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1.
Chinese Journal of Neurology ; (12): 199-203, 2021.
Article in Chinese | WPRIM | ID: wpr-885403

ABSTRACT

Objective:To investigate whether children with benign childhood epilepsy with centrotemporal spikes (BECT) still have attention network damage and its correlative factors after complete remission.Methods:Thirty BECT patients over 16 years old and without seizures over two years (BECT group; 21 males, nine females, median age 17 years) in the Department of Neurology, Provincial Children′s Hospital Affiliated to Anhui Medical University from January 1, 2009 to December 31, 2010 and 42 healthy controls (control group; 30 males, 12 females, median age 17 years) from the First Affiliated Hospital of Anhui Medical University were tested by the attention network test tool.Results:There was not statistically significant difference in the accuracy rate and total reaction time of attention network test between the BECT group and the control group [97.0% (95.0%, 99.0%) vs 98.0% (95.5%, 98.0%), Z=-0.437, P=0.662; 587.50 (523.50, 668.75) ms vs 610.00 (584.25, 631.75) ms, Z=-0.320, P=0.749; respectively]. And there was not statistically significant difference in the efficiency of the alert network, directional network, and executive control network in the BECT group compared with the control group [(46.13±24.97) ms vs (48.52±27.65) ms, t=-0.376, P=0.708; (32.23±18.12) ms vs (33.21±19.68) ms, t=-0.215, P=0.830; (124.50±39.87) ms vs (117.60±50.13) ms, t=0.626, P=0.533; respectively]. The accuracy of attention network test was positively correlated with the age of onset ( b=0.925, P=0.012), and was negatively correlated with the total number of seizures ( b=-0.853, P=0.025). Conclusion:Although the accuracy of attention network test in BECT patients after remission was correlated with age of onset and total number of seizures, BECT patients had no attention network damage after complete remission compared with healthy controls.

2.
Article in Chinese | WPRIM | ID: wpr-883050

ABSTRACT

Sexual health is an important part of the overall health of patients.The ability of nurses to carry out sexual health care directly affects the overall level of medical care. This article reviews the concepts of sexual health and sexual health care, the evaluation tools of sexual health care, the practical models and influencing factors of nurses' sexual health care, with a view to providing a reference for improving the practice level of nurses carrying out sexual health care.

3.
Protein & Cell ; (12): 128-144, 2021.
Article in English | WPRIM | ID: wpr-880899

ABSTRACT

Pancreatic ductal adenocarcinoma (PDAC) has poor prognosis due to limited therapeutic options. This study examines the roles of genome-wide association study identified PDAC-associated genes as therapeutic targets. We have identified HNF4G gene whose silencing most effectively repressed PDAC cell invasiveness. HNF4G overexpression is induced by the deficiency of transcriptional factor and tumor suppressor SMAD4. Increased HNF4G are correlated with SMAD4 deficiency in PDAC tumor samples and associated with metastasis and poor survival time in xenograft animal model and in patients with PDAC (log-rank P = 0.036; HR = 1.60, 95% CI = 1.03-2.47). We have found that Metformin suppresses HNF4G activity via AMPK-mediated phosphorylation-coupled ubiquitination degradation and inhibits in vitro invasion and in vivo metastasis of PDAC cells with SMAD4 deficiency. Furthermore, Metformin treatment significantly improve clinical outcomes and survival in patients with SMAD4-deficient PDAC (log-rank P = 0.022; HR = 0.31, 95% CI = 0.14-0.68) but not in patients with SMAD4-normal PDAC. Pathway analysis shows that HNF4G may act in PDAC through the cell-cell junction pathway. These results indicate that SMAD4 deficiency-induced overexpression of HNF4G plays a critical oncogenic role in PDAC progression and metastasis but may form a druggable target for Metformin treatment.

4.
Article in Chinese | WPRIM | ID: wpr-909152

ABSTRACT

Cutaneous malignant melanoma arises from the neural crest-derived melanocytes and is a highly malignant tumor with complex clinical and pathological manifestations. In recent years, its incidence rate is increasing gradually. It is one of the most common cutaneous malignant tumors. This paper reviews the advances of the diagnosis of cutaneous malignant melanoma.

