Objective To investigate the efficacy and safety of repeated botulinum toxin type A (BTX-A) treatment for Meige's syndrome in senile people. Methods Forty-eight senile patients with Meige's syndrome received BTX-A treatment for twelve times or over. The improvements of spasm were evaluated before and after the first, the sixth and the twelfth treatment according to Cohen's criteria. The onset time, effective duration and side effects were studied and compared among the three times treatments. Results The obvious effective rate of the three times treatment were all 100%. The average onset time of the three times treatments were (3.5± 1.7)days,(3.2±1.8)days and (3.3±1.9)days, and the average effective duration were (25.4±2.1)weeks,(24.6±2.3)weeks and (25.4±1.8)weeks, respectively. The incidences of side effects were 8. 3% (4/48), 6.3(3/48)%and 8.3%(4/48), respectively. All the differences were not statistically significant(P>0.05). Conclusions Repeated BTX-A treatment is an effective and safe method for Meige's syndrome in senile people.

Objective Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus ( DM2).The aim of this study is to compare the effect of three diagnostic criteria on the prevalence of GDM.Methods 2864 pregnant women receiving obstetric care at 24 to 28 weeks of gestation at Peking University First Hospital,underwent the 75 g oral glucose tolerance test for routine GDM screening.The pregnancies were evaluated bythe American Diabetes Association (ADA 2004) Cuideline,the new criteria which was proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG 2010) based on the HAPO study,not by the criteria of American College of Obstetricians and Chinese Obstetrics and Gynecology (6th edition 2005).Venous plasma glucose was measured by the IDMS-traceable glucose oxidase method.Results The mean age of the women was 30 years.590 women were diagnosed with GDM using the IADPSG criteria.According to the IADPSG standard,GDM diagnostic rate reached 20.6％.The diagnostic rate of new criteria was increased by 307％ and 199％ compared with the Chinese Obstetrics and Gynaecology (6th edition) and the old ADA standard,respectively.If increasing the number of abnormal glucose values in the IADPS standard to 2 or more,the number of positive cases dropped to 227 people.The diagnostic rate of GDM plummeted to 7.93％,similar with that of the old ADA diagnostic criteria (6.8％).Conclusions The diagnosis rate of GDM was significantly higher using the IADPSG criteria,due to more stringent glucose abnormality recommended by the IADPSG.

Objective To evaluate left ventricular systolic function by real-time three-dimension speckle tracking imaging (RT3D-STI) in coronary artery diseases (CHD) patients,to determine the clinical value of RT3D-STI in CHD.Methods 34 control subjects and 55 patients with CHD by coronary angiography were involved.Left ventricular global longitudinal strain (GLS),left ventricular global circumferential strain (GCS),left ventricular global radial strain (GRS),left ventricular global area strain (GAS) and left ventricular ejection fraction (LVEF),etc,was acquired by RT3D-STI,respectively.The parameters by RT3D-STI to diagnose CHD were analyzed.Results Compared with control group,GLS,GCS,GRS and GAS were significantly decreased in CHD group (P ＜ 0.05).The area under receiver operating characteristics (AUC) curve of GLS to diagnose CHD was 91.6％.The cutoff value,the sensitivity and Youden index of GLS were-12.5,90.3 ％ and 0.612,respectiuely.The cutoff value,the sensitivity and Youden index of GAS were-23.0,95.8％ and 0.539,respectiuely.GLS,GAS correlated well with LVEF in CHD group (r =-0.860,r =-0.926).Conclusions GLS is the most sensitivity and GAS is the most specificity in the all of strain parameters.RT3D-STI can early show the changes of left ventricular global systolic function in patients with CHD.

