Objective To compare the efficacy and safety of intravenous thrombolysis on cardiogenic cerebral infarction and noncardiac infarction by recombinant tissue plasminogen activator (rt-PA). Methods Comparations of NIHSS, mRS and adverse events before and after treatment were made between the cardiogenic group and the noncardiac group. Results No significant differences in the NIHSS and mRS were found between the two groups. The incidence of brain hernia and dermatorrhagia in the cardiogenic group was higher than that in the noncardiac group. Conclusion Rt-PA therapy in cardiogenic cerebral infarction was effective and safe in spite of higher incidence of hemorrhage and brain hernia.

The number of new cases of hypophyseal tumor increases along with the advances in neuroimaging technology in recent years. The common treatment models include surgical treatment, radiotherapy, and medical therapies. This article discusses the application of long-term follow-up in non-operative hypophyseal tumor patients and its influence on the prognosis. Meanwhile, since the medical mode has switched from biomedical model to biopsychosocial medical model, management of hypophyseal tumor should not be limited in its biological aspect, but also from the perspective of psychology by providing more humanistic care to meet the patients'psychological needs.
Follow-Up Studies ; Humans ; Pituitary Neoplasms ; therapy ; Prognosis

ObjectiveTo introduction of perforator flaps,muscle flaps pedicled by descending branch of lateral circumflex femoral artery,method and their clinical application that multiple soft tissue defects of hand are repaire by muliplefoliated tissue flap only branch lateral circumflex femoral artery.MethodsFifteen patients with multiple soft tissue defects of hand were repaired muliplefoliated tissue flap only pedicled bydescending branch lateral circumflex femoral artery.At first,the anterolateral thigh perforator flap was designed and harvested according to the soft tissue defects of hand, then the descending branch lateral circumflex femoral artery was dissected at the same time the segmented perforator flap,fascia lata flap,rectus femoris muscle flap, vastus lateralis muscle flap, vastus intermedius muscle flap and distal spatium intermusculare flap were harvested in need according to distance among soft tissue defects.The muliplefoliated tissue flap was harvested only pedicled by descending branch lateral circumflex femoral artery, at last muscle flaps and fascia lata flaps were covered by skin graft, so the multiple soft tissue defects of hand were repaired in one time.ResultsNo vascular crisis happened. All skin grafts survived well, the contour of all repaired soft tissue defects was good and protective feeling was recovered by skin grafts of all flaps. All cases were got follow-up and the range was from 6 to 20 months(the average was 8.7 months).Wound of donor site healed well, muscle strength of quadriceps and motion of knee were normal. Three cases were excellent,nine cases were well and 3 cases were good, according to upper extremity function evaluation criteria of Chinese Medical Society for the Surgery of the Hand, the rate of good was 80 percent.ConclusionMultiple soft tissue defects of hand can be repaired by muliplefoliated flap only pedicled by descending branch of lateral circumflex femoral artery. Its advantages included reduction of operation time and treatment, good recovery of hand contour and function. It is a good method to repair multiple soft tissue defects of hand.

OBJECTIVETo analyze the causes of misdiagnosis of primary hypothyroidism (PH), with an attempt to reduce the misdiagnosis or mistreatment.

METHODSTotally 70 PH children with a history of misdiagnosis but whose conditions were confirmed in Peking Union Medical College Hospital and the First Hospital of Jilin University from July 2000 to May 2009 were enrolled in this study. The clinical data were collected and the causes of misdiagnoses were analyzed.

RESULTSOf these 70 patients, 19 were misdiagnosed as anaemia and dystrophy, 18 as pituitary tumors, 10 as adiposities, 6 as myocarditis or pericardial effusion, 4 as Downs syndrome, 3 as hepatitis, 3 as amyasthenia, 3 as cerebral palsy, 2 as cystis thyrolingualis, and 2 as congenital megacolon. The duration of misdiagnoses ranged from 6 to 72 months. The clinical manifestations of these patients were complicated, involving multiple organs and systems.

