ObjectiveTo investigate the classification of seizures, etiology,EEG examination, treatment and prognosis of senile epilepsy. MethodsThe clinical data of 92 senile epileptsy patients in the Second Affiliated Hospital Of Chongqing Medical University from January 2012 to September 2015 were retrospectively analyzed. ResultsFrom the selected sample,15 cases suffered from SPS(16.3%),22 cases suffered from CPS(23.9%),40 cases suffered from GTCS(43.5%),4 cases suffered from partial seizures with secondary generalization(4.3%),11 cases suffered from both partial seizures and generalized seizures(12.0%).The common causes include cerebrovascular disease (57.6%),intracranial tumors (10.9%), degenerative brain diseases (7.6%) and so on.The abnormal ratio of REEG and AEEG was 87.1% and 91.7% respectively.The ratio of typical epileptiform activity in the REEG and AEEG was 22.6% and 70.8% respectively.82 cases(89.1%) were treated with AED,but only 69 cases had been taking orally AED among the patients treated with AED.57 cases(82.6%) were on monotherapy.55 cases (67.1%) were controlled effectively with drug treatment,11 cases (13.4%) were ineffective and 16 patients (19.5%) died. Advanced age was the important cause of death. Age was positively correlated with the fatality rate.9 cases(10.9%) appeared side effect,the frequency of sleepiness was the highest among all the adverse reactions. ConclusionThe majority of senile epilepsy suffer from symptomatic epilepsy.The main cause is cerebrovascular disease,the generalized tonic-clonic seizures constituted a high proprotion in the sample.The ratio of typical epileptic discharge in the REEG was low from senile patients with epilepsy,we recommend the AEEG examination in the senile patients suspected with epilepsy. AED has excellent therapeutic effects in senile epileptics,and a few patients appeared light adverse reactions.
ObjectiveTo investigate the clinical features and prognosis of patients with choroidal tuberculoma. MethodsA retrospective and observational study. From 2011 to 2022, 15 patients (16 eyes) with choroidal tuberculoma diagnosed and treated in Department of Ophthalmology, Shanghai Eye & ENT Hospital of Fudan University were included. The patients underwent examinations including best corrected visual acuity (BCVA), fundus color photography, optical coherence tomography (OCT), fluorescein fundus angiography (FFA), and indocyanine green angiography (ICGA). Chest CT examination, purified protein derivative test and interferon-γ release test were also performed. BCVA was performed using the Snellen visual acuity chart, which was converted to Logarithm of the minimum angle of resolution (logMAR) visual acuity when recorded. All the patients received antitubercular therapy and the duration was 12-15 months. Thirteen patients were combined with oral corticosteroids. The average follow-up time was 36 months. Rank sum test was used to compare logMAR BCVA before and after treatment. ResultsAmong the 15 patients, 5 were male and 10 were female; 1 case was bilateral involvement; 7 patients had a strong positive tuberculin skin test; 8 patients had a positive interferon-γ release assay. Six patients had pulmonary tuberculosis. One patient had peritoneal tuberculosis. Lesions were located in the posterior pole in 12 eyes, 1 eye with papillary tuberculoma. Peripheral lesions were found in 4 eyes. There were 9 eyes each with anterior segment inflammation or vitreous inflammation; 7 eyes were with exudative retinal detachment. OCT examination revealed a hyporeflective thickening of the choroidal stroma, the corresponding elevation of the retina, and often accompanied by subretinal fluid. FFA revealed hyperfluorescence of the mass and fluorescence accumulation with subretinal fluid at the late stage. ICGA revealed hypofuorescence of the lesion. The lesions subsided after treatment, and there was no recurrence during follow-up period. Cataract surgery was performed in 4 eyes due to complicated cataract. One eye undergone vitrectomy due to secondary rhegmatogenous retinal detachment. Anti-vascular endothelial growth factor therapy was performed in 1 eye due to secondary choroidal neovascularization. Ocular wall perforation occurred in 1 eye, and the condition was stable after treatment. Before treatment, the average logMAR BCVA was 1.02±0.57, which improved to 0.31±0.35 after treatment. The difference between the mean logMAR BCVA before and after treatment was statistically significant (P＜0.05). ConclusionsCombination of medical history, clinical manifestations, laboratory tests, and imaging can assist in the diagnosis of choroidal tuberculoma. The main manifestations are subretinal yellowish-white lesions in posterior pole. Standardized anti-tuberculosis therapy can effectively improve the prognosis of vision.
