endometriosis. Understanding of such lesions is avoided misdiagnosing for other benign or malignant tumors on clincal, intraoperative or pathologic assesment, and influ-ences the clinical treatment.
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Objective To assess the clinical significance of fetal pyelectasis and its changing in utero. Methods One hundred and ninty-seven isolated pyelectasis cases were retrospective reviewed from Jan 2012 to Jul 2014.Isolated pyelectasis was defined as a renal pelvis anteroposterior diameter (RPAPD)of ≥5 mm without other fetal anomaly in second trimester.Persistent or progressive pyelectasis was defined as a RPAPD of ≥10 mm before delivery.They were divided into two groups according to the size of renal pelvis in second trimester:group A (RPAPD 5 - 10 mm)and group B (RPAPD ≥ 10 mm).As the same,there were two groups after 32 weeks of gestation:group C (RPAPD < 10 mm)and group D (RPAPD ≥ 10 mm).Results Totally 1 54 cases were followed up.There were 1 88 cases (95.4%)in group A,with 41 cases lost,141 cases (95.9%)RPAPD <10 mm,6 cases (4.1 %)RPAPD ≥10 mm before delivery.There were 9 cases (4.6%)in group B,with 2 cases lost,remained 7 cases RPAPD ≥ 10 mm before delivery. Conclusions Although most of the fetuses with RPAPD 5 - 10 mm in second trimester will remain the same or resolved before delivery,those with RPAPD ≥ 10 mm may persistent or progress.Prenatal assessment of fetal renal pelvis may provide properly consultation.
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Objective To study the relationship of three-dimensional power Doppler ultrasonographic parameters and endocrine profile in different symptoms of patients with polycystic ovary syndrome(PCOS).Methods One hundred and forty nine women with PCOS were divided into two groups,which included obese PCOS(OB-PCOS) group and non-obese PCOS (NOB-PCOS) group.The ultrasonic parameters such as follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,vascularization index(Ⅵ),flow index(FI),vascularization flow index(VFI) were measured and compared.Serum levels of luteinizing hormone (LH),follicle stimulating hormone (FSH),progesterone (P),estradiol (E2),testosterone(T),prolactin (PRL),sex hormone binding globulin (SHBG),free androgen index (FAI),fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment-IR(HOMA-IR) were also measured and compared.The correlation of the ultrasonic parameters and hormonal factors were analyzed.Results The follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,FI and VFI,FINS,HOMA-IR,FAI of OB-PCOS were significantly higher than those of NOB-PCOS (P ＜0.01 or 0.05),the FSH,SHBG were significantly lower than those of NOB-PCOS (P ＜0.05 or 0.01).In OB-PCOS group,the follicle number was significantly associated with FSH(r =0.771,P ＜0.01).The ovarian volume,stromal volume,FI and VFI were significantly associated with HOMA-IR(r =0.412,0.842,0.389,0.415,P ＜0.05 or 0.01),FI was significantly associated with FAI (r =0.812,P ＜0.01).In NOB-PCOS group,the follicle number,ovarian volume were significantly associated with FAI(r =0.472,0.552,P ＜0.05)..Conclusions There are some different characters in ultrasonography and endocrine parameters between obese and non-obese PCOS patients.
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Objective To establish the reference ranges for fetal cardiac axis in the mid-second trimester and to evaluate the use of fetal cardiac axis in prenatal diagnosis.Methods 6744 unselected singleton pregnancies were enrolled from September 2008 to October 2010.Routine screening scan of second trimester and fetal echocardiography were performed at 18- 23+6 weeks gestation.Fetal cardiac axis was measured on the four-chamber view of the heart.Results The 6744 fetuses had a mean cardiac axis of (37.03 ± 6.10)°,ranging from 9.80° to 102.41°. Using above or below 95％ range of population (26.63° -49.40°) as a cut-off,there were significant difference of cardiac axis between normal group [(36.96 ± 5.91)°,P ＜0.01] and the group with heart defects [(43.12 ± 15.67)°,P ＜0.01],the group with intrathoricic anomalies or abdominal wall defect [(51.74 ± 15.97)°].ConclusionsThe reference ranges of fetal cardiac axis for local population in mid-second trimester may helpful for detecting congenital defects.Presence of an abnormal cardiac axis in the fetuses is associated with a substantial risk of congenital heart disease and/or other extra cardiac defects.
