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Carcinoid is a rare clinical disease, especially primary carcinoid of testis. On December 11, 2019, a patient with primary testicular carcinoid was admitted to the Fourth Hospital of Hebei Medical University. The physical examination, color Doppler ultrasound and scrotal CT showed that left testicular tumor. The patient underwent radical orchiectomy and sent for pathology examination on December 14, 2019. Gastroscopy, enteroscopy and CT examination of pelvic and abdominal cavity showed no obvious abnormalities. Postoperative pathology combined with immunohistochemistry was diagnosed as primary carcinoid of testis. The patient was followed up for 23 months with no recurrence.
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Objective:To explore the imaging manifestations of thoracic CT in patients with Gaucher disease (GD) in order to improve the diagnostic ability.Methods:Forty-three patients with GD were collected from May 2003 to October 2018 in Beijing Children′s Hospital, including 25 males and 18 females, aged from 10 to 34 years, with an average age of (21±6) years. All the patients underwent routine chest CT examinations, and analysis and description of pulmonary interstitial and parenchyma imaging manifestations were performed.Results:Among the 43 GD patients, 20 patients presented with abnormal chest CT findings: 10 showed diffuse interlobular septa thickening, mainly distributed in the lower lobes of both lungs; 5 showed ground glass opacities in a single or multiple lobes of the lung. There were 2 cases with small nodules, which showed round-like nodules of different sizes. One case had pulmonary fibrosis, especially in the left upper lobe. Other manifestations included bullae in 3 cases,localized pleural thickening in 2 cases, pneumothorax in 1 case; pulmonary hypertension in 1 case and thymus enlargement in 12 cases. Most of the GD patients had pulmonary lesions between 10 and 14 years old. The signs of interlobular septa thickening and thymus enlargement were common, with 5 cases in each age group.Conclusions:GD involves the lungs in half of the patients. The manifestations of the lungs are diverse, and most of them are diffuse interstitial lesions. The main signs are interlobular septal thickening and ground glass opacity, which are consistent with the pathology of Gaucher cell infiltration.But the signs are not specific, the diagnosis should be made in combination with the clinical information, and attention should be paid to the differentiation of lung infiltration caused by other diseases.
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Objective:To understand the relationship between joint bleeding and joint disease in hemophilia children, and to provide a theoretical basis for clinical treatment and prognosis.Methods:The patients with severe hemophilia A between 1 and 7 years old and with relevant nodal bleeding records were selected.All the patients admitted in Beijing Children′s Hospital, Capital Medical University, and Chengdu New Century Women′s and Children′s Hospital since June 2016 to January 2017.All the joint bleeding of each child was taken as the study joint, and the joint bleeding was collected during the last 3 months.The joints were assessed by using ultrasound, X-ray, magnetic resonance imaging(MRI) and Hemophilia Joint Health Score (HJHS) scoring systems.The correlation analysis was conducted between the joint bleeding, ultrasound, X-ray, MRI and HJHS scores.The correlation analysis was conducted for baseline ultrasound, X-ray, MRI and HJHS scores.Results:(1) There were 18 patients enrolled.The mean age was (5.6±1.8) years old.There were 30 joints bleeding in the observation period in total, with the annul median joint bleeding times of 4 (4-16 times), and the annul median target joint bleeding times of 8 (4-16 times). (2) Joint bleeding times of was correlated with ultrasound and X-ray evaluation ( r=0.390, P=0.033; r=0.517, P=0.008), and not correlated with HJHS or MRI(all P>0.05). (3) There was significantly positive correlation among ultrasound, X-ray, HJHS and MRI [ r=0.815(ultrasound vs.X-ray), r=0.510(ultrasound vs.HJHS), r=0.812(ultrasound vs.MRI), r=0.666(X-ray vs.HJHS), r=0.911(X-ray vs.MRI), r=0.781(HJHS vs.MRI), all P<0.01]. (4) There was no correlation between times and assessment for joints whose ultrasound and /or MRI in joints with abnormal ultrasound and /or MRI evaluation( P>0.05). Conclusions:The results of joint bleeding and joint evaluation are inconsistent.Joint bleeding can not truly reflect the situation of joint diseases.The assessment of hemophilia should include comprehensive evaluation of joint structure, function, activity ability and other aspects to guide the treatment of haemophi-lia children.
