ABSTRACT
Objective To investigate the value of SPECT imaging in the evaluation of rCBF improvement after bypass surgery in patients with moyamoya disease (MMD).Methods Retrospective analysis was conducted in 13 patients with MMD (5 children aged 3-8 years and 8 adults aged 45-55 years).The SPECT cerebral perfusion imaging data before and after operation were analyzed.Age matched subjects who underwent cerebral perfusion imaging for accidental headache (10 children,10 adults) were taken as control group.Two-sample t test or paired t test was used to compare rCBF of different groups.The brain DSA and MRI results during follow-up were taken as the reference of perfusion improvement.Results Based on visual judgment of SPECT,11/13 in MMD group showed significant improvement in the blood perfusion reduction area after surgery.The coincidence rates of SPECT-DSA and SPECT-MRI was 8/11 and 9/11,respectively.The rCBF of the control group and MMD group before surgery was (51.19±1.63) ml · 100 g-1 · min-1 and (38.83±2.22) ml · 100 g-1 · min-1 respectively (t=-18.465,P＜0.05).The rCBF of MMD group before and after surgery was significantly different ((38.83±2.22) ml · 100 g-1 · min-1 vs (45.03±2.63) ml · 100 g-1 · min-1,t=-11.707,P＜0.05).The rCBF of MMD group after surgery and the control group was significantly different (t =-8.313,P＜0.05).There was no significant difference of rCBF between the children and adults in the control group ((51.81±1.82) ml · 100 g-1 · min-1 vs (50.55±1.18) ml · 100 g-1 · min-1 ;t=0.081,P＞0.05).Conclusions Brain perfusion SPECT may effectively reflect the regional distribution and changes of blood flow in the ischemic tissue before and after MMD surgery.Thus it may be helpful in evaluation of the effect of surgical treatment.
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Objective To compare the efficacy of different thyroidectomy surgery on postoperative quality of life in elderly patients with thyroid cancer.Methods 56 patients with thyroid cancer in the hospital from August 2011 to October 2014 were selected,and they were divided into observation group and control group according to the different methods of treatment.Patients in the observation group accepted small incision improvement while the control group accepted conventional thyroidectomy.The operation time,intra -operative blood loss,intra -operative blood transfusion,postoperative drainage,length of hospitalization period,complications occurring,VAS pain score and SF -36 score 1 month after treatment in two groups were recorded for statistical analysis.Results In the observation group,the operation time,intra -operative blood loss,intra -operative blood transfusion,postoperative drainage,length of hospitalization period were obviously lower than these in the control group,the difference was statistically significant (t =3.568,2.139,6.368,3.716,3.569,all P <0.05).The VAS pain score and SF -36 score in the observation group of (2.02 ±0.25)points and (77.21 ±8.13)points were obviously higher than these in the control group of (2.61 ±0.29)points and (43.46 ±5.63)points,the difference was statistically significant (t =3.867,4.568,all P <0.05).The rates of postoperative complication in the control group and the observation group were respectively 16.0% (4 /25 )and 35.5% (11 /31 ),the difference was statistically significant (χ2 =0.035,P <0.05 ). Conclusion Small incision improvement has a better curative effect with fewer complications and can improve quality of life for patients with thyroid cancer,thus it's worth popularization and application in clinic.
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Objective To identify the disease-causing gene mutation and investigate the genotypephenotype correlation in a Chinese pedigree with familial hypertrophic cardiomyopathy.Methods In this study we collected a large multigenerational Chinese family with FHCM.Total genome DNA was extracted from 67 subjects' peripheral leucocytes.The exons and boundary introns of MYH7 gene was amplified by PCR and directly sequenced by ABI PRISM 3700 DNA sequencer.Then,the mutation was examined.Results Fourteen family members had hypertrophic cardiomyopathy,including 4 deceased 2 of whom died from sudden death at young age.Analysis by echocardiography showed all the 10 living affected individuals have a maximal leftventricular-wall thickness of at least 13 mm.Three single nucleotide polymorphisms (SNP) which had been reported in NCBI SNP database,were found mutated.No mutation co-seperated with the disease was identified.Conclusion FHCM of this family was not caused by MYH7 mutation.Other genes should be screened to further identify the disease-causing gene mutation in hypertrophic cardiomyopathy.