3种不同支气管动脉栓塞方法治疗大咯血的疗效比较

目的 探讨3种不同支气管动脉栓塞术治疗大咯血的临床价值,观察不同的栓塞物质和栓塞方式对大咯血治疗的临床效果及与并发症的关系。方法 93例大咯血病例,26例行单纯明胶海绵栓塞,30例行夹心面包法栓塞,37例行四重夹心面包法栓塞。所有病例随访6～24个月。结果 3组病例近期（6个月内）有效率：单纯明胶海绵栓塞92％（24／26）,夹心面包法栓塞100％（30／30）,四重夹心面包法栓塞100％（37／37）;远期疗效（6-24个月）单纯明胶海绵栓塞和夹心面包法栓塞均有复发病例,四重夹心面包法栓塞无复发病例。结论 四重夹心面包法支气管动脉栓塞术是治疗大咯血的一种简便、创伤小,且高效的治疗手段。     

先天性纤维血管瞳孔膜患儿的眼部生物学参数和屈光状况

目的：:观察先天性纤维血管瞳孔膜（CFPM）患儿的临床表现、术前生物学参数及术后屈光状况。方法：:回顾性系列病例研究。分析2016年7月至2019年12月在温州医科大学附属眼视光医院杭州院区接受手术治疗的CFPM患儿13例（15眼）的临床资料,其中11例单眼发病,2例双眼发病。记录患儿手术年龄、合并症、眼部生物学参数、...     

超声引导下射频消融联合乙醇消融与单纯射频消融治疗甲状腺良性囊实性结节的疗效对比

目的 探讨射频消融联合乙醇消融与单纯射频消融对良性囊实性甲状腺结节治疗效果的差异.方法 选取2015年1月-2018年7月就诊于郑州大学第一附属医院甲状腺外科,颈部彩超确认为甲状腺囊实性结节,且结节最大直径≥20 mm,穿刺病理结果为良性,拟行甲状腺射频消融手术的80例患者的病理资料,根据病情及患者意愿,分别行单纯射频...     

Eosinophilic fasciitis associated with generalized morphea and IgA nephropathy

Eosinophilic fasciitis (EF) is a rare connective tissue disease characterized by increased peripheral blood eosinophils and diffuse fasciitis, generalized morphea (GM) is a subtype of localized scleroderma, and IgA nephropathy is a chronic glomerulonephritis caused by abnormal deposition of IgA in the mesangial area of the glomeruli. We describe a 49‐year‐old male patient with hard skin, cutaneous hyperpigmentation, and proteinuria. The patient had suffered from a long disease course of hard skin, while urine protein was newly detected. Finally, the clinical presentation and physical examination, limb MRI, skin biopsy, and renal biopsy confirmed the diagnosis of eosinophilic fasciitis associated with generalized morphea and IgA nephropathy. This case is the first report of EF associated with GM and IgA nephropathy.     

Altered amygdala resting-state functional connectivity following acupuncture stimulation at BaiHui (GV20) in first-episode drug-Naïve major depressive disorder

Amygdala is an important locus of dysfunction implicated in major depressive disorder(MDD). Aberrant amygdala networks(AN) had been reported in resting-state functional magnetic resonance imaging (rs-fMRI) study. The safety and efficacy of acupuncture treatment for MDD have been verified in previous clinical studies. This study is aimed to investigate whether acupuncture at GV20 could modulate the abnormal AN of patients with the first-episode, drug-naïve MDD by using rs-fMRI combined with functional connectivity (FC) method. Thirty MDD patient underwent 6-min rs-fMRI scans respectively before and after 20-min electro-acupuncture stimulate(EAS) at GV20. Twenty-nine healthy subjects underwent only a 6-min rs-fMRI scan. Based on the amygdala as the seed region, FC method was adopted to examine abnormal AN in patients by comparing with healthy subjects and to evaluate the influence of EAS on intrinsic connectivity within the AN in patients with MDD. Compared to healthy subjects, MDD patients had aberrant intrinsic AN which mainly showed increased FC between amygdala and hippocampus, precuneus, precentral gyrus and angular gyrus, as well as decreased FC between amygdala and orbital frontal cortex(OFC). Moreover, our results indicated that EAS at GV20 induced increased/decreased FC between amygdala and certain regions in MDD patients. In addition, the intrinsic amygdala FC within other certain brain regions in MDD patients were regulated by EAS at GV20. The abnormal AN of MDD patients could be modulated by EAS at GV20. Our findings may further provide the potential imaging evidence to support the modulatory mechanisms of acupuncture on MDD.