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Objective To assess prenatal heart disease screening program by ultrasound. Methods A total of 11 544 second-trimester screening scans were performed before 24 weeks′ gestation on 11 410 women between February 2004 and May 2007 in Obstetrics and Gynecology Hospital of Fudan University. Fetal heart screening was based on four-chamber and outflow tract views( left ventricular outflow + three vessel view). The sensitivity and specificity of different views were evaluated. Follow-up data of newborns was obstained. Results (1) Among 11 544 cases, 48 cases of congenital heart disease (CHD) were diagnosed in utero. Six cases were false negative, and 2 cases were false positive. The incidence of CHD was 0.47% (54/11 544). (2) Thirty-three CHDs were detected based on the four-chamber view, including 18 ventricular septal defect (9 with conotroncal anomalies),6 anomalous atrioventricle valve, 9 disproportion of left/right ventricle. The sensitivity of the four-chamber view alone was 61.11% (33/54), and the specificity was 99. 98% ( 11 488/11 490). Fifteen CHDs were detected based on the left ventricular outflow and three vessel views, including 1 pulmonary atresia, 3 pulmonary valve stenosis, 2 transposition of the great arteries ( TGA ), 1 pulmonary stanosis with TGA, 6 tetralogy of Fallot, and 2 pulmonary stenosis. The sensitivity of the combination of the four-chamber and outflow tract views was 88. 89% (48/54), and the specificity was 99. 98% (11 488/11 490). (3)Of 48 CHDs,11 cases were eceompanied by other malformations. Eleven cases were performed amniocentesis, amony whom 5 cases were trisemy 21. Conclusion The screening program based on four-chamber and outflow tract views shows good sensitivity and excellent specificity. Our prenatal heart screening program is clinically feasible.
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[Objective]To explore the outcome of repairing nerve defects with nerve allografts stored in green tea polyphenol solution.[Method]Forth-eight male mice were randomly divided into 4 groups of nerve grafting,with 12 rats in each group.A 1.0 cm sciatic nerve segment,5 mm away from infrapiriform foramen,was removed and repaired by 4 kinds of nerve allografts.Group A:autografts.Group B:allografts.Group C:cryopreserved nerve allografts.Group D:nerve allografts stored in green tea polyphenol solution.At 6 weeks and 12 weeks,a series of examinations were performed,including the gross appearance,electrophysiological test,histological observation,electron microscopic study and quantitative analysis with image analysis system.[Result]All the parameters of groups A and D were better than those in groups B and C(P
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Objective To study the CT findings and diagnostic role in morning glory syndrome (MGS). Methods CT study of 7 patients with MGS diagnosed by clinical information was reviewed retrospectively. Results CT findings included: (1) the crater like excavation of the disc in 3 patients; (2) the funnel shaped widening of the retrobulbar optic nerve, a pear shaped deformity of the globe in 2 patients; (3) two patients with cystic expansion of the optic nerve, which was of water density and was continuous with the vitreous humor. Conclusion The CT findings of MGS were particularly striking. CT is the imaging method of choice in the diagnosis of this disorder.
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Objective To analyze CT findings of blunt laryngeal trauma (BLT) and evaluate the value of CT in the diagnosis of BLT. Methods CT diagnosis and treatment of 16 patients with BLT were reviewed. Results Soft tissue injuries were detected in five cases including swelling of the aryepiglottic folds, the false or true vocal cords and airway narrowing in four, and left cricoarytenoid dislocation and card paralysis in one. Supraglottic injuries in two cases including c fractures of the epiglottis in 2 and associated with a laceration of the aryepiglottic folds and the hypopharynx. Glottic injuries in four cases including ventricle fracture of the right thyroid ala in one and midline ventricle or comminute fractures of the thyroid cartilage in three, a square segment of cartilage was depressed into the larynx, and the true vocal cords and the anterior commissure were disrupted in one of this series. Subglottic injuries in five cases including cricoid ring fracture on the opposite side following a lateral force in one, with the fragment depressed into the larynx. Two showed marked comminution of the cricoid ring. Midline vertical fracture of the posterior cricoid plate associated with the laceration of the first tracheal ring in one, and one presented marked disruption of the right cricothyiod joint. Conclusion CT clearly shows the extent of cartilaginous injury and displacement, related soft tissue changes and the degree of resulting airway encroachment, and it may be successfully used to determine the need for open exploration and repair in selected cases of blunt trauma to the larynx.