5.
Article in Chinese | WPRIM | ID: wpr-828871

ABSTRACT

OBJECTIVE@#To investigate the effects of etomidate on electrophysiological properties and nicotinic acetylcholine receptors (nAChRs) of ventral horn neurons in the spinal cord.@*METHODS@#The spinal cord containing lumbosacral enlargement was isolated from 19 neonatal SD rats aged 7-12 days. The spinal cord were sliced and digested with papain (0.18 g/30 mL artificial cerebrospinal fluid) and incubated for 40 min. At the ventral horn, acute mechanical separation of neurons was performed with fire-polished Pasteur pipettes, and perforated patch-clamp recordings combined with pharmacological methods were employed on the adherent healthy neurons. In current-clamp mode, the spontaneous action potential (AP) of the ventral horn neurons in the spinal cord was recorded. The effects of pretreatment with different concentrations of etomidate on AP recorded in the ventral horn neurons were examined. In the voltage-clamp mode, nicotine was applied to induce inward currents in the ventral horn neurons, and the effect of pretreatment with etomidate on the inward currents induced by nicotine were examined with different etomidate concentrations, different holding potentials and different use time.@*RESULTS@#The isolated ventral horn neurons were in good condition with large diverse somata and intact processes. The isolated spinal ventral horn neurons (=21) had spontaneous action potentials, and were continuously perfused for 2 min with 0.3, 3.0 and 30.0 μmol/L etomidate. Compared with those before administration, the AP amplitude, spike potential amplitude and overshoot were concentration-dependently suppressed ( < 0.01), and spontaneous discharge frequency was obviously reduced ( < 0.01, =12). The APs of the other 9 neurons were completely abolished by etomidate at 3.0 or 30 μmol/L. At the same holding potential (VH=-70 mV), pretreatment with 0.3, 3.0 or 30.0 μmol/L etomidate for 2 min concentration-dependently suppressed the current amplitude induced by 0.4 mmol/L nicotine ( < 0.01, =7). At the holding potentials of - 30, - 50, and - 70 mV, pretreatment with 30.0 μmol/L etomidate for 2 min voltage-dependently suppressed the current amplitude induced by 0.4 mmol/L nicotine ( < 0.01, =6 for each holding potential). During the 6 min of 30.0 μmol/L etomidate pretreatment, the clamped cells were exposed to 0.4 mmol/L nicotine for 4 times at 0, 2, 4, and 6 min (each exposure time was 2 s), and the nicotinic current amplitude decreased gradually as the number of exposures increased. But at the same concentration, two nicotine exposures (one at the beginning and the other at the end of the 6 min pretreatment) resulted in a significantly lower inhibition rate compared with 4 nicotine exposures ( < 0.01, =6).@*CONCLUSIONS@#etomidate reduces the excitability of the spinal ventral neurons in a concentration-dependent manner and suppresses the function of nAChR in a concentration-, voltage-, and use-dependent manner.


Subject(s)
Animals , Animals, Newborn , Etomidate , Neurons , Patch-Clamp Techniques , Rats , Spinal Cord
6.
Chinese Journal of Rheumatology ; (12): 540-543, 2020.
Article in Chinese | WPRIM | ID: wpr-868231

ABSTRACT

Objective:To explore the possible related factors of Beh?et's disease complicated with tendinitis, in order to better understand the etiology and development mechanism so to guide clinical diagnosis and treatment.Methods:The clinical data of patients with Beh?et's disease complicated with tendonitis treated at Department of Rheumatology and Immunology of Lanzhou University Second Hospital from October 2018 to September 2019 were retrospectively reviewed and related literature were reviewed.Results:Two patients were diagnosed as Beh?et's disease. Foot pain occurred during the treatment. Ultrasound showed tendonitis, and the corresponding treatment relieved the symptoms.Conclusion:Tendons may be involved and presents as a chronic change in patients with Beh?et's disease. In patients with rheumatic diseases, attention should be paid to the correlation between the disease and tendonitis. Aggressive treatment can prevent adverse consequences.