Objective:To evaluate the feasibility and the application values of quantitative susceptibility mapping (QSM) for the assessment of meniscal injury and in distinguishing meniscus degeneration and tears.Methods:The clinical and imaging data of 70 patients suspected of meniscus injury and scheduled for arthroscopy in Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University from November 2019 to June 2020 were analyzed retrospectively. Thirty age-and sex-matched healthy subjects were also examined as controls. All subjects received knee joint QSM and routine MR imaging. According to the results of arthroscopy, the patients was divided into meniscus degeneration and meniscus tear groups, respectively. The conventional MR was evaluated by two radiologists. The meniscus injury area was delineated on the original QSM magnitude images (the central area of the posterior corner of the lateral meniscus was selected in the healthy controls) and mapped to the corresponding QSM maps, and the magnetic susceptibility values were measured. Kruskal-Wallis H test was used to analyze the magnetic sensitivity values of meniscal degeneration, meniscal tear and healthy control groups; and Bonferroni was used to correct the pairwise comparison. ROC curve was established to evaluate the threshold and efficacy of magnetic susceptibility value in the diagnosis of meniscal tear. The results were compared with those of conventional MRI. Results:The magnetic susceptibility values of meniscus of healthy controls, meniscal degeneration and meniscal tear groups were (0.035±0.016)ppm, -0.031(-0.040,-0.005)ppm, and(-0.122±0.115)ppm, respectively, with significant difference found among the three groups (χ2=44.419, P<0.05). The magnetic susceptibility values of meniscus of healthy controls was significantly higher than those of meniscus degeneration patients and meniscus tear patients (χ2=-23.843, -48.253, P<0.05). The magnetic susceptibility values of meniscus of meniscus tear group was significant lower than those of meniscus degeneration group (χ2=-24.410, P<0.05). Taking magnetic susceptibility values of -0.062 5 ppm as threshold, the area under the ROC curve for the diagnosis of meniscal tears was 0.949, with the sensitivity as 87% and the specificity as 100%. The sensitivity and specificity of conventional MRI in the diagnosis of meniscal tears were 86.8% and 87.5%, respectively. Conclusion:QSM can quantitatively evaluate meniscus injury and can be used as an effective supplement method to conventional MRI, which is helpful to improve the diagnosis of meniscus tear.

Objective:To construct cluster intervention strategy with medical adhesive-related skin injury (MARSI) based on multi-criterion decision analysis (MCDA) .Methods:Literatures related to nursing care of MARSI were systematically searched in Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, CNKI, VIP database, Wanfang Database and other Chinese and English databases. The retrieval period was from January 1, 2008 to December 31, 2018. A total of 10 correspondence experts used MCDA to assign scores to various nursing measures of cluster intervention strategies for MARSI patients. The recommendation score of each measure was calculated to form the recommendation, and the feasibility of cluster intervention strategy was verified through pre-test.Results:The authority coefficient of 10 letter experts was 0.830 and the positive coefficient of experts was 100%. After consultation with experts, 14 nursing recommendations were drawn up and entered into the item pool of cluster intervention strategies. The top 5 nursing measures were strengthening education and training for medical staff, standardization of application and removal of medical adhesives, application of alcohol-free skin protectants before using medical adhesives, complete skin dryness before using medical adhesive products (≥30 s) and correct description of damage type, color, range, etc.Conclusions:The use of MCDA can scientifically construct MARSI cluster intervention strategies.

Many studies at home and abroad have focused on the quality of life and influencing factors of patients with gastroesophageal reflux after surgical treatment. However, the improvement of patients' quality of life is affected by many factors. Therefore, this article reviews the evaluation tools, influencing factors and intervention measures of patients' quality of life after laparoscopic fundoplication, aiming to provide reference for promoting the recovery of patients' quality of life after surgery and the formulation of nursing plans.

OBJECTIVETo study the clinicopathologic features and significance of aberrant CD56 expression in diffuse large B-cell lymphoma (DLBCL).

METHODSThe clinical and pathologic profiles of 10 cases of DLBCL with aberrant expression of CD56 were investigated. Immunohistochemical staining, in-situ hybridization for Epstein-Barr virus encoded RNA and gene rearrangement for IgH and Igκ were carried out.

