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Objective:To study the efficacy of laparoscopic ovarian cyst aspiration in the treatment of neonatal simple ovarian cyst.Methods:From August 2019 to December 2021, infants with neonatal simple ovarian cyst receiving laparoscopic ovarian cyst aspiration in the Department of Pediatrics of Gansu Provincial Maternity and Child-care Hospital were retrospectively studied. The clinical characteristics, age of surgery, operation duration, length of hospital stay, complications and follow-up were analyzed.Results:A total of 6 full-term infants were included. Simple ovarian cysts were located on the right side of the body in 5 cases and on the left in 1 case. The average cyst diameter was (6.1±1.4) cm, the surgery were performed at 2~5 d of age, the average duration of the surgery was (18.8±2.4) min and the average hospital stay was (5.3±1.0) d. No complications occurred before or after surgery. All the 6 infants had favorable growth and development. The ovarian cysts were all enlarged again in 1 month after surgery, then gradually shrunk at 3 to 6 months after surgery and completely resolved in 2 cases.Conclusions:Neonatal simple ovarian cysts are more common on the right side of the body and laparoscopic ovarian cyst aspiration has good and safe clinical efficacy.
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Objective:To explore the value and risk of electronic bronchoscope applied in perioperative management of children with congential tracheoesophageal fistula.Methods:Sixty-five children with congential tracheoesophageal fistula performed electronic bronchoscope examination from September 2014 to November 2020 were enrolled in this study.The results of examination and complications were analyzed.Results:Sixty-three children with congenital tracheoesophageal fistula were diagnosed by electronic bronchoscopy.The diagnosis rate was 96.92%.Fifty-four children with congenital tracheoesophageal fistula were diagnosed by esophagography.The diagnosis rate was 91.53%.Sixty-one children with congenital tracheoesophageal fistula were diagnosed by multislice spiral computed tomography.The diagnosis rate was 93.85%.Airway anatomic abnormity was found in 27 children, including three cases of nasopharyngeal soft tissue collapse, 14 cases of laryngomalacia, five cases of tracheal stenosis, nine cases of tracheobronchomalacia, and nine cases of tracheobronchial and abnormal opening of the bronchus.The incidence was 41.54%.Three children with difficult ventilator weaning were related to tracheobronchial stenosis or tracheobronchomalacia.They were gradually weaning from ventilator after a long period of mechanical ventilation and treatment.Two children with transient decrease in oxygen saturation were noticed as complication.Conclusion:Electronic bronchoscopy is a safe and effective method for the diagnosis of congenital tracheoesophageal fistula and recurrence after operation.It is of great value to the airway management after operation by early detection of respiratory anatomic abnormity.
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OBJECTIVES@#To evaluate the value of thrombospond in Type I domain-containing 7A (THSD7A) and M-type phospholipase A2 receptor (PLA2R) in primary membranous nephropathy (PMN) and to explore the relationship between their antibody levels and prognosis.@*METHODS@#Renal tissues in 128 patients with membranous nephropathy in the Second Xiangya Hospital of Central South University were collected from February 2015 to August 2017, including 108 patients with primary membranous nephropathy (PMN group) and 20 patients with secondary membranous nephropathy (SMN) (SMN group). Indirect immunofluorescence method was used to detect the expression of PLA2R antigen in kidney tissues,and the glomerular expression of THSD7A antigen was examined by immunohistochemistry and indirect immunofluorescence. The serum levels of anti-PLA2R antibodies and THSD7A antibodies were also detected by ELISA. According to the results of PMN examination,the patients were also divided into a PLA2R-related membranous nephropathy group and a THSD7A-related membranous nephropathy group.@*RESULTS@#The positive rate of PLA2R in the renal tissues in the PMN group was higher than that in the SMN group (78% in the PMN group, 35% in the SMN group, <0.01),while the positive rate of anti-PLA2R antibody in the PMN group was also higher than that in the SMN group (50% in the PMN group, 25% in the SMN group, <0.05).The serum level of anti-PLA2R antibody was positively correlated with 24 h urine protein (=0.254, <0.05) and negatively correlated with serum albumin (=-0.236, <0.05). The expression of THSD7A was positive in glomeruli in 7 cases of the PMN group (6%) by immuno-histochemistry, and which was positive in 1case of the SMN group (5%).The serum levels of anti-THSD7A antibody in the PMN group were higher than those in the SMN group [(0.49±0.26) pg/mL in the PMN group,(0.34±0.27) pg/mL in the SMN group, <0.05]. There was no difference in the clinical characteristics between the PLA2R-related membranous nephropathy group and the THSD7A-related membranous nephropathy group.@*CONCLUSIONS@#PLA2R and THSD7A are the target antigen of PMN, and the associated autoantibodies are helpful for the differential diagnosis of PMN. The anti-PLA2R antibody levels can reflect the severity of the disease and evaluate the effect of treatment. The incidence of THSD7A membranous nephropathy is low, and monitoring the serum anti-THSD7A antibody levels can assess patients' condition and predict disease outcome.