7.
Article in Chinese | WPRIM | ID: wpr-754386

ABSTRACT

Objective: To investigate the vascular anatomy of the stomach, especially the right gastroepiploic artery for the reconstruc-tion of a gastric tube during esophagectomy. Methods: The vascular anatomy of the stomach was studiing in 28 embalmed human specimens provided by the Department of Anatomy, Shanghai Medical College, Fudan University, included 10 female and 18 male spec-imens. The length and diameter of gastric vessels were measured. The ratio of the length of the right gastroepiploic artery to the length of the greater curvature was calculated. Anastomosis between the left and right gastroepiploic arteries was also assessed. Re-sults: Twenty-five left gastric arteries were observed in the autopsies, with the mean diameter of 3.40 (2.10-6.40) mm. Twenty-one right gastric arteries were measured, with the mean diameter of 1.97 (0.68-3.56) mm. Twenty-six left gastroepiploic arteries were ob-served, with the mean diameter of 1.87 (0.80-2.96) mm. Twenty-eight right gastroepiploic arteries were measured, with the mean di-ameter of 2.82 (1.58-4.80) mm. The mean lengths of the 28 right gastroepiploic arteries and their greater curvatures were 216.71 (120-318) mm and 356.39 (248-487) mm, respectively. The ratio of the length of right gastroepiploic arteries and greater curvatures was 0.61 (0.45-0.82). The anastomosis between the left and right gastroepiploic arteries was observed in 60.7% (17/28) of the specimens. Conclusions: The length and diameter of gastric vessels were calculated. It was assumed that the right gastroepiploic artery provides an average of 61% of the blood supply for the great curvature. In addition, the anastomotic branch of the right and left gastroepiploic arteries was observed in 60.7% specimens. These anatomical data allow surgeons to estimate the blood supply and to choose an opti-mal method of gastric tube reconstruction during esophagectomy.

8.
Chinese Journal of Radiology ; (12): 941-945, 2019.
Article in Chinese | WPRIM | ID: wpr-801044

ABSTRACT

Objective@#To evaluate the feasibility and accuracy of deep learning in CT image segmentation and further lesion-volume assessment of spontaneous intracerebral hemorrhage.@*Methods@#A total of 1 223 cases of spontaneous intracerebral hemorrhage including parenchymal hemorrhage, ventricular hemorrhage, subarachnoid hemorrhage and mixture hemorrhage, from April 2016 to April 2018 in Tianjin Medical University General Hospital, were retrospectively enrolled and analyzed. The patients were randomly divided into training set (905 cases), validation set (156 cases) and test set (162 cases), among each group, the number of parenchymal hemorrhage was 498, 107 and 100, respectively. The bleeding area manually outlined by physician was served as the reference standard to build the segmentation model and to evaluate the performance of the validation set. Patients were divided into 3 groups according to the volume calculated by reference standard. The volume of hematoma in group 1 was less than 5 ml, while group 2 was 5-25 ml, and group 3 was more than 25 ml. Comparison of the hematoma volume calculated by segmentation model and that calculated by ABC/2 formula was conducted in 97 simple intraparenchymal hemorrhage cases.@*Results@#In 162 cases of test set, the Dice coefficients of the segmentation model were 0.87, 0.85, 0.67 and 0.77 in parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage and mixture hemorrhage, respectively. The estimated hematoma volume in the 97 intraparenchymal hemorrhage cases calculated by the segmentation model was (29.55±37.69) ml, and that calculated by the ABC/2 formula was (24.04±31.22) ml. Compared with reference standard, the absolute errors of three segmentation model were (0.52±0.54), (1.53±1.22) and (7.93±8.49) ml in group 1, 2 and 3 respectively. The absolute errors of the ABC/2 formula were (0.68±0.60), (3.16±2.90) and (19.31±17.23) ml in group 1, 2 and 3.@*Conclusion@#Deep learning based segmentation model improved detection of intraparenchymal hematoma volume, compared with ABC/2 formula.

9.
Journal of Practical Radiology ; (12): 1867-1869,1873, 2018.
Article in Chinese | WPRIM | ID: wpr-733379

ABSTRACT

Objective To analyze the correlation between CT characteristics and epidermal growth factor receptor (EGFR)mutations in pulmonary adenocarcinoma.Methods 82 patients (87 lesions)with pulmonary adenocarcinoma were retrospectively collected.All patients were underwent CT examination before operation,and EGFR gene were determined after operation.Results EGFR mutations were found in 44 of 87 lesions (50.57%).The EGFR mutations rate was 50.00% in females and 47.50% in males,there was no statistical difference between genders (P=0.821).The EGFR mutations rate was 46.55% in the right lung and 58.62% in the left lung,while no statistically significant difference was found (P=0.289).Among all the CT characteristics,the mutations rate was 63.89% in spiculated lesions and 60.71% in lesions with pleural indentation,the differences was statistically significant (P<0.05).The mutations rate was 59.25% in lesions containing solid component and 36.36% in pure ground glass opacity lesions,the difference was statistically significant (P=0.011). There were no statistically differences in lobulation,cavitation and lymphadenectasis (P>0.05).The pleural indentation was the highest in sensitivity (77.27%)and negative predictive value (67.74%).The spiculation was the highest in specificity (69.77%)and positive predictive value (63.89%).Conclusion Among all the CT characteristics,pleural indentation,spiculation and the lesion containing solid component are prone to EGFR mutations.

