Objective To evaluate the relationship between the change of the aortomitral angle (AMA) with left ventricular systolic function in patients with ischemic cardiomyopathy (ICM) by echocardiography.Methods Thirty-one patients were enrolled in the ICM group,and 59 healthy subjects were selected as the control group.On the parasternal left ventricular long axis plane,AMA were measured at the R wave apex (R-AMA),J-point(J-AMA),ST-segment midpoint(ST-AMA),T-final wave (T-AMA)and P-final wave (P-AMA).The angle difference(⊿ θ) =AMAmax-AMAmin,the angle changing rate =⊿ θ/AMAmax.The global left ventricular longitudinal strain (GLS) and global circumferential strain (GCS) were obtained by 2D-speckle tracking echocardiography.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV) and left ventricular end-systolic volume(LVESV) were measured using Simpson biplane method.Results The J-AMA was the largest in the control group,while the ST-AMA was the largest in the ICM group.The levels of LVEDV,LVESV and AMA in ICM group were significantly higher than those in control group,while LVEF,GLS,GCS,⊿ θ/AMAmax and ⊿ θ were decreased (P ＜0.05).In the control group,there was a correlation between T-AMA and LVEF (r =-0.349,P =0.007),and ⊿ θ was negatively correlated with GLS (r =-0.372,P =0.004).In the ICM group,⊿1 θ/AMAmax and ⊿ θ were correlated with LVEF (r =0.424,P =0.018;r =0.490,P =0.005).Conclusions AMA in ICM patients is significantly increased.The angle difference and the rate of its change are closely related to the LVEF,which is a manifestation of three-dimensional structure change of the myocardial.

Hypereosinophilia (HE) is a kind of hematology disorder affecting multiple organs. Multiple studies demonstrated that HE was correlated with ischemic stroke, and it could be a rare and reversible cause for ischemic stroke. Therefore, more and more concerns have been concentrated by neurologists in recent years. Based on the research data, the definition, typical characteristics, possible mechanism, diagnosis and treatment principles of HE related ischemic stroke were summarized systematically, in order to provide possible personalized treatment strategies for this disease.

Objective:To evaluate the effect of Barker aseptic application on the treatment of deep second-degree burns and scars after healing.Methods:According to the inclusion and exclusion criteria, deep second-degree patients admitted to the Affiliated Hospital of Jining Medical College from September 2016 to September 2019 were randomly divided into treatment and control groups using a random number table method. Barker aseptic application was used for the treatment group, and silver sulfadiazine cream was used for the control group. Patients in two groups were changed dressing every 2 to 3 days. Wound healing time, times of dressing change, pain score during the dressing change, secondary trauma score, and Vancouver Scar Scale (VSS) score at 1, 3, and 6 months after wound healing were compared between the two groups. Differences in patient satisfaction at discharge and 6 months after wound healing were also compared at follow-up. According to the result type of the data, it is expressed as Mean±SD, M( Q1, Q3) or frequency (percentage), and it is described as the t-test, Mann-Whitney U test, or chi-square test. Results:One hundred and thirty-two burn patients were enrolled in each treatment and control group. There were 115 males and 17 females in the treated group, aged (34.5±11.1) years, with the burn surface area accounting for (15.87±8.66)% of the total body surface area (TBSA). 107 males and 25 females were in the control group, aged (32.4±14.1) years, with burn surface area accounting for (16.31±7.06)% TBSA. The healing time of the treated group was significantly shorter than that of the control group [(17.65±5.87) d vs. (23.06±8.78) d, P<0.01], and the VSS scores at 1, 3, and 6 months after wound healing were also lower than that of the control group [5(3, 5) vs. 6(5, 7), 4(3, 5) vs. 6(4, 7), 4(3, 5) vs. 5(4, 6), P<0.01]. In addition, the number of dressing changes, pain scores during dressing changes, and secondary trauma scores in the treatment group were lower than in the control group (all P values<0.01). The satisfaction score and percentage of satisfaction with treatment were higher in the patients at discharge and 6 months of wound healing than in the control group (all P values<0.01). Conclusions:Barker aseptic application can significantly shorten the healing time of deep second-degree burn wounds, reduce scar hyperplasia, improve comfort during dressing changes, and improve patient satisfaction.

A female patient aged 42 years with deep burn on right lower limb was admitted to Affiliated Hospital of Jining Medical University on January 25, 2019. The patient previously had cerebral infarction, hypertension, and hysteria, with long-term use of aspirin and risperidone. After admission, the patient underwent tangential excision twice. On the third day after the second tangential excision and skin grafting, the muscle strength of the right limb gradually decreased, and the patient was treated with emergency craniocerebral magnetic resonance imaging, which suggested acute cerebral infarction. Improvement of cerebral circulation and vasodilatation were given immediately. The limb muscle strength of the patient gradually recovered on the fifth day after the operation, and no sequela was left when the patient was discharged. After the case was discussed, we think that postoperative decreased blood volume and blood concentration resulting from tangential excision bleeding of deep burn and wound exudate as well as inadequate fluid infusion are the main causes of hemodynamic change, the patient had the basis of multiple cerebral artery stenosis, and superposition of multiple factors led to the occurrence of postoperative acute cerebral infarction. Appropriate increase in the fluid infusion volume during and after surgery and transfusion if necessary to increase blood and oxygen supply to the brain can reduce the occurrence of cerebral infarction.