RESULTSThere were 6 male and 4 female patients. The medium age of patients was 46 years. All of them presented with extranodal lymphoma involvement, with gastrointestinal tract being the commonest site (5/10). Histologic examination showed that most of the atypical lymphoid cells were centroblast-like and demonstrated a diffuse growth pattern. Apoptosis and necrosis were identified in some cases. Immunohistochemical study showed that the tumor cells were positive for CD20 or CD79α and aberrantly expressed CD56. Five cases had the GCB phenotype while the remaining cases had the non-GCB phenotype, according to Hans classification. Bcl-6 was positive in most cases (9/10). All cases showed a high proliferation index by Ki-67. The tumor cells were negative for CD3ε, CD138 and granzyme B. In-situ hybridization for Epstein-Barr virus encoded RNA was performed in 7 cases and none of them showed positive signals. IgH gene rearranged bands were detected in 4 cases (4/6) and Igκ was detected in 3 cases (3/6). Follow-up data were available in 8 patients. Two patients died of disease progression within 5 to 13 months after diagnosis and the other 6 patients were alive 8 to 60 months after therapy.

CONCLUSIONSDLBCL with aberrant expression of CD56 is rare. Most of them present with extranodal involvement, show high frequency of bcl-6 expression and high proliferation index. The patients often have good response to chemotherapy.

Antigens, CD20 ; metabolism ; Apoptosis ; CD56 Antigen ; metabolism ; CD79 Antigens ; metabolism ; Disease Progression ; Female ; Gene Rearrangement ; Granzymes ; metabolism ; Herpesvirus 4, Human ; genetics ; Humans ; Immunophenotyping ; In Situ Hybridization ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Necrosis ; Phenotype ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; RNA, Viral ; analysis

OBJECTIVETo investigate the clinicpathologic features and diagnosis of plasmablastic lymphoma (PBL).

METHODSEleven cases of PBL were collected and followed up, with review of the literature. HIV and EBV status and their relationships with the tumor were specially compared as well.

RESULTSIn the current cohort, 10 patients were serologically HIV negative; the male to female ratio was 8 to 3, and the median age was 57 years. Ten cases showed extranodal involvement and one case was nodal based. At presentation, five patients had mid-facial involvement, including sinonasal area (3 cases) and oral cavity (2 cases). Histologically, six were PBL of oral mucosa type, and five were PBL with plasmacytic differentiation. In all cases, the neoplastic cells expressed CD138 and MUM-1, and were negative for CD20 and CD3ε; the median Ki-67 index was 80%. Five cases were EBER1/2 in situ hybridization positive. IgH or/and Igκ gene rearrangement was detected in all five cases examined.

CONCLUSIONSMost patients were no congenital or acquired immunodeficiency in the retrospective study. Of the died patients, EBER1/2 in situ hybridization were negative and their disease staging were Ⅳ, The neoplastic cells were immunoblastic or plasmablastic, sometimes the plasmacytoid cell can be seen and the neoplastic cell had mature plasma cell phenotype, the pathologic diagnosis of the lymphoma is still controversial now. Differentiate with plasma cell neoplasm is difficult, it is necessary to accumulate more cases for advanced study and observation in the future.

Female ; Gene Rearrangement ; Humans ; In Situ Hybridization ; Male ; Middle Aged ; Multiple Myeloma ; Plasma Cells ; Plasmablastic Lymphoma ; diagnosis ; pathology ; RNA, Viral ; metabolism ; Retrospective Studies

Objective To improve perioperative nursing behaviors and nursing quality by continuous quality improvement .Methods Questionnaire on perioperative nursing quality was designed according to perioperative nursing routine and quality inspection , and was used to investigate perioperative nursing effect and quality on postoperative patients in 10 wards before and after continuous quality improvement .Results Through continuous quality improvement , perioperative nursing quality in all wards was improved .The score improved from (78.7 ±3.25)to (96.3 ±1.29)in Neurosurgery Department, from (70.1 ±4.31) to (98.2 ±1.09) in Cardiothoracic Department , and the differences were statistically significant ( t=19.86,18.87, respectively;P<0.01).Problems of nursing also dropped after continuous quality improvement , the rate of no preoperative visits by nurses decreased from 25.4% to 3.6%, the rate of wrong reservation of postoperative wristbands decreased from 10.6% to 3.6%, and the differences were statistically significant (χ2 =23.72, 9.13, respectively;P<0.01).Conclusions Continuous quality improvement can effectively enhance perioperative nursing quality, reduce postoperative complications and improve patients ’ satisfaction.

OBJECTIVE: Utilