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Sialidosis is a rare lysosomal storage disease caused by NEU1 gene mutation at 6p21.33. It is characterized by myoclonic, ataxia, epilepsy, and decreased vision. A pair of twins with sialidosis type 1 are reported to enrich clinicians ′ understanding of the disease, so as to improve the diagnosis and treatment. The proband was a 16-year-old male. The main symptom was intermittent limb involuntary trembling for 2 years, with paroxysmal loss of consciousness. Fundus examination showed cherry-red spots. His twin brother had similar symptoms, but the overall performance was mild. Whole exome sequencing results showed that both patients carried compound heterozygous mutations of c.239C>T (p.P80L) and c.803A>G (p.Y268C) in NEU1 gene, which were from their normal phenotype mother and father.
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Objective:To investigate the clinical features of diagnosis and treatment of renal parenchymal invasive urothelial carcinoma.Methods:The clinical data of 23 patients with renal parenchymal invasive urothelial carcinoma admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2014 to December 2020 were retrospectively analyzed. There were 12 males and 11 females. The mean age was (67.3±10.1) years old. Among them, 7 cases complained of painless hematuria and 9 cases were asymptomatic. Three cases underwent preoperative MRI examination, 19 patients underwent preoperative enhanced CT examination, and 1 patient underwent both MRI and enhanced CT examination. MRI examination showed renal lobulated and other T1 mixed with T2 signals, the boundary was not clear, and DWI showed obvious restricted diffusion. The tumor was located on the left side in 15 cases and on the right side in 8 cases. Preoperative diagnosis was made by fine needle aspiration biopsy in 1 patient, and specimens were obtained by flexible ureteroscope in 2 patients. No tumor was reported. The preoperative diagnosis of 22 patients was unclear and the nature of the tumor could not be determined. One patient was considered to have urothelial carcinoma by fine needle aspiration. All patients were treated by surgery, including 20 cases of laparoscopic radical nephrectomy and 3 cases of nephroureterectomy with bladder sleeve resection.Results:Postoperative pathological specimens showed yellow-white mass, high-grade invasive urothelial carcinoma invading renal parenchyma. Nine cases were T 3a stage, 14 cases were T 3b stage, and 5 cases were lymph node metastasis. The average postoperative follow-up time was (18.6±6.72)months, 2 patients were lost to follow-up, 8 patients died, and the overall mortality rate was 38.1%. Seven patients died of recurrence or metastasis. There were 3 cases of bladder recurrence and 5 cases of metastasis after operation. Conclusions:Renal parenchymal infiltrating urothelial carcinoma is difficult to diagnose in the early stage, with poor clinical biological behavior and poor overall prognosis. For patients diagnosed with renal parenchymal invasive urothelial carcinoma preoperatively, laparoscopic nephroureterectomy + bladder sleeve resection is recommended.
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ObjectiveTo explore the association between dietary retinol intake and prognosis of patients with esophageal squamous cell carcinoma. MethodsThe study enrolled 388 cases with primary esophageal squamous cell carcinoma that was pathologically diagnosed in the first affiliated hospital of Fujian medical university and the cancer hospital of Fujian medical university from July 2014 to August 2019. Chi-square test was used to determine the relationship between retinol and patients' characteristics. Kruskal-Wallis rank sum test was used to analyze the relationship between retinol and multiple nutrients. Cox proportional hazards regression model was used to explore the association between dietary retinol and esophageal squamous cell carcinoma. ResultsPatients with esophageal squamous cell carcinoma did not significantly differ in gender， age， TNM stage， tumor length or nutrient intake by different retinol intakes （P>0.05）. Multivariate Cox regression analysis showed that the high retinol intake group had a better prognosis （overal survial：HR=0.279，95%CI：0.150‒0.520，P<0.001；disease-free survival：HR=0.306，95%CI：0.181‒0.516，P<0.001）. ConclusionHigh dietary retinol intake may improve the prognosis of patients with esophageal squamous cell carcinoma.
