简介:AbstractObjective:Scoping review of published literature to establish clinical characteristics and audiologic outcomes in patients diagnosed with Susac’s Syndrome(SS) who have undergone cochlear implantation (CI).Data sources:All published studies of CI in SS and contribution of two of our own patients who have not been reported previously.Methods:A comprehensive search of MEDLINE (via PubMed) was carried out in March 2020 using the following keywords and related entry terms: Susac’s Syndrome, Cochlear Implantation. Results: Our search identified a total of five case reports of CI in SS. With the addition of our two patients reported here, we analyzed characteristics and outcomes in seven patients. Mean age at implantation was 30 years old (range 19-46), with six women and one man implanted. Mean time from onset of hearing loss to implantation was 17 months (range three months to four years). Best reported postoperative speech understanding was reported via different metrics, with six of seven patients achieving open set speech scores of 90% or better, and one subject performing at 68%. Vestibular symptoms were present preoperatively in four of seven patients (57%), with vestibular testing reported in two patients, and showing vestibulopathy in one patient. No complications were reported following cochlear implantation.Conclusion:Cochlear implantation is a viable option for hearing rehabilitation in patients with SS, with levels of attainment of open set speech comparable to other populations of CI candidates.
简介:AbstractThe main treatments for Parkinson’s disease (PD) currently include surgery, rehabilitation, and most commonly, drug therapy. However, the drugs that are currently used to treat PD provide only symptomatic relief and delayed disease progression but have no curative effect and cause many adverse reactions. When considering pathogenic factors and metabolic regulation, PD and type 2 diabetes have a high rate of comorbidity; this provides a theoretical basis for the treatment of PD with first-line antidiabetic drugs. Among these agents, metformin reduces neuronal damage in the brains of PD patients via neuroprotection and the inhibition of oxidative stress and inflammatory responses, thus providing a novel strategy for the clinical treatment of PD. Here, we present the current state of knowledge about the use of metformin to treat PD and discuss its clinical prospects.
简介:ThehistogensisofextramammaryPaget’sdiseasehasnotbeensolvedandremainedcontroversial.EightcasesofextramammaryPaget’sdiseaseofgeni-tocruralregionwereinvestigatedbyalcianblueandPASstainandimmunoreactionofanti-CEAandanti-keratin.Itwasfoundthatthepatternandintensityofalcianblue,PASstainingwereidenticalforPagetcellsandsecretorycellsofapocrinesweatgland;andCEAimmunoreactivitywasuniformlyobservedinbothPagetcellsandeccrinesweatgland.Thekeratinimmunoreactionwaspositiveinkeratinocytes,apocrineandeccrinesweatgland,whereasPagetcellswerenegative.TheseresultssuggestedthatPagetcellsofextramammaryPaget’sdiseasecouldbederivedfrommultipotentialepidermalgermcells.
简介:StandardTherapyforHeartFailureUntilnowtheprincipalfocusofheartfailuretherapyhasbeenonthesympatheticnervoussystemandtherenin-angiotensinsystem.Betablockadecounterstheunwantedeffectsofcatecholaminesonthemyocardiumaswellasmoderatelyreducingafterload.Sinceangiotensinisavasoconstrictorandhassometoxiceffectonthemyocardium,bothcontributingtoheartfailure,inhibitionoftherenin–angiotensinsystemhasbeenlogicaltherapyforheartfailure.However,useofangiotensinconvertingenzyme(ACE)inhibitorsmayincreasebradykininlevels,whichareresponsibleforthecoughthatmaybeassociatedwiththeiruseaswellasangioedemathatmayresultfromthesamemedications.
简介:ObjectivesToevaluateperipheralauditorydysfunctioninseniledementiaofAlzheimer'sdisease(AD)anditsrelationshipwithcognitivedysfunction.MethodsPuretonethresholds,wordrecognitionscores(WRS),acousticimmittanceandauditorybrain-stemresponses(ABR)weretestedtoevaluatetheauditoryfunctionin43ADpatientsand50normalsubjects.ThetestreliabilityinthesesubjectswasexaminedbeforethetestresultswereevaluatedfortheircorrelationwiththeMiniMentalStateExamination(MMSE)score.ResultsTherewerenostatisticallysignificantdifferencesinperipheralauditoryfunctionsbetweenthetwoearsinthetestedsubjectsorbetweenthetwogroupswhentheauditometricresultsoftherightearwerecompared(P>0.05).Also,therewerenostatisticallysignificantdifferencesbetweenthetwogroupswhenaudiometrictestreliability,acousticimpedanceandABRresultswerecompared(P>0.05).ConclutionsThepuretoneaudiometricthresholdandWRSinADpatientsaresimilartothoseincomparablenon-ADsenilesubjects.Peripheralauditorydysfunctionisnotrelatedtocognitivedysfunction.
