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【Objective】 To evaluate the efficacy and safety of different doses and frequencies of oral Sildenafil in the treatment of erectile dysfunction (ED). 【Methods】 The randomized,open clinical trial included 120 ED patients who met the inclusion and exclusion criteria. The patients were randomly divided into the following groups:on-schedule (25 mg/day),on-demand (50 mg,taken irregularly half an hour before each sexual life),new regular group (25 mg/day,50 mg more before each sexual life),regular group (100 mg/time,twice/week). All treatments lasted for 8 weeks. The follow-up indexes included the five-item International Index of Erectile Function (IIEF-5),Erection Hardness Scale (EHS) and Sexual Encounter Profile (SEP2/3). The adverse reactions were recorded. 【Results】 The IIEF-5 scores of the four groups were significantly higher than those after baseline treatment (P0.05). In terms of effective rate,at the 16th week,there were significant differences between the on-demand group (10.7%) and new regular group (62.1%),and between the on-demand group (10.7%) and regular group (50.0%) (P<0.001). In terms of EHS, the percentage of grade 4 patients in regular group was significant higher than that in the on-demand group at the 8th week and 16th week (all P<0.05). In terms of positive rate of SEP-3,there was a significant difference between the on-demand group and regular group (P=0.042) at the 16th week. In the course of treatment,there were transient adverse reactions such as headache,blurred vision,stuffy nose and back pain,which did not affect the treatment. 【Conclusion】 All of the four treatment methods of oral sildenafil showed good efficacy. Both regular group and new regular group maintained good clinical efficacy during the follow-up,which is better than that of the on-demand group. The new regular scheme can be used as a new,safe and effective treatment option.
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Objective:To evaluate the distribution characteristics of postinterventional cerebral hyperdensities (PCHDs) in patients with acute anterior circulation large vessel occlusive stroke after interventional therapy using the Alberta Stroke Program Early CT Score (ASPECTS) and to investigate its predictive value for symptomatic intracranial hemorrhage (sICH).Methods:Consecutive patients with acute anterior circulation large vessel occlusive stroke underwent endovascular mechanical thrombectomy (EMT) in the Stroke Center of Dongguan People's Hospital from January 2018 to December 2020 were retrospectively enrolled. The clinical, imaging and follow-up data were collected. The immediate PCHDs-ASPECTS after endovascular therapy were analyzed. Multivariate logistic regression analysis and receiver operator characteristic (ROC) curve were used to investigate its predictive value for sICH. Results:A total of 161 patients were enrolled in the study, including 115 males (71.4%). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.6±5.6; 66 patients (41.0%) developed PCHDs and 35 (21.7%) had sICH. The baseline NIHSS score, the proportion of patients with severe stroke, the number of retrieval attempts and the detection rate of PCHDs in the sICH group were significantly higher than those in the non-sICH group, while diffusion weighted imaging-ASPECTS and PCHDs-ASPECTS were significantly lower than those in the non-sICH group (all P<0.05). Multivariate logistic regression analysis showed that PCHDs had a significant independent positive correlation with sICH (odds ratio 6.036, 95% confidence interval 1.45-25.123; P=0.013), and PCHDs-ASPECTS had a significant independent negative correlation with sICH (odds ratio 0.70, 95% confidence interval 0.496-0.992; P=0.045). ROC analysis showed that the area under the curve predicted by PCHDs-ASPECTS was 0.832 ( P<0.05). When its cut-off value was 8 points, the sensitivity and specificity were 74.3% and 83.3% respectively. Conclusions:In patients with acute anterior circulation large vessel occlusive stroke treated with EMT, the immediate postoperative PCHDs is an independent predictor of sICH, and PCHDs-ASPECTS can early predict the risk of sICH after EMT.
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The construction of safe hospital is the foundation of high-quality development of the hospital, and innovation provides power for the construction of safe hospital from the perspective of high-quality development. Taking Zhejiang Provincial People′s Hospital as an example, the authors introduced the innovation construction path of safe hospital in detail, and put forward the construction strategy of safe hospital with " two hearts" (patient-centered, employee-centered)and " four wings" (multimedia doctor-patient communication, Wulin aunt medical studio, integrated operation safety inspection, third-party medical liability insurance). Through the combination of basic safety management and innovative practice, the hospital vigorously promoted the culture of " two hearts" , and established an efficient collaborative information management system, so as to form replicable and promotable practical experience and promote the development of safe hospital.