CONCLUSIONSPH has complicated clinical manifestations and individual variations, and therefore can be easily misdiagnosed. Good knowledge, sufficient history-taking, and cautious physical examinations can help avoid misdiagnosis. Neonatal screening is helpful for diagnosis and treatment of congenital hypothyroidism.

Adolescent ; Child ; Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Hypothyroidism ; diagnosis ; Infant ; Male

OBJECTIVETo study the characteristics of thyroglossal tract cyst epidemiology and summarize how to improve the operation therapeutic effect.

METHODSThe clinic appearance, the pathological characteristics and the therapeutic effect of the 60 thyroglossal tract cyst cases were analyzed.

RESULTSThyroglossal tract cyst mostly occurred in children and teenagers. The incidence of female patients was more than that of male patients. Most of thyroglossal tract cyst located in the middle line of the neck and were explored tubular-objects and fibroropes. The histopathological feature was variform.

CONCLUSIONThe clinical appearance and pathology characteristic of thyroglossal tract cyst are variform. Thyroglossal tract cyst may be recurred easily if it is not operated well.

Adolescent ; Child ; Female ; Humans ; Male ; Thyroglossal Cyst

Compartment Syndromes ; diagnosis ; etiology ; Female ; Fractures, Bone ; complications ; Hematoma ; complications ; Humans ; Middle Aged ; Pelvic Bones ; injuries ; Retroperitoneal Space

Objective To investigate the efficacy and safety of endovascular therapy for small unruptured intracranial aneurysms (sUIAs). Methods Patients with unruptured intracranial aneurysms who underwent endovascular therapy in the Department of Neurology, Guangzhou First People's Hospital from January 2008 to January 2018 were retrospectively included. According to the size of the aneurysms, they were divided into the sUIAs group (diameter <5 mm) and the non-sUIAs group (diameter ≥5 mm). Demographics, vascular risk factors, aneurysm characteristics, and treatment method, effectiveness, perioperative complications, and outcomes of endovascular therapy were compared between the two groups. Results A total of 80 patients with unruptured intracranial aneurysms were enrolled, including 33 patients with sUIAs (41.25% ) and 47 patients with non-sUIAs. The age of patients (51.1 ± 9.7 years vs. 61.2 ± 8.1 years; t=5.058, P<0.001), and the maximum diameter (3.6 ± 1.1 mm vs. 8.2 ± 3.2 mm; t=7.923, P<0.001) and neck width (3.1 ± 0.5 mm vs. 4.5 ± 2.5 mm; t=3.167, P=0.002) of aneurysms as well as the proportion of patients with wide-neck aneurysm (3.0% vs. 21.3% ; χ2 =7.213, P=0.007) and stent-assisted embolization (6.1% vs. 23.4% ; χ2 =4.285, P=0.038) in the sUIA group were significantly less than those of the non-sUIAs group. The embolization results, the perioperative complication rate and the good outcome rate were comparable between the two groups. Conclusion For sUIAs, endovascular therapy is effective and safe, comparable to endovascular therapy for non-sUIAs.

