1.The features of nerve electrophysiology in children with Miller-Fisher syndrome
Journal of Clinical Pediatrics 2017;35(1):24-27
Objective To explore the features of nerve electrophysiology in Miller-Fisher syndrome (MFS) in children.Methods Thirty-four children with MFS were selected.The examinations of routine motor sensory nerve conduction,H reflexes of soleus muscle and F wave of median and tibial nerevs were performed.At the same time,33 healthy children of the same age were selected as control group and 30 children with typical Guillain-Barre syndrome (GBS) selected as GBS group,which were compared with children with MFS.Results In children with MFS,routine motor nerve conduction velocity and amplitude,and sensory nerve conduction velocity were in normal range.Twelve cases (35.29%) showed a decrease in sensory nerve amplitude potential (SNAP),5 cases (14.71%) showed sural sparing phenomena (the decline degrees of SNAP in median or ulnar nerve greater than in sural nerve),22 cases (64.71%) showed abnormality of H reflex,and 12 cases (35.29%) showed the decline of SNAE Compared with control group,there was no difference in sensory nerve conduction velocity and SNAP in sural nerve in children with MFS (P<0.05);While there were significant decreases in SNAP in both median nerve and ulnar nerve (P<0.05).Compared with GBS group,children with MFS had significantly higher sensory conduction amplitude and faster velocity (P<0.01).Conclusion A decrease of terminal sensory nerve conduction amplitude could be found in children with MFS,but,the SNAP had limited impact on it.H reflex abnormality is the most common electrophysiologic abnormalities in MFS.
2.The probability and timing of Miller-Fisher syndrome progressing to Guillain-Barre syndrome or Bickerstaff brainstem encephalitis in childhood
Ruidi SUN ; Bing FU ; Jun JIANG
Journal of Clinical Pediatrics 2017;35(6):441-445
Objective To investigate the probability and timing of childhood Miller-Fisher syndrome (MFS) progressing to Bickerstaff brainstem encephalitis (BBE), classical Guillain-Barre syndrome (GBS), and pharyngeal-cervical-brachial (PCB-GBS). Methods The clinical data of 128 children with confirmed MFS diagnosis were retrospectively analyzed. Results Among 128 children, 60 cases were simple MFS (ocular muscle paralysis, ataxia, reflexes diminished or disappeared, without limbs weakness and lethargy; laboratory tests suggest cerebrospinal fluid protein-cell separation and/or serum anti-GQ1b antibody positive), 28 cases developed MFS/PCB-GBS (met MFS diagnosis criteria, accompanied by weakness of pharynx, neck and upper limb, weakened or disappeared of upper limb reflex, without weakness of lower limb), 22 cases developed MFS/GBS (met MFS diagnosis criteria, accompanied by weakness of limb), 18 cases developed MFS/BBE (met MFS diagnosis criteria, accompanied by lethargy, pyramidal tract positive). There were no differences in the age at onset, the interval from onset to the start of the treatment, Hughes functional grading, and the percentage of cases having a history of preceding infections, the rate of positive serum anti-GQ1b antibody, the ratio of albumin cytological dissociation in cerebrospinal fluid among 4 groups (P>0.05). The interval from MFS onset to progression to MFS/PCB-GBS, MFS/GBS, or MFS/BBE was within 10 days. Conclusions In children with MFS, 50% developed PCB-GBS, GBS, or BBE, which occurred within 10 days after onset. Clinicians should pay attention to the time window and adjust the medicine rationally.
3.CT findings of primary pulmonary non-Hodgkin lymphoma
Gang PENG ; Xiaohua ZHU ; Xiwen SUN ; Sen JIANG ; Jun MA
Chinese Journal of Radiology 2008;42(2):141-144
ObjectiveTo analyze the CT appearances of primary pulmonary non-Hodgkin lymphoma(PPNHL)in order to improve its diagnosis.MethodsCT manifestations of 19 cases with PPNHL confirmed by pathology and clinical follow-up were retrospectively analyzed.ResuitsNodules 7 cases and masses 8 cases in PPNHL were ill-defined and markedly enhanced,in which air bronchogram was commonly seen.Muhiple patchy areas distributed in the bilateral lungs were found in 9 cases.Consolidation 7 cases was lobar and markedly enhanced,in which air bronchogram was commonly seen.Interstitial change manifested as bilateral diffuse ground-glass opacities and reticular shadow was found in 1 case.Mixed imaging manifestations were detected in 10 cases.Pleural effusion 4 cases was uncommon.Conclusion CT manifestations of PPNHL are varied,but some specific imaging features still exist,CT examination combined with clinical manifestations is helpful for the diagnosis of PPNHL.
4.The relationship between the molecular biology and the clinical characters and prognosis of colorectal cancer
Jun LI ; Jianzhong CHEN ; Baojun SUN ; Weidong JIANG
Chinese Journal of General Surgery 1997;0(04):-
0.05).The prognosis was worse with increase in Dukes stage,negative expression of gene nm23,and positive expression of gene p53 and C-erb-2.Reverse expressions had better prognosis.Conclusions It can be likely to get a more reliable prognosis predication if a combine examination together with p53,C-erb-2,nm23 and their clinical pathology such as Dukes stages,was done in colorectal cancer patients.