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Blastocystis sp. is a kind of protozoa living in the intestinal tract of human and animals, which will cause intestinal diseases such as diarrhea, abdominal distension and vomiting. This paper was aimed to understand the infection of Blastocystis sp. In golden monkeys and the transmission path in North China. Thirty-seven feces samples from golden monkeys and 116 cockroach samples from Shijiazhuang Zoo were collected from July to October 2019 for PCR analysis of Blastocystis sp. Genetic diversity analysis was further conducted on the samples with positive PCR results. The results showed that the infection rate was 48.7% (18/37) in golden monkeys and 82.8% (96/116) in cockroaches, respectively. The genetic evolution analysis based on small subunit ribosomal RNA demonstrated that three subtypes (ST) of Blastocystis sp. including ST1, ST2, and ST3 existed in the intestinal tract of golden monkeys, while only ST2 was detected in the intestinal tract of cockroaches. This paper may provide supports for the quarantine and control of Blastocystis sp. for the zoo in Northern China.
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Objective@#To explore the imaging manifestations of thoracic CT in patients with Gaucher disease (GD) in order to improve the diagnostic ability.@*Methods@#Forty-three patients with GD were collected from May 2003 to October 2018 in Beijing Children′s Hospital, including 25 males and 18 females, aged from 10 to 34 years, with an average age of (21±6) years. All the patients underwent routine chest CT examinations, and analysis and description of pulmonary interstitial and parenchyma imaging manifestations were performed.@*Results@#Among the 43 GD patients, 20 patients presented with abnormal chest CT findings: 10 showed diffuse interlobular septa thickening, mainly distributed in the lower lobes of both lungs; 5 showed ground glass opacities in a single or multiple lobes of the lung. There were 2 cases with small nodules, which showed round-like nodules of different sizes. One case had pulmonary fibrosis, especially in the left upper lobe. Other manifestations included bullae in 3 cases,localized pleural thickening in 2 cases, pneumothorax in 1 case; pulmonary hypertension in 1 case and thymus enlargement in 12 cases. Most of the GD patients had pulmonary lesions between 10 and 14 years old. The signs of interlobular septa thickening and thymus enlargement were common, with 5 cases in each age group.@*Conclusions@#GD involves the lungs in half of the patients. The manifestations of the lungs are diverse, and most of them are diffuse interstitial lesions. The main signs are interlobular septal thickening and ground glass opacity, which are consistent with the pathology of Gaucher cell infiltration.But the signs are not specific, the diagnosis should be made in combination with the clinical information, and attention should be paid to the differentiation of lung infiltration caused by other diseases.
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Objective@#To explore the clinical characteristics and long-term prognosis of recipients with end-stage autoimmune liver diseases (AILD) after liver transplantation.@*Methods@#A retrospective study was conducted. The data of 147 end-stage autoimmune liver diseases recipients who underwent liver transplantation admitted to department of liver transplantation of Tianjin First Center Hospital from January 2004 to August 2018 were collected. Patients were followed till March 1st, 2019. The postoperative survival was analyzed, the cumulative survival rate was estimated by the Kaplan-Meier survival curve, and the cause of death was analyzed. Postoperative rejection, recurrence of AILD, biliary complications, and hepatitis virus infection were also summarized.@*Results@#Among the 147 recipients, 25 were autoimmune hepatitis (AIH), 94 were primary biliary cholangitis (PBC), 14 were AIH overlapping PBC (AIH-PBC), 14 were primary sclerosing cholangitis (PSC). The 147 recipients were consisted of 22 males and 125 females, with a ratio of 1∶5.7, with a mean age of (53.2±10.1) years old. The average model for end-stage liver disease (MELD) score was 14.6±9.0. After a median follow-up of 49.0 months, 21 recipients died, and 126 recipients survived. The survival curve analysis showed that the 1-, 3-, 5- and 10-year cumulative survival rate was 98.6%, 94.0%, 84.6%, and 76.9%, respectively. The main cause of death was graft dysfunction, followed by graft failure and respiratory failure. Among the 147 recipients, 17 (11.56%) rejection occurred, 19 recurrence (12.93%) were diagnosed with liver biopsy, and of which 2 PBC recipients overlapped de novo AIH-PBC. Biliary complications happened in 37 recipients (25.17%). De novo hepatitis virus infection was found in 19 recipients (12.93%), including 14 with hepatitis B virus (HBV) and 5 with hepatitis C virus (HCV).@*Conclusions@#The majority patients of the end-stage of AILD were middle-aged and old women, and PBC was the most common. Liver transplantation is an effective treatment for end-stage autoimmune liver diseases with excellent prognosis. Postoperative immunosuppressant usage and recurrence should be emphasized.
