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NDFIP1 has been previously reported as a tumor suppressor in multiple solid tumors, but the function of NDFIP1 in NSCLC and the underlying mechanism are still unknown. Besides, the WW domain containing proteins can be recognized by NDFIP1, resulted in the loading of the target proteins into exosomes. However, whether WW domain-containing transcription regulator 1 (WWTR1, also known as TAZ) can be packaged into exosomes by NDFIP1 and if so, whether the release of this oncogenic protein via exosomes has an effect on tumor development has not been investigated to any extent. Here, we first found that NDFIP1 was low expressed in NSCLC samples and cell lines, which is associated with shorter OS. Then, we confirmed the interaction between TAZ and NDFIP1, and the existence of TAZ in exosomes, which requires NDFIP1. Critically, knockout of NDFIP1 led to TAZ accumulation with no change in its mRNA level and degradation rate. And the cellular TAZ level could be altered by exosome secretion. Furthermore, NDFIP1 inhibited proliferation in vitro and in vivo, and silencing TAZ eliminated the increase of proliferation caused by NDFIP1 knockout. Moreover, TAZ was negatively correlated with NDFIP1 in subcutaneous xenograft model and clinical samples, and the serum exosomal TAZ level was lower in NSCLC patients. In summary, our data uncover a new tumor suppressor, NDFIP1 in NSCLC, and a new exosome-related regulatory mechanism of TAZ.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/metabolism , Carrier Proteins/metabolism , Cell Line , Cell Proliferation , Exosomes/metabolism , Lung Neoplasms/genetics , Membrane Proteins/metabolism , Transcriptional Coactivator with PDZ-Binding Motif Proteins/metabolismABSTRACT
Objective:To assess the relationship between appendicular skeletal muscle mass (ASM) and ankle brachial index (ABI) among patients with type 2 diabetes.Methods:In this cross-sectional study, from July 2018 to March 2019, a total of 278 patients with type 2 diabetes treated in Zhongda Hospital were enrolled in this study, and there were 158 males and 120 females. General information and clinical biochemical parameters and ABI in the patients were collected. The appendicular muscle mass was quantitatively measured with body composition analyzer to achieve ASM. And the appendicular skeletal muscle mass index (ASMI), skeletal muscle index (SMI), and appendicular skeletal muscle mass/body mass index (ASM/BMI) were calculated respectively. Correlation analysis and multiple linear regression analyses with different adjustment models were conducted to analyze the correlation between ABI and above-mentioned indexes.Results:The Pearson correlation analysis showed that ABI had significant positive correlation with ASM, ASMI and ASM/BMI ( r=0.14, 0.13, 0.13, all P<0.05), but a marginal relation with SMI ( r=0.116, P=0.053). Multiple linear regression analysis suggested that ASMI ( β=0.053, 95% CI: 0.006-0.101, P=0.027) and AMI/ABI ( β=0.347, 95% CI: 0.040-0.654, P=0.027) were significantly related to ABI. Conclusion:ASM is positively associated with ABI in patients with type 2 diabetes.
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A total of 6 patients were treated with surface knee joint prosthesis combined with 3D-printed customized bionic tibial block for reconstruction of bone defect after giant cell tumor (GCT) in proximal tibia (1 male and 5 females, aged 50, 40, 68, 53, 35, 42, respectively). 3 patients with primary and 3 patients with recurrence of GCT. After resection of the tumor, the bone defect was filled with 3D-printed block combined with surface knee prosthesis, the surrounding ligaments were reconstructed with microporous structure and artificial mesh. All cases were followed up for 60, 90, 60, 60, 75, and 50 months, respectively. During the follow-up, there was no local recurrence, no radiolucent lines around prosthesis, and no signs of loosening. The clinical scores of the American Knee Society Score (KSS) were 87, 92, 85, 90, 95 and 78. The functional scores were 70, 100, 70, 100, 100 and 80 respectively. Musculoskeletal Tumor Society Score (MSTS) were 27, 28, 26, 26, 26, 27, respectively. Surface knee prosthesis combined with bionic block can effectively fill the bone defect after resection of GCT in proximal tibia, achieve anatomical and functional reconstruction of knee joint.
