Motivation: Excessive subcortical metal deposition seen on susceptibility imaging has suggested a characteristic pattern in neurological Wilson’s disease (NWD). Goal(s): To develop a novel imaging biomarker of NWD using 7T SWI. Approach: WD patients, monoallelic ATP7B variant carriers, health controls, and patients with comparable clinical or imaging manifestations were recruited for development of a novel biomarker of NWD and exploratory comparative analysis. All underwent 7T SWI with quantitative susceptibility mapping and principal component analysis performed. Results: The novel biomarker of NWD termed "hyperintense globus pallidus rim sign" showed high diagnostic accuracy. It revealed a special metal deposition pattern in the lenticular nucleus in NWD. Impact: A novel imaging biomarker of neurological Wilson’s disease (NWD) termed "hyperintense globus pallidus rim sign" could aid the diagnosis and monitoring of NWD.
AIM:To construct a DNA vaccine encoding human alphafetoprotein (hAFP)/heat shock protein 70 (HSP70), and to study its ability to induce specific CTL response and its protective effect against AFP-expressing tumor. METHODS:A DNA vaccine was constructed by combining hAFP gene with HSP70 gene.SP2/0 cells were stably transfected with pBBS212-hAFP and pBBS212-hAFP/HSP70 eukaryotic expression vectors.Mice were primed and boosted with DNA vaccine hAFP/HSP70 by intramuscular injection, whereas plasmid with hAFP or HSP70 was used as controls.ELISPOT and ELISA were used to detect IFNγ-producing splenocytes and the level of serum anti-AFP antibody from immunized mice respectively.In vivo tumor challenge was measured to assess the immune effect of the DNA vaccine. RESULTS:By DNA vaccine immunization, the results of ELISPOT and ELISA showed that the number of IFN-γproducing splenocytes and the level of serum anti-AFP antibody were significantly higher in rhAFP/HSP70 group than in hAFP and empty plasmid groups (95.50±10.90IFN-γ spots/10 6 cells vs 23.60±11.80IFN-γ spots/10 6 cells, 7.17±4.24IFN-γ spots/10 6 cells, P<0.01; 126.50±8.22µg/mL vs 51.72±3.40µg/mL, 5.83±3.79µg/mL, P<0.01).The tumor volume in rhAFP/HSP70 group was significantly smaller than that in pBBS212-hAFP and empty plasmid groups (37.41±7.34mm 3 vs 381.13±15.48mm 3 , 817.51±16.25 mm 3 , P<0.01). CONCLUSION:Sequential immunization with a recombinant DNA vaccine encoding AFP and heat shock protein70 could generate effective AFP-specific T cell responses and induce definite antitumor effects on AFP-producing tumors, which may be suitable for some clinical testing as a vaccine for HCC.
Objective To evaluate the efficacy and safety of ureteroscopic endo-incision and drainage in the treatment of renal cysts.Methods Thirty cases(19 females and 11 males)of renal cysts(1 1 parapelvie cysts,15 simple cysts.and 4 multiple cysts)were treated with ureteroscopic endo-incision and drainage.The renal cysts were located in renal pelvis,and opened and decompressed by electrotme with ureteroscope.Double J stent was placed afterwards.Urinary and blood biochemistry were tested post-operatively.Results All the operations were successfully completed with no severe complication.The cyst managing time ranged from 15 tO 45 min.Urinary biochemistry(urinary protein and glucose)turned normal 1 2 days after the surgery.Patients were followed up for 3 to 9 months.Renal cysts disappeared in 24 cases,diminished in 4 cases,and recurred in 2 cases.Conclusion Application of ureteroscopic technique in the treatment of renal cyst is safe,effective and minimally invasive.
Key words:
Renal cysts; Surgical procedures,ureteroscopic; Endo-incision; Drainage
The aim of this study was to investigate the long-term results of computed tomography (CT)-guided percutaneous radiofrequency thermocoagulation (PRT) for glossopharyngeal neuralgia (GPN). A retrospective review of medical records for patients with GPN who were treated with CT-guided PRT between 2003 and 2014 was performed to investigate baseline characteristics and immediate outcomes during the hospitalization. Long-term pain relief outcomes and complications were obtained via telephone survey. Duration of pain-free was assessed by Kaplan–Meier analysis. Eighty patients with GPN were treated with CT-guided PRT, and 71 patients could be contacted for the follow-up. The mean length of follow-up after PRT was 56.2 ± 43.3 months. Pain relief occurred in 63 patients (78.8%) immediate after the PRT procedure. The percentage of patients who remained in an “excellent” or “good” pain relief condition was 73.2%, 63.0%, 53.2%, and 43.0% at 1, 3, 5, and 10 years. Postprocedure complication included dysesthesias, dysphagia, and diminished gag reflex. No mortality was observed during or after PRT procedures. This study indicates that CT-guided PRT is a safe and effective method for patients with GPN and should be considered as an alternative treatment for these patients.