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To explore the clinical characteristics and long-term prognosis of recipients with end-stage autoimmune liver diseases (AILD) after liver transplantation. Methods A retrospective study was conducted. The data of 147 end-stage autoimmune liver diseases recipients who underwent liver transplantation admitted to department of liver transplantation of Tianjin First Center Hospital from January 2004 to August 2018 were collected. Patients were followed till March 1st, 2019. The postoperative survival was analyzed, the cumulative survival rate was estimated by the Kaplan-Meier survival curve, and the cause of death was analyzed. Postoperative rejection, recurrence of AILD, biliary complications, and hepatitis virus infection were also summarized. Results Among the 147 recipients, 25 were autoimmune hepatitis (AIH), 94 were primary biliary cholangitis (PBC), 14 were AIH overlapping PBC (AIH-PBC), 14 were primary sclerosing cholangitis (PSC). The 147 recipients were consisted of 22 males and 125 females, with a ratio of 1∶5.7, with a mean age of (53.2±10.1) years old. The average model for end-stage liver disease (MELD) score was 14.6±9.0. After a median follow-up of 49.0 months, 21 recipients died, and 126 recipients survived. The survival curve analysis showed that the 1-, 3-, 5- and 10-year cumulative survival rate was 98.6%, 94.0%, 84.6%, and 76.9%, respectively. The main cause of death was graft dysfunction, followed by graft failure and respiratory failure. Among the 147 recipients, 17 (11.56%) rejection occurred, 19 recurrence (12.93%) were diagnosed with liver biopsy, and of which 2 PBC recipients overlapped de novo AIH-PBC. Biliary complications happened in 37 recipients (25.17%). De novo hepatitis virus infection was found in 19 recipients (12.93%), including 14 with hepatitis B virus (HBV) and 5 with hepatitis C virus (HCV). Conclusions The majority patients of the end-stage of AILD were middle-aged and old women, and PBC was the most common. Liver transplantation is an effective treatment for end-stage autoimmune liver diseases with excellent prognosis. Postoperative immunosuppressant usage and recurrence should be emphasized. sclerosing cholangitis; Liver transplantation; Prognosis
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Objective To investigate the status of self‐management of blood pressure (BP) among elderly hypertensive patients living in new rural communities of Shanghai. Methods We enrolled a total of 2 241 hypertensive patients over 60 years old who participated in the National Key Research and Development Project "Cohort study on hypertension" of the 13th Five‐Year Plan in Langxia, Shanghai from May to July 2018. Questionnaires, physical examinations, and laboratory tests were conducted. We collected participants' demographic information, cardiovascular history, and self‐management behaviors related to hypertension. The status of self‐management of BP among participants with hypertension was analyzed. Pearson's chi‐squared test was used to explore the differences between males and females. Results Participants'mean age was (70.0±6.8) years, and males accounted for 38.8% of all participants. The systolic and diastolic BP levels of participants were (147.8±15.4) mmHg (1 mmHg=0.133 kPa) and (82.8±9.8) mmHg, respectively. The systolic blood pressure level of women was higher than that of men, and the diastolic blood pressure level of men was higher; the difference was statistically significant (all P<0.05). The awareness, treatment, and control rate of hypertension were 79.0%, 78.0%, and 25.6%, respectively. Males had a significantly higher control rate than females (P<0.05). The status of self‐management of blood pressure was as follows: (1) As to lifestyle, 84.4% of participants lacked exercise, and 69.2% were overweight or obese. The prevalence of smoking and drinking was higher in males (40.7% and 46.2%, respectively), and the proportion of females (12.4%) with anxiety and/or depression was higher than that of males (P all<0.001). (2) Concerning