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OBJECTIVE@#To compare the effects of artificial liver treatment with double plasma molecular adsorption system(DPMAS) mode and traditional plasma exchange (PE) mode on platelets in patients, and to evaluate the clinical efficacy of recombinent human thrombopoietin (rhTPO) in the treatment of thrombocytopenia.@*METHODS@#A total of fifteen patients undergoing artificial liver with DPMAS model admitted to the Fifth Affiliated Hospital of Guangzhou Medical University from January 2018 to November 2020 were selected and included in the DPMAS group, and another 15 patients receiving PE were selected and included in the PE group. The improvement of clinical symptoms, such as fatigue, jaundice, oliguria, edema, etc. before and after artificial liver treatment was compared between the two groups, and the trend of blood routine (especially platelet), coagulation function and other indexes before and after treatment were compared between the two groups. The use of rhTPO and the number of platelets were recorded during treatment.@*RESULTS@#The improvement rate of clinical symptoms in DPMAS group was 86.67%, which was higher than that in PE group, but the difference was not statistically significant (P>0.05). There was no statistical significance in the outcome of the two groups within 90 days (P>0.05). There was no significant difference in white blood cell (WBC) and hemoglobin (HB) between the two groups after treatment (P>0.05). However, the level of platelet(PLT) in DPMAS group was significantly lower than that before treatment (P < 0.05), and was significantly lower than that in PE group (P < 0.05). After treatment, the international normalized ratio (INR) level in PE group was significantly improved (P < 0.05), but there was no significant difference in the INR level in DPMAS group (P>0.05). The patients in the DPMAS group received an average of (8.2±3.1) doses of rhTPO and (1.5±0.3) IU of platelet transfusions during hospitalization. In DMPAS group, platelets increased significantly after infusion of terbium.@*CONCLUSION@#Compared with PE mode, the artificial liver with DPMAS mode can reduce platelet levels in patients, but the application of rhTPO can stimulate platelet regeneration and increase platelet levels in the patients, thereby reducing the risk of bleeding due to platelet hypoplasia.
Subject(s)
Humans , Blood Platelets , Liver, Artificial , Plasma Exchange , Recombinant Proteins , Thrombocytopenia/therapy , ThrombopoietinABSTRACT
By referring to the relevant ancient herbal literature， medical records and prescription books， the textual research of Violae Herba has been conducted to verify the name， origin， producing area， quality evaluation and processing method changes. The results showed that the name of Zihua Diding originated from its flower color and plant morphological characteristics. The primitive plant of Violae Herba is Viola genus of Violaceae， V. yedoensis， as stipulated in the 2020 edition of Chinese Pharmacopoeia， has been the mainstream in past dynasties of China. Violae Herba is mainly wild， and it is widely distributed throughout the country. Since modern times， the quality of Violae Herba is better with integrity， green color and yellow root. There are few records on the harvesting and processing methods of Violae Herba in ancient times， most of which are directly used after drying. It is suggested that the collection and processing methods of Violae Herba in the famous classical formulas can be implemented in accordance with the provisions of the 2020 edition of Chinese Pharmacopoeia.