Objective To investigate clinical and epidemiological features of pneumocystis jirovecii pneumonia (PJP) in kidney transplant recipients. Methods Clinical data of 68 kidney transplant recipients admitted from July, 2021 to December, 2021 were collected. All patients were divided into the PJP group (n=11), common pulmonary infection group (n=24) and non-pneumonia group (n=33) according to the status of pulmonary infection. The incidence and treatment of PJP after kidney transplantation were analyzed. Basic characteristics and laboratory parameters of the recipients were compared among all groups. The genotyping and transmission map of PJP patients were evaluated. Results Among 64 kidney transplant recipients, 11 cases were definitely diagnosed with PJP. The most common clinical manifestations included elevated body temperature, and dry cough complicated with progressive dyspnea. Chest CT scan showed diffuse interstitial inflammation and ground glass-like lesions of bilateral lungs in all patients. After diagnosis, all patients were orally given with compound sulfamethoxazole for 3-4 weeks. Two patients received non-invasive ventilator-assisted ventilation due to severe lung infection and dyspnea, and the remaining patients were given with nasal cannula oxygenation. One patient experienced elevated serum creatinine level upon discharge, and developed renal allograft failure. The remaining 10 recipients with PJP obtained normal renal allograft function, and no recipient died. Compared with the non-pneumonia group, the rejection rate was higher, the length of hospital stay was longer, the lymphocyte count was less, the lymphocyte proportion was lower, the levels of C-reactive protein, serum creatinine and lactate dehydrogenase were higher, and the levels of serum albumin was lower and CD4⁺T cell count was less in the PJP group (all P < 0.05). Compared with common pulmonary infection group, the lymphocyte count was less, the lymphocyte proportion was lower, the CD4⁺T cell count was less and 1, 3-β-D- glucan (BDG) level was higher in the PJP group (all P < 0.05). No new genotype was detected in 10 of the 12 testing samples. It was considered that PJP mainly depended on two transmission chains and two independent transmission individuals. Conclusions Kidney transplant recipients are prone to pneumocystis jirovecii (PJ) infection due to impaired cellular immune function. The most common clinical manifestations consist of elevated body temperature and dry cough complicated with progressive dyspnea, accompanied by headache and fatigue in partial patients. Chest CT scan shows diffuse interstitial inflammation and ground glass-like lesion of bilateral lungs. PJ may be transmitted through respiratory tract. Small-scale PJP might occur in the follow-up outpatient of kidney transplant recipients. Preventive measures should be delivered in a timely manner.

Objective To develop a vector inserted with complete genome of poliovirus strain Sabin Ⅰ. Methods The 3 fragments of the complete genome of Sabin Ⅰ was amplified and cloned to pEASY-T3 by molecular biological technology. These cloned pEASY-T3 were then digested by Restriction enzymes and ligated to pWSK29 step by step and identified. Results The complete genome of poliovirus strain Sabin Ⅰ was successfully cloned into vector pWSK29 with 9 nucleotide mutations. Conclusion The complete genome plasmid was constructed and it provided a basis for further research of the function of Sabin Ⅰ.

OBJECTIVETo analyze the clinical features and prognosis of the primary myelodysplastic syndrome with myelofibrosis (MDS-MF) patients and to improve the cognition of MDS-MF.

METHODSFour hundred and sixty-six primary MDS patients with bone marrow (BM) biopsy were divided into two groups according to whether BM associated with fibrosis, the clinical features and prognosis of the two groups were analyzed retrospectively.

RESULTS167 (35.8%) MDS cases revealed myelofibrosis, of which MF-1 123 cases (26.4%), MF-2 40 cases (8.6%), MF-3 4 cases (0.9%). The proportion of hepatosplenomegaly in MDS-MF group was significantly higher than in MDS without MF group, the difference had statistical significance (P = 0.031). The proliferation of BM biopsy in MDS-MF group was significantly more active than in MDS without MF group. The number of blasts, megakaryocytes and abnormal megakaryocytes in MDS-MF group were significantly higher than in MDS without MF group, the differences had statistical significance (P < 0.05). Among the 345 patients who had available results of cytogenetic analysis, 121 cases were MDS-MF patients, the proportion of middle and high-risk prognostic group according to IPSS karyotype prognosis groups in MDS-MF group were significantly higher than in MDS without MF group, the differences had statistical significance (P = 0.047). The median survival was 17 (1 - 60) months in MDS-MF group, and was 32 (1 - 62) months in MDS without MF group. The difference had statistical significance (P = 0.001). Myelofibrosis had independent prognostic significance by multi-variable analysis (P = 0.019).

CONCLUSIONThe myelofibrosis in MDS is main the proliferation of reticular fiber. The proliferation of reticular fiber is closely related with the number of blast cells, the proliferation and developmental abnormalities of megakaryocytes and the karyotype. The prognosis of MDS-MF patients is poor.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Karyotyping ; Male ; Middle Aged ; Myelodysplastic Syndromes ; complications ; diagnosis ; pathology ; Primary Myelofibrosis ; complications ; diagnosis ; pathology ; Prognosis ; Retrospective Studies ; Young Adult