5.The effect of gastric mucosal blood flow and Na~+-K~+-ATPase activity on gastric transmucosal potential difference during severe intraperitoneal infection in rats
Chao ZHANG ; Jun JIANG ; Nianxu SUN ; Zongcheng YANG
Chinese Journal of General Surgery 1993;0(03):-
Objective To investigate the effect of gastric mucosal blood flow and Na + -K + -ATPase activity on gastric transmucosal potential difference during severe intraperitoneal infection in rats. Methods A rat model of intraperitoneal infection was established by cecal ligation and puncture(CLP). Laser Doppler blood flowmeter was used to examine the gastric mucosal blood flow and electric-physiological recorder was applied for measuring gastric mucosal potential difference. Assay of Na + -K + -ATPase activity in gastric mucosal tissue was conducted by biochemistry method. Results Gastric mucosal blood flow(GMBF,mV) in infected group was significantly lower than in control group(43.7?2.8 vs. 57.9?2.7,P
6.Spinal sagittal imbalance in patients with osteoporotic vertebral compression fractures
Xiangwei ZHANG ; Jianmin SUN ; Xingang CUI ; Zhensong JIANG ; Jun DONG
Chinese Journal of Tissue Engineering Research 2014;(26):4224-4228
BACKGROUND:The reasons for spinal imbalance include spinal deformity, spinal degenerative disease osteoporotic vertebral compression fractures. We believe that the power factor (back muscle) plays a key role in spinal sagittal imbalance. OBJECTIVE:To analyze the reasons for spinal sagittal imbalance by observing clinical manifestations and therapeutic outcomes in patients with osteoporotic vertebral compression fractures. METHODS:A total of 41 patients with osteoporotic compression fractures combined with spinal sagittal imbalance were retrospectively analyzed from January 2012 to May 2013. Al patients were subjected to percutaneous bal oon vertebroplasty under local anesthesia. Before treatment, they received bone density, standing ful-spine lateral X-ray, CT and MR imaging with injured vertebrae as the center. Using standing ful-spine radiographs, the height of anterior border of the injured vertebrae, Cobb angle of kyphosis and improved angle, wedging angle of the injured vertebrae and improved angle were measured. The patients underwent weight loading test and walking test. Preoperative and postoperative data were compared. RESULTS AND CONCLUSION:The patients affected spinal sagittal imbalance symptoms, so the walking distance was significantly shorter than that postoperatively (P<0.05). Moreover, the time of weight loading test was significantly shorter than that postoperatively (P<0.05). In standing ful-spine radiographs, the average difference of Cobb angle was (10.01±0.76)°. The mean difference of vertebral wedging improvement was (4.84±0.40)° (P<0.05). Al patients were fol owed up. Low back pain and sagittal imbalance symptoms were relieved. No severe complications appeared after percutaneous bal oon vertebroplasty. Results indicated that patients with osteoporosis compression fractures can affect the symptoms of spinal sagittal imbalance, which is not only induced by wedging of the injured vertebra. In addition, after percutaneous bal oon vertebroplasty, imbalance symptoms are apparently improved, suggesting that back pain after spinal fracture limits back muscle strength and is an important cause for spinal sagittal imbalance.
7.Influence of bone morphogenetic protein on articular cartilage regeneration after periosteal grafting
Yimin ZHANG ; Xin JIANG ; Yongzhi GUO ; Yanshan SUN ; Jun WANG
Chinese Journal of Tissue Engineering Research 2007;0(19):-
AIM: Bone morphogenetic protein (BMP) as polyphenic morphogen can induce the formation of bone and cartilage. This study investigates the effect of BMP on articular cartilage regeneration after periosteal graft. METHODS: Experiments were performed at the Animal Laboratory (absl-3) of Weifang People's Hospital from September 2006 to January 2007. Sixteen New Zealand white rabbits (32 knees) (2.5-3.0 kg) were divided into experimental and control groups randomly, each 8 rabbits (16 knees). The 3.5 mm in diameter of full-thickness articular cartilage defect was made on femoral intercondylar fossa in all rabbits, and 3.5 mm in diameter of periosteum was cut out from the anteromedial part of the upper tibial bone. In the experimental group, the cartilage defect was covered with periosteum, into which 20 ?g BMP and 20% Pluronic were injected. In the control group, the cartilage defect was covered with periosteum, into which the same dosages of 9 g/L saline and 20% Pluronic were injected. All the rabbits were sacrificed in 4, 8 and 12 weeks postoperatively. Motion of joint, conjunction of repair tissue and perienchyma were examined macroscopically. Haematoxylin-eosin staining and toluidine blue staining were used to observe the characteristics of repair tissues. Histological scores on samples in each group were measured by Wakitani score standard at different time points with light microscope. Ultramicrostructure of transplanted tissues was observed with scanning electron microscopy (SEM). RESULTS: Sixteen rabbits were included in the final analysis. Macroscopic observation: 4 weeks after the surgery, the defect was covered with tissue like cartage in the experimental group, and with periosteum in the control group. 