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The existing doctor-patient communication pattern often falls prey to insufficient informed consent and even medical disputes. In the patient centered perspective, Zhejiang Provincial People′s Hospital explored a new communication mode centering on patients. Based on diagnosis-related groups catalogues and high-frequency surgeries catalogues of the departments, multimedia technology was called into play to produce dubbed PPTs and videos that were easy to understand, standardized and homogeneous, which were embedded into medical records system. Following observation of the PPT or video, patients could directly sign an informed consent on the computer. This practice not only deepens patient′s understanding and achieves homogeneous level of the communication, but also elevates doctor′s work efficiency, contributing to building a harmonious doctor-patient relationship.
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Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, and the new cases of HCC in China account for more than half of the global cases every year. High incidence mortality and limited treatment methods are the main challen-ges for HCC prevention and treatment in China. Immunotherapy has brought new treatment options and hope of prolonging the survival to patients with advanced HCC. Data from the IMbrave 150 study published in the New England Journal of Medicine in May 2020 showed that the median overall survival of all patients was 19.2 months, and the median overall survival of the Chinese subgroup was 24.0 months, which suggested significant efficacy in prolongating patient survival and controlling tumor. Interven-tional therapy has been playing an important role in the treatment of HCC, and more and more clinical studies have adopted systematic therapy combined with interventional therapy. Interven-tional therapy and systematic therapy have synergistic efficacy which lead to significant clinical efficacy. The authors introduce the diagnosis and treatment of an advanced HCC patient undergoing interventional therapy combined with bevacizumab plus attilizumab treatment, which lead to signifi-cant clinical efficacy of tumor controlling.
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OBJECTIVE@#Clinical examination and molecular genetic analysis were carried out for one case with special facial features with developmental retardation, hearing impairment and cleft lip and palate.@*METHODS@#The intelligence test, hearing test, and MRI test were performed. At the same time, the blood were collected to detect the copy number variation of the whole genome with the chromosomal karyotype analysis and the chromosomal microarray analysis (CMA). And the whole exome sequencing (WES) was used to analyze the pathogenic variant.@*RESULTS@#The children had mild mental retardation and the IQ was 61. There was moderate hearing loss in both ears(left ear 60 dB, right ear 65 dB). And bilateral horizontal hypoplasia of semicircular canal was found by cranial MRI test. No copy number abnormality was found by chromosome karyotype analysis and chromosome microarray analysis in peripheral blood. And whole exome sequencing suggested that there was heterozygous pathogenic variants in KMT2D gene (p.Leu545Argfs*385).@*CONCLUSION@#The patient has a peculiar face and multiple system defects, and was diagnosed as Niikawa-Kuroki syndrome type I by KMT2D gene variant. The whole exome sequencing is helpful for the diagnosis of complex genetic diseases.
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Child , Humans , Abnormalities, Multiple , Cleft Lip , Cleft Palate , DNA Copy Number Variations , Face/abnormalities , Hematologic Diseases , Vestibular DiseasesABSTRACT
Objective:To explore the effect of mirror visual feedback combined with exercise relearning in rehabilitation of upper extremity dysfunction after stroke.Methods:Patients with upper extremity dysfunction received stroke rehabilitation treatment in the Nanyang No. 9 People's Hospital from August 2016 to August 2018 were enrolled prospectively. According to the random number table method, they were divided into either mirror visual feedback combined with exercise relearning group (mirror therapy group) or exercise relearning alone group (control group). The rehabilitation treatment was 1-2 times a day, 5 d a week, and 1 week was a course of treatment, for a total of 4 courses. Fugl-Meyer Assessment (FMA) was used to assess upper extremity function. Carroll Upper Extremity Function Test (UEFT) was used to assess hand function. Action Research Arm Test (ARAT) was used to assess upper extremity operability and flexibility. Motor Assessment Scale (MAS) was used to assess the motor function of hands, fingers and upper extremities. Visual Analogue Scale (VAS) was used to assess upper extremities pain. The modified Barthel Index (MBI) was used to assess self-care ability in daily life. The modified Ashworth Spasm Scale was used to assess the degree of spasm of shoulder joints, wrist joints, and elbow joints. According to the FMA score, the clinical efficacy of both groups of patients was evaluated, and a score of >31 was