Objective To evaluate the days of hospitalization of acute transverse myelitis and its influencing factors.Methods File's of 158 patients with acute transverse myelitis as the first diagnosis in Feicheng Mining Centre Hospital were analyzed retrospectively.Access to the original medical records through the medical record number, and supplemented information, mainly including demographic data, neurological function defect degree, complications and complications.Results Hospitalization time was 4-41 d, an average of (17±6) d,including 23 patients hospitalized time ≤ 10 d(14.56％), 83 cases were ＞ 10-＜20 d(52.53％), 52 cases was≥20 d(32.91％).Age and Neurological score comparative differences are statistically significant (F=60.90,8.68, P＜0.05).Payment method, deep vein thrombosis, comparative differences were statistically significant(x2 =20.04, 14.27, 12.17,9.37,7.05;P＜0.05).There were ralationship between acute transverse myelitis with age, neurological score, payment (OR =1.140, 0.500,83.930,0.041;P＜ 0.005).Conclusion The degree of neurologic impairment is the most important influencing factors of acute transverse myelitis.Controlling hospital infection, preventing deep vein thrombosis, strengthening medical insurance management, are the effective ways to shorten the days of hospitalization of acute transverse myelitis.

Objective To investigate the correlation between serum glutamate levels and post-stroke depression (PSD). Methods The consecutive patients with acute ischemic stroke were enroled. At 3 month after onset, the PSD diagnosis was conducted according to the American Diagnostic and Statistical Manual of Mental Disorders (4th Edition) somatic disease caused mood disorder and Hamilton depression scale (HAMD) was used to evaluate the severity of depressive symptoms in patients with PSD. The demographics and baseline clinical data were compared and analyzed in the PSD group and the non-PSD group. Results A total of 177 patients were enroled in the study, including 55 in the PSD group and 122 in the non-PSD group. The age (64. 4 ± 7. 8 years vs. 60. 1 ± 11. 1 years; t = - 2. 575, P = 0. 012), NIHSS scores (median and interquartile: 6 [5 - 8] vs. 3 [2 - 5 ]; Z = - 5. 463, P = 0. 002 ), serum homocysteine (16. 9 ± 4. 9 μmol/L vs. 14. 3 ± 3. 9 μmol/L; t = - 3. 929, P = 0. 001 ), high-sensitivity C-reactive protein (1. 0 [0. 8 - 1. 7] mg/L vs. 0. 4 [0. 7 - 1. 3] mg/L; Z = - 3. 439, P = 0. 002 ), glutamate levels (279 [205 - 345] μmol/L vs. 161 [110 - 209] μmol/L; Z = - 6. 172, P = 0. 001 ), as wel as the proportion of women (50. 9% vs. 34. 4% ; χ2 = 4. 308, P = 0. 038) in the PSD group were significantly higher than those in the non-PSD group, while the education level was significantly lower than that in the non-PSD group (χ2 = 9. 679, P = 0. 003). Spearman correlation analysis showed that serum glutamate levels were significant positive correlated with HAMD scores ( r = 0. 491, P < 0. 001 ). Multivariate logistic regression analysis showed that the increased serum glutamate level (odd ratio 1. 016, 95% confidence interval 1. 010 - 1. 023; P = 0. 002) was an independent risk factor for PSD in patients with acute ischemic stroke. Conclusions The increased serum glutamate level may be an independent risk factor for PSD.

Objective To investigate the diagnostic value of narrow-band imaging for flat bladder lesions.Methods Forty-nine patients with flat bladder lesions diagnosed by white light cystoscopy + narrow-band imaging followed by transurethral resection were included.The diagnostic value of narrow-band imaging was evaluated based on postoperative pathological results.Results A total of 59 flat lesions were identified,in which 8 were normal urothelium,3 were chronic inflammation,1 was papillary urothelial neoplasm of low malignant potential,1 were mild dysplasia,1 was moderate dysplasia,1 were severe dysplasia,3 were carcinoma in situ,16 were low-grade papillary urothelial carcinoma,16 were high-grade papillary urothelial carcinoma,and 8 were invasive papillary urothelial carcinoma.For narrow-band imaging,the sensitivity was 86.7 ％ (39/45),specificity was 57.1％ (8/14),diagnostic accuracy was 79.7 ％ (47/ 59),false-positive rate was 42.9％ (6/14),positive predictive value was 86.7％ (39/45),negative predictive value was 57.1％ (8/14),area under ROC curve was 0.719.Among these lesions,the sensitivity and specificity for postoperative recurrent lesions were 100％ (3/3) and 40％ (2/5),respectively,and those for erythematous patch-like lesions were 90％ (9/10) and 100％ (4/4),respectively.Conclusion Narrow-band imaging can improve the detection rate for flat bladder tumor lesions,and reduce the risk for missed diagnosis under white light cystoscopy,especially for otherwise indistinguishable erythematous patch-like lesions.

Objective To perform an exploratory investigation on confocal laser endomicroscopy (CLE) in the diagnosis of malignant bladder tumour.Methods From June 10 to July 11,2017,6 male bladder cancer patients underwent white light cystoscopy (WLC) + CLE examination,aging 64-86 years (median 72 years).All patients received TURBT on suspected lesions.WLC and CLE imaging results were recorded and validated by pathologic specimens.Results Lesions confirmed by histopathology were 3 low grade non-invasive papillary urothelial carcinomas,1 high grade non-invasive papillary urothelial carcinoma,1 low grade invasive urothelial carcinoma,1 high grade invasive urothelial carcinoma,1 carcinoma in situ (CIS),1 high grade dysplasia,1 cystitis glandularis,1 chronic inflammation,and 1 scar tissue.For CLE images in the normal urothelium,three layers of cells with different presentation were observed,namely,the superficial umbrella cells,the intermediate cells smaller in size and uniformly shaped,and the capillary network in the lamina propria.For non-invasive urothelial carcinoma,tumour cells appeared as papillary lesions growing from fibrovascular cores,with low grade cells appearing monomorphic and more cohesively arranged,and high grade cells relatively pleomorphic,more disorganised and with tortuous blood vessels in the fibrovascular core.For invasive urothelial carcinoma,tumour cells invaded the lamina propria,with uniform appearances,poor cohesion and indistinct cellular borders,and high grade ones were more pleomorphic.CIS and inflammation both appeared as erythematous patch-like flat lesions under WLC and sometimes difficult to differentiate.Under CLE,the former appeared as dysplastic and disorganised cells with indistinct cellular borders,with intact lamina propria,and inflammatory cells were discovered as infiltrative clusters in the lamina propria that were uniformly shaped and loosely connected.Dysplasia appeared somewhat similar compared with CIS under WLC,but with lower cellular irregularity as confirmed with pathology.Cellular appearance and structure in scar tissue was similar to that in the normal urothelium,but superficial umbrella cells were more likely absent,with thinner cell layers,and inflammatory infiltration was sometimes discovered in the lamina propria.Conclusions CLE provides real-time cellular imaging of the urothelium,and shows promising potential for clinical diagnosis,especially in differentiating fiat urothelial lesions.Large prospective studies are required for further validation.