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Humanos , Autoanticuerpos , Glomerulonefritis Membranosa , Inmunohistoquímica , Receptores de Fosfolipasa A2 , TrombospondinasRESUMEN
Objective To compare the clinical value of two kinds of imaging methods including CT and MRI in early diagnosis of acute multiple cerebral infarction. Methods The imaging data of CT and MRI of 108 patients with acute multiple cerebral infarction were analyzed. The total detection rate, the detection rate in different time periods,the number and area of detected lesions and the inspection time of CT and MRI in early diagnosis of acute multiple cerebral infarction were compared. Results The total detection rates of patients with acute multiple cerebral infarction by CT and MRI were 57. 41%,96. 30%,respectively. The total detection rate of MRI was significantly higher than CT(χ2 =9. 73,P<0. 05). The detection rates of patients with acute multiple cerebral infarction for onset within 24h and 24-72h by MRI were significantly higher than CT(χ2 =18. 54,16. 20,all P<0. 05). There was no significant difference in detection rate of patients with acute multiple cerebral infarction for onset >72h between CT and MRI(P>0. 05). The number of detected lesions of patients with acute multiple cerebral infarction by MRI was significantly more than CT(t=2. 39,P<0. 05). The area of detected lesions and the inspection time of patients with acute multiple cerebral infarction by MRI were significantly less than that by CT(t =2. 43,2. 60,all P <0. 05). Conclusion Compared with CT, MRI in the early diagnosis of acute multiple cerebral infarction can effectively improve the detection rate in early stage, avoid the missed diagnosis of small lesions and is helpful to shorten the examination time.
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Objective To compare the clinical value of two kinds of imaging methods including CT and MRI in early diagnosis of acute multiple cerebral infarction. Methods The imaging data of CT and MRI of 108 patients with acute multiple cerebral infarction were analyzed. The total detection rate, the detection rate in different time periods,the number and area of detected lesions and the inspection time of CT and MRI in early diagnosis of acute multiple cerebral infarction were compared. Results The total detection rates of patients with acute multiple cerebral infarction by CT and MRI were 57. 41%,96. 30%,respectively. The total detection rate of MRI was significantly higher than CT(χ2 =9. 73,P<0. 05). The detection rates of patients with acute multiple cerebral infarction for onset within 24h and 24-72h by MRI were significantly higher than CT(χ2 =18. 54,16. 20,all P<0. 05). There was no significant difference in detection rate of patients with acute multiple cerebral infarction for onset >72h between CT and MRI(P>0. 05). The number of detected lesions of patients with acute multiple cerebral infarction by MRI was significantly more than CT(t=2. 39,P<0. 05). The area of detected lesions and the inspection time of patients with acute multiple cerebral infarction by MRI were significantly less than that by CT(t =2. 43,2. 60,all P <0. 05). Conclusion Compared with CT, MRI in the early diagnosis of acute multiple cerebral infarction can effectively improve the detection rate in early stage, avoid the missed diagnosis of small lesions and is helpful to shorten the examination time.
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Objective To find out whether NOTCH receptors can serve as direct downstream targets of transforming growth factor β(TGF-β)/Smad4 signaling in endothelial cells.Methods Real-time PCR and Western blotting were performed to verify whether the expression of notch1 and notch4 was regulated by TGF-β pathway.Luciferase reporter assay was employed to investigate how the promoter of notch1 and notch4 was regulated by TGF-β.Then, ChIP assay was used confirm whether the promoter of notch1 and notch4 physically interacted with SMAD protein.Results TGF-β1 and bone morphogenetic protein 4 (BMP4) treatment increased the expression of both notch1 and notch4 at the transcriptional level.In addition, SMAD4 was physically associated with the SMAD binding sites on the notch4 promoter, which was largely enhanced under the treatment of TGF-β1 and BMP4.Importantly, TGF-β1 and BMP4 failed to transactivate notch4 in the absence of endogenous SMAD4 or the SMAD binding regions on the notch4 promoter.Conclusion The expression of NOTCH receptor can be directly up-regulated by SMAD4-mediated TGF-β/BMP signaling in cerebrovascular endothelial cells.