defined as excellent.Results:A total of 60 stroke patients with upper extremity dysfunction were enrolled ( n=30 in the mirror therapy group and n=30 in the control group). There were no statistical differences between the two groups in age, gender, course of disease, stroke type, and stroke location, as well as each baseline score. After treatment, the FMA score, UEFT score, ARAT score, MAS score, MBI score and the proportion of the modified Ashworth grade Ⅰ and grade Ⅰ + were significantly higher than those before treatment in both groups (all P<0.05), while VAS score and the proportion of modified Ashworth grade Ⅲ and grade Ⅳ was significantly lower than those before treatment (all P<0.05). After treatment, FMA score, UEFT score, ARAT score, MAS score, MBI score, as well as the proportion of Ashworth grade Ⅰ and grade Ⅰ + in the mirror therapy group was significantly higher than that in the control group (all P<0.05), while VAS score and the proportion of modified Ashworth grade Ⅲ were significantly lower than those in the control group ( P<0.05). According to the FMA score, the excellent and good rate of treatment in the mirror therapy group was significantly higher than that in the control group (93.3% vs. 70.0%; χ2=5.455, P=0.020). Conclusions:The curative effect of mirror visual feedback combined with exercise relearning is superior to exercise relearning alone in rehabilitation therapy for upper extremity dysfunction after stroke.
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Objective:To investigate the value of anal swabs positive for 2019-nCoV in patients with COVID-19 and the clinical features of the patients.Methods:Throat swabs, sputum and blood samples, and anal swabs were collected from 104 patients with COVID-19 at admission to test for 2019-nCoV nucleic acid. Clinical characteristics and hematological indexes were compared between viral nucleic acid-positive and -negative groups of different sample types. Fifteen patients whose anal swabs were positive for viral nucleic acid were selected to analyze the length of time before the nucleic acid turned negative in different specimens.Results:Compared with the patients having negative anal swab test results, those having positive test results showed decreased lymphocytes, increased lactate dehydrogenase (LDH) and high-sensitivity C-reactive protein (HsCRP), and higher incidence of severe COVID-19. The levels of HsCRP and IL-6 and the incidence of severe COVID-19 were significantly higher in patients with positive throat swab test results than in those with negative results. No significant difference in hematological indexes or the proportion of severe cases was detected between the patients with positive and negative sputum test results. Only 1.92% of the patients had positive blood test results, but all of them were severe patients. The positive rate of sputum test was the highest, which was 46.15%. Patients with positive results of both throat and anal swab test had significantly decreased lymphocytes, increased HsCRP and IL-6 levels, and higher incidence of critical COVID-19. It took longer time for patients to have negative anal swab and sputum test results. Moreover, it should be noticed that the viral nucleic acid in sputum might become positive again after it turned negative.Conclusions:Patients with positive anal swab test results had reduced lymphocytes, enhanced inflammatory response and higher incidence of severe COVID-19, suggesting that a positive anal swab test might be an indicator of severe COVID-19. Moreover, the time of 2019-nCoV nucleic acid turning negative in anal swabs was longer than that in throat swabs. The combined detection of throat swabs and anal swabs would help to predict the occurrence of severe COVID-19.
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Chimeric antigen receptor (CAR) T cells have been indicated effective in treating B cell acute lymphoblastic leukemia and non-Hodgkin lymphoma and have shown encouraging results in preclinical and clinical studies. However, CAR T cells have achieved minimal success against solid malignancies because of the additional obstacles of their insufficient migration into tumors and poor amplification and persistence, in addition to antigen-negative relapse and an immunosuppressive microenvironment. Various preclinical studies are exploring strategies to overcome the above challenges. Mobilization of endogenous immune cells is also necessary for CAR T cells to obtain their optimal therapeutic effect given the importance of the innate immune responses in the elimination of malignant tumors. In this review, we focus on the recent advances in the engineering of CAR T cell therapies to restore the immune response in solid malignancies, especially with CAR T cells acting as cellular carriers to deliver immunomodulators to tumors to mobilize the endogenous immune response. We also explored the sensitizing effects of conventional treatment approaches, such as chemotherapy and radiotherapy, on CAR T cell therapy. Finally, we discuss the combination of CAR T cells with biomaterials or oncolytic viruses to enhance the anti-tumor outcomes of CAR T cell therapies in solid tumors.
