Cerebral amyloid angiopathy (CAA) is an age-dependent disease affecting older subjects. CAA is characterized by lobar intracerebral hemorrhage (ICH), lobar cerebral microbleeds (CMBs), nontraumatic subarachnoid hemorrhage, and cortical superficial siderosis (cSS), which is the main causes of spontaneous intracranial hemorrhage in the elderly. If a patient had experienced dementia, psychiatric symptoms, recurrent or multiple lobar hemorrhage, the possibility of CAA should be considered. Epilepsy can be associated with CAA. Literature studies had found that CAA-related inflammation are predisposing factors for the development of epilepsy. It is a unique subtype of CAA, which is a form of inflammation and a rare clinical manifestation of sporadic CAA. CAA-ri is a special type of central nervous system vasculitis. Once CAA patients had exhibited atypical clinical manifestations, such as headache, epilepsy, behavioral changes, focal neurological signs, consciousness impairment combined with asymmetric T2 weighted magnetic resonance imaging high signal lesions, clinicians had to consider it maybe CAA-ri. Although CAA- ri is rare, timely diagnosis is important because once seizure had occured, which may indicated the inflammation in CAA patients may had reached a very serious level. Therefore, timely identification and treatment are particularly important. Literature shows that most patients responded well to immunosuppressants. Because of its uncommon, researches on epilepsy in CAA mainly focused on case reports currently, and there were many controversies about its pathological mechanism, treatment and prognosis. This article mainly reviews the incidence rate , pathological mechanism, treatment and prognosis of epilepsy in CAA.
Objective To analyze hospitalization cost, length of stay, cost composition, hospital-level differences, and mortality burden of solid tumors related to general surgery in Sichuan Province. MethodsData were obtained from publicly released Sichuan Health Statistical Yearbooks. Six hospitalization-cost diseases closely related to general surgery were included: nodular goiter, acute appendicitis, acute cholecystitis, inguinal hernia, gastric cancer, and esophageal cancer. The solid tumor burden analysis included gastric cancer, esophageal cancer, colorectal cancer, liver cancer, pancreatic cancer, and breast cancer. Hospital admissions, bed occupancy rate, average length of stay, and average inpatient expenditure were used as contextual indicators for surgical inpatient services. Descriptive statistics, proportions, hospital-level cost ratios, and 2019-based indices were performed. Results① General surgery-related disease. In 2023, acute appendicitis (90 353 discharges) and inguinal hernia (61 237 discharges) had the largest discharge volumes among the six hospitalization-cost diseases, with average inpatient costs of 8 243.59 yuan and 9 648.75 yuan, respectively. Gastric cancer and esophageal cancer had longer average length of stay (12.96 days and 12.51 days, respectively) and higher average inpatient costs (30 162.44 yuan and 24 310.18 yuan, respectively). Hospital-level cost differences were most evident for gastric cancer (tertiary/county cost ratio: 3.13) and esophageal cancer (tertiary/county cost ratio: 2.73). The cost composition analysis showed that acute cholecystitis had the highest proportion of diagnosis fees (44.2%), inguinal hernia had the highest proportion of material fees (37.1%), and the proportion of material fees for gastric cancer and esophageal cancer were 29.5% and 27.5%, respectively. ② Solid tumors in general surgery. In 2023, the crude mortality rates of solid tumors related to general surgery, ranked from highest to lowest, were as follows: liver cancer (14.25 per 100 000), colorectal cancer (13.61 per 100 000), esophageal cancer (8.06 per 100 000), gastric cancer (8.00 per 100 000), breast cancer (6.56 per 100 000), and pancreatic cancer (6.46 per 100 000). ③ Hospital inpatient service background. In 2023, hospital admissions in Sichuan Province were 16.364 1 million, increasing by 17.03% compared with 13.982 7 million in 2019. The average length of stay decreased from 10.28 days in 2019 to 9.71 days in 2023, a decrease of 5.54%. The hospital bed occupancy rate was 86.01%, a 3.76% decrease from 89.37% in 2019. The average inpatient cost per discharge increased by 0.88%, from 8 528.00 yuan in 2019 to 8 602.67 yuan in 2023. ConclusionGeneral surgery-related diseases in Sichuan Province are characterized by coexistence of high-volume short-stay diseases, high-cost tumor diseases, and solid tumors with high mortality burden.
目的 探討重組人p53腺病毒(recombinant human p53 adenovirus, rAd-p53)在脊柱轉移瘤的治療中的近期療效。 方法 2006年6月-2009年8月，以經皮注射rAd-p53聯合放療及單獨放療方法治療肺鱗狀細胞癌來源脊柱轉移瘤患者各18例，通過比較兩組治療前后的腫瘤體積變化評價療效，觀察兩組治療后腫瘤細胞壞死率情況，檢測P53蛋白在癌組織中的表達以及血清中抗特異p53基因腺病毒抗體水平。 結果 聯合治療組療效評定有效率為66.7%，高于單獨放療組的27.8%，差異有統計學意義(Plt;0.05)。聯合治療組可見明顯腫瘤細胞壞死、P53蛋白表達陽性及血清中抗特異p53基因腺病毒抗體水平強陽性。 結論 rAd-p53基因治療能抑制腫瘤生長，聯合放療可彌補單一放療的不足，提高放療的敏感性，有效治療脊柱轉移瘤。
Objective To study the effect of signal-selective parathyroid hormone (PTH) analogue peptide on Wnt signal ing factors in osteoblasts isolated from neonatal mouse, and provide theoretical basis for the mechanism of PTH’s function in bone metabolism. Methods Osteoblasts were isolated from calvaria of 2-3-day-old C57BL neonatal mouse and identified by alkal ine phosphatase (ALP) staining, and Alizarin red staining. The cells at passage 1 were divided into 4 groups: control group, PTH (1-34) group, G1R19 (1-34) group, and G1R19 (1-28) group. Then the medium was changed to α-MEM supplemented with 1%FBS. After 12 hours, trifluoroacetic acid or three peptides [(10 nmol/L PTH (1-34), 10 nmol/L G1R19 (1-34), and 100 nmol/L G1R19 (1-28)] were added into the culture medium. After 4 hours, the cells were washed gently ithcold PBS 3 times before total RNA was isolated. The expressions of Wnt related genes were measured by quantitative eal-time PCR. Results Most of the cells were polygonal and triangular; the cells were positive for ALP staining with blue cytoplasm at 14 days and the Al izarin red staining showed the formation of red mineral ized nodules in the special mineral ization induction medium at 28 days. The expressions of osteocalcin mRNA and Wnt5b mRNA in PTH (1-34) group, G1R19 (1-34) group, and G1R19 (1-28) group were significantly higher than those in control group (P lt; 0.05); the expression of Wnt2 mRNA was significantly lower than that in control group (P lt; 0.05); the expression of β-catenin mRNA in PTH (1-34) group was significantly higher than that in control group (P lt; 0.05); the expression of Wnt7b mRNA in PTH (1-34) group and G1R19 (1- 34) group was higher than that in control group, and the G1R19 (1-34) group was higher than PTH (1-34) group and G1R19 (1-28) group (P lt; 0.05). Conclusion In the Wnt-related factors, PTH (1-34) and G1R19 (1-34) affect mainly canonical Wnt signal factors, but the G1R19 (1-28) chiefly acts on non-canonical Wnt signal factors.