Primary pigmented nodular adrenal disease (PPNAD) is a kind of autosomal dominant inherited disease. Patient in the study presented with Cushing's syndrome, and clinical and pathological diagnosis of PPNAD was confirmed. It is now confirmed that there are two relevant genes and their mutations may lead to PPNAD. This study showed no mutations in the patient, surpecting if there would be an alternative mechanism or a new gene in playing the role.

Objective:To investigate the effect of optimized catheter clipping training and automatic balloon retraction ureteral catheter removal on first urination of patients after neurosurgery, and provide guidance for postoperative micturition of these patients.Methods:From August 2020 to August 2021, 208 patients admitted to Department of Neurosurgery, the Affiliated Hospital of Xuzhou Medical University, undergoing craniocerebral surgery under general anesthesia and indurating catheter were selected as the study subjects by convenient sampling. They were divided into control group ( n=69), observation group A ( n=69) and observation group B( n=70) by random number table method. The control group received routine catheter clipping training and routine ureteral catheter removal, the observation group A received optimized catheter clipping training and routine ureteral catheter removal, and the observation group B received optimized catheter clipping training and automatic balloon retraction ureteral catheter removal. The first micturition time, first micturition volume, micturition circumstance, pain score and urethral irritation sign of the three groups were observed and compared. Results:The first urination time in observation group A and B were (11.58 ± 6.59) min and (10.06 ± 5.91) min, respectively, lower than (37.14 ± 13.74) min in control group, and the difference was statistically significant ( t=13.94, 15.07, both P<0.05); there was no significant difference between observation group B and observation group A ( P>0.05). The first urine volume were (303.66 ± 43.74) ml in control group, (299.06 ± 41.26) ml in observation group A and (299.28 ± 43.17) ml in observation group B, and the difference was not statistically significant ( P>0.05). The incidence of urination (spontaneous urination, induced urination and urinary retention) in observation group A was better than control group ( χ2=16.47), while observation group B was better than observation group A and control group ( χ2=8.59, 37.83), the differences were statistically significant (all P<0.05). There was no significant difference in pain score of ureteral catheter removal between observation group A (2.71 ± 0.67) and control group (2.87 ± 0.78) ( P>0.05). The score of observation group B (1.41 ± 0.65) was lower than that of control group and observation group A, the differences were statistically significant ( t=11.93, 11.62, both P<0.05). There was no significant difference of the incidence of urethral irritation (grade 0, 1, 2, and 3) between observation group A and control group ( P>0.05). Observation group B was lower than control group and observation group A, the differences were statistically significant ( t=38.81, 25.27, both P<0.05). Conclusions:Optimized catheter clipping training and automatic balloon retraction ureteral catheter removal can effectively shorten the first urination time of patients after neurosurgery, reduce the pain of ureteral catheter removal and urethral irritation during the first urination, improve the success rate of the first urination, and effectively prevent the occurrence of urinary retention.

OBJECTIVETo analyze the ultra microstructures and the expression of platelet peroxidase (PPO) of megakaryocytes from bone marrow, their clinical manifestations and laboratory characteristics in patients with acute megakaryoblastic leukemia (AMKL).

METHODSKaryocytes from bone marrow of 22 AMKL patients were divided into two parts by lymphocyte separation liquid, one part was used to prepare the ordinary transmission electron microscope specimens to observe the morphological structures of megakaryocytes, the other was used to prepare the histochemical specimens of platelet peroxidase to analyze the positive reaction of PPO in AMKL, which were coupled with the patients' data of with bone marrow morphology, cell chemistry, and chromosome karyotype examination.

RESULTSMegakaryocytes from 17 of 22 patients were in the first stage, less than 20 µm in diameter, the nucleis were round, the cytoplasm contained microtubules, membranous vesicles and minute dense granules, no demarcation membrane system and surface-connected canalicular system, less dense granules and α-granules; Megakaryocytes in 5 cases were mainly in the first stage, while containing second and third stage megakaryocytes; the positive rate of PPO in megakaryocytes of 22 patients was 0-80%. The primitive and naive megakaryocytes were found in bone marrow smears of 22 cases, CD41 staining of the megakaryocytes was detected in the primitive and naive megakaryocytes, and more complex chromosome karyotype anomalies were observed.

CONCLUSIONThe majority of megakaryocytes in AMKL patients were the first stage ones, the rest were second and third stage ones, and the positive PPO reaction was significantly different. CD41 staining of the megakaryocytes was specific with complex chromosome karyotypeswere.

Blood Platelets ; enzymology ; Bone Marrow ; pathology ; Cell Count ; Chromosome Aberrations ; Chromosome Disorders ; Humans ; Karyotyping ; Leukemia, Megakaryoblastic, Acute ; diagnosis ; pathology ; Megakaryocytes ; pathology ; Peroxidase ; metabolism ; Staining and Labeling

【Objective】 To evaluate the clinical efficacy and safety of platelet-rich plasma(PRP) in acute achilles tendon injury by meta-analysis. 【Methods】 Literature on clinical randomized controlled trial of PRP in the treatment of acute achilles tendon injury from Wanfang database, CNKI, VIP database, The Chinese Biological Literature Database, The Chinese Clinical Trials Registry, PubMed, Embase, Cochrane and The US Clinical Trials Registry as of August 2023 were retrieved. The control group received conventional treatment for acute achilles tendon injury, while PRP treatment group received additional PRP treatment. The primary outcome measure was visual analogue pain scale, and the secondary outcome measures were the achilles tendon fracture score, maximum heel rise height, calf circumference and ankle range of motion. The quality of the literature was assessed using the Cochrane manual, and a meta-analysis of qualified literature was performed using RevMan 5.3 software. 【Results】 Seven articles were finally included, involving 421 patients with acute achilles tendon injury, including 212 patients in the PRP treatment group, and 209 patients in the conventional treatment group. The results of meta-analysis showed that there was no difference between the conventional treatment group and the PRP treatment group in terms of the visual analogue pain scale(SMD=-0.44, 95%CI: -0.94~0.06, P>0.05), calf circumference (MD=1.14, 95% CI: -1.56-3.84, P>0.05), ankle joint toe flexion range of motion (SMD=1.85, 95%CI: -1.38-5.09, P>0.05), ankle dorsiflexion range of motion(SMD=2.61, 95%CI: -0.95-6.17, P>0.05), achilles tendon fracture score (MD=-5.60, 95%CI: -15.36-4.16, P>0.05) and the maximum heel rise height (MD=-2.48, 95%CI: -5.30-0.33, P>0.05). And there was no difference in the incidence of adverse reactions between the two groups (X²=2. 455, P>0.05). 【Conclusion】 PRP injection for acute achilles tendon injury does not improve the biomechanical and clinical outcomes of patients, and the use of PRP does not increase the occurrence of adverse reactions.