10.
Article in Chinese | WPRIM | ID: wpr-752175

ABSTRACT

Object: To systematically evaluate the effect of Danhong injection combined with conventional medication on inflammatory factors after percutaneous coronary intervention in coronary heart disease, and providing evidence for further research and design. Methods: PubMed, The Cochrane Library, EMbase, MEDLINE, CBM, VIP, CMCI, CNKI, Wanfang Medical Database and other Chinese and foreign medical databases collected the clinical study of Danhong injection in the treatment of inflammatory factors after coronary intervention, using Revman 5.3 software for analysis.Results: A total of 7 studies were included, including 831 patients. 1) Inflammatory response index: hs-CRP of danhong injection treatment group was significantly different from that of control group [RR=-0.86, 95%CI (-1.03, -0.69), P <0.0001]. There were significant differences in IL-6 test values between the danhong injection group and the control group[RR =-1.19, 95%CI (-1.41, -0.96), P < 0.00001]. The MMP-9 test values of danhong injection group were significantly different from those of the control group [RR =-0.39, 95%CI (-0.78, -0.00), P = 0.05]. 2) Myocardial injury index:There were significant differences in the CK MB test values of danhong injection treatment group and control group[RR =-0.89, 95% CI (-1.12, -0.67, P < 0.00001) ]. The cTnT test values of the danhong injection group were significantly different from those of the control group [RR =-1.25, 95%CI (-1.51, -0.98), P < 0.00001]. Conclusion:Current research indicates that Danhong injection can reduce inflammatory factors hs-CRP, IL-6 and MMP-9 and myocardial injury indicators creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT) after coronary intervention. In other words, Danhong injection can reduce the levels of inflammatory factors such as hs-CRP, IL-6 and MMP-9 and improve the myocardial injury index such as CK-MB and cTnT after coronary intervention, and then have a certain protective effect on the myocardium. However, the above conclusions still need further research and verification.

11.
Article in Chinese | WPRIM | ID: wpr-752174

ABSTRACT

Objective: To evaluate the effect of Danhong injection on endothelial function after percutaneous coronaryintervention (PCI) in coronary heart disease (CHD) . It provides the basis for further research and design. Methods: Sevendatabases of CNKI, VIP, Wanfang Data, CBM, PubMed, The Cochrane Library, Embase and others were searched bycomputer cents with coronary heart disease treated by Danhong injection combined with conventional drugs. Twoevaluators independently sifted the literature, extracted the data and evaluated the bias risk in the study. The data werestatistically analyzed by RevMan 5.3 software. Results: A total of 12 RCTs, involving 1325 patients were included. Metaanalysis showed that the treatment group (Danhong injection combined with routine therapy) was superior to the controlgroup in improving the endothelium index after operation. The index NO[MD=9.57, 95%CI (8.22, 10.93), P < 0.00001], vWF [MD=-31.60, 95%CI (-41.47, -21.72), P < 0.00001], ET-1 [MD=-2.19, 95%CI (-3.11, -1.27), P < 0.00001], ET[SMD=-0.92, 95%CI (-1.49, -0.35), P < 0.01], FMD[MD = 1.81, 95%CI (1.26, 2.37), P < 0.00001]. There was statisticalsignificance between each index. Conclusion: Danhong injection combined with conventional therapy can improveendothelial function after PCI. However, due to the low quality of included studies and the problem of heterogeneity, these conclusions need to be further verified by high quality multicenter, large sample and double blind randomizedcontrolled trials.