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Humans , Immunotherapy, Adoptive , Neoplasms/therapy , T-Lymphocytes , Tumor MicroenvironmentABSTRACT
This study presents an electronic portal imaging devices (EPIDs) based on daily check tool for Linac that is usable for different cancer centers.Several images of open rectangle fields were acquired with EPID and the key items of daily Linac check were derived from the obtained images using an in-house developed automatic analysis software.The experiment results showed that each parameter calculated by this tool is as reliable as the corresponding result measured by the commercial quality assurance devices and its measuring efficiency is much higher.
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Electronics, Medical , Electrons , Particle Accelerators , Phantoms, Imaging , Radiometry , SoftwareABSTRACT
Objective To evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT) using Cyberknife in the treatment of patients with recurrent cholangiocellular carcinoma (RCC) after surgery.Methods Clinical data of 26 patients with recurrent RCC after surgery undergoing Cyberknife SBRT from 2010 to 2015 were retrospectively analyzed.The median recurrence time was 10 months (range 2.0-63.0 months) and the median tumor diameter was 2.8 cm (range 1.2-4.8 cm).The median prescription dose/fraction was 45 Gy/5f (range 40-50 Gy/3-8 f).The tumor progression was evaluated based on enhanced CT or MRI.Overall survival (OS),progression-free survival (PFS) and local control rate (LC) were analyzed by Kaplan-Meier method.Toxicity was assessed using the common terminology criteria for adverse events version 4.0.Results For the entire cohort,the median OS and PFS were 13.5 months and 6.5 months at a median follow-up of 29.3 months (range 2.1-62.0 months).The 1-and 2-year OS and PFS rates were 52％ and 21％ as well as 28％ and 15％,respectively.Among them,4 patients (4/26,15％) were recurrent in situ after SBRT.Three patients experienced grade Ⅲ adverse reactions including 1 case of gastrointestinal reaction,1 case of liver dysfunction and 1 case of biliary tract infection.Only 1 patient suffered from ≥ grade Ⅳ gastrointestinal bleeding during the advanced stage.Conclusions SBRT using Cyberknife is a safe and effective treatment for patients with recurrent RCC after surgery.The adverse reactions can be tolerated by patients.
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To screen the hearing loss and deafness-related genes in newborns,the screenings for hearing loss and the mutations of common deafness-related genes were performed among 8 187 infants born in Shaoxing Maternal and Child Health Care Hospital from August 2013 to November 2014.Twenty mutation spots in deafness-related genes GJB2,GJB3,12SrRNA and SLC26A4 were detected with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).Of 8 187 newborns,hearing loss was confirmed in 10 cases,and mutations in deafness-related genes were detected in 441 cases with a detection rate of 5.39％.Among 441 cases with positive gene mutations,there were 243 cases with GJB2 mutations (2.97％).147 cases with SCL26A4 mutations (1.80％),43 cases with GJB3 mutations (0.53％) and 15 cases with mutations of mitochondrial gene 12SrRNA (0.18％).The spot of highest detection frequency was GJB2 235delC (2.31％),followed by SCL26A4 IVS72A ＞ G (1.31％).The deafness gene detection rate for newborns who did not pass the hearing tests (8.16％,79/968) was higher than these who passed (5.01％,362/7 219;x2 =10.978,P ＜0.05).Five of 10 newborns with hearing loss were detected carrying deafness genes.The detection rate of the common deafness genes among the newborns is relatively high in this region.Screening for hearing loss and deafness gene may contribute to early diagnosis and intervention,and also to long-term precaution for those carrying heterozygosity deafness genes.
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Theories of classified management which are based on risk governance are introduced into the newly revised , but the punishments on the manufacturers of unconformity products are not classified based on the severity and risks caused by the test items. This article analysed the disadvantages of current punishment measures on the manufacturers of unconformity products and the theoretical basis of classified punishments. The feasibility of classified punishments had also been studied and some basis of discretionary punishments was provided under the current regulations.