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Objective@#To explore and analyze the possible mechanism of liver injury in patients with coronavirus disease 2019 (novel coronavirus pneumonia, NCP).@*Methods@#The correlation between ALT, AST and other liver enzyme changes condition and NCP patients’ disease status reported in the literature was comprehensively analyzed. ACE2 expression in liver tissue for novel coronavirus was analyzed based on single cell sequencing (GSE115469) data. RNA-Seq method was used to analyze Ace2 expression and transcription factors related to its expression in liver tissues at various time-points after hepatectomy in mouse model of acute liver injury with partial hepatectomy. t-test or Spearman rank correlation analysis was used for statistical analysis.@*Results@#ALT and AST were abnormally elevated in some patients with novel coronavirus infection, and the rate and extent of ALT and AST elevation in severe NCP patients were higher than those in non-severe patients. Liver tissue results of single cell sequencing and immunohistochemistry showed that ACE2 was only expressed in bile duct epithelial cells of normal liver tissues, and very low in hepatocytes. In a mouse model of acute liver injury with partial hepatectomy, Ace2 expression was down-regulated on the first day, but it was elevated up to twice of the normal level on the third day, and returned to normal level on seventh day when the liver recovered and hepatocyte proliferation stopped. Whether this phenomenon suggests that the bile duct epithelial cells with positive expression of Ace2 participate in the process of liver regeneration after partial hepatectomy deserves further study. In RNA-Seq data, 77 transcription factors were positively correlated with the expression of ACE2 (r > 0.2, FDR < 0.05), which were mainly enriched in the development, differentiation, morphogenesis and cell proliferation of glandular epithelial cells.@*Conclusion@#We assumed that in addition to the over activated inflammatory response in patients with NCP, the up-regulation of ACE2 expression in liver tissue caused by compensatory proliferation of hepatocytes derived from bile duct epithelial cells may also be the possible mechanism of liver tissue injury caused by 2019 novel coronavirus infection.
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Endocrine therapy is one of the standard treatment options for breast cancer which plays an important role in treating patients with estrogen receptor (ER) positive and human epidermal growth factor receptor 2 (HER2) negative breast cancer.However,some patients develop resistance during therapy due to factors such as tumor heterogeneity,which is particularly acute in the treatment of advanced breast cancer.Based on aiming at a rational and effective treatment,some clinical trials recently have demonstrated that compared to endocrine therapy alone,cyclin-dependent kinase 4/6 (CDK4/6) inhibitors combined with endocrine therapy can significantly improve the prognosis of ER-positive,HER2-negative advanced breast cancer.Its main products are Palbociclib,Ribociclib and Abemaciclib.This review mainly focuses on the mechanism and related clinical trials of CDK4/6 inhibitor inhibitors in ER-positive,HER2-negative advanced breast cancer.
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Objective To compare the MRI features of ovarian thecoma-fibroma and adult-type ovarian granulosa cell tumor (OGCT),and to investigate the differential value of MRI.Methods 13 patients (8 cases of ovarian thecoma-fibroma,5 cases of adult-type OGCT)confirmed by pathology were collected,in which MRI findings were analyzed retrospectively.Results 13 lesions were all unilateral.The shape of more lesions appeared round or oval,and huge lesions were lobulated.Most tumors were dominant solid and well-defined borders.The length-diameter of ovarian thecoma-fibromas ranged from 23 to 268 mm,with the mean diameter of (124±84)mm;on T1WI the solid part of tumors showed equal signal in 5 cases,slight lower signal in 3 cases,on T2WI all tumors were heterogeneous signal,6 lesions appeared equal signal with obscure nebulous high signal;all of 8 lesions were enhanced slightly;4 cases were accompanied with pelvic effusion and other type tumors of the ovarian.The length-diameter of adult-type OGCT tumors ranged from 27 to 110 mm, with the mean diameter of (84±33)mm;the solid part of lesions showed slight lower signal on T1WI and high signal on T2WI,the honeycomb and fissure cystic areas were found in all tumors,4 cases were accompanied with hemorrhage;all tumors were enhanced from moderately to highly,and delay contrast enhancement;the cases were accompanied with endometrial hyperplasia in 3 cases,endometrial carcinoma in 1 case.The non-enhanced cystic areas of two groups of tumors showed lower signal on T1WI and high signal on T2WI. Conclusion There are different characteristics between ovarian thecoma-fibroma and adult-type OGCT on MRI findings,which are helpful to the differential diagnosis.