12.
Article in Chinese | WPRIM | ID: wpr-752117

ABSTRACT

Objective: To conduct a comprehensive and systematic review of the efficacy and safety of Wenxin Keli (WXKL) in the treatment of atrial fibrillation (AF) . Methods: Seven databases (PubMed, The Cochrane Library, Web ofScience, CNKI, Wanfang Database, VIP and SinoMed) were searched to identify relevant randomized controlled trials (RCTs) from inceptions to 1 October, 2018. Two review authors independently assessed the methodological quality andanalyzed data by Cochrane handbook and the Rev Man 5.3 software. Begg.s test was conducted to assess publication biasvia Stata 14 software. Results: Twenty-four RCTs with 2246 patients were included in this review. Compared with blankcontrol, placebo or western medicine alone, WXKL alone or combined with western medicine could effectively reducerapid ventricular rate (MD=-7.14, 95%CI:-8.42——5.87), the frequency and duration of AF. It could also shorten thesinus rhythm conversion time (MD=-3.04, 95%CI:-3.47——2.61), increase the sinus rhythm conversion rate (RR=1.19, 95% CI: 1.09~1.29) and decrease recurrence rate of AF (RR=0.28, 95% CI: 0.13-0.59) . Besides, WXKL alone orcombined with western medicine was beneficial for improving the left ventricular ejection fraction (LVEF) (MD=3.44, 95% CI: 0.87-6.01), left ventricular end diastolic diameter (LVEDD) (MD=-2.47, 95% CI:-2.86——2.08), left atrialdiameter (LAd) (MD=-0.91, 95%CI:-1.58——0.25) and P wave dispersion (Pd) (MD=-4.04, 95%CI:-4.15——3.93) .WXKL combined with low-dose amiodarone was superior to conventional-dose amiodarone alone in improving themaximum P wave (Pmax) (MD=-8.25, 95% CI:-10.33——6.17), and WXKL combined with conventional-doseamiodarone is more effective (MD=-13.10, 95%CI:-13.65——12.55) . Compared with the control group, the treatmentgroup had fewer adverse reactions, and the Begg.s test did not find any publication bias. Conclusion: WXKL alone orcombined with western medicine exhibited better therapeutic effects in the treatment of AF, but these results still needhigh-quality evidence to verify.

13.
Chinese Journal of Surgery ; (12): 928-932, 2018.
Article in Chinese | WPRIM | ID: wpr-810308

ABSTRACT

Objective@#To evaluate the clinical value and outcomes of technical improvement of hybrid operatical clipping for large paraclinoid internal carotid artery aneurysms.@*Methods@#A review was conducted on 18 cases of large paraclinoid internal carotid artery aneurysm which were clipped by balloon non-fluoroscopic occlusion of the parent artery via a micro-bone window frontolateral approach in hybrid operating room at Neurosurgery Department of Tianjin Medical University General Hospital from June 2014 to December 2017. There were 8 males and 10 females with age of (63±4) years. There were 6 cases of unruptured aneurysm and 12 cases of ruptured aneurysm of subarachnoid hemorrhage (6 cases of grade Ⅱ, 4 cases of grade Ⅲ and 2 cases of grade Ⅳ in Hunt-Hess classification). Frontolateral approach incision (average length of about 5 cm) and bone window about 3 cm×3 cm were performed. No incision of the neck was needed to expose the internal carotid artery for temporary occlusion. In the operation, the balloon was slowly pushed to the preset position of the internal carotid artery under non-fluoroscopy. The balloon was expanded to block the blood flow of internal carotid artery. Then aneurysm was clipped. The balloon was loosened and retraced to the guiding catheter after clipping. The clipping condition was examined by cerebral angiography. If there was residual aneurysm neck or stenosis of the parent artery, the balloon was pushed under non-fluoroscopy again to temporary occlusion and the clip was adjusted until the aneurysm neck was clamped satisfactorily.@*Results@#Eighteen aneurysms were successfully clipped in hybrid operating room. Fourteen aneurysms showed complete occlusion of the aneurysm neck and no stenosis of the parent artery. Four cases showed residual aneurysm neck after clipping by intraoperative angiography, then aneurysms were clipped satisfy by adjusting the aneurysm clip. The patients were followed up for 3 months to 1 year. Ten patients recovered well (modifed Rankin score (mRS): 0), and 3 patients had no obvious disability (mRS: 1). Two patients with Hunt-Hess grade Ⅲ were slightly disabled (mRS: 2). 1 patients with Hunt-Hess grade Ⅲ were moderately disabled (mRS: 3). 1 patients with Hunt-Hess grade Ⅳ were severely disabled (mRS: 4). One elderly patients with Hunt-Hess grade Ⅳ were seriously disabled (mRS: 5).@*Conclusions@#Application of balloon non-fluoroscopic occlusion clipping for large paraclinoid internal carotid artery aneurysm via a micro-bone window frontolateral approach is safe, effective and minimally invasive.