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Objective: To study the diagnostic value of immediate color Doppler ultrasonography on traumatic hepatic hemorrhage after tissue sampling with ultrasound-guided liver biopsy and the clinical effect of its-directed local compression hemostasis at puncture-site. Methods: 132 hospitalized patients with various liver diseases underwent ultrasound-guided hepatic puncture-biopsies, including 61 cases with diffuse parenchymal and 71 cases with focal liver lesions. Immediate postoperative color Doppler ultrasonography was performed following liver biopsy. Abnormal blood flow signal was observed at hepatic puncture biopsy site, and if there were hemorrhagic signals, ultrasound-directed local compression hemostasis was performed until the bleeding signal disappeared. F-test and Chi-square test were used for statistical analysis. Results: Immediate color Doppler ultrasonography showed traumatic hemorrhage in 36.1% (22/61) and 40.8% (29/71) cases of diffuse liver disease and focal liver disease group, respectively. All hemorrhagic signals were eventually disappeared after ultrasound-directed local compression hemostasis. The median hemostasis time was 2 min in both groups, and there was no statistically significant difference in bleeding rate and hemostasis time between the two groups (P>0.05). There were no serious complications and deaths. Conclusion: Traumatic hepatic hemorrhage along the needle puncture tract is a common accompanying condition during liver biopsy. Immediate postoperative color Doppler ultrasonography can trace bleeding signals in timely manner and direct effective compression hemostasis, so it should be used routinely to help avoid occurrence of severe hemorrhagic complications.
Subject(s)
Humans , Biopsy , Hemorrhage/etiology , Hemostasis/physiology , Liver/pathology , Liver Diseases/pathology , Ultrasonography , Ultrasonography, Doppler, Color/adverse effectsABSTRACT
Objective To examine the effect of the integrated schistosomiasis control measures in Hunan Province from 2004 to 2019, so as to provide insights into the development of the schistosomiasis elimination strategy. Methods The integrated schistosomiasis control measures implemented by the health, agriculture, water resources, forestry, land and resources sectors were retrospectively collected in Hunan Province from 2004 to 2019, and the completion of each measure, cost of control measures, Schistosoma japonicum infections in humans and bovines, and snail status were analyzed each year. An index system for assessing the integrated schistosomiasis control effect was constructed using the Delphi method to calculate the integrated schistosomiasis control effect index. In addition, a cost-effect analysis was performed in terms of the decline in the prevalence of S. japonicum infections in humans and bovines, areas with snails in inner embankments, and areas with infected snails. Results A total of 7 110 926 500 Yuan were invested into the integrated schistosomiasis control program of Hunan Province from 2004 to 2019. During the 16-year period, a total of 277 437.12 hm2 snail habitats received molluscicidal treatments, 6 927 230 person-times given expanded chemotherapy, 2 116 247 bovine-times given expanded chemotherapy, 954 850 harmless toilets built, 290 359 bovines fenced, 136 666 bovines eliminated, 141 905 machines used to replace bovines, 39 048.63 hm2 water lands improved as dry lands, 724.12 km irrigation regions improved, 3 994 300 populations covered with safe water, 191 102.89 hm2 forests planted and 38 535.27 hm2 lands leveled. The prevalence of S. japonicum infections was 4.29% in humans and 4.48% in bovines in Hunan Province in 2004, with 2 449.37 hm2 snail habitats in inner embankments and 3 423.74 hm2 infected snail areas. In 2019, the prevalence of S. japonicum infections reduced to 0 in both humans and bovines, and areas of snail habitats reduced to 540.92 hm2 (77.92% reductions), while the areas with infected snails reduced to 0. The overall integrated schistosomiasis control effect index appeared a tendency towards a rise over years since 2004, and the integrated schistosomiasis control effect index was 97.35 in 2019; the annual mean costs for a 1% reduction in the prevalence of S. japonicum infections in 100 populations and 100 bovines were 70.11 Yuan and 4 204.78 Yuan, and the annual mean costs for a 1% reduction in the snail areas in inner embankments and infected snail areas were 2 010.20 Yuan and 1 298.09 Yuan, respectively. Conclusions The integrated control measures achieve remarkable effectiveness for schistosomiasis control in Hunan Province, with a remarkable decline in the prevalence of S. japonicum infections in humans and bovines and great shrinking of snail areas in inner embankments and infected snail areas. Adequate fund investment is required to improve the integrated schistosomiasis control measures and consolidate the control achievements.