简介:摘要目的探讨完全后腹腔镜经膀胱外途径规范化直视下(P.R.E.S.S.)膀胱袖套状切除术的操作要点和疗效。方法回顾性分析2017年8月至2020年12月收治的95例上尿路尿路上皮癌(UTUC)患者的病例资料,分别为海军军医大学长征医院30例,北京大学第一医院21例,烟台毓璜顶医院20例,大连医科大学附属第二医院21例,东部战区总医院3例。男57例,女38例。平均年龄(67.7±10.0)岁。中位肿瘤最大径3.0 cm。95例均行单次体位全程后腹腔镜肾输尿管全长切除联合P.R.E.S.S.技术膀胱袖套状切除术,根据术者手术习惯和经验分别采用四孔法(36例)和五孔法(59例)套管布局完成手术。四孔法组和五孔法组的年龄[(66.3±11.2)岁与(68.6±9.1)岁]、性别(男/女:25/11例与32/27例)、体质指数[(25.0±3.0)kg/m2与(24.8±3.4)kg/m2]、肿瘤最大径[2.8(1.6,3.5)cm与3.0(2.0,4.0)cm]、肿瘤侧别(左/右:19/17例与34/25例)、临床分期(T1~2/T3~4/Tis期:25/10/4例与49/10/0例)、多灶性肿瘤(3例与2例)比较差异均无统计学意义(P>0.05);术侧合并肾积水(13例与39例,P=0.004)、肿瘤位置(肾盂肾盏及上段输尿管/中段输尿管/下段输尿管:23/9/4例与35/4/20例,P=0.005)的差异均有统计学意义。术中行P.R.E.S.S.技术膀胱袖套状切除时,以脐动脉索为解剖标志,扩大输尿管周围的盆底侧方腹膜外间隙,切开膀胱壁后形成气膀胱效应,进行充分的膀胱袖套状切除和确切的膀胱袖口关闭。记录围手术期临床指标及随访结果。比较四孔法组和五孔法组的相关临床指标,分析套管布局方式对手术操作的影响。结果本研究95例中,91例(95.8%)采用P.R.E.S.S.技术完成膀胱袖套状切除;1例(1.1%)因出血中转开放手术;3例(3.1%)因局部空间显露困难,仅以Hem-o-lok夹闭输尿管远端完成手术。手术时间中位值180(125,230)min。术中估计出血量中位值100(50,100)ml。总体并发症发生率10.5%(10/95),其中术中并发症2例(2.1%)均为出血,1例术中输血400 ml,1例中转开放手术,未输血;术后并发症8例(8.4%),其中Clavien-DindoⅡ级7例[继发出血3例,药物过敏、急性肾功能减退(血肌酐490 μmol/L)、肺部感染及淋巴漏各1例],Ⅲa级1例(肠梗阻,局麻下置入肠梗阻导管),患者经对症治疗后均顺利出院。四孔法组和五孔法组在手术中转率[8.3%(3/36)与1.7%(1/59)]、术中估计出血量(100 ml与60 ml)、术中淋巴结清扫率[25.0%(9/36)与20.3%(12/59)]、P.R.E.S.S.技术膀胱袖套状切除成功率[91.7%(33/36)与98.3%(58/59)]、并发症发生率[13.8%(5/36)与8.5%(5/59)]、肿瘤病理分期(pT1~2/pT3~4/pTis期:22/11/3例与37/19/3例)以及复发转移比例[8.3%(3/36)与3.4%(2/59)]方面差异均无统计学意义(P>0.05);在手术时间(190 min与170 min,P=0.011)和术后住院时间(5 d与6 d,P=0.005)方面差异均有统计学意义。结论P.R.E.S.S.技术通过建立扩大的盆底侧方腹膜外间隙和气膀胱效应,以脐动脉索为解剖标志,可直视下确切地行膀胱袖套状切除术,用于单次体位完全后腹腔镜肾输尿管全长切除术安全、可行。五孔法布局较四孔法布局更适用于下段输尿管肿瘤患者,但可能延长术后住院时间。
简介:目的:探讨S100A8、S100A9在子宫颈鳞癌及正常宫颈组织中的表达及其意义。方法:采用半定量的RT-PCR技术和免疫组织化学的方法,从mRNA及蛋白水平检测32例子宫颈鳞癌和15例正常宫颈组织中S100A8、S100A9的表达,及与不同临床病理参数的关系。结果:子宫颈鳞癌组织中,S100A8、S100A9在mRNA及蛋白水平上均低表达(P<0.05),其中,低分化肿瘤的表达明显低于高、中分化肿瘤(P<0.05)。结论:S100A8、S100A9在子宫颈鳞癌组织中低表达,且可能与鳞状细胞的分化程度相关。提示S100A8、S100A9低表达可能与子宫颈鳞癌的发生发展有关系。