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Equipment Failure , Equipment and Supplies , Reference Standards , PunishmentABSTRACT
This phase I clinical trial (NCT01935843) is to evaluate the safety, feasibility, and activity of chimeric antigen receptor-engineered T cell (CART) immunotherapy targeting human epidermal growth factor receptor 2 (HER2) in patients with advanced biliary tract cancers (BTCs) and pancreatic cancers (PCs). Eligible patients with HER2-positive (>50%) BTCs and PCs were enrolled in the trial. Well cultured CART-HER2 cells were infused following the conditioning treatment composed of nab-paclitaxel (100-200 mg/m) and cyclophosphamide (15-35 mg/kg). CAR transgene copy number in the peripheral blood was serially measured to monitor the expansion and persistence of CART-HER2 cells in vivo. Eleven enrolled patients received 1 to 2-cycle CART-HER2 cell infusion (median CAR T cell 2.1 × 10/kg). The conditioning treatment resulted in mild-to-moderate fatigue, nausea/vomiting, myalgia/arthralgia, and lymphopenia. Except one grade-3 acute febrile syndrome and one abnormal elevation of transaminase (>9 ULN), adverse events related to the infusion of CART-HER2 cells were mild-to-moderate. Post-infusion toxicities included one case of reversible severe upper gastrointestinal hemorrhage which occurred in a patient with gastric antrum invaded by metastasis 11 days after the CART-HER2 cell infusion, and 2 cases of grade 1-2 delayed fever, accompanied by the release of C-reactive protein and interleukin-6. All patients were evaluable for assessment of clinical response, among which 1 obtained a 4.5-months partial response and 5 achieved stable disease. The median progression free survival was 4.8 months (range, 1.5-8.3 months). Finally, data from this study demonstrated the safety and feasibility of CART-HER2 immunotherapy, and showed encouraging signals of clinical activity.
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Aged , Female , Humans , Male , Middle Aged , Biliary Tract Neoplasms , Allergy and Immunology , Therapeutics , Immunotherapy, Adoptive , Pancreatic Neoplasms , Allergy and Immunology , Therapeutics , Receptor, ErbB-2 , Allergy and Immunology , Receptors, Chimeric Antigen , Allergy and Immunology , T-Lymphocytes , Allergy and ImmunologyABSTRACT
Objective To investigate the long term effect of stent implantation for severe carotid stenosis. Methods The clinical data of 66 patients with severe carotid artery stenosis who were hospitalized from January 2009 to December 2015 were retrospectively reviewed.40 patients underwent carotid artery stenosis stent implanta-tion(as study group)and 26 patients were treated with conventional drug theraphy(as control group).All patient were followed up for 36 months.and the quality of life of the patients was evaluated by SF-36 and the incidence of cerebrovascular events was recorded by following up.Results The quality of life score of the study group were sig-nificantly higher than those of the control group at 3 months,12 months,24 months and 36 months after operation (P<0.05);the incidence of cerebrovascular events after 12 months,24 months and 36 months in the study group was lower than in the control group,and the difference was significant(P<0.05).Conclusions There is obvious long-term effect of carotid artery stenting in the treatment of severe carotid stenosis,in which the quality of life can be effectively improved and the incidence of cerebrovascular events can be reduced in patients with carotid stenosis.
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Objective To compare the clinical efficacy between laparoscopy and open cholecystectomy for patients of acute calculous cholecystitis. Methods Fifty patients of acute cholecystitis from February 2014 to February 2017 were divided into control group treated with open cholecystectomy and observation group with laparoscopic cholecystectomy;a retrospective analysis was conducted to compare time of resuming peristaltic sound ,postoperative 24h VAS score and hospitalization time. Results There were shorter time of resuming peristaltic sound,higher postoperative 24 h VAS score and shorter hospitalization time in observation group when compared with those in control group (P < 0.05). Conclusions For patients of acute calculous cholecystitis , laparoscopic cholecystectomy,is conducive to shortening patient′s recovery time,alleviating patients′ pain signifi-cantly and decreasing the incidence of complication.