14.
Article in Chinese | WPRIM | ID: wpr-345325

ABSTRACT

<p><b>OBJECTIVE</b>To detect potential mutation of iduronate-2-sulfatase (IDS) gene in a family affected with mucopolysaccharidosis type Ⅱ (MPS Ⅱ).</p><p><b>METHODS</b>For the proband and his unaffected mother, the whole coding sequence of the IDS gene was analyzed with PCR and bidirectional Sanger sequencing.</p><p><b>RESULTS</b>A novel splicing mutation, c.709-1G>A, was detected in the proband, for which his mother was heterozygous.</p><p><b>CONCLUSION</b>The c.709-1G>A splicing mutation of the IDS gene is probably causative for the MSP Ⅱ in the proband. Prenatal diagnosis for the mutation may avoid birth of further child affected with this disease.</p>


Subject(s)
Base Sequence , Child , DNA Mutational Analysis , Methods , Family Health , Female , Genetic Predisposition to Disease , Genetics , Glycoproteins , Genetics , Metabolism , Heterozygote , Humans , Iduronate Sulfatase , Genetics , Metabolism , Male , Mothers , Mucopolysaccharidosis II , Diagnosis , Genetics , Mutation
15.
Article in Chinese | WPRIM | ID: wpr-617233

ABSTRACT

Objective: To assess the diagnostic rate, safety and clinical application of percutaneous renal masses biopsy for advanced renal cell carcinoma patients.Methods: In this retrospective study, we collected the data of renal masses from the patients who underwent renal masses biopsy under ultrasound from April 2001 to December 2014 in Peking University First Hospital.A total of 75 patients who were undiagnosed or diagnosed with advanced renal cell carcinoma by the imageological method were enrolled in this study.The patient and lesion characteristics such as tumor size, pathology of tumor, histologic subtype, pathological grade, biopsied location and biopsied cores were recorded and analyzed.Results: Among all the 75 patients, biopsy was diagnostic in 64 cases (85.3%) and non-diagnostic in 11 cases (14.7%).Of the 64 diagnostic biopsies, 60 were malignant, including 37 (61.7%) renal cell carcinoma (RCC), 13 (21.7%) urothelial carcinoma and 10 (16.7%) other malignant masses.Of all the RCC subjects, 24 suffered from clear cell RCC, 5 papillary RCC, 3 collecting duct carcinomas, 1 unclassified RCC and 4 unknown subtypes.The 11 non-diagnostic biopsied samplings included inflammatory, blood and extrarenal tissue and normal renal tissue.The proportion of collecting duct carcinoma in RCC was 10.8% and the proportion of squamous carcinoma in urothelial carcinoma was 23.1%, which were both higher than the previous research findings.For the male and female groups, non-diagnostic yields were 6.5% and 30.4%, respectively (P=0.022).Of all the 75 patients, 13 renal cell carcinoma patients underwent the surgical treatment and got the results of postoperative pathology.Comparing preoperative biopsy pathological diagnosis with postoperative pathological diagnosis, we found the diagnostic correct rates for benign and malignant lesions, pathological subtype and pathological grade were 100%, 81.8% and 60%, respectively.Mild macroscopic hematuria occurred in 1 case after RMB and there were no serious complications in all the cases.Conclusion: Percutaneous renal masses biopsy under ultrasound with a high diagnostic rate which can define the histologic subtype of renal cell carcinoma.With targeted therapy, more and more patients whose evaluation suggests local advanced disease or metastatic tumors adopt renal tumor biopsy to define the histologic subtype, which could avoid unnecessary surgical treatment.