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Objective To investigate the levels and clinical significance of pentraxin 3 (PTX3) and high sensitive C-reactive protein(Hs-CRP) in patients with chronic obstructive pulmonary disease (COPD).Methods Seventy COPD patients at acute exacerbation stage were selected as the acute exacerbation group,70 COPD patients at disease remission stage were selected as remission group,and 70 healthy subjects were selected as control group.According to pulmonary function,70 COPD patients at acute exacerbation stage were divided into mild-to-moderate group(37 cases) and severe-to-very severe group (33 cases).The serum levels of PTX3,Hs-CRP,white blood cell count (WBC),neutrophils (NE) were measured.Results The serum levels of PTX3,Hs-CRP,WBC and NE of the acute exacerbation group and remission group [(0.89 ± 0.38) μg/L,(52.14 ± 4.25) mg/L,(12.13 ± 4.78) ×109/L,(79.68 ± 9.02)％;(0.47 ± 0.12) μg/L,(10.28 ± 3.42) mg/L,(8.02 ± 3.24) × 109/L,(67.24 ± 8.02) ％] were higher than those of the control group [(0.18 ± 0.04) μg/L,(4.42 ± 2.02) mg/L,(4.97 ± 2.57) × 109/L,(63.38 ± 8.79) ％] (t =213.252,245.168,48.647,53.241;121.426,124.352,21.425,24.352,all P ＜0.05).The serum levels of PTX3,Hs-CRP,WBC and NE of the acute exacerbation group were higher than those of the remission group (t =89.435,93.214,18.325,16.325,all P ＜ 0.05).In COPD patients at acute exacerbation stage,the serum levels of PTX3,Hs-CRP,WBC and NE of the mild-to-moderate group and severe-to-very severe group [(0.77 ±0.32) μg/L,(41.23 ±3.74) mg/L,(8.24 ±4.48) × 109/L,(71.54 ±8.73)％;(1.13 ±0.43) μg/L,(59.32 ± 4.65) mg/L,(14.21 ± 5.02) × 109/L,(87.96 ± 9.36) ％] were significantly higher than those of the control group [(0.18 ± 0.04) μg/L,(4.42 ± 2.02) mg/L,(4.97 ± 2.57) × 109/L,(63.38 ± 8.79) ％](t =43.253,314.265,53.241,67.324;47.315,289.253,46.572,63.241,all P ＜ 0.05).The serum levels of PTX3,Hs-CRP,WBC and NE of the severe-to-very severe group were higher than those of the mild-to-moderate group (t =38.942,267.425,46.537,58.932,all P ＜ 0.05).There was positive correlation between serum PTX3 and Hs-CRP,WBC,NE in COPD patients at acute exacerbation stage (r =0.532,0.498,0.697,all P ＜ 0.05).The serum Hs-CRP was positively correlated with WBC and NE (r =0.542,0.713,P ＜ 0.05).Conclusion Serum levels of PTX3 and Hs-CRP are elevated in patients with COPD.The serum levels of PTX3 and Hs-CRP are associated with disease severity.
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Objective To investigate the clinical value of vacuum pad and body film fixation in radiotherapy for thoracic and abdominal tumors. Methods A total of 240 patients with thoracic and abdominal tumors who were treated with radiotherapy were randomly selected and divided into group A (simple vacuum pad fixation,60 patients),group B(simple body film fixation with unimproved solid plate, 60 patients),and group C(vacuum pad and body film fixation with improved solid plate,120 patients).The difference between groups were analyzed with single variance analysis method. Results The setup error was small in group C and large in groups A and B. There were significant differences in the setup error between the three fixation methods(P=0.000). Conclusions A combination of vacuum pad and body film fixation is better than vacuum pad or body film fixation in radiotherapy for thoracic and abdominal tumors. The combination method has many benefits, including simple and convenient operation, comfortable and repeatable body fixation,reduced artificial errors,and improved positioning precision.