ObjectiveTo explore expressions of the metaherin (MTDH) mRNA and its protein in hepatitis B related hepatocellular carcinoma tissues and its clinical significance. MethodsSeventy two tissues of patients with hepa-titis B related hepatocellular carcinoma who were treated in Affiliated Taihe Hospital of Hubei Medical University from Jul. 2012 to Oct. 2013 were collected retrospectively. Quantitative PCR (Q-PCR) and Western blot methods were used to detect the expression levels of MTDH mRNA and its protein in 10 cases of hepatitis B related hepatocellular carcinoma tissues and pericarcinoma tissues. Besides, immunohistochemistry was used to determine the expression of MTDH protein in 72 cases of hepatocellular carcinoma tissues, then the relationship of expression of MTDH protein and clinico-pathological features was explored. ResultsThe expression levels of MTDH mRNA and its protein in hepatocellular carcinoma tissues were both higher than those of pericarcinoma tissues (8.50±0.84 vs. 4.55±0.81, t=10.797, P=0.000; 0.65± 0.24 vs. 0.25±0.16,t=6.375, P=0.013). The MTDH protein was positively expressed in 42 cases (58.3%) and negatively expressed in 30 cases (41.7%) of hepatocellular carcinoma tissues. The results of logistic regression showed that,MTHD protein was up-regulated in patients with category Ⅲ of Edmondson grade (OR=4.783, 95% CI:2.663-11.918, P=0.020), microvascular invasion (OR=37.790, 95% CI:2.227-99.434, P=0.005), and lymph node metastasis (OR=7.332, 95% CI:3.325-30.669, P=0.023). ConclusionExpressions of MTDH mRNA and its protein are both higher in hepatitis B related hepatocellular carcinoma tissue, which are correlated with poor prognosis.
Objective To investigate the expression of cerb B2 and CathepsinD in gastric carcinoma and its correlation with the biological behavior of gastric carcinoma (GC). MethodsThe expression was studied by immunohistochemical technique. The expression of cerb B2 and CathepsinD were analyzed with their relation to histologic types, depth of invasion, growth pattern, lymph node metastasis and prognosis of gastric carcinoma. ResultsThirtynine of the 102 gastric carcinoma specimens (38.24%) were positive for cerb B2 and correlated with depth of invasion (P＜0.05) and lymph node metastasis (P＜0.05); eightythree of the 102 gastric carcinoma specimens (81.37%) were positive for CathepsinD and correlated with depth of invasion (P＜0.05), growth pattern (P＜0.05), lymph node metastasis (P＜0.05) and blood vessels cancer embolus (P＜0.05). Prognosis of patients with gastric carcinoma with positive expression of cerb B2 or CathepsinD was poor. The 5year survival rate was significantly lower in gastric carcinoma patients with positive expression of cerb B2 or CathepsinD. Conclusion cerb B2 and CathepsinD are highly related to growth, invasion, metastasis and prognosis of gastric carcinoma.
Abstract: Objective To observe the expression of integrinlinked kinase (ILK) and matrix metalloproteinases9 (MMP9) in human nonsmall cell lung cancer (NSCLC) and investigate the correlation of ILK and MMP9 expression with the prognosis of NSCLC. Methods The expression of ILK and MMP9 in 75 specimens of NSCLC resected from January 2002 to January 2004 were detected by immunohistochemistry. According to the median of integral optical density (IOD), all patients were divided into the high or low ILK expression group and the high or low MMP-9 expression group. The relativity of ILK and MMP9 was determined, and the relationship of survival time with clinical features including expression of ILK and MMP-9 was compared by Logrank test. Results Both ILK and MMP-9 were expressed in NSCLC specimens. The expression between ILK and MMP-9 was positively correlated in 75 patients of our group (r=0.79, Plt;0.05). Patients with lower expression of ILK and MMP9 had a significantly longer survival time than those with higher expression of ILK and MMP-9 in the postoperative followup (χ2=15.067,14301,Plt;0.05). The survival time was not correlated with sex,age,smoking history or pathological type(χ2=0450,0078, 1.460, 1.623，Pgt;0.05), while tumor diameter, lymph node metastasis, TNM stage, the expression of ILK and MMP-9 significantly influenced the survival time (χ2=3.963, 15.169,20.529, 15.067，14.301，Plt;0.05). Conclusion The expression of ILK and MMP9 affects the prognosis of NSCLC. MMP-9 may advance infiltration and metastasis of tumor cells through ILK pathway. In summary, the expression of ILK and MMP9 may play an important role in the evaluation of prognosis for patients with NSCLC.
