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Objective To improve the cliniciansˊ awareness of Kluver-bucy syndrome (KBS), we retrospectively analyzed 4 cases of KBS such as clinical manifestation, MRI feature, treatment and prognosis. Methods We performed a retrospective analysis on 4 cases of KBS including general clinical data, key clinical symptoms, findings from cerebrospinal fluid and Cranial MRI examination, treatment strategy and prognosis, and literature review. Results All four patients showed KBS in the course of primary disease. The clinical symptoms of KBS mainly presented as gentle, indiscriminate dietary behavior, hypersexuality, hypermetamorphosis, hyperorality and visual agnosia. MRI Showed primary disease-associated alterations in diverse brain regions including hippocampus, the temporal lobe, the insula, the frontal lobe, and the cingulate gyrus. Three cases achieved completely clinical remission after treatment with carbamazepine,fluoxetine and antipsychotic drugs. One patientˊs symptoms disappeared spontaneously and no recurrence of symptoms was observed in the following 6~12 months. Conclusion Bulimia is often the first symptom of KBS. Cranial MRI is the characteristic of the primary disease and has great diagnostic value. Treatment with antiepileptic and antipsychotics can achieve favorable prognosis.
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Objective To investigate the clinical values of Dynamic changes of evaluation of central venous pressure (△CVP) combining with the pulse Doppler records of early mitral dilatation of blood flow velocity and peak atrial systolic blood flow velocity ratio (E/A) in the diagnosis and prognosis assessment of septic patients.Methods The study totally enrolled patients who were admitted to Intensive Care Unit of the Central Hospital of Puyang during January 2013 to June 2016.By the standard of 28 days,all the cases were divided into the survival group and the dead group.All patients admitted in the intensive treatment unit (ICU) in the same period were recorded of the acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score and sequential organ failure score (SOFA).Observe the dynamic changes of the two groups of patients on central venous pressure (△CVP) and E/A changes record into the family,after 6 hours and 24 of the related E/A value on each node,at the same time record the related CVP values,calculated the absolute value of the dynamic change of each node in the comparison after 6 h and 24 hours,the records of the node values mapped the receiver-operating characteristic curve (ROC) to evaluate the value of each index for prognosis.Results A total of 233 cases of sepsis patients enrolled,28 d survival of 122 cases,survival rate was 52.4％;111 cases died,mortality was 47.6％.The ICU blood lactate,APACHE Ⅱf,SOFA score of the dead group was significantly higher than the survival group,and their stay in ICU was significantly shorter than the survival group (P＜0.05),other clinical features of the difference was not statistically significant(P＞0.05).The E/A value differences between the dead group and survival group into the ICU 0h and 6h were 0.54±0.17,0.69±0.24;0.57±0.28,0.85±0.25 (P＜0.05),the ROC curve analysis is 0.792,0.818,and there are different CVP change value △h2 CVP change value △h1,24 hours and after 6 hours of the patient,namely:5.67 ± 4.16,7.82 ±4.81;6.58±3.89,8.82±2.40 (P＜0.05) the area under the ROC curve it was,0.778,0.705,wherein when the 6h,the cutoff value E/A 0.75 area taken under the ROC curve (AUC) was 0.818 for the highest single index,the sensitivity and specificity were forecast 74.16％,95.45％,which the ICU 6 when E/A area under the ROC curve of dynamic changes in the value of a ACVP with CVP (AUC) of up to 0.844;0.471 to take their cut-off point,the sensitivity of the prognosis was 88.32％,specificity degree of 90.71％,better predictive strength thanthe other indicators,as well as sensitivity and specificity.Conclusion Early E/A can be used as prognostic evaluation of sepsis as new and important indicator,combining with dynamic changes of the early CVP as an early assessment of the clinical condition of patients with sepsis,and can be prediction of the prognosis of patients,as well as reference for the therapeutic intervention on high-risk patients.
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As a receptor tyrosine kinase, mesenchymal to epithelial transition factor (MET) is the membrane receptor for hepatocyte growth factor (HGF), which is related with a series of biological functions, such as cell proliferation, progression, apoptosis, metastasis and morphological changes. As research continues, MET is amplified or overexpressed in a wide range of human cancers and closely related with worse prognosis. Therefore, various MET inhibitors are currently being developed as potential treatments for a variety of cancers. Based on our current study we summarize the existing knowledge on structure, biological function and its inhibitors of MET and provide a data phase for future researchers.