     

Oxaliplatin-induced neuropathic pain involves HOXA6 via a TET1-dependent demethylation of the SOX10 promoter

Chemotherapy-induced neuropathic pain is a common dose-limiting side effect of cancer treatment but the underlying mechanisms are largely unknown. Here, we used a whole-genome expression microarray and gene ontology analysis to identify the upregulation of a sequence-specific DNA-binding protein, HOXA6, in the spinal dorsal horn on Day 10 after injection of rats with oxaliplatin. Genetic disruption of HOXA6 with siRNAs alleviated mechanical allodynia after oxaliplatin administration. Reduced representation bisulfite sequencing assays indicated that oxaliplatin decreased the methylation levels of the SOX10 promoter but not of HOXA6. TET1 was also upregulated by oxaliplatin. Genetic disruption of TET1 with siRNA blocked the promoter demethylation of SOX10 and the upregulation of HOXA6 and SOX10. Importantly, inhibition of SOX10 by intrathecal application of SOX10 siRNA ameliorated the mechanical allodynia induced by oxaliplatin and downregulated the expression of HOXA6. Consistently, overexpression of SOX10 through intraspinal injection of AAV-SOX10-EGFP produced mechanical allodynia and upregulated the expression of spinal dorsal horn HOXA6. Moreover, chromatin immunoprecipitation assays demonstrated that oxaliplatin increased the binding of SOX10 to the promoter region of HOXA6. Taken together, our data suggest that HOXA6 upregulation through the TET1-mediated promoter demethylation of SOX10 may contribute to oxaliplatin-induced neuropathic pain.     

淋巴管畸形介入硬化治疗的效果分析

目的回顾性分析介入硬化治疗淋巴管畸形的方法与疗效,探讨淋巴管畸形介入硬化治疗的有效性及安全性。方法收集2016年12月至2019年5月福建省福州儿童医院采用介入硬化治疗的头面颈部、躯干和四肢体表局灶性淋巴管畸形患儿临床资料,回顾其治疗年龄、硬化剂选择及硬化治疗方法。评价治疗前后囊肿体积或大小,评价指标为:优良,体积减小>90%;中等,体积减小>50%;不显著,体积减小<50%;治疗无反应。将优良和中等定义为显著有效。结果29例淋巴管畸形患儿中,巨囊型8例,微囊型8例,混合型13例。平均疗程1.62次,治疗1次18例,治疗2次4例,治疗>2次7例。巨囊型平均治疗1.375次,6例治疗1次;混合型平均治疗1.46次,9例治疗1次;微囊型平均治疗2.13次,治疗均超过2次。随访时间3个月至2年。所有病例治疗优良率为58.7%(17/29),疗效中等率为31%(9/29),不显著率为10.3%(3/29)。巨囊型显著有效率为100%(优良率100%);混合型显著有效率92.3%(优良率53.8%,中等率38.5%);微囊型显著有效率75%(优良率25%,中等率50%)。3种不同类型淋巴管畸形的显著有效率差异无统计学意义(χ2=2.336,P=0.431);对3种不同类型淋巴管畸形的优良率进行比较,差异有统计学意义(χ2=9.77,P=0.009)。巨囊型的优良率明显高于微囊型(P=0.007),混合型优良率与巨囊型(P=0.046)、微囊型(P=0.367)比较均无统计学意义。并发症:2例术后出现发热,3例术后出现囊内出血,2例发生局部色素沉着,1例发生局部感染,无一例出现过敏性休克等全身不良反应或局部组织坏死情况。结论介入硬化治疗淋巴管畸形有显著疗效,其中巨囊型淋巴管畸形疗效最佳,混合型和微囊型次之,且硬化介入治疗的并发症少。介入硬化治疗可作为体表局灶性淋巴管畸形的首要治疗手段。     

Clinical and pathological features in adult-onset NIID patients with cortical enhancement

Journal of Neurology - Neuronal intranuclear inclusion disease (NIID) is a neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions in multiple organs. On...