Early infantile manifestations of incontinentia pigmenti mimicking acute encephalopathy

Objective

We retrospectively reviewed six patients with incontinentia pigmenti (IP) who had encephalopathic manifestations during early infancy.

Methods

We enrolled six patients who met the following criteria from the mailing list of the Annual Zao Conference: (1) diagnosis of IP; (2) encephalopathic manifestations with reduced consciousness and clusters of seizures by 6 months of age; and (3) no evidence of central nervous system infection or metabolic derangement.

Results

The onset of the encephalopathic events was within the first 2 months of life in all but one patient. All had clusters of focal clonic seizures. The duration of seizures was typically 5 min. The seizures ceased within 5 days in all patients. Various degrees of reduced consciousness were observed in association with the frequent seizures. Diffusion-weighted imaging during the acute phase showed reduced water diffusion in the subcortical white matter, corpus callosum, basal ganglia, thalami, and internal capsule in two patients. Scattered subcortical white matter lesions were observed on fluid-attenuated inversion-recovery images in two patients.

Conclusions

The encephalopathic manifestations in patients with incontinentia pigmenti were characterized by seizure clusters and reduced consciousness, albeit of relatively short duration. Magnetic resonance imaging abnormalities were predominant in the subcortical areas in most patients.     

外侧小切口全髋置换早期疗效对比研究

目的评价外侧小切口全髋关节置换术(THA)的早期疗效。方法选择2005年1月—2010年1月行外侧小切口全髋关节置换术120例(132髋)患者作为试验组,选择同期接受常规外侧切口手术76例(82髋)作为对照组,比较2组患者术后3个月、术后6个月、术后1年假体位置及Harris评分等。结果术后2组患者假体位置比较无显著性差异,试验组在术后3,6个月Harris评分较对照组高;术后1年,2组Harris评分比较差异无统计学意义。结论外侧小切口全髋置换术术后早期在功能及软组织损伤上比常规切口全髋置换有明显优势,随着时间的推移,差异减小。外侧小切口全髋关节置换的中远期疗效需要进一步评估。     

3种方法治疗早期先兆流产疗效分析

目的评价3种方法治疗肾虚型早期先兆流产的临床疗效。方法将219例肾虚型早期先兆流产患者随机分为3组,治疗组72例、对照1组77例、对照2组70例。治疗组：保胎灵结合黄体酮胶囊口服;对照1组：黄体酮胶囊口服;对照2组：黄体酮肌肉注射。比较3组疗效及女性激素的影响。结果治疗组总有效率94.4%,对照1组总有效率80.5%,对照2组总有效率81.4%。对照组总有效率比较,差异无统计学意义（P〉0.05）。治疗组总有效率与对照组比较,差异有统计学意义（P〈0.05）。有效组与无效组治疗后3组P、β-hCG水平比较,差异无统计学意义（P〉0.05）,3组中有效组治疗后均能明显提高P、β-hCG水平差异有统计学意义（P〈0.05）,而3组中无效组治疗前后比较P、β-hCG水平差异无统计学意义（P〉0.05）。结论黄体酮胶囊200 mg与黄体酮20 mg肌注疗效相当。保胎灵结合黄体酮胶囊是目前较理想的治疗肾虚型早期先兆流产的方法,值得推广。     

2型糖尿病早期肾损害患者血清胱抑素C与尿微量白蛋白/肌酐比值的检查意义

[目的]探讨血清胱抑素C与尿微量白蛋白/肌酐比值对诊断2型糖尿病早期肾损害患者的临床诊断价值。[方法]选取2009年5月～2010年10月于某院内分泌科住院治疗的2型糖尿病尿蛋白定性试验为阴性患者60例为观察组,选择体检健康人60例作为对照组,分别对两组患者血清胱抑素C与尿微量白蛋白/肌酐比值进行检测,将检测结果进行统计分析。[结果]观察组患者Cys-C与mAlb/Cr检测结果分别为(0.95±0.24)mg/L、(0.75±0.42)mg/mmol,较对照组(1.62±0.34)mg/L、(12.42±10.37)mg/mmol,差异有统计学意义,P﹤0.05。[结论]Cys-C联合mAlb/Cr检测能提高对T2DM早期肾损害诊断的敏感性,具有较高临床意义,值得推广。     

中医药治疗肝炎后早期肝硬化疗效评价

目的：观察中医药治疗肝炎后早期肝硬化的临床疗效。方法：从2013年1月-2014年1月,选取我院的100例肝炎早期肝硬化患者为研究对象,随机分为观察组和对照组两组。观察组50例患者采用中医药治疗,对照组50例患者服用安慰剂,对两组治疗效果以及肝功能指标进行分析比较。结果：两组患者治疗效果对比,观察组采用中医药治疗肝炎后早期肝硬化的显效比占56.00%（28/50）,有效率为94.00%（47/50）,均显著高于对照组采用安慰剂治疗的26.00%（13/50）,42.00%（21/50）。差异均有统计学意义（均P＜0.05）;两组患者治疗前后肝功能指标比较,两组治疗前谷丙转氨酶（ALT）、总胆红素（TBiL）及白蛋白（Alb）水平均无明显差异（P＞0.05）,治疗后两组的谷丙转氨酶（ALT）、总胆红素（TBiL）及白蛋白（Alb）水平均较治疗前显著提高（P＜0.05）,但观察组显著高于对照组的安慰剂治疗（P＜0.05）,更接近正常水平。结论：中医药治疗肝炎后早期肝硬化疗效好,肝功能指标恢复好。具有安全性高、临床效果好等特点,值得临床进一步推广。     

Diagnostic efficacy of gadoxetic acid-enhanced MRI for hepatocellular carcinoma and dysplastic nodule

AIM:To evaluate the relationship between the signal intensity of hepatobiliary phase images on gadoxetic acid-enhanced magnetic resonance imaging(MRI)and histological grade.METHODS:Fifty-nine patients with 82 hepatocellular lesions were evaluated retrospectively.Hepatobiliary phase images on gadoxetic acid-enhanced MRI were classified into 3 groups:low,iso or high.Angiographyassisted computed tomography(CT)findings were also classified into 3 groups:CT during arterial portography,and CT hepatic arteriograph...     

中医综合方案早期干预缺血性中风的临床观察

目的:观察中医综合方案早期干预缺血性中风临床疗效和安全性。方法:按照随机原则选取符合标准的病例72例,分为中医组和西医组。中医组给予中医康复技术,基础治疗除基础干预外,还增加中药注射剂早期介入,辨证中药汤剂,中药泡洗。西医组为现代康复技术和基础干预。两组各观察14d,观测指标为两组患者的神经功能缺损(NIHSS)、日常生活能力(ADL)量表、中医证候的变化情况。结果:两组治疗后神经功能缺损程度积分、ADL-R量表评分较治疗前均有改善(P<0.05);两组治疗后中医证候积分较治疗前均降低(P<0.05);神经功能缺损程度积分、ADL-R量表评分组间比较无统计学意义。结论:中医综合方案早期干预缺血性中风具有治疗作用,可明显促进患者神经功能恢复、显著改善患者临床症状、提高患者生活能力。     

The rule of bigeminy revisited: analysis in sudden cardiac death syndrome

Background

The rule of bigeminy is commonly explained by a reentrant mechanism. We hypothesize that in patients with prolonged ventricular repolarization, the rule of bigeminy may be caused by premature ventricular complexes (PVCs) due to early afterdepolarizations. We evaluated these ventricular arrhythmias over extended periods in patients with sudden cardiac death syndrome.

Methods

The electrocardiographic (ECG) characteristics of 15 recordings from the PhysioNet Sudden Cardiac Death Holter Database were analyzed for the persistence of bigeminy, interaction between the underlying cardiac rhythm and the coupling interval, and influence of a prolonged initiating RR cycle on the self-perpetuation of the arrhythmias.