简介:摘要目的探讨微小RNA-101a(miRNA-101a)是否通过调控肌醇需要酶1α蛋白(IRE1α)信号通路介导肝星状细胞活化以及对肝纤维化的影响。方法建立CCl4诱导的小鼠肝纤维化模型,实时定量PCR检测肝组织中miRNA-101a的表达,Western印迹法检测α平滑肌肌动蛋白(αSMA)、I型胶原、IRE1α的蛋白表达。肝星状细胞(HSC)-T6处理分为HSC组、转化生长因子(TGF)β1活化组、TGFβ1+miRNA-NC组(转染miRNA-101a空白对照质粒)和TGFβ1+miRNA-M组(转染miRNA-101a模拟质粒)。给予对应干预后,检测各组间miRNA-101a、αSMA、I型胶原和IRE1α的表达差异。结果与对照组小鼠相比,实验组小鼠肝组织中纤维沉积明显[(0.17±0.06)%比(2.09±0.39)%],miRNA-101a相对表达水平下调[(1.00±0.05)比(0.43±0.05)],差异有统计学意义(均P<0.001);而且实验组小鼠肝组织αSMA、I型胶原及IRE1α蛋白相对表达水平上调[(1.00±0.23)比(4.09±0.80)、(1.00±0.21)比(4.98±1.19)、(1.00±0.24)比(3.27±0.65)],差异有统计学意义(均P<0.001)。TGFβ1处理抑制HSC-T6细胞miRNA-101a表达,诱导HSC-T6活化,导致αSMA、I型胶原以及IRE1α蛋白表达上调;TGFβ1+miRNA-M组中miRNA-101a表达水平(1.89±0.20)明显高于TGFβ1+miRNA-NC组(0.59±0.19),差异有统计学意义(P<0.001)。过表达miRNA-101a后,αSMA、I型胶原蛋白表达明显降低[(2.65±0.69)比(0.84±0.13)、(3.15±0.59)比(1.31±0.25)],差异有统计学意义(均P<0.05);IRE1α蛋白表达亦下调[(2.63±0.47)比(1.03±0.15)],差异有统计学意义(P<0.001)。结论miRNA-101a可能通过抑制IRE1α信号通路抑制肝星状细胞活化和肝纤维化形成。
简介:摘要目的探讨复合凝乳酶胶囊联合生大黄粉治疗早产儿喂养不耐受的疗效及相关不良反应。方法复合凝乳酶组(A组,31例)给予复合凝乳酶1粒/次,将胶囊内容物取出,加1ml温开水冲服,2次/天,于奶后30分钟喂入;生大黄粉组(B组,30例)给予生大黄粉10mg/kg.次,温开水3ml冲服,2次/天,于奶前30分钟喂入;联合治疗组(C组,40例),同时给予复合凝乳酶胶囊和生大黄粉,用法及剂量同前。A组、B组、C组疗程1周。结果C组腹胀、胃潴留消失时间、足量胃肠喂养日龄和住院时间与A组和B组比较,差异有统计学意义(P<0.01)。结论复合凝乳酶联合生大黄粉治疗早产儿喂养不耐受疗效显著,优于单用复合凝乳酶或生大黄粉治疗,且未见明显不良反应。
简介:摘要目的对比研究多发或巨大子宫肌瘤患者采用腹腔镜子宫肌瘤剔除术和传统开腹剔除术两种方式进行治疗的临床效果。方法选择在我院手术的78例多发或巨大子宫肌瘤患者,分成对照组和治疗组,每组39例。对照组采用传统开腹剔除术进行治疗;治疗组采用腹腔镜子宫肌瘤剔除术进行治疗。结果;治疗组患者子宫肌瘤手术治疗总有效率为92.3%,对照组71.8%(P<0.05);术后不良反应仅有1例,少于对照组的5例(P<0.05);术后住院时间短于对照组(P<0.05)。结论多发或巨大子宫肌瘤患者采用腹腔镜子宫肌瘤剔除术治疗,能够缩短住院时间,减少不良反应。
简介:1.Whickarethetreatmentalprinciplesofacupuncture?(1)Reinforcingtechniquesareusedforde-ficiencysyndromesandreducingtechniquesareusedforexcesssyndromes.(2)Clearingmethodisusedforheatsyn-dromesandwarmingmethodisusedforcoldsyndromes.