BP‐monitoring, only 10.1% of participants measured BP every week, 22.9% had BP measurement instruments at home, and 4.6% recorded their BP levels. There was no significant difference in self‐blood pressure monitoring behavior between men and women. (3) Regarding adherence to medication treatment, 97.6% took antihypertensive drugs regularly, and 21.6% were on combination therapy. The proportion of men taking combined drugs was higher than that of women, but there was no significant difference. Conclusions The rates of awareness, treatment, and control of hypertension in elderly hypertensive patients in new rural communities of Shanghai were above the national average. However, the status of self‐management of BP was still not satisfactory. More attention should be paid to healthy lifestyle, home BP monitoring, and effective pharmaceutical treatment strategies for hypertension.
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Objective To investigate the effect of axial load test in Taylor spatial frame treatment of external fixation for tibia and fibula fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 36 patients with open fracture of tibia and fibula admitted to Tianjin Hospital from March 2015 to June 2017.There were 22 males and 14 females,aged 21-71 years[(46.1±14.2)years].All patients received Taylor spatial frame external fixation for tibia and fibula fracture within 1 week after injury.After operation,18 patients received axial load test(experiment group),and the other 18 did not(control group).When the value of axial load test was less than 5% in experiment group,the Taylor spatial frame was removed.The control group used traditional method to remove the Taylor spatial frame.Comparisons were made between the two groups in terms of treatment duration,total cost,re-fracture after Taylor spatial frame removal and incidence of stent-tract infection.Results All patients were followed up for 3-14 months with an average of 8.6 months.Compared with control group,the treatment duration[(36.17±11 .44)weeks vs.(44.50±9.16)weeks]and total cost[(93.7±7.9)thousand yuan vs.(120.1±10.6)thousand yuan]of experiment group were significantly lower(P＜0.05).In the experiment group,there was 0 patient with re-fracture and two patients with stent-tract infection,with the complication incidence of 11%,while there were two patients with re-fracture and three patients with stent-tract infection,with the complication incidence of 28% in the control group(P＞0.05).Conclusions After Taylor spatial frame external fixation for tibia and fibula fractures,regular axial load test can safely and timely guide the removal of Taylor spatial frame.It can reduce the treatment duration and cost compared with the traditional removal method,being safe and reliable.
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Objective To discuss the clinical effects of hysteroscopy and hysteroscopy combined with laparoscopy on typeⅡcesarean scar pregnancy (CSP). Methods We selected 58 patients diagnosed as having typeⅡCSP in Shengjing Hospital, China Medical University, between February 2013 and January 2016. Group A consisted of 36 patients who were treated with hysteroscopic CSP resection, while group B consisted of 22 patients treated with hysteroscopy combined with laparoscopic CSP resection and uterine repair. We compared the operation condition, single-operation success rate, postoperative recovery, and succeeding pregnancy outcome. Results The operation time in group A was 26.6±4.9 min, which was obviously shorter than that in group B. The bleeding volume in group A was 71.9±9.7 mL, which was obviously less than that in group B. No operation complication occurred in the two groups. The single-operation success rate was83.3％ in group A and 86.4％ in group B, indicating no significant difference. No significant differences in menstruation recovery and the rate of decrease in human chorionic gonadotropin level to normal were found between groups A and B. Conclusion Both hysteroscopy and hysteroscopy combined with laparoscopy can be used to treat typeⅡcesarean scar pregnancy.