Objective Heparanase can specifically cleave carbohydrate chains of heparan sulphate proteoglycans, which is an important component of the extracellular matrix. This study was designed to investigate the expression of heparanase in patients with colorectal cancer, and to analyze its relationships with progression of the cancer and clinical prognosis. Methods Samples were collected from 36 patients with colorectal cancers from 2003 to 2004 in Peking Union Medical College Hospital, and were embeded by Paraffin and fresh-frozened. The expression of heparanase mRNA and its protein were measured by RT-PCR and immunohistochemistry. The relationships between these expressions and the clinicopathologic information (tumor invasion, tumor differentiation, lymph node involvement, accompanying with colorectal adenoma and 2-year survival) were also evaluated. Results The expressions of heparanase mRNA in colorectal cancer (19/31， 61.3%) were significantly higher than those in normal colorectal tissues (6.5%). The overexpressions in normal tissues were positively correlated to the incidence of adenoma in patients with colorectal cancer （r=0.352， P=0.024）. The result of immunohistochemistry also showed that heparanase mainly expressed in the vascular endothelium within cancer tissues and the peripheral invased region outside cancer tissues. The 2-year disease-free-survival in patients with negative heparanase expression (88.9%) was higher than that with positive heparanase expression (50.0%), but there was no significant difference （P=0.078）. Conclusion Heparanase overexpressed in colorectal cancer tissues, and thus it may take a role as an indicator for the formation and prognosis of colorectal cancer.
ObjectiveTo explore the association between glycosylated hemoglobin level and poor prognosis in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis.MethodsThe AIS patients treated with recombinant tissue-type plasminogen activator who were hospitalized in the Department of Neurology of the First Affiliated Hospital of Henan University of Science and Technology from September to December 2020 were retrospectively included. According to different levels of glycosylated hemoglobin, they were divided into pre-diabetic group (5.7%≤glycated hemoglobin≤6.4%), diabetic group (previously diabetic or glycosylated hemoglobin≥6.5%), and non-diabetic group (glycated hemoglobin <5.7%). The relevant information of the patients was collected, and a telephone follow-up was conducted 90 days after discharge. According to the modified Rankin Scale (mRS) score, the patients were divided into the good prognosis group (mRS score≤2) and the poor prognosis group (mRS score>2). Logistic regression analysis was used to determine the risk factors for the poor prognosis of intravenous thrombolysis in patients with AIS.ResultEventually 101 patients were included, including 44 in the non-diabetic group, 24 in the pre-diabetic group, and 33 in the diabetic group. And 64 patients were in the good prognosis group and 37 patients were in the poor prognosis group. Regression analysis results showed that diabetes was associated with poor prognosis 3 months after intravenous thrombolysis in patients with AIS [odds ratio=6.518, 95% confidence interval (1.568, 27.096), P=0.010]; and the higher the National Institutesof Health Stroke Scale score at admission was, the higher the risk of poor prognosis would be [odds ratio=1.421, 95% confidence interval (1.231, 1.640), P<0.001].ConclusionIn AIS patients who received intravenous thrombolysis, diabetes is associated with poor prognosis after 3 months.