16.
Tianjin Medical Journal ; (12): 176-179, 2017.
Article in Chinese | WPRIM | ID: wpr-507265

ABSTRACT

Objective To compare and analyze the occurrence of delayed cerebral ischemia(DCI)after coiling and clipping of intracranial aneurysms, and explore the risk factors of DCI. Methods A total of 236 patients with aneurysms diagnosed by CT angiography (CTA) or digital subtraction angiography (DSA) in Department of Neurosurgery, Tianjin Medical University General Hospital were enrolled in this study from March 2011 to May 2014. Patients were divided into clipping group(n=135) and coiling group(n=101). The clinical characteristics were compared between two groups, including gender, age, medical history, GCS score, Hunt-Hess grade, Fisher grade, WFNS grade, aneurysm location, prognosis and incidence of DCI. Risk factors for DCI were investigated by Logistic regression analysis. Results DCI was occurred in 36 patients (26.7%) underwent clipping operation while in 11 patients (10.9%) underwent coiling operation. The incidence was significantly higher in clipping group compared with that of coiling group (P 0.01). The overall mortality was 11.0%, the former had a lower mortality rate (5.9% vs. 17.8%, P <0.01). According to Logistic regression analysis, Fisher Grade 3-4, postoperative pulmonary infection and surgical procedure were independent risk factors for DCI (P<0.01). Conclusion DCI is one of the most significant factors for high fatality and morbidity of postoperative aneurysm patients. There is a low occurrence of DCI after coiling compared with that of clipping. If we pay more attention to risk factors associated with the DCI, it will improve the prognosis of postoperative aneurysm patients greatly.

17.
Article in Chinese | WPRIM | ID: wpr-335129

ABSTRACT

<p><b>OBJECTIVE</b>To analyze mutations of IDUA gene in two pedigrees affected with mucopolysaccharidosis type I and provide prenatal diagnosis for them.</p><p><b>METHODS</b>The 14 exons of the IDUA gene were subjected to PCR amplification and Sanger sequencing.</p><p><b>RESULTS</b>For pedigree 1, the proband was found to harbor compound heterozygous mutations c.46-57delTCGCTCCTGGCC (p.Ser16_Ala19del) of exon 1 and c.1147delC (p.Arg383Alafs*57) of exon 8 of the IDUA gene, which were inherited from his father and mother, respectively. The latter was unreported previously. Prenatal diagnosis suggested that the fetus has carried a heterozygous c.46-57delTCGCTCCTGGCC mutation. For family 2, the proband was also found to carry compound mutations of the IDUA gene, namely c.721T to C (p.Cys241Arg) of exon 6 and c.1491delG (p.Thr497fs27) of exon 8, which were inherited from her mother and father, respectively. Neither mutation was reported previously. Prenatal diagnosis suggested that the fetus has carried a heterozygous c.721T to C mutation.</p><p><b>CONCLUSION</b>Mutations of the IDUA gene probably underlie the MPS-I in both pedigrees. Above results have enriched the spectrum of IDUA gene mutations and facilitated prenatal diagnosis for both families.</p>


Subject(s)
Adult , Asians , Genetics , Base Sequence , Child , Child, Preschool , China , DNA Mutational Analysis , Female , Fetal Diseases , Diagnosis , Genetics , Heterozygote , Humans , Iduronidase , Genetics , Male , Molecular Sequence Data , Mucopolysaccharidosis I , Diagnosis , Embryology , Genetics , Pedigree , Pregnancy , Prenatal Diagnosis , Sequence Deletion
18.
Chinese Journal of Surgery ; (12): 151-155, 2017.
Article in Chinese | WPRIM | ID: wpr-808141

ABSTRACT

Objective@#To compare the diagnosis and treatment experience of brain abscesses and improve prognosis.@*Methods@#The data of 302 patients of brain abscess at Department of Neurosurgery in Tianjin Medical University General Hospital from 1980 to 2014 was analyzed retrospectively. There were 215 male and 87 female patients aged from 11 to 82 years with mean age of (30±8) years. The patients was divided into 1980-2001 group and 2002-2014 group according to different diagnosis and the treatment methods. The therapy methods include operation and conservative treatment. There were 196 cases received operation, including 95 cases of excision, 89 cases of ventriculopuncture, 12 cases of excision after ventriculopuncture, 106 cases received drug conservative therapy. Two groups of information including clinical manifestation, abscess location, therapeutic effect and prognosis were compared by χ2 test.@*Results@#Compared to 1980-2001 group, adjacent infection incidence declined(χ2=8.000, P=0.005). The ratio of single abscess declined and multiple abscess increased(χ2=11.060, P=0.001), the infection proportion of frontal lobe and temporal lobe decreased(χ2=9.080, P=0.003; χ2=15.440, P=0.000). The ratio of headache and vomit and papilledema declined significantly(χ2=23.290, P=0.000; χ2=21.020, P=0.000; χ2=2.290, P=0.001). Total mortality of 302 patients were 23 cases and 5 cases of 1980-2001 group and 2002-2014 group (10.4% vs. 6.3%, χ2=1.180, P=0.277). However, there were statistical difference in postoperative mortality between both groups (14.4% vs. 4.0%, χ2 =3.880, P=0.049).@*Conclusion@#With the application of antibiotics and the development of neurosurgical techniques, the prognosis of brain abscess has been improved.