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Articular cartilage is hyaline cartilage and has weak self-healing ability.Articular cartilage injury is difficult to heal due to lack of blood supply and nerve tissue nutrition.The early pathological changes of many kinds of motor disorder diseases are accompanied by articular cartilage injury.It will inevitably cause more serious damage and accelerate joint degeneration if the articular cartilage injury cannot be treated timely.Therefore,early diagnosis of cartilage injury is key to preventing and delaying joint degeneration.This article reviews the early diagnosis of cartilage injury from three aspects of imaging examination,biomarker detection and arthroscopy so as to provide reference for the clinical treatment of early cartilage injury.
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Objective To analyze the complications of radical vaginal hysterectomy in patients with locally bulky cervical cancer.Methods All 258 patients of early cervical cancer (stage Ⅰ A2-Ⅱ A) selected in our hospital during the period of June 2011 to June 2016 undergoing radical vaginal hysterectomy and laparoscopic pelvic lymph node dissection were analyzed.All cases were divided into observation (locally bulky) and control (conventional) groups.Comparison analysis was performed for complications of the two groups and the influence of neoadjuvant chemotherapy on the complications of local bulky patients.Results The incidence of complications in the observation group was 26 cases (27.9％),higher than that in the control group of 28 cases (17.0％),the difference was statistically significant (P ＜ 0.05).The incidence of bladder injury (5 cases vs 2 cases) in observation group was significantly higher than that in control group (P ＜ 0.05).For patients with locally bulky early cervical cancer,the incidence rate of complications of the neoadjuvant chemotherapy group (15.8％) was significantly lower than the simple operation group (36.4％) (P ＜ 0.05).The incidence rate of ureteral injury in neoadjuvant chemotherapy group (0 cases vs 6 cases) was significantly lower than that in simple operation group (P ＜ 0.05).Conclusions Early cervical cancer patients with locally bulky (stage Ⅰ B2/ 1Ⅱ A2) had higher incidence of complications of radical vaginal hysterectomy,and neoadjuvant chemotherapy can reduce the incidence of surgical complications.
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Objective To examine the effect of aerobic exercise training on plasma metabolites in pre-diabetes mellitus(PDM)subjects.Methods Twenty-five PDM subjects were selected,and each 10 age-and sex-matched with normoglycemia and new-onset T2DM subjects were enrolled.PDM subjects underwent aerobic exercise(n=13)or health education (n=12) for 12 weeks.The aerobic exercise was con ducted 3 times/week,50 min/time at 40％-60％ of oxygen uptake reserve.Liquid chromatography-mass spectrometry(LC-MS)was used to analyze the spectrum of plasma metabolites.Principal component analysis was employed to study the differences in plasma metabolite profiles between subjects with different glycemic level and between PDM subjects before and after aerobic exercise.Results After training,the body fat percentage,2-hour plasma glucose,and low density lipoprotein cholesterol of PDM subjects reduced significantly(by 4.6％,16.22％ and 9.27％ on average).Comparison of plasma metabolizers in PDM subjects before and after exercise revealed 31 differential metabolites,with 25 metabolites such as phosphatidylcholine,lysophosphatidylcholines,sphingomyelin and betaine increasing,and 6 metabolites,such as oleic acid and cytosine decreasing.Conclusion Aerobic exercise has a marked effect on the plasma metabolites in PDM subjects.Phosphatidylcholine,lysophosphatidylcholines,sphingomyelin and oleic acid may be the potential biomarkers of aerobic exercise improving the glycolipid metabolism in PDM subjects.These findings can help us better understand the mechanism of aerobic exercise preventing T2DM diabetes.