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Objective To investigate the feasibility of short-segment percutaneous pedicle screw non-fusion fixation plus electro-acupuncture for the treatment of single thoracolumbar fracture.Methods Forty-three patients with single thoracolumbar fracture were treated with short-segment percutaneous pedicle screw fixation without fusion,and then were given electro-acupuncture on points such as Jiaji (EX-B2),Huantiao (GB30),and Zhibian (BL54) after the operation.Before and after operation and during the follow-up,X-ray images of the spine at positive position and lateral position were taken for the measurement of vertebral anterior and posterior diameter ratio and the vetebral kyphosis Cobb's angle.Lumbago visual analogue scale (VAS) scores and Oswestry scores for lumbago function disorder were used for the evaluation of clinical efficacy.Results (1) All of the 43 patients were followed-up,and the follow-up period lasted for 10-27 months.(2) After the operation and at the end of follow-up,vertebral anterior and posterior diameter ratio and Cobb's angle were much improved (P ＜ 0.01compared with those before the operation),and the two indexes at the end of follow-up were improved as compared with those after the operation (P ＜ 0.05).(3) One week after the operation and at the end of follow-up,VAS scores and Oswestry scores were obviously improved as compared with those before treatment (P ＜ 0.01),and the two kinds of scores at the end of follow-up were also improved as compared with those after the operation (P ＜0.01).Conclusion Short-segment percutaneous pedicle screw fixation without fusion plus electro-acupuncture at points such as Jiaji is effective for the treatment of single thoracolumbar fracture by relieving pain in the waist and back,which ensures the satisfactory effect of operation.
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Objective:To observe the clinical characteristics with different peritoneal transport type in patients with continuous ambulatory peritoneal dialysis (CAPD),and to investigate the factors associated with peritoneal transport function.Methods:The clinical data of 158 CAPD patients were analyzed retrospectively.According to peritoneal equilibration test,a method for evaluation of the peritoneal transport function,the patients were divided into 2 groups:a high average and high peritoneal transport group (Group A,n=84) and a low average and low peritoneal transport group (Group B,n=74).T-he demographics,clinical biochemical indexes and the incidence of cardiovascular complications were compared between the 2 groups.Logistic regression analysis was used to find the factors relevant to peritoneal transport function.Results:The level of serum albumin (ALB) in the Group B was significantly higher than that in the Group A (P＜0.05).The 4 h dialysate/plasma creatinine (D/Pcr),high-sensitivity C-reactive protein (hs-CRP),body mass index (BMI),and the rates of cardiovascular complications in the Group A were significantly higher than those in the Group B (P＜0.05).Correlation analysis showed that the D/Pcr was positively correlated with the BMI,serum hs-CRP and cardiovascular complications (r=0.179,0.373 and 0.426,respectively,P＜0.05),while it was negatively correlated with ALB (r=-0.393,P＜0.01).Logistic regression analysis showed that the high BMI (OR=1.178,P＜0.05),cardiovascular complications (OR=5.035,P＜0.01),and the low serum ALB (OR=0.852,P＜0.01)were the risk factors for high peritoneal transport.Conclusion:The serum ALB level,BMI and the cardiovascular complications are associated with high peritoneal transport,which are useful markers for predicting the peritoneal transport function before peritoneal dialysis.
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@#Objective To follow up the rehabilitation, education, and assistive devices utilization of school age children with cerebral palsy. Methods From 2012 to 2015, 80 children with cerebral palsy were called their parents with telephone and filled in the questionnaires. Results 69 children (85.25%) continued to receive rehabilitation, 11 children (13.75%) stopped rehabilitation. 42 children (56.25%) received education in ordinary schools, 15 children (18.75%) received education in special schools, 4 children (5.00%) were nursed in nursing institu-tion, 16 children (20.00%) stayed at home and did not receive any education. The main problem and needing at present were receiving reha-bilitation, receiving school education, relief the rehabilitation cost of more than one institution, etc. 61 children (76.25%) ever applied for as-sistive devices, 19 children (23.75%) did not. The feedback of application process in order were smoothly;applied, but didn't get;the assis-tive devices that received was inappropriate. 29 children (73.75%) needed assistive devices currently, 21 children (26.25%) did not. When asked the category of needed assistive devices at present, 19 parents (20%) answered that they did not know the category of assistive devices well or they did not know which kind of assistive devices they needed. Conclusion It is important to provide quality and quantity rehabilita-tion and education service, popularize the knowledge of assistive devices and their clinical application for cerebral palsy children. Assistive devices providing departments should do more communication with cerebral palsy children and their parents, in order to reduce the waste of resources, and increase the rational use of resources, and provide more benefits for children with disabilities.