Objective:To evaluate the effect of Barker aseptic application on the treatment of deep second-degree burns and scars after healing.Methods:According to the inclusion and exclusion criteria, deep second-degree patients admitted to the Affiliated Hospital of Jining Medical College from September 2016 to September 2019 were randomly divided into treatment and control groups using a random number table method. Barker aseptic application was used for the treatment group, and silver sulfadiazine cream was used for the control group. Patients in two groups were changed dressing every 2 to 3 days. Wound healing time, times of dressing change, pain score during the dressing change, secondary trauma score, and Vancouver Scar Scale (VSS) score at 1, 3, and 6 months after wound healing were compared between the two groups. Differences in patient satisfaction at discharge and 6 months after wound healing were also compared at follow-up. According to the result type of the data, it is expressed as Mean±SD, M( Q1, Q3) or frequency (percentage), and it is described as the t-test, Mann-Whitney U test, or chi-square test. Results:One hundred and thirty-two burn patients were enrolled in each treatment and control group. There were 115 males and 17 females in the treated group, aged (34.5±11.1) years, with the burn surface area accounting for (15.87±8.66)% of the total body surface area (TBSA). 107 males and 25 females were in the control group, aged (32.4±14.1) years, with burn surface area accounting for (16.31±7.06)% TBSA. The healing time of the treated group was significantly shorter than that of the control group [(17.65±5.87) d vs. (23.06±8.78) d, P<0.01], and the VSS scores at 1, 3, and 6 months after wound healing were also lower than that of the control group [5(3, 5) vs. 6(5, 7), 4(3, 5) vs. 6(4, 7), 4(3, 5) vs. 5(4, 6), P<0.01]. In addition, the number of dressing changes, pain scores during dressing changes, and secondary trauma scores in the treatment group were lower than in the control group (all P values<0.01). The satisfaction score and percentage of satisfaction with treatment were higher in the patients at discharge and 6 months of wound healing than in the control group (all P values<0.01). Conclusions:Barker aseptic application can significantly shorten the healing time of deep second-degree burn wounds, reduce scar hyperplasia, improve comfort during dressing changes, and improve patient satisfaction.

OBJECTIVETo identify potential mutation of the colony stimulating factor 1 receptor gene (CSF1R) in a large Chinese family affected with hereditary diffuse leukoencephalopathy with spheroids (HDLS) and analyze the genotype-phenotype correlation.

METHODSThe proband was evaluated physically and radiologically to ascertain the HDLS phenotype. Genomic DNA was extracted from peripheral blood samples from family members. The coding region of the CSF1R gene was amplified with PCR and subjected to direct DNA sequencing.

RESULTSThere were 9 affected members (5 alive) in this five-generation family (1 member had died during the follow-up). A missense mutation c.2563C>A (p.P855T) of the CSF1R gene has been identified in the proband. The same mutation was identified in 3 affected and 1 unaffected members of the family.

CONCLUSIONThe family was consistent with autosomal dominant inheritance. CSF1R gene mutation is also a disease-causing mutation in Chinese patients.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Female ; Genes, Dominant ; Humans ; Leukoencephalopathies ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation, Missense ; Pedigree ; Receptor, Macrophage Colony-Stimulating Factor ; genetics

Objective:To explore the safety and feasibility of optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation(DKT)and evaluate its effectiveness to provide more alternative protocols for kidney transplantation from extended criteria donors.Methods:DKT was performed in 10 recipients using the same protocol from June 2019 to May 2021.And retrospective reviewing was performed for clinical data, including characteristics of donors and recipients, optimized pathological evaluation system, modified surgery, treatment regimens, complications and follow-ups.Results:There were 8 male and 2 female donors with an age of(57.9±12.8)years and BMI(24.1±4.1)kg/m 2.The percentage of DCD was 70% and DBD 30%.The serum creatinine before procurement was 107.6(93.3-163.5)μmol/l.Zero-point puncture biopsy was performed for both kidneys and optimized pathological evaluation system was implemented(Banff criteria & Remuzzi score). The pathological results indicated that glomerular sclerosis for left and right kidneys were 2.0(1.5-2.0)and 1.5(1.0-2.0). And Remuzzi score for left and right kidneys were(4.4±1.2)and(3.6±1.5)points respectively.All recipients were male with an age of(43.1±9.0)years and BMI(22.2±1.9)kg/m 2.All PRAs were negative pre-operation.Modified surgery was performed in all recipients(two kidneys were implanted outside iliac vessels without patch and artery of superior kidney was anastomosed to internal iliac artery). Operative duration was(195±54.3)min and serum creatinine before discharge 125.0(102.0-199.0)μmol/L.Renal dynamic scintigraphy indicated that glomerular filtration rate was(30.0±8.2)ml/min for left kidney and(29.2±13.9)ml/min for right kidney.MRA results indicated that morphologies of renal arteries and veins were regular.The time between operation and discharge was(22.4±4.7)days.Compared with SKT, serum creatinine before discharge of DKT was lower and DGF incidence of DKT was higher without statistical significance.The time between operation and discharge was longer for DKT than that for SKT( P<0.05). The complications consisted of 20% donor derived infection(DDI)and 50% DGF.And there was no surgical complication associated with vessels and ureter.Renal function remained stable during 6-month follow-ups. Conclusions:Optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation are both safe and feasible.The postoperative function of transplanted dual kidney is successfully restored.However, long-term follow-ups are required for evaluating its effectiveness.