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Objective To investigate spatial distribution and temporal trend of main water-soluble inorganic ions in PM2.5 of Wuhan. Methods PM2.5 samples were simultaneously collected at 5 sites in Wuhan from January 2017 to December 2017 (7 consecutive days per month). The main water-soluble ions in PM2.5 were determined by weighing method and ion chromatography. The seasonal variations and spatial distribution differences were analyzed. Results The results showed that the mass concentration of PM2.5 in Wuhan changed in different seasons. It was highest in winter, followed by spring and autumn, and lowest in summer. There were obvious seasonal changes in the mass concentrations and proportions of distinct ions. The concentrations of the four detected water-soluble inorganic ions were highest in winter. SO42- had highest concentration and proportion, followed by NO3- and NH4+, and Cl- was the lowest. In terms of spatial distribution, the total ion concentration and proportion was the largest in Wuchang and the lowest in Dongxihu. Conclusion The seasonal variation of main water-soluble inorganic ions in PM2.5 was obvious, and the spatial distribution was also different in Wuhan.
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Objective@#To study the anatomical features of the distal humerus in Chinese healthy adults.@*Methods@#A total of 121 cases of normal elbow joint CT images were selected from the picture archiving and communication system (PACS), and reconstructed and measured on the AW4.5 workstation. Coronal plane and horizontal plane were determined by flexion-extension (FE) axis and humeral shaft, while the sagittal plane was perpendicular to the FE axis. The angle between the axis of humerus medullary cavity and the FE axis of elbow (H-FE angle) was measured on the coronal plane. The capitellar height (CH), lateral trochlear height (LTH), trochlear height (TH) and medial trochlear height (MTH) were measured on four different sagittal planes. The capitellar width (CW), capitellar depth (CD), anterior lateral trochlear width (ALTW), posterior lateral trochlear width (PLTW), trochlear width (TW), anterior medial trochlear width (AMTW), posterior medial trochlear width (PMTW), trochlear depth (TD), anterior lateral trochlear depth (ALTD), posterior lateral trochlear depth (PLTD), anterior medial trochlear depth (AMTD), posterior medial trochlear depth (PMTD), and distal humeral width (W) were measured on the horizontal plane. The gender differences in measured parameters, correlations between data, and differences in H-FE angle from 90° were analyzed.@*Results@#In male, CH was 21.5± 1.3 mm, CW 17.5±1.1 mm, CD 10.8±0.9 mm, TW 25.1±2.2 mm, TH 17.3±1.5 mm, TD 17.5±1.4 mm, ALTW 7.7±1.2 mm, PLTW 12.5±1.6 mm, AMTW 12.4±1.6 mm, PMTW 9.8±2.0 mm, ALTD 10.0±0.8 mm, PLTD 16.3±1.4 mm, AMTD 12.9±1.4 mm, PMTD 13.2±1.4 mm, LTH 20.6±1.3 mm, MTH 25.0±2.4 mm, W 42.6±2.5 mm. The above parameters in female was 18.7±1.1 mm, 15.3±1.1 mm, 9.5±0.6 mm, 21.7±1.5 mm, 15.4±1.7 mm, 15.6±1.5 mm, 6.8±1.3 mm, 10.7±1.4 mm, 10.6±1.4 mm, 8.5±1.4 mm, 8.9±0.8 mm, 14.5±1.1 mm, 11.4±1.1 mm, 11.5±1.0 mm, 18.1±1.4 mm, 21.6±1.4 mm and 37.0±1.8 mm, respectively. All the above anatomical parameters in men were larger than those in women with statistically significant difference (P<0.05). However, the H-FE angle (male: 87.4°±3.5°, female 87.8°±3.3°), CW/CH (male: 0.8±0.1, female: 0.8±0.1), TW/CW (male: 1.4±0.2, female: 1.4±0.1), MTH/LTH (male: 1.2±0.1, female: 1.2±0.1), AMTW/TW (male: 0.5±0.1, female: 0.5±0.1), PMTW/TW (male: 0.4±0.1, female: 0.4±0.1), ALTW/TW (male: 0.3±0.0, female: 0.3±0.1), PLTW/TW (male: 0.5±0.1, female: 0.5±0.1) were not statistically different between male and female groups (P>0.05). All measurements except for the H-FE angle had a positive correlation with the articular width (0.335≤r≤0.928, P<0.05). The difference between the angle of the H-FE axis (87.6°±3.4°) and 90° was statistically significant (t=-7.287, P<0.05).@*Conclusion@#The size of the distal humerus in male is larger than that in female without difference in shape. Distal humerus width can be used as an indicator to measure the size of the distal humerus. The humeral shaft is more biased toward the radial side.