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Objective To evaluate the MDCT and MRI findings of the ovarian thecofibroma.Methods 15 patients with 16 lesions of ovarian thecofibroma confirmed by pathology after surgery were analyzed retrospectively.MDCT was performed in 1 2 patients and MRI in 8.Results 16 lesions were all unilateral,of which 1 patient had 2 lesions on the same side.10 lesions were located in the right side of ovary,while 6 ones were in the left side.The shape of more lesions was round or oval,and that of huge lesions was lobulated. 14 lesions were well-defined.These tumors were solid in 4 lesions,mixed in 9,and cystic in 3.The largest diameter of tumors ranged from 20 to 220 mm with a mean value of (89±58.29)mm.Plain MDCT showed the substantial part of tumors with iso-den-sity or slight lower density with the mean CT value of (40±8)HU.There was no or slight enhancement in comparison with the mean CT values of (49±9)HU on enhanced MDCT.5 lesions with isointensity and 3 with slight hypointensity on T1-weighted ima-ges,and all the tumors with heterogeneous signal on T2-weighted images were found.6 lesions appeared isointensity with obscure nebulous high signal on T2-weighted.The capsules of 5 lesions showed incomplete ring with lower signal.There was high signal ring outside of tumor capsule on T2-weighted in 5 lesions.All of 8 lesions were enhanced slightly,and the cystic portion was lower signal on T1-weighted images and high signal on T2-weighted images.Among all patients,ascites was found in 10 cases (66.7%)and other kinds of tumors of ovarian or uterus in 13 cases (86.7%).Conclusion MDCT and MRI findings of the ovarian thecofibroma have cer-tain characteristics,which is helpful for the diagnosis and differential diagnosis.
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Objective To compare the difference in radiotherapy dose caused by different ways of adding bolus.Methods A total of 20 patients who needed to receive postmastectomy chest wall irradiation from October to December on 2014 were selected.Each patient underwent two CT scans;CT-1 was to perform CT scan directly without bolus, and CT-2 was to perform CT scan after adding bolus to the body surface.An equivalent bolus was added for CT-1 in the radiotherapy planning system, and Plan-1, which met the clinical requirements, was performed.Then Plan-1 was put on CT-2 through image fusion and plan verification to develop Plan-2, which was to develop plans with equivalent boluses at other times and perform radiotherapy with a bolus added to the surface of the body.At last, CT-2 was used to perform radiotherapy Plan-3, which met the clinical requirements.The paired t-test was used for comparison of clinical data between any two plans with SPSS 19.0.Results The V20 of the whole lung, V20 of the diseased lung, V30 of the heart, and Dmax of the healthy breast showed no significant differences across the three plans (P=0.074-0.871).The V50 , V55 , conformity index, and homogeneity index of the planning target showed significant differences across the three plans, and the total number of monitor units showed a significant difference between Plan-1 and Plan-2(P=0.002-0.049).The dose distribution in the target volume and the number of monitor units in each radiation field also showed significant differences.Conclusions When the equivalent bolus is added to the body surface before CT scan, such a plan can accurately reflect the dose distribution of the planning target and the dose to organs at risk.
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Objective The aim of this study was to analyze the effect of gender and age on shoulder and hip range of motion (ROM) and to determine the differences of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011) in China. Methods We collected cases with unilateral injury of shoulder or hip from clinical forensic medicine. The differences of ROM of normal side joint between the data we collected and the published standards were studied. Descriptive statistics was calculated between male and female subjects in ifve age groups including 0~25, 26~40, 41~50, 51~60 and >60 years, and the ROM changes with age were also studied. Results The data collected in this study was signiifcantly different from the published standard. With age growth, the ROM of shoulder and hip were decreased and a significant difference between genders in partial activity direction of shoulder and hip was found in the individuals who were over 50 years. Conclusion Gender and age appear to be inlfuential factors to determine the normal ROM of the shoulder and hip joint, and there is signiifcantly difference of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011).