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Objective: To determine the effectiveness and the safety of the Taylor spatial frame in treatment of intermediate or distal tibiofibula fractures. Methods: The clinical data of 74 patients with intermediate or distal tibiofibular fractures treated between January 2015 and January 2017 were retrospectively analyzed. According to fixation methods, they were divided into internal fixation group (26 cases) and external fixation group (48 cases). There was no significant difference in the age, gender, cause of injury, type of fracture, time from injury to operation between 2 groups ( P>0.05). The intraoperative blood loss, fracture healing time, fixator removal time, and complications were recorded and compared. The final function evaluation criteria of Johner-Wruhs humeral shaft fracture were used to evaluate the function of the affected limb. The lower limb force line recovery after operation was evaluated according to the standard evaluation of LUO Congfeng et al. Results: Both groups were followed up 6-22 months (median, 14 months). All patients obtained the fracture healing. The intraoperative blood loss, fracture healing time, and fixator removal time were significantly higher in the internal fixation group than those in the external fixation group ( P<0.05). There were 1 case of plate exposure, 1 case of delayed fracture healing, and 1 case of plate fracture in the internal fixation group; and there were 2 cases of delayed fracture healing and 4 cases of soft tissue defect in the external fixation group; no significant difference was found in the incidence of complications between 2 groups ( χ2=0.015, P=0.904). The function of the affected limb was evaluated by Johner-Wruhs standard at 10 months after operation, the results was excellent in 19 cases, good in 5 cases, and fair in 2 cases in the internal fixation group, with an excellent and good rate of 92.3%; the results was excellent in 42 cases, good in 3 cases, and fair in 2 cases in the external fixation group, with an excellent and good rate of 95.7%; showing no significant difference between 2 groups ( χ2=0.392, P=0.531). The lower limb force line recovery after operation was evaluated according to the standard evaluation of LUO Congfeng et al.at 4 months after operation, the results was excellent in 24 cases, fair in 1 case, poor in 1 case in the internal fixation group, with an excellent and good rate of 92.3%; the results was excellent in 46 cases, fair in 1 case, poor in 1 case in the external fixation group, with an excellent and good rate of 95.8%; showing no significant difference between 2 groups ( χ2=0.520, P=0.471). Conclusion: The use of Taylor spatial frame in the treatment of the intermediate or distal tibiofibular fractures can obviously reduce the healing time and complications than the internal fixation of the plate. It can reduce the fracture treatment cycle and is beneficial to the fracture healing and limb function recovery, which is relatively safe and reliable.
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Objective To analyze the CT and MR imaging characteristics of the subcutaneous and organ lesions of uvenile xanthogranuloma (JXG) in children.Methods The CT and MR images of the head,chest,abdomen and subcutaneous soft tissue of 11 patients (6 females and 5 males,aged 2 months-12 years old,median age 8 months old) with JXG from 2006 to 2018 were collected and retrospectively analyzed.Eight patients underwent CT scan and/or contrast-enhanced CT scan,and 7 patients underwent MRI and/or MRI and contrast-enhancement MRI.Results In 11 cases of JXG,5 cases were classified as simple skin type,involving the skin and deep soft tissue in the right posterior neck,the right frontal and parietal parts of the head,the nose root,and the fat layer and the deep muscle in the extremities.The lesions were the subcutaneous soft tissue nodules or mass showing isodensity on CT or high signal on T2WI.And the other 6 cases were classified as systemic type whose lesions involved one or more than one part except the skin.In the 6 cases,3 cases involved the central nervous system,including the pituitary gland,cerebral hemisphere,cerebellum,brain stem,basal ganglia,thalamus,optic chiasma and spinal cord.The lesions of the pituitary gland were manifested as pituitary enlargement,thickening of the pituitary stalk,and disappearance of high signal on T1WI in the neurohypophysis.The brain parenchyma,the spinal cord and the optic chiasma showed multiple flake or nodular masses,which were iso/low signal on T1WI,low / high signal on T2WI,diffusion restricted,and enhanced markedly.Two cases involved lung tissue,and their lesions showed diffuse or scattered multiple cloudy shadow,reticular opacity,strip and small nodule shadow on chest CT.There was pleural effusion in one case.Two cases involved the livers and 2 cases involved the kidneys,showing multiple nodules with low signal on T2,WI and slight enhancement.One case involving the pancreas showed a low density in the head of the pancreas and slight enhancement on CT.One case involving the greater omentum,chest wall and peritoneum showed thickening of the corresponding tissues on CT.Conclusions Subcutaneous and systemic lesions of JXG show some characteristics on CT and MRI images.The main manifestations are single or multiple nodulars,which are diffusely distributed and vary in size in subcutaneous soft tissue and various organs.The combination of imaging appearances,clinical manifestations and biopsy has important clinical significance for the correct diagnosis and evaluation of JXG.