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Objective To study the anatomical features of the distal humerus in Chinese healthy adults.Methods A total of 121 cases of normal elbow joint CT images were selected from the picture archiving and communication system (PACS),and reconstructed and measured on the AW4.5 workstation.Coronal plane and horizontal plane were determined by flexion-extension (FE) axis and humeral shaft,while the sagittal plane was perpendicular to the FE axis.The angle between the axis of humerus medullary cavity and the FE axis of elbow (H-FE angle) was measured on the coronal plane.The capitellar height (CH),lateral trochlear height (LTH),trochlear height (TH) and medial trochlear height (MTH) were measured on four different sagittal planes.The capitellar width (CW),capitellar depth (CD),anterior lateral trochlear width (ALTW),posterior lateral trochlear width (PLTW),trochlear width (TW),anterior medial trochlear width (AMTW),posterior medial trochlear width (PMTW),trochlear depth (TD),anterior lateral trochlear depth (ALTD),posterior lateral trochlear depth (PLTD),anterior medial trochlear depth (AMTD),posterior medial trochlear depth (PMTD),and distal humeral width (W) were measured on the horizontal plane.The gender differences in measured parameters,correlations between data,and differences in H-FE angle from 90° were analyzed.Results In male,CH was 21.5± 1.3 mm,CW 17.5±1.1 mm,CD 10.8±0.9 mm,TW 25.1±2.2 mm,TH 17.3±1.5 mm,TD 17.5±1.4 mm,ALTW 7.7±1.2 mm,PLTW 12.5±1.6 mm,AMTW 12.4±1.6 mm,PMTW 9.8±2.0 mm,ALTD 10.0±0.8 mm,PLTD 16.3±1.4 mm,AMTD 12.9±1.4 mm,PMTD 13.2±1.4 mm,LTH 20.6±1.3 mm,MTH 25.0±2.4 mm,W 42.6±2.5 mm.The above parameters in female was 18.7±1.1 mm,15.3± 1.1 mm,9.5±0.6 mm,21.7±1.5 mm,15.4±1.7 mm,15.6±1.5 mm,6.8±1.3 mm,10.7±1.4 mm,10.6±1.4 mm,8.5±1.4 mm,8.9±0.8 mm,14.5±1.1 mm,11.4±1.1 mm,11.5±1.0 mm,18.1±1.4 mm,21.6±1.4 mm and 37.0±1.8 mm,respectively.All the above anatomical parameters in men were larger than those in women with statistically significant difference (P＜0.05).However,the H-FE angle (male:87.4°±3.5°,female 87.8°±3.3°),CW/CH (male:0.8±0.1,female:0.8±0.1),TW/CW (male:1.4±0.2,female:1.4±0.1),MTH/LTH (male:1.2±0.1,female:1.2±0.1),AMTW/TW (male:0.5±0.1,female:0.5±0.1),PMTW/TW (male:0.4±0.1,female:0.4± 0.1),ALTW/TW (male:0.3±0.0,female:0.3±0.1),PLTW/TW (male:0.5±0.1,female:0.5±0.1) were not statistically different between male and female groups (P＞0.05).All measurements except for the H-FE angle had a positive correlation with the articular width (0.335≤r≤0.928,P＜0.05).The difference between the angle of the H-FE axis (87.6°±3.4°) and 90° was statistically significant (t=-7.287,P＜0.05).Conclusion The size of the distal humerus in male is larger than that in female without difference in shape.Distal humerus width can be used as an indicator to measure the size of the distal humerus.The humeral shaft is more biased toward the radial side.