8 weeks after the surgery, the surface of the defect was smooth, with boundary unclear in the experimental group. In the control group, the outcome was the opposite. In 12 weeks, cartilage had formed in the experimental group, and tissue like cartilage began to happen in control one. Histological observation: 4 weeks after the surgery, the defect was filled with cells and matrix with abundant proliferation of periosteal cambium layer in the experimental group, and slight proliferation in the control group. 8 weeks after the surgery, the periosteum in the experimental group became fibrocartilage with little hyaline cartilage. Just little fibrocartilage with on hyaline one was detected in the control group. In 12 weeks, the repair tissue in the experimental group approached to normal cartilage. Just fibrous tissue with little fibrocartilage was detected in the control group. Regenerative repair of cartilage defect was better in the experimental group than in the control group (P
8.Clinical significance of subclavian artery angiography in arterial embolization for hemoptysis
Sen JIANG ; Xiwen SUN ; Wenxiang ZHI ; Jun MA ; Zhengqian YOU
Journal of Interventional Radiology 1994;0(04):-
Objective To study the subclavian artery angiography for hemoptysis and its clinical value.Methods Thirty-eight cases of hemoptysis undertook subclavian artery angiography after embolization of bronchial arteries and branches of thoracic aorta. Group A: 4 recurrent cases underwent subclavian artery angiography (unilateral: n =2, bilateral: n =2). Group B: 16 cases underwent subclavian artery angiography according to the manifestation on X-ray and CT (right: n =10, left: n =6). Group C: 18 cases underwent bilateral subclavian artery angiography.Results of subclavian artery angiography were divided into three classes: normal(-),chaotic and hyperplasia of small branchi vessels(+),obviously bleeding (++).Some of the obviously bleeding cases were embolized and analysed for clinical efficacy and complications. Results Bleeding cases accounted for 63.2%(24/38)and bleeding subclavian arteries accounted for 50%(29/58), including(++):37.9%(22/58) and(+): 12.1%(7/58). Positive rate of chronic fibro-cavitary pulmonary tuberculosis was the highest. Bleeding sites were coincided with lung lesions. Twelve cases were embolized with the immediate cessation rate of hemoptysis reaching 100%. Eight cases with long-term follow-up showed 5 cured, 1 with significant effect and 2 recurrent. The complications occurred with fever, vomiting, chest pain, hiccup and dyspnoea.Conclusions Subclavian artery angiography has important clinical value in artery embolization for hemoptysis, especially for lesions in the upper lobes of lungs and with more fruitful result for chronic fibro-cavitary pulmonary tuberculosis.
10.The diagnostic value of VILIP-1 and NR2 peptide combined detection in the early ischemic stroke
Xiaoli LIU ; Xiuzhi ZHANG ; Changyi SUN ; Jun CAI ; Xiaofeng JIANG
Chinese Journal of Laboratory Medicine 2014;(6):469-472
Objective To Investigate the concentration of VILIP-1 and NR2 peptide in the serum of patients with ischemic stroke , and to explore their clinic value in early diagnostic of ischemic stroke patients.Methods The levels of VILIP-1 and NR2 peptide were examined by ELISA ( enzyme linked immunosorbent assay ,ELISA) with suspicious TIA ( defined as a neurological deficit that resolved within 24 hours) or acute ischemic stroke patients ( within 72 hours of onset of symptoms ) 340 cases,102 healthy controls,98 patients with vascular risk factors and 35 patients with hemorrhagic stroke.Among all the groups , VILIP-1 and NR2 peptide level were analyzed using the nonparametric Wilcoxon test.Diagnostic performance were analyzed among the groups with the two biomarkers independently and combinedly .Results Serum levels of VILIP-1 and NR2 peptide in patients with ischemic stroke (IS) were 9.80 (1.90-14.22) μg/L, 14.40 (5.60-27.91) μg/L respectively,which was higher than that of the healthy control group [VILIP-1:0.02 (0.01-0.09),NR2:0.33 (0.02-1.15),χ2 were 5.61 and 9.54,P<0.001],the group with vascular risk factors [VILIP-1:0.03 (0.02-0.16),NR2:0.27 (0.01-1.54),χ2 were 6.74 and 10.62,P<0.001], the group of patients non-stoke [VILIP-1:0.04 (0.03-0.19),NR2:0.53 (0.45-1.21),χ2 were 3.78 and 7.63, P <0.001 ].The levels of VILIP-1 and NR2 peptide was significantly increased in IS patients presenting within 3 h of symptom onset.When differentiating IS from patients with hemorrhagic stroke ,NR2 had a AUC of 0.934,showing a strong distinguishing effectiveness.Differentiating IS from healthy controls , patients with vascular risk factors and non-stroke patients,the AUC of combination of VILIP-1 and NR2 was 0.974,which was higher than the AUC of either VILIP-1(0.849) or NR2(0.862) alone(P <0.05). Conclusions VILIP-1 and NR2 peptide are very sensitive and specific biomarkers to the early diagnosis of IS.The combination of VILIP-1 and NR2 peptide has higher value of clinical applications than one of them independently.