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Objective@#To detect the arthropathies on no bleeding history joints in pre-school hemophilia A children in order to provide evidence for further prevention and control of joint disease in children with hemophilia A.@*Methods@#This study was a cross-sectional study based on China Hemophilia Individualized prophylaxis study (CHIPS). The basic data of outpatients with hemophilia in Beijing Children's Hospital and Chengdu Women's and Children's Central Hospital between August 2016 and June 2017 were collected and a three-month follow-up was conducted. The target joints (six joints of bilateral elbows, knees and ankles) of thirty-four children aged 1-7 years old with severe hemophilia A were examined by ultrasound, X-ray and joint function examination (4-7 years old, hemophilia joint health score (HJHS)). To find out whether there are arthropathies in patient's joints with no bleeding history and analyze the relevant factors by chi-square test, rank sum test and other statistical methods.@*Results@#There were 32 analyzable cases with 112 no-bleeding history target joints, 42.9% (48/112) were elbow joints. Arthropathies were revealed in 34.8% (39/112) of them by joint structural and functional examination and 46.2% (18/39) were ankles (χ2=8.379, P=0.015) . Ultrasound showed abnormalities in 18.3% (20/109) joints, X-ray showed abnormalities in 3.8% (3/79) joints and HJHS showed abnormalities in 25.3% (20/79) joints. There was no correlation between ultrasound and HJHS (r=0.015, P=0.895), no correlation was found between X-ray and HJHS (r=-0.101, P=0.390) either, which suggested that joint structural and functional examination could not replace each other. The related risk factors of arthropathies in this group were >4.91 years old (OR=3.917, 95%CI:1.610-9.528) and combining with target joint (OR=3.530, 95%CI:1.316-9.465).@*Conclusions@#Detecting the joint structure and function on no bleeding history joints in pre-school hemophilia A children could reveal the arthropathies and majority of them were ankle arthropathies. Joint structural and functional examinations could not replace each other. For patients more than 5 years old and those with target joints, the joints with no complaint of bleeding should be examined regularly to reveal the arthropathies in time.
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Objective:To observe the therapeutic effect ofcapsaicin at different concentrations on chronic knee arthritis pain model in mice.Methods:Choosing 50 healthy adult male Kunming mice builded chronic knee arthritis pain model by injecting 0.01 mL CFA (Complete Freund's Adjuvant,CFA) into left joint cavity.The model would be succeed in building after 3 weeks.The successful model mice were divided into five groups randomly (n=10):The first experimental group (saline group),the second experimental group (capsaicin excipient group),the third experimental group (0.5 ％ of capsaicin),the fourth experimental group (3 ％ of capsaicin) and the fifth experimental group (8 ％ of capsaicin).All of the mice would be observed the time of withdrawal latencies from the thermal heated surface after administration of one,four and seven hours,and thermal withdrawal time within 60 days after the injection.Results:①The physiological saline group compared with excipient group,the thermal withdrawal time had no statistically significant difference (P＞0.05)after administration of one,four and seven hours,and thermal withdrawal time within 60 days.②The acute pain duration of the third group would disappear after capsaicin injection 7 hours,four hours for the fourth group,and one hour for the fifth group.③The duration of analgesia of the third group,lasted for 18.9± 1.1 days;The analgesia time of the fourth group lasted for 33.7± 1.0 days;The analgesia time of the fifth group lasted for 58.2± 1.2 days.Conclusions:Capsaicin has analgesic effects on chronic knee pain model in mice induced by CFA,and the days of analgesia increases with the concentration of capsaicin.