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In this paper, a case of pleural amoebic empyema and its diagnosis and treatment were reported.
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The clinical manifestations of Streptococcus pneumoniae disease(SPD) are various, and some patients with rare SPD types have a worse prognosis.Among them, the mortality is up to 70% after 48-72 hours of the onset of Streptococcus pneumoniae (SP)-related overwhelming post-splenectomy infection(OPSI). Purpura fulminans of SP(SP-PF) is often characterized by extensive purpura, fever, hypotension and disseminated intravascular coagulation, and prognosis of the patients without prodromal symptoms is poor.Infectious endocarditis has a mortality rate of 20.7% in SP-related cardiovascular diseases, and Austrian syndrome has a fatality rate of 43.5%.The mortality rate of bacterial pericarditis was 13.56%.At present, SP vaccine can not completely cover the 7 serotypes reported.Vasculitis mainly occurs in the thoracic and abdominal aorta and its branches, middle cerebral artery and so on.Of the 8 cases of hemophagocytic syndrome, 2 cases died.Early anti-infection, methylprednisolone shock and surgical treatment can improve the prognosis.Vaccination and drug prophylaxis can help those with under-lying diseases such as splenic dysfunction to reduce the incidence of SPD, such as SP-OPSI.
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Objective@#To build an automatic bone age assessment system based on China 05 Bone Age Standard and the latest deep learning technology, and preliminary clinical verification was carried out.@*Methods@#The left-hand radiographs of 5 000 children with suspected metabolic disorders were acquired from Wuxi Children′s Hospital. Among these cases, 2 351 patients were randomly chosen as training set, and 101 patients were randomly used as validation set. Four professional pediatric radiologists annotated the development stage according to the China 05 RUS-CHN standard with double-blind method. The mean value of the bone age assessed by experts was the reference standard which was used to train and validate the deep learning mothods based artificial intelligence (AI) model. Accuracy, mean absolute error (MAE), root mean squared error (RMSE) and time efficiency of bone age assessment were compared by using Chi-square test and t test and F test between resident doctors and AI model in the validation set.@*Results@#The MAE and RMSE was (0.37±0.35) years and 0.50 years between AI model and reference standard, respeactively. When the error range was within ±1.0, ±0.7 and ±0.5 years, the accuracy of model on the validation set was 94.1% (95/101), 89.1% (90/101), 74.3% (75/101) respectively. The accuracy between two resident doctors and AI prediction wasn′t statistical significant (P>0.05).@*Conclusion@#The AI model of bone age assessment based on deep learning is feasible and has the characteristics of high accuracy and efficiency.
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Objective To investigate the imaging features of necrotizing pneumonia(NP)caused by mycoplasma pneumoniae in children and to review the changes of serum CGreactive protein (CRP)and plasma DGdimer,which may provide an objective and effective help for clinicians.Methods 54 children with mycoplasma pneumoniae pneumonia (MPP)infection in our hospital were studied retrospectively,including 24 cases of NP and 30 cases of nonGNP (the control group).The dynamic changes of chest imaging,serum CRP and plasma DGdimer were compared between two groups.Results Chest imaging in NP group:All cases showed consolidation and necrosis,accompanied by pulmonary cavities,pleural effusion,bronchiectasia,and thickening of the bronchial wall.Decreased enhancement areas could be found in all 24 cases by enhanced CT.The review after treatment showed that the pulmonary consolidation was absorbted or narrowed,accompanied by cavities in lung,atelectasis,and pleura thickening.The imaging of non NP group showed mainly patches and spots shadow in lung, and only a little consolidation.After treatment,the lung lesions were basically absorbed.Only a few cases had fibrotic streaks and pleural thickening.The peak values of serum CRP in group NP and non NP group were respectively 91(33－266)mg/L,37(18－189) mg/L,and the duration of the abnormity were 1 9(1 1－3 8)d and 8(4－1 9)d.The peak values of plasma DGdimer in the 2 groups were respectively 2 3 78(1 9 84－5 908)ng/mL,1 7 6(1 2－41 9)ng/mL,and the duration of the abnormity were 24(13－64)d and 3(0－10)d. There were significant differences between the 2 groups with all parameters above.Conclusion The imaging characteristics of NP caused by MP in children include consolidation,necrosis (decreased enhancement areas in consolidation),pneumothorax ,cavities ,cystic degenerations, atelectasis,bronchial wall thickening,pleural effusion and pleura thickening.The course of NP was long,and the absorption was slow. The peaks value of serum CRP and plasma DGdimer in NP group were significantly higher than those in the non NP group,and the duration was longer than that in non NP group.Therefore,the clinicians should pay more attention to CR,DGdimer and chest imaging,which may help clinicians with the diagnosis and treatment.