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Objective To investigate the gender differences and psychological influencing factors for anal rectal function in senile patients with functional constipation (FC) .Methods The gender differences and correlation of anal rectal function and psychological factors were compared in elderly patients and control group by anorectal manometry and psychological testing methods .Results The anal pressure drops of analog defecation of elderly female and male patients were attenuated and the rectal sensation thresholds increased compared with that of control group ,and the maximal squeezing pressure ,the rectal defecation pressure and anorectal pressure difference of elderly female patients were attenuated compared with that of elderly male patients .The SAS and SDS stand‐ard score of elderly female and male patients were significantly higher than that of control group .The SAS standard score of elderly female patients were higher than elderly male patients .SAS and SDS were negatively correlated with anorectal pressure difference and positively correlated with rectal first sensation volume (FSV) .Conclusion Anorectal dysfunction and psychological factors were involved in the elderly FC pathogenesy ,and they were related .Elderly female patients suffered more severe anxiety and anorectal motility disorders than male patients .
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Objective To evaluate the safety and efficacy of bipolar plasmakinetic system in exfoliative tran-surethral resection of bladder tumors .Methods Clinical data of 72 patients with non muscle invasive bladder cancer (NMIBC) were retrospectively analyzed.Transurethral bipolar plasmakinetic system was used ,30°viewer,F27 outer sheath was pushed off and bladder tumor was cut .When the bladder filling state ,pushed off bladder mucosa distance from tumor basal 2cm,then electricity cut the exfoliative bladder tumor .When bladder half filling state electricity cut the base of the bladder muscle layer of bladder tumor .Results This group of 72 cases were successfully completed surgery,surgery time 37~93 min,without intraoperative bladder perforation ,slight obturator nerve reflex in 5 cases. The keeping intact pathologic specimens was good for pathological staging .Conclusion Exfoliative transurethral resection of bladder tumors with bipolar plasma is a safe , practical and effective way of operation , which can avoid severe obturator reflex occurred in the operation , and greatly reduce the occurrence of bladder perforation , without TURS,surgical removal of the pathological specimens is specification .
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OBJECTIVE@#To observe the changes of plasminogen activator inhibitor-1 and D-dimer during continuous blood purification (CBP) and related factors.@*METHODS@#Sixteen patients who were diagnosed with multiple organ dysfunction syndrome (MODS) were randomly divided into 2 groups: 8 patients received standard continuous blood purification with heparin anticoagulation, and the other 8 received CBP without anticoagulation. Ten normal blood samples were collected from healthy volunteers as controls. All patients underwent CBP for 8 h. Blood was taken from those patients at 0, 15, 60, 120 and 480 min during the CBP. Plasma plasminogen activator inhibitor-1, D-dimer and serum TNF-α and IL-1β were measured by ELISA.@*RESULTS@#Plasma levels of PAI-1 and D-dimer were increased significantly compared with those in the control group (P<0.05). Plasma level of PAI-1 was reduced (P<0.05) and D-dimer was increased (P<0.05) after the CBP. The level of plasma PAI-1 in the heparin group was significant reduced compared with the group of CBP without anticoagulation (P<0.05). There was negative correlation between the level of PAI-1 and the dosage of heparin used during a CBP session in the heparin group (r=-0.746, P<0.001).@*CONCLUSION@#The level of PAI-1 and D-dimer is higher in patients with MODS than that in the normal controls. After the CBP treatment, there is significant decrease in PAI-1 and increase in D-dimer in both groups. Heparin used during CBP can reduce PAI-1 which intensifies its function of anticoagulation.