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Objective To understand the characteristics of common causes of acute pancreatitis (AP) in China and evaluate the association of the aetiology with gender and mortality.Methods The relevant literature was searched by the China journal full-text database (CNKI),Wanfang database,Weipu database and other databases and proceeding.Based on collecting data retrieval strategy,according to the inclusion criteria selection literature,Meta analysis was performed mainly for gallstone,hyperlipidemia,alcohol and other AP from the aspects of gender and case fatality rate.Results The Meta analysis included 11 articles which were accordance with the criteria,involving 13 601 patients,including 6 732 cases of biliary AP,1 372 cases of hyperlipidemia AP and 1 169 cases of alcohol AP.The Meta analysis showed that biliary AP male to female ratio was 0.79 ∶ 1,hyperlipidemic AP male to female ratio was 1.54 ∶ 1,alcoholic AP male to female ratio was 10.47 ∶ 1,overeating AP male to female ratio was 1.29 ∶ 1,and there was significant difference (P ＜ 0.05).Alcoholic AP mortality rate was the highest,which was 2.81 times than the biliary AP and 2.46 times than the hyperlipemic AP,and there was significant difference (P ＜0.05).Conclusions Biliary tract disease is the main etiologic cause of AP in China,and there are more females than males.The mortality rate of alcoholic pancreatitis is the highest,and there are more males.But we should investigate further high-quality,large-scale trails in patients with AP.
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Objective To discuss the value of high frequency ultrasound in assessment the changes of knee,ankle and elbow joints with haemophiliac arthropathy in children.Methods Eighty joints of 42 haemophiliac patients were enrolled in this study.Sixty two joints of 29 patients were examined by X-ray at the same time.The correlation of ultrasonography and X-ray on bone aspects were compared.Results Among 80 joints of 42 haemophilic patients,soft tissue swelling was showed in 12 joints,synovial hypertrophy was in 48 joints,the thickness range of synovial membrane was from 2.01 to 11.12 mm [(4.71± 2.26)mm],increased blood flow was in 40 joints,effusion in 53 joints,haemosiderin was in 33 joints,bone erosion was in 36 joints,subchondral cyst formation was in 20 joints,cartilage damage or disappear was in 31 joints.Ultrasonograthy showed bone erosion in 29 joints,subchondral cyst formation was in 16 joints,cartilage damage was in 24 joints.X-ray showed bone erosion in 23 joints,subchondral cyst was in 16 joints,narrowing joint space was in 20 joints.There was high correlation between the osteochondral domain of the ultrasonography and X ray:Kappa value were 0.803,0.832,0.790 respectively(P ＜0.05).Conclusions Ultrasonography is sensitive to detect the signs of enrolled joints in hemophiliac patients.It is an important method on diagnosis for hemophiliac arthrophv.
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<p><b>OBJECTIVE</b>To study the current situation of coagulation factor VIII (FVIII) inhibitor development in children with hemophilia A (HA) through a cross-sectional survey, and to explore the risk factors of inhibitor development in order to provide evidence for further prevention and management strategies.</p><p><b>METHOD</b>The clinical data of outpatients with hemophilia A in Beijing Children's Hospital seen from November 2012 to May 2013 were collected, FVIII inhibitor was screened and analyzed its risk factors.</p><p><b>RESULT</b>A total of 102 HA children were enrolled, 5 were mild cases, 32 were moderate, and 65 were severe cases; the median age on enrollment was 55.5 (3.0-200.0) months:19(18.6%) of patients had inhibitors and 9 (8.8%) had low-titer inhibitors, 10 (9.8%) had high-titer inhibitors. Receiving FVIII treatment for life-threatening bleeding (P = 0.03) ,OR 4.10 (95%CI:1.17-14.32) was a risk factor for inhibitor generation and patients within 20 exposure days have more chances of inhibitor development (P = 0.04) ,OR 3.32 (95%CI:1.02-10.86) . High and intense FVIII exposure within short term was the risk factor for high titer inhibitor development (P = 0.01) ,OR 5.25 (95%CI:1.45-21.92) .</p><p><b>CONCLUSION</b>Intense FVIII exposure for severe hemorrhage was the risk factor of inhibitors development especially of high titer inhibitors.</p>