19.
Article in Chinese | WPRIM | ID: wpr-496214

ABSTRACT

Objective:Carcinoma of bladder is the most common malignancy in the urinary system in China.Most patients with this disease had non-muscle invasive bladder cancer (NMIBC)at the time of diagnosis.Radical cystectomy was indicated for patients with high risk or refractory NMIBC.We aimed to investigate the overall survival and disease-specific survival and related influence factors in patients un-dergoing radical cystectomy for pathological non-muscle invasive bladder cancer.Methods:From Jan. 2006 to Dec.2012,a total of 164 patients with pathological non-muscle invasive bladder cancer under-went radical cystectomy in Peking University First Hospital.Clinical data were retrospectively collected. Incidence of lymph node metastasis and disease recurrence were calculated.The risk factors of disease re-currence were analyzed.Kaplan-Meier plots were used to estimate the overall survival and cancer-specific survival.Multivariate Cox regression analysis was used to evaluate the prognostic factors for survival.Re-sults:Of all the patients included,159 had T1 disease,and 5 had CIS only.The median follow-up dura-tion was 46.5 months (range:7 -99 months).Fourteen patients were lost during the follow-up.Lymph node metastasis was noted in 6 patients (3.7%),4 patients had N1 disease,one patient had N2 di-sease,and one patient had N3 disease.Disease recurrence occurred in 16 patients (9.8%).The most common recurrence sites were the liver,bones,and lungs.The 5-year overall survival and disease-spe-cific survival for all the patients were 85% and 91%,respectively.The patients who underwent pelvic lymph node dissection showed a better prognosis in terms of disease-specific survival than those without (P =0.012).Patients with recurrence harbored a significant poorer survival (P <0.001).According to univariate Cox regression analysis,whether lymph node dissection was performed was an independent risk factor of disease recurrence (P =0.050,OR =2.695,95%CI 0.999 -7.271).In COX regression mo-del,age (P =0.008,OR =1.071,95%CI 1.018 -1.126)and whether lymph node dissection was performed (P =0.011,OR =3.385,95%CI 1.329 -8.621)were related to disease-specific survival. Conclusion:Patients with pathological non-muscle invasive bladder cancer underwent early radical cys-tectomy have a favorable prognosis,and bilateral pelvic lymph node dissection is essential for this proce-dure as it gains a survival benefit for the patients.

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Article in Chinese | WPRIM | ID: wpr-496207

ABSTRACT

Objective:To study the clinicopathological features and differential diagnosis of metaneph-ric adenoma (MA).Methods:The clinicopathological data of 16 cases with MA diagnosed and treated in Peking University First Hospital from 2004 to 2016 were retrospectively analyzed,and the clinical characteristics,pathologic parameters,differential diagnosis,treatment options and prognosis of MA were analyzed with literature review.Results:The patients included 10 females and 6 males.The age of pa-tients ranged from 14 to 83 years (mean =33.7 years).The partial nephrectomy was carried out for most patients.All cases were located in renal codex with 3 growing into the renal sinus.Histologically,the tumor was composed of tubules,papillary or glomeruloid structures and psammoma bodies were focally seen.Immunohistochemical study showed that all the cases expressed vimentin,and 94% cases ex-pressed CD57,63% WT1,75% AE1 /AE3,19% cytokeratin 7 (CK7 )and 13%α-methylacyl-CoA racemase (AMACR),and negative expressions for MA included CD10,neuron-specific enolase (NSE) and CD56.Follow-up information from 1 to 125 months was available in all the patients;and none of the patients showed any evidence of recurrence and metastasis.Conclusion:The benign tumor characteris-tics of MA are not obvious for preoperative imaging diagnosis,and the diagnosis of MA should be based on the unique pathological features.Positive immunostain of CD57 is a useful indicator for MA diagnosis and differential diagnosis.The partial nephrectomy surgical treatment can achieve good clinical cure with good prognosis.

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