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Objective To study the surgical strategy and clinical efficacy of hypertensive basal ganglia hematomas via transsylvian transinsular approach individually.Methods The clinical data of 45 patients with hypertensive basal ganglia hematomas underwent microsurgical treatment with different sylvian anatomical points in Jianhu Hospital Affiliated to Nantong University from October 2014 to June 2016 were retrospectively analyzed.Results The anterior hematomas was dissected through anterior point of lateral fissure,accounted for 66.7％ (30 cases),the posterior hematoma was dissected through rolandic points under lateral fissure,accounted for 22.2％ (10 cases),the long axis type hematoma was dissected between the anterior point of the lateral fissure and the lower rolandic point,accounted for 11.1％ (5 cases).The postoperative CT scan showed that 42 cases were removed the hematomas for more than 90.0％,3 cases were removed the hematomas for more than 75.0％,there was no postoperative rebleeding.According to GOS score,14 cases returned to preoperative life status,20 cases recovered sufficiently to return to family life,9 cases could ambulate with a crotch but needed assistance,one case showed vegetative survival,one patient died.Conclusion Transsylvian transinsular approach via individual sylvian anatomical point should be advocated to remove basal ganglia hematomas,and it has the advantages of minimally invasion,high hematoma evacuation rate,low rebleeding rate,good neurological recovery and so on.
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Objective:To investigate the metal artifact reduction effect of orthopedic metal artifact reduction (O-MAR) techonology and its improvement effect on the image quality in CT examination in the patients with arthroplasty, and to elaborate the significance of the technology in clinical diagnosis and treatment of arthroplasty.Methods:The CT data of 20patients with hip or knee prostheses was collected.There were two tube voltages in each group of CT data:120and 140Kev.There were also two groups of CT data in each tube voltage group:nonO-MAR group and O-MAR group;there were four subgroups of CT data of each case:120 Kev/-O-MAR, 120Kev/+O-MAR, 140Kev/-O-MAR, 140Kev/+O-MAR.After data collection, Mimics software was applied to conduct three-dimensional (3D) reconstruction for purpose of the qualitative and quantitative analysis of CT data.Qualitative analysis mainly included the grade of severity of metal artifact and quality of data.Quantitative analysis included the volume of metal artifact, the average CT value and standard deviation (SD) in region of interest (ROI) .ROI 1and ROI 2were chosen at the location of beam hardening artifact (radial high-density metal artifact) and photon starvation artifact (band low-density metal artifact) , respectively.Results:According to the result of3D measurement, the volumes of artifact had no significant difference between 120 Kev/-O-MAR group and140Kev/-O-MAR group (P=0.062) , but there were siginificant differences in the volumes of artifact between other groups (P＜0.05) ;O-MAR technology decreased the volume of beam-hardening artifact obviously (P＜0.05) .According to the results of two-dimensional (2D) measurement, there was no significant difference in the average CT values in ROI 2between 120Kev/-O-MAR group and 140Kev/-O-MAR group (P=0.069) , but there were significant differences in the average CT values between other groups (P＜0.05) ;O-MAR technology decreased the high-density beam-hardening metal artifact and the low-density photon-starvation metal artifact in 2D measurement.Conclusion:O-MAR technology could significantly reduce the CT metal artifact of hip and knee prostheses and increase the clinical value of CT data.