Esophagopericardial fistula (EPF) is an uncommon complication of esophageal disease. Although, the esophagus is in direct contact with the pericardium in the lower thoracic vertebrae level, EPF is still rare. Recorded causes of EPF include ingested foreign bodies such as fish bone, benign ulceration in association with hiatus hernia, esophageal carcinoma, and achalasia. Congenital EPF occurs even less but with a high ratio of mortality and misdiagnosis. We present a case of PEF in a 1-year-old boy. It is unique in that the patient was a very young child which is rarely reported in literature and the main cause factor seemed to be repeated vomiting since birth. However, he had a good outcome with surgical treatment.
Objective To investigate the role of xenogenic (porcine) ADM as dermal substitute in scar treatment. Methods After scar excision, the wounds were covered with composite grafts of DR procine ADM and autologous thin split-thickness grafts in one stage or in two stages. Results 22 out of 47 cases were treated in two-staged procedure. After the ADMs were applied to the wound, the autologous thin split-thickness grafts were implanted 7 days later. 25 cases were treated in one-staged procedure. The survival rates of composite grafts were (88.3 +/- 3.7)% for subcutaneous recipient bed and (89.7 +/- 3.4)% for deep fascia recipient bed in group with two-staged procedure, compared with (92.5 +/- 4.1)% and (93.2 +/- 5.2)%, respectively, in group with one-staged procedure. Early after grafts taken, the grafts had a pink colour and smooth surface. The patients were followed up for 90 days at most. The survived composite grafts were durable, elastic, smooth and soft with good function and appearance like normal skin. They could even be pinched up. The scar along the edge of the grafts was slightly hypertrophic. Conclusions The survival rate of composite graft is higher in patients with one-staged procedure. The elasticity and textural of the taken grafts are better on subcutaneous recipient bed than on deep fascia recipient bed, though the function has no difference. Xenogenic (porcine) ADM can be an optimal dermal substitute for wound coverage after scar excision.
Objective
To observe the curative effect of percutaneous transvascular stenting on elderly patients with lower extremity arteriosclerosis obliterans.
Methods
A retrospective analysis of 46 patients with lower extremity arteriosclerosis obliterans admitted to Shenzhen Hospital of Traditional Chinese Medicine from July 2014 to January 2018 was made. The patients were randomly divided into control group and observation group, with 23 cases in each group. Percutaneous balloon angioplasty was used in the control group, and percutaneous balloon angioplasty and stenting were used in the observation group. The clinical effects and complications of the two groups were compared. And the ankle brachial index and claudication distance were compared, when the patients had been followed up for 6 months and 12 months.
Results
The clinical effective rate of the observation group (95.65%) was higher than that of the control group (73.91%), and the difference was significant(P<0.05). The incidence of complications in the observation group (4.35%) was lower than that in the control group (26.09%), and the difference was significant (P<0.05). The sputum index and the sacral distance 6 months and 12 months after treatment in the two groups were significantly improved with the prolongation of the postoperative time. The sputum index and the claudication distance of the observation group were significantly higher than the control group, and the difference was significant (P<0.01).
Conclusions
In elderly patients with lower extremity arteriosclerosis obliterans, percutaneous balloon angioplasty combined with endovascular stenting can effectively improve the clinical treatment effect, reduce the incidence of postoperative complications, and improve the postoperative index and claudication distance with ideal effects.
Key words:
Percutaneous balloon angioplasty; Endovascular stenting; Elderly lower extremity arteriosclerosis obliterans; Efficacy analysis
Objective
To investigate the effects of real-time feedback devices on chest compression quality test in non-medical staff during cardiopulmonary resuscitation (CPR) training.
Methods
A total of 120 volunteers were recruited and trained according to American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care set in 2015. CPR performance with compression for six minutes was tested on a manikin. Volunteers were randomized into 3 groups. Group A was tested without any feedback. Group B was self-corrected in compression quality(include compression depth、rate and rebound of chest wall) using a real-time feedback device (Link CPR) . Group C was guided with a metronome. All compression data were collected via WiFi signal and stored.
Results
Significantly better mean chest compression depth was achieved in group B than that in group A and C(5.38±0.483 cm vs. 4.42±0.572cm and 4.25±0.843 cm, P < 0.05).Significantly better compression rate were observed in both group B and C than that in group A ( 113.4±5.9 and 109.0±6.8 compressions/min vs. 129.6±8.3 compressions/min, P < 0.05). Significantly less rebounding were observed in both group B and C compared with group A (56.10±32.3 and 68.30±28.8 compressions vs. 174.30±38.8compressions, P < 0.05). Pearson correlation analysis confirmed the compression rate was positively correlated with the numbers of rebounding (r=0.776, P<0.01). Significant statistical difference in accuracy was observed among the groups (9.8% vs. 72.9% vs. 58.5%, P < 0.05).
Conclusions
In CPR training test real-time feedback device contributes to the improvement of chest compression quality through self-adjustment of compression depth, rate and rebound.
Key words:
Out-of-hospital cardiac arrest; Cardiopulmonary resuscitation; Training; Feedback device; Compression quality
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