Objective To analyze the etiology trends, etiological characteristics treatment effects of endophthalmitis in 10 years which from 2000 to 2009 in our hospital. Methods 165 patients (172 eyes) of endophthalmitis in hospital from January 2000 to December 2009 were enrolled in this study. The patients included 122 males and 43 females. The median age was (39.0plusmn;23.7) years. The best visual acuity (BCVA) was non light perception in 16 eyes, light perception 0.05 in 135 eyes, ＞0.05 in 12 eyes. Nine children did not have visual acuity records. There were 141 patients (85.45%) with exogenous endophthalmitis which including 89 patients of trauma, 43 patients after intraocular surgery and nine others; 24 patients (14.55%) with endogenous endophthalmitis. 113 eyes were received intravitreal injection with vancomycin 0.1 ml (10 mg/ml). 152 eyes had pathogenic microorganisms culture records of aqueous humor or aqueous humor and vitreous. The positive records were given drug sensitivity test. The types of endophthalmitis, pathogenic microbial culture and drug sensitivity test results and treatment effects were analyzed. Software of SPSS was used for the clinical data statistical analysis in this study. Results Of 152 eyes with a record of aqueous/vitreous samples pathogenic bacteria culture, 42 eyes (27.63%) had a positive result. In which, 28 eyes showed positive in bacteria culture, 12 eyes was positive in fungus culture and two eyes had a positive in culture of fungus and bacteria growing. The culture positive rate was higher in exogenous endophthalmitis than that in endogenous endophthalmitis (chi;2=4.721 9,P=0.029 8).Most of the G+ positive bacteria were resistance to cephalosporin and quinolones except levofloxacin; but sensitive to vancomycin, rifampin and sulfamethoxazole. The intervention effect was more available for postoperative endophthalmitis than that for traumatic endophthalmitis and endogenous endophthalmitis, the difference was statistically significant（chi;2=38.941 3，P=0.000 0).The BCVA of 23 cases was ＞0.05 after the treatment, compared with before the treatment, the difference was statistically significant (chi;2=3.867 3,P=0.049 2).Compared the ratio of past five yearsprime; to that of recent five years, endogenous endophthalmitis was increased from 7.89% to 20.23% (chi;2=5.014 0，P=0.025 1); postoperative endophthalmitis decreased from 27.63% to 24.72%, and traumatic endophthalmitis decreased from 60.53% to 48.31%, other causes linked endophthalmitis raised from 3.95% to 6.74%. Conclusions In recent 10 years (from 2000 to 2009), the patients with endogenous endophthalmitis are growing. The positive rate of pathogenic agent culture is low, but the culture positive rate of the specimens from endogenous endophthalmitis is higher than that from exogenous endophthalmitis.The treatment was more available for postoperative endophthalmitis than that for other two types of endophthalmitis. The general visual prognosis is poor.
ObjectiveTo systematically review the efficacy of double autologous hematopoietic stem cell transplantation (ASCT) in newly diagnosed multiple myeloma (NDMM). Methods PubMed, EMbase, The Cochrane Library, CNKI, and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on double ASCT for NDMM from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software. Results A total of 6 RCTs involving 2 226 NDMM patients were included. The results of meta-analysis indicated that compared with single ASCT, more patients who received double ASCT could achieve satisfactory partial response (VGPR) or better (RR=1.12, 95%CI 1.01 to 1.25, P=0.03). Double ASCT resulted in a higher progression-free survival (PFS) rate from the second year for high-risk patients (2-year: RR=0.49, 95%CI 0.28 to 0.86, P=0.01; 5-year: HR=0.61, 95%CI 0.43 to 0.85, P=0.004). There were no statistical differences in treatment-related mortality and 5-year overall survival between the two groups. ConclusionsCompared with single ASCT, double ASCT can improve the VGPR rate of NDMM patients and the PFS rate of high-risk patients with comparable toxicities. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Objective To explore the value of expression of carcinomaassociated antigens in early diagnosis and predicting prognosis in gallbladder carcinoma. MethodsThe expression of carcinoembryonic antigen (CEA), carbohydrate antigen (CA50), Ecadherin (ECD) and proliferating cell nuclear antigen (PCNA) in 10 cases of cholecystitis, 10 cases of gallbladder adenomas and 50 cases of gallbladder carcinomas were detected by immunohistochemistry. ResultsThe positive rate of CEA, CA50 and PCNA labeling index (LI) in gallbladder carcinomas were significantly higher than that of gallbladder adenomas and cholecystitis (P＜0.05 and P＜0.01). The positive rate of ECD in gallbladder carcinomas, especially with metastasis, was significantly lower than that of gallbladder adenomas and cholecystitis (P＜0.05). The 3year survival rate was significantly lower in gallbladder carcinomas with CEA and PCNA overexpression (P＜0.05), the 3year survival rate in patients with ECD positive tumors was higher than that of those with negative tumors (P＜0.05). Conclusion The detection of CEA, CA50 and PCNA is useful for early diagnosis of malignant change in gallbladder adenomas and gallbladder carcinomas. Therefore, the CEA, PCNA and ECD might be useful for predicting prognosis of gallbladder carcinomas.