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Objective@#To study the surgical strategy and clinical efficacy of hypertensive basal ganglia hematomas via transsylvian transinsular approach individually.@*Methods@#The clinical data of 45 patients with hypertensive basal ganglia hematomas underwent microsurgical treatment with different sylvian anatomical points in Jianhu Hospital Affiliated to Nantong University from October 2014 to June 2016 were retrospectively analyzed.@*Results@#The anterior hematomas was dissected through anterior point of lateral fissure, accounted for 66.7%(30 cases), the posterior hematoma was dissected through rolandic points under lateral fissure, accounted for 22.2%(10 cases), the long axis type hematoma was dissected between the anterior point of the lateral fissure and the lower rolandic point, accounted for 11.1%(5 cases). The postoperative CT scan showed that 42 cases were removed the hematomas for more than 90.0%, 3 cases were removed the hematomas for more than 75.0%, there was no postoperative rebleeding.According to GOS score, 14 cases returned to preoperative life status, 20 cases recovered sufficiently to return to family life, 9 cases could ambulate with a crotch but needed assistance, one case showed vegetative survival, one patient died.@*Conclusion@#Transsylvian transinsular approach via individual sylvian anatomical point should be advocated to remove basal ganglia hematomas, and it has the advantages of minimally invasion, high hematoma evacuation rate, low rebleeding rate, good neurological recovery and so on.
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The clinical manifestations of Streptococcus pneumoniae disease (SPD) are various,and some patients with rare SPD types have a worse prognosis.Among them,the mortality is up to 70％ after 48-72 hours of the onset of Streptococcus pneumoniae (SP)-related overwhelming post-splenectomy infection (OPSI).Purpura fulminans of SP (SP-PF) is often characterized by extensive purpura,fever,hypotension and disseminated intravascular coagulation,and prognosis of the patients without prodromal symptoms is poor.Infectious endocarditis has a mortality rate of 20.7 ％ in SP-related cardiovascular diseases,and Austrian syndrome has a fatality rate of 43.5 ％.The mortality rate of bacterial pericarditis was 13.56％.At present,SP vaccine can not completely cover the 7 serotypes reported.Vasculitis mainly occurs in the thoracic and abdominal aorta and its branches,middle cerebral artery and so on.Of the 8 cases of hemophagocytic syndrome,2 cases died.Early anti-infection,methylprednisolone shock and surgical treatment can improve the prognosis.Vaccination and drug prophylaxis can help those with under-lying diseases such as splenic dysfunction to reduce the incidence of SPD,such as SP-OPSI.
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In this paper, a case of pleural amoebic empyema and its diagnosis and treatment were reported.
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Objective@#To evaluate the clinical efficacy and adverse events of recombinant human interleukin-11(rhIL-11) in the prevention of thrombocytopenia induced by craniospinal irradiation.@*Methods@#In this randomized control study, 100 patients were randomly divided into A (rhIL-11 group, n=50) and B groups (control group, n=50). In the A group, subcutaneous injection of rhIL-11 was delivered at a dose of 50 μg/kg/d, once daily when the platelet count was< 100×109/L during radiotherapy or decreased by> 50% compared with the baseline level. The administration of rhIL-11 was terminated when the platelet count was ≥ 200×109/L. In the B group, the same protocol was conducted when the platelet count was< 50×109/L and terminated until the platelet count was ≥ 100×109/L. The clinical efficacy was assessed in 92 patients. Subcutaneous injection of rhIL-11 could significantly elevate the minimal platelet count during craniospinal irradiation (P<0.01), considerably shorten the duration of thrombocytopenia (P<0.01) and effectively shorten the duration of radiotherapy (P<0.01). Main adverse events included mild pain at the injection site, sclerosis, redness and fatigue, etc.@*Conclusions@#Injection of rhIL-11 can significantly enhance the platelet count, effectively reduce the incidence of thrombocytopenia throughout craniospinal irradiation, guarantee the success of radiotherapy and yield mild adverse events.