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Objective To evaluate the effects of early tracheotomy and delay tracheotomy on the prognosis of patients with severe craniocerebral injury.Methods Data of randomized controlled test (RCT) of early tracheotomy on the prognosis of the patients with severe craniocerebral injury were retrieved by using Conchrane Library,PubMed,Embase,OVID,CBM,CNKI,Wanfang and VIPdatahase.The retrievaled time was limited from their building to March 2016,and all the index of the obtained references was accessed.Two researchers independently screened the literature in accordance with the established criteria for inclusion or exclusion.The incidence of VAP,mechanical ventilation time and ICU length of hospital stay,mortality were considered as evaluation indexes.The methodology quality of the included references was evaluated,and the Meta-analysis was performed by using Review Manager 5.3 software.Results Finally,4 randomized controlled studies (RCT) were enrolled,including 220 patients.Meta-analysis results showed that:early tracheotomy did not have any effects on VAP incidence rate (P=0.15) and fatality rate (P=0.20) of the patients with severe craniocerebral injury,there was not any statistically difference;but there was a statistically difference between the mechanical ventilation (P =0.01) and ICU hospitalization time (P =0.05).Conclusion Early tracheostomy could not significantly reduce the incidence of VAP and fatality rate of the patients with severe craniocerebral injury,but it can reduce the mechanical ventilation time and ICU hospitalization time.
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Objective To study the prognosis of patients with unstable angina in PCI adverse events factor analysis,and the function of CYP2C 19 gene mutations.Methods From May 2013 to May 2015,226 cases of PCI postoperative patients,after surgery all took aspirin + clopidogrel maintenance to treat for 1 years,analyzed CYP2C19*1,CYP2C19*2,CYP2C19 *3 genotype with fluorescent polymerase chain reaction (PCR),the patients were followed up for 6 months.According to the result of detection of genotype divided into wild type group (CYP2C19 *1/*1),the mutation of mixed group (CYP2C19 *1/*2 and CYP2C19 *1/*3) group and mutations in pure form group (CYP2C19 *2/*2 and CYP2C19 *3/*3).Observed the occurrence of unstable angina of three groups prognosis.Results The mutation of mixed to form and mutation of pure form had a record of hospital clinical adverse events (61.9％ and 45.3％) was significantly higher risk of wild group (42.4％),with statistical significance (P ＜0.05);Logistic regression analysis of diabetes and CYP2C19 genotype with PCI postoperative patients with unstable angina occurred in hospital records of clinical adverse events had good correlation (R =3.424,P=0.009 and R =5.679,P =0.001).Conclusion The CYP2C19 gene mutations and diabetes patients with unstable angina PCI postoperative prognosis is closely related,the lack of CYP2C19 gene type are more likely to affect the prognosis of unstable angina,provide reliable basis for further research.
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Objective To analyze the related influence factors on the prognosis of hypertensive cerebral hemorrhage in basal ganglia with operation treatment,provide the basis for clinical prevention and treatment.Methods 80 patients for treatment of hypertensive cerebral hemorrhage were selected.By a retrospective study,we collected the clinical data and postoperative following -up data,status,complications,and observed the postoperative recovery.Sta-tistical different hypertension,preoperative breaking into the ventricle,disturbance of consciousness,operation time and preoperative hematoma volume of the prognosis.Results In 80 patients,48 cases(60.00%)of patients has good prognosis;moderate disability,taking care of themselves life 10 cases(12.50%);severe disability,life can not take care of 9 cases(11.25%);plant survival of 5 cases(6.25%)and 8 cases of death(10.00%).22 cases of patients with brain hemorrhage again,3 cases postoperative pulmonary infection,6 cases of secondary organ dysfunction.Poor prognosis of preoperative ventricle prognosis and disturbance of consciousness of patients was 88.26%(18 /23)and 63.64%(21 /33),which was higher than the preoperative without breaking into the ventricle and no disturbance of consciousness 24.54%(14 /57)and 36.36%(21 /33),the difference was statistically significant(χ2 =10.38,9.76, P 60mL was 47.62%(20 /42),which was higher than the preoperative hematoma volume 40 -60mLpatients31.38%(12 /38),the difference was statistically significant(χ2 =9.12,P <0.05).Conclusion It has obvious effect on surgery operation prognosis of patients with hypertensive cerebral hemorrhage,including optimal time for operation;bleeding time,intraventricular hemorrhage,disturbance of consciousness and bleeding volume.If the clinical treatment in the prevention and treatment to improve the survival and quality of life of patients with cerebral hemorrhage.
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Objective To discuss the incidence trends of hyperuricemia in people of different TCM constitutional types by analyzing the constitutional types of patients with hyperuricemia,and to lay a foundation for follow-up study in preventive and therapeutic measures for hyperuricemia.Methods 518 healthy people and 525 people of hyperuricemia were included in our research by identifying their TCM constitutional types by the self testing table of constitutional classification and determination of TCM promulgated by China Association of Chinese Medicine.Hyperuricemia's high-risk constitutional types were analyzed.Results People of dampness-heat constitution (24.57％),phlegm-dampness constitution (22.86％) and static-blood constitution (11.05％) were top 3 groups in occurrence rate of hyperuricemia,the risk ofhyperuricemia in these three groups above were significantly higher than the other constitutional types.On the contrary,the risk of hyperuricemia in the group of the mildly constitution (8.57％) and the group of qi-asthenia constitution (6.29％)were significantly lower than the other groups.Conclusion People of dampness-heat constitution,phlegm-dampness constitution and static-blood constitution were high risk groups of hyperuricemia,which deserved our attention in research of preventive and therapeutic measures for hyperuricemia.