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Objective To investigate the multi -slice CT angiography(MSCTA)findings and explore the clinical value of cavernous transformation of the portal vein(CTPV).Methods CT and clinical materials of 29 cases CTPV were retrospectively analyzed.Results Portal vein obstruction and surrounding fine dialated portoportal collat-erals were found in all 29 cases,Gastroesophageal varices and abnormal hepatic perfusion signs were detected in 25 patients and 8 cases respectively.Pericholedochal venous plexus and cystic vein were dilated and varicose in 9 cases. Conclusion Multi -slice CT has an important clinical role in CTPV diagnosis and treatment,and it can be used to evaluate the the portal vein obstructed status,the collateral vessels,and the accompanied complications of CTPV.
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Objective To study the application of pulmonary angiography and reconstruction techniques with 16-detector row spiral CT in the diagnosis of pulmonary embolism (PE) in the elderly.Methods Twenty-four elderly patients with suspected pulmonary thromboembolism received detection of CT and pulmonary artery angiography ( CTPA ) on 16-detector MSCT.Post-reconstruction techniques included maximum intensity projection (MIP), volume rendering (VR)and multiple planar reformation (MPR). Results A total of 161 pulmonary artery thrombi were detected in 24 elderly patients. The direct signs of pulmonary embolism included total occlusion (16.8%, 27/161), partial filling defect (67.7%, 109/161) and central filling defect or track sign (15.5%, 25/161). A total of 161 pieces of pulmonary thrombi were detected in transect image, 153 (95.0%) in MPR, 113 (70.2%) in MIP and 69 (42.9%) in VR. The transect image excelled evidently MIP and VR image in displaying pulmonary thrombi, especially the thrombi in pulmonary lobe and pulmonary artery branch (χ2 =235.36 and 243.41, P＜0.05). Conclusions The 16-detector row spiral CT pulmonary angiography is non-invasive, fast and high sensitive, it should be the first choice for the diagnosis of PE in the elderly.
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ObjectiveTo evaluate the effect of N-acetylcysteine (NAC) on alleviating hepatorenal damage caused by combined chemotherapy using cisplatin-based regiments in elderly patients. MethodsAll 40 elderly patients with malignant tumors were randomly divided into AB and BA group in cross-over pattern. In AB group, combination of chemotherapy and NAC was administrated for 10 days first, and then combination of chemotherapy, carnine and vitamin C was given for 10 days. In BA group, combination of chemotherapy, earnine and vitamin C was administrated for 10 days first, and then combination of chemotherapy and NAC was given for 10 days, a cycle was 21 days. The hepatorenal damage degree was observed and the curative effect of NAC on hepatorenal damage was evaluated. ResultsThere were no differences in the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and serum creatinine(Cr) between pre chemotherapy and post chemotherapy in A cycle[(25.32±5.23) U/L vs. (29.18±5.43) U/L,(29.21±6.51)U/L vs. (32.37±7. 13)U/L, (89.87±19.56)Mmol/L vs. (95.22±20. 60)μmol/L,all P>0. 05] . In B cycle, the levels of ALT,AST and Cr were (56.76±5.53) U/L, (48.83±6.64)U/L and (137.33±21.16)μmol/L post chemotherapy, respectively, which were evidently higher than pre chemotherapy[(26.19 ± 5.51) U/L, (29.95±6.56) U/L and (88.66±18.27)μmol/L,respectively] (all P<0.01) . ConclusionsNAC has better preventive and therapeutic effects on hepatorenal damage caused by the chemotherapeutic drugs in elderly patients with malignant cancer.
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Objective To study the correlation between the main parameters and the effect of repression in MR fluid attenuated inversion recovery(FLAIR).Methods 0.5 unit was used in this experiment.The protein aqua of different material appearance and concentration was prepared.FLAIR was performed using the tube imitative experimented method and with different paramters.The best scan parameters were selected by comparison each other and their relativity was analysed.Results The best technical parameters:TR=4000~5000 ms,TE=90~100 ms,TI=1800~2000 ms.Conclusion TI is the key parameter in determining the repression effect,TR and TE only determine the scans time and layer number.FLAIR's repress result is stable,and it can estimate the protein content in the protein aqua.
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Objective To study CT and MRI findings of the spongiform myelinopathy in poisoning by heroin.Methods CT and MRI findings in 6 patients with spongiform myelinopathy in poisoning by heroin were retrospectively analyzed with review of literature.Results The lesions were located in white matter,they were multiform and symmetrically distributed.On plain CT scans,the lesions were low density.On MRI,the lesions were low signal on T1WI and high signal on T2WI.The border of lesions was clear or not and no enhancement appeared.MRI is precedent of CT in the diagnosis of this disease,totally 55 focal lesions in the brain ,4 in midbrain and 8 in cerebellum were displayed by MRI.Conclusion CT and MRI findings of the spongiform myelinopathy in poisoning by heroin are more characteristic,according to the drug taking history and central nervous system symptom of patients,differentiating this disease from the other demyelinating disease is not difficult.