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Humans , Anticoagulants , Therapeutic Uses , Fibrin Fibrinogen Degradation Products , Heparin , Therapeutic Uses , Interleukin-1beta , Blood , Plasminogen Activator Inhibitor 1 , Blood , Renal Dialysis , Tumor Necrosis Factor-alpha , BloodABSTRACT
<p><b>BACKGROUND</b>Laparoendoscopic single-site (LESS) surgery through the retroperitoneal approach has been seldom reported. We aimed to evaluate the outcomes of LESS and conventional laparoscopic surgery via the retroperitoneal approach in the management of large, impacted ureteral calculi.</p><p><b>METHODS</b>Between November 2011 and July 2013, retroperitoneal LESS ureterolithotomy was performed in 12 patients using a homemade single-port device comprising a surgical glove and several strips of tape. Another 16 patients underwent conventional retroperitoneal laparoscopic ureterolithotomy. We compared the operative time, complications, and surgical outcomes, retrospectively.</p><p><b>RESULTS</b>All patients were completed without conversion to conventional laparoscopic or open surgery. The operative time of the LESS group and of the conventional laparoscopic group were (125.3 ± 12.8) minutes and (116.9 ± 14.4) minutes, respectively (P = 0.119). The intraoperative blood loss was (42.9 ± 8.9) and (43.4 ± 14.7) ml, respectively (P = 0.914). Postoperative radiologic evaluation revealed that the stones had been removed completely. Cosmetic results were superior in the LESS group (P = 0.001).</p><p><b>CONCLUSION</b>Retroperitoneal LESS ureterolithotomy using a homemade single-port device can be considered a feasible and safe alternative to conventional laparoscopic ureterolithotomy.</p>
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Adult , Female , Humans , Male , Middle Aged , Laparoscopy , Methods , Retroperitoneal Space , General Surgery , Ureteral Calculi , General Surgery , Urologic Surgical Procedures , MethodsABSTRACT
<p><b>BACKGROUND</b>Single-fiber electromyography is the most sensitive neurophysiological test for the diagnosis of myasthenia gravis (MG), but its use is limited by the potential risk of transmission of infections. Jitter analysis with disposable concentric needle electrodes (CNEs) is therefore being investigated. This pilot study aimed to evaluate jitter analysis with CNEs for the diagnosis of MG.</p><p><b>METHODS</b>Forty-two healthy Chinese volunteers and 44 MG patients were prospectively enrolled. MG patients were classified according to the Osserman classification, and acetylcholine receptor antibody titer was measured. Jitter analysis with CNEs in the extensor digitorum communis and repetitive nerve stimulation (RNS) testing were performed. Jitter was expressed as the mean consecutive difference (MCD), and 20 action potential pairs were analyzed in each subject. The mean MCD in each subject and the mean individual MCD of all action potential pairs were compared between groups.</p><p><b>RESULTS</b>The mean MCD and mean individual MCD were higher in MG patients ((42.3 ± 20.0) µs and (42.2 ± 26.0) µs) than in healthy volunteers ((23.0 ± 3.1) µs and (22.8 ± 7.5) µs). The area under the receiver operating characteristic curve for the mean MCD of MG patients and healthy volunteers combined was 0.85. The mean MCD and mean individual MCD were higher in generalized MG patients ((64.1 ± 18.5) µs and (63.6 ± 30.0) µs) than in ocular MG patients ((33.1 ± 12.0) µs and (33.2 ± 17.6) µs), and were higher in MG patients with abnormal RNS results ((57.2 ± 18.3) µs and (57.3 ± 29.2) µs) than in MG patients with normal RNS results ((32.9 ± 14.8) µs and (32.7 ± 18.3) µs). Abnormal RNS results were observed in 38.60% (17/44) of MG patients and abnormal jitter were observed in 72.70% (32/44) of MG patients.</p><p><b>CONCLUSION</b>Jitter analysis with CNEs is feasible for the diagnosis of MG.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Electrodes , Electromyography , Myasthenia Gravis , Diagnosis , Needles , Prospective StudiesABSTRACT
Objective To validate the technique and establish the reference jitter values in voluntarily activated extensor digitorum communis using a concentric needle electrode (CNE) in healthy Chinese adults.Methods From January to August 2013,forty-two Chinese subjects from healthy examination center of our hospital were prospectively studied,including 20 males and 22 females.Routine electromyogram was tested and jitter was recorded with CNE in all subjects.The jitter values of action potentials pairs of muscle fibers were expressed as the mean consecutive difference (MCD) after 20 analyzed potential pairs.Results The mean MCD of 42 subjects was (23.0 ± 3.1) μs ranging from 17 to 32 μs.The mean jitter value of all 840 potential pairs was (22.8 ± 7.5) μs ranging from 8 to 54 μs.Upper 95％ confidence limits for mean MCD and individual MCD were 29.2 μs and 37.8 μs,respectively.The mean value of MCD of 20 males and 22 females were (23.2 ± 2.8) μs and (22.8 ± 3.4) μs,respectively.There was no statistic difference between genders in MCD (t =0.44,P =0.66).There was no correlation between age and MCD (r =0.11,P =0.48).The mean value of mean interpotential interval was (802 ± 139) μs ranging from 541 to 1 160 μs.Conclusion The present study confirms the suitability of jitter analysis with CNE,which can serve as an objective and valuable method for testing the function of neuromuscular conjunctions.