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BACKGROUND:Primates are considered to be the most appropriate animal model of lumbar intervertebraldisc degeneration, but the disc degenerated characteristics of monkeys were rarely reported. OBJECTIVE:To verify the degenerated regularity and characteristics of lumbar intervertebral disks in rhesus monkeys with magnetic resonance T2 mapping and T1ρimaging technology. METHODS:The sagittal lumbar intervertebral disc magnetic resonance T2 weighted imaging,T2 weighted mapping imaging and T1ρweighted imaging of 63 adult rhesus monkeys were acquired on 1.5T magnetic resonance equipment. The T2-map value and T1ρvalue of lumbar intervertebral disc regions of interest were calculated on the post-processing workstation. RESULTS AND CONCLUSION:(1) This study obtained 425 better magnetic resonance images of lumbar intervertebral disks in adult rhesus monkeys. T2-map value and T1ρvalue of nucleus pulposus were most consistent by different persons, and the Kappa coefficient was more than 0.93. (2) The T2-map value and T1ρvalue of nucleus pulposus were both negatively correlated significantly with Pfirrmann grades (r=-0.842, P<0.01;r=-0.896, P<0.01). The T1ρvalue and T2-map value of nucleus pulposus were significantly statistical y different between Pfirrmann grades I-IV (P<0.001, P<0.001). The T1ρvalue of nucleus pulposus was negatively correlated significantly with Pfirrmann grade II-III (r=-0.517, P<0.01) and Pfirrmann grade IV-V (r=-0.499, P<0.01). The T2-map value of nucleus pulposus was also negatively correlated significantly with Pfirrmann grade II-III (r=-0.617, P<0.01) and Pfirrmann grade IV-V (r=-0.652, P<0.01). (3) The T2-map value of L1-2 and L2-3 segments nucleus pulposus were significantly lower than that in L6-7 and L7-S1 segments (P<0.05). (4) There were significant differences in age among the T1ρvalue and T2-map value of nucleus pulposus (r=-0.702, P<0.001, r=-0.730, P<0.001). (5) It is concluded that magnetic resonance T2 mapping and T1ρimaging technology can objectively and sensitively assess the degenerated process of nucleus pulposus in rhesus monkeys. The degeneration in upper lumbar segments (L1-2 and L2-3) was earlier and more severe than that in lower lumbar segments (L6-7 and L7-S1) in rhesus monkeys. Age is one of the most important factors in lumbar intervertebral disc degeneration of adult rhesus monkeys.
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Background The characteristics of eye movement waveforms in congenital nystagmus eyes is so complicated that the time-series waveform can hardly demonstrate the oscillational kinetic property of the eye movement of nystagmus,which is not convenient for the clinical diagnosis and evaluation.The eye movement system is a nonlinear feedback control system,and phase portrait analysis is a useful method in describing the characteristics of movement in a nonlinear system.Objective This study was to establish the phase portrait analysis method of the eye movement waveforms in congenital nystagmus eyes and provide a new technique for the clinical diagnosis and evaluation of congenital nystagmus.Methods A prospective series-case observational study was performed.This study complied with the Declaration of Helsinki and was approved by Ethic Commission of Tianjin Eye Hospital.Written informed consent was obtained from each patient before examination.Twenty-five patients with congenital nystagmus were enrolled and received examination of video-oculography (VOG) in Tianjin Eye Hospital from April 2012 to February 2013,including 12 patients with congenital motor nystagmus (CMN) and 13 patients with latent nystagmus (LN).The VOG data were format-converted and processed by a Matlab routine.VOG-based phase portraits of eye movement cycles were drawn and related parameters were measured from the phase portraits for further analysis and comparison.Main measurement indexes were cycle position shift (CPS),slow phase peak velocity (SPV),standardized slow-phase peak (SSPV),fast phase peak velocity (FPV) and standardized fast-phase peak velocity (SFPV).Two principal types of waveforms,increasing-velocity type and decreasing-velocity type were compared.Results The phase portraits of the waveforms of congenital nystagmus were cycles of reciprocating trajectories.The slow phases were in dense ribbon region,and the fast phases were in sparse annular region,and all the trajectories travelled in clockwise.The CPS,SPV and FPV of increasing-velocity type were (4.646 ± 1.565),(223.821 ± 114.049),(767.481 ±263.560) ° per second,respectively.The CPS,SPV and FPV of decreasing-velocity type were (9.373 ±4.189),(357.531 ± 154.300) and (1 148.706 ±541.362) ° per second,respectively.The SPVs and FPVs of both increasing-velocity type and decreasing-velocity type showed strong correlation with CPS,respectively (the increasing-velocity type:rSPV-CPS =0.685,P=0.000;rFPV-CPS =0.680,P=0.000;the decreasing-velocity type rSPV-CPS =0.783,P =0.000;rFPV-CPS =0.803,P =0.000).FPVs were significantly larger than SPVs in both types of waveforms (t =6.558,P =0.000;t =5.068,P =0.000).The SSPV of increasing-velocity type was (48.062 ± 15.365) ° per second,which was slightly larger than (41.099± 17.027) ° per second of decreasing-velocity type,with no significant difference between them (t=1.070,P=0.296).The SFPV of increasing-velocity type was (171.186±47.825)° per second,which was larger than (125.317-±38.266)° per second of decreasing-velocity type,showing a significant difference between them (t =2.658,P =0.014).Conclusions Phase portraits can visualize the cyclically dynamic features of congenital nystagmus in a direct way.It facilitates the measurement of eye movement amplitude,speed and other parameters.The phase portrait analysis method provides a novel useful tool in the clinical diagnosis and treatment efficacy evaluation of congenital nystagmus.