Results

Eight (53%) patients had classic torsade de pointes (TdP), 5 (33%) had other polymorphic ventricular tachycardia (VT), and 2 (13%) had monomorphic VT. Group A, which comprised 6 of the patients with TdP, had the following ECG tetrad: (1) frequent ventricular bigeminy (>5% of total ventricular arrhythmias), (2) long corrected QT interval (>0.5 second), (3) relatively fixed coupling interval, and (4) onset of bigeminy (n = 4) and TdP (n = 6) after a short-long RR sequence. Patients in group A had slower heart rates (mean RR = 1.12 ± 0.26 vs 0.77 ± 0.13 seconds, P < .01), longer QT intervals (corrected QT = 0.57 ± 0.06 vs 0.45 ± 0.06 second; P < .01) and more cases with prominent U waves (83% vs 33%, P < .05) than patients in group B (n = 9), composed of patients who had other types of VT, or TdP without frequent bigeminy.

Conclusions

We identified a set of ECG characteristics that supports the notion that premature ventricular complexes during self-perpetuating ventricular bigeminy (“rule of bigeminy”) in long QT syndromes may be due to early afterdepolarizations.     

降钙素原、血清淀粉样蛋白及超敏C-反应蛋白水平检验在诊断早期脓毒血症的临床价值

目的：探析降钙素原、血清淀粉样蛋白及超敏C-反应蛋白水平检验在早期脓毒血症临床诊断中的应用价值。方法选择该院2010年1月—2014年8月期间所收治的96例脓毒血症患者进行研究,根据是否为细菌感染分为A、B两组,所有患者均于清晨采集2 mL外周静脉血后测定PCT、hs-CRP、SAA水平,比较两组PCT、hs-CRP、SAA水平及三种检测方法敏感性、特异性。结果A、B两组PCT、hs-CRP、SAA水平均存在较大差异(<0.05),差异有统计学意义。A、B两组中PCT检测敏感性均最高,与hs-CRP、SAA的两两比较均存在显著差异(<0.05),差异有统计学意义。结论与hs-CRP、SAA相比,早期脓毒血症患者的血清PCT水平检测具有更高敏感性与特异性,更利于脓毒血症早期确诊,进而提供治疗指导,临床价值较高,值得借鉴与应用。     

Associations between anthropometric indicators in early life and low-grade inflammation,insulin resistance and lipid profile in adolescence

Background and aimsThe long-term relations between excessive adiposity in early childhood and unfavourable cardiometabolic profiles in later ages are not yet completely understood. We aimed to assess the associations between birth weight (BW) and BMI from 6 months to 6 years of age, with biomarkers indicative of low-grade inflammation, insulin resistance and lipid profiles in adolescence.Methods and resultsRetrospective school-based study with 415 Portuguese adolescents (220 girls), mean age of 14.08 ± 1.6 years old. Anthropometric data from birth to 6 years old was extracted from individual child health book records. Actual weight and height were measured and BMI calculated. Participants were classified at each time point as normal weight or overweight according to WHO reference values. Biomarkers were obtained from venous blood samples. Linear regressions were used to explore the associations between the biomarkers and early life anthropometric indicators. From 2 years onwards, BMI associated positively with the inflammatory score and HOMA-IR in adolescence. Children who were overweight/obese from 2 to 6 years of age presented significantly higher inflammatory score and HOMA-IR later in adolescence. TC/HDL ratio was also positively associated with BMI from the age of 5 years onwards. The associations between BMI and cardiometabolic outcomes remained positive in adolescence, with overweight adolescents presenting a higher inflammatory score, HOMA-IR and TC/HDL than normal weight adolescents.ConclusionA high BMI from an early age was consistently associated with worse inflammatory and lipid profiles and insulin resistance in adolescence. No associations were found between BW and the same studied outcomes.