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Objective To compare the iodine contrast agent dosage,radiation dose and image quality in CT pulmonary angiogra-phy (CTPA)with low tube voltage and high tube current in 64-slice spiral CT.Methods 60 patients with suspected pulmonary em-bolism in our hospital were randomly chosen and divided into three groups:Group Ⅰ:20 patients,using 120 kV,180 mA,contrast dose of 70 mL.Group Ⅱ:20 patients,using 100 kV,280 mA,contrast dose of 50 mL.Group Ⅲ:20 patients,using 80 kV,automat-ic tube current modulation techniques (300-500 mA),comparative dose of 30 mL.CT values and image noise of three pulmonary central areas and a segment branch were measured in each group.Objective indicators,subjective image quality assessment,CT dose index volume (CTDIvol),dose-length product (DLP)and effective absorbed dose (ED)were compared in three groups to evaluate the value of low kV,high mA with low-contrast dose in CTPA.Analysis of variance and t-test was used for data analysis.Results Compared with those of the standard method of CTPA,all pulmonary dry in two groups of low dose were well displayed.There was no statistical significance between each two groups in image quality score (P > 0.05),but was statistical significance in CT values, noise,SNR and CNR (P < 0.01).The CT radiation dose,CTDIvol and DLP of Group Ⅱ and Group Ⅲ were significantly lower than those of Group Ⅰ (P < 0.01).Conclusion Compared with traditional methods,low dose contrast agent injections under 80 kV could reduce the dose of contrast agent and the effect of hardening artifacts due to contrast agent in superior vena cava on right pul-monary artery.It is helpful to reduce the risk of contrast induced nephropathy and reduce patients’exposure to X-ray radiation.
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<p><b>OBJECTIVE</b>To screen for common mutations of deafness-related genes in order to determine the carrier rate, types of mutation, and their relevance to hearing loss.</p><p><b>METHODS</b>For 4 deafness-related genes GJB2, GJB3, 12S rRNA and SLC26A4, 20 common mutations were screened among 2725 newborns from Shaoxing, Zhejiang by matrix-assisted laser desorption ionization-time of flight-mass spectrometry.</p><p><b>RESULTS</b>Among the 2725 newborns,149 (5.47%) were diagnosed with mutations, which included 84 (3.08%) with GJB2 mutations, 13 (0.48%) with GJB3 mutations, 49 (1.80%) with SLC26A4 mutations and 3 (0.11%) with 12S rRNA mutations. Fourteen mutational hotspots were identified. The most common mutations have included GJB2 c.235delC (65 cases), SLC26A4 IVS7-2A>G (34 cases), GJB2 c.299_300delAT (13 cases), GJB3 c.538C>T (7 cases), GJB2 c.176_191del16 (6 cases) and GJB3 c.547G>A (6 cases).</p><p><b>CONCLUSION</b>The detecting rate for deafness-related gene mutations has been relatively high. To broaden the screening spectrum may improve such rate. Besides GJB2, 12S rRNA, SLC26A4, GJB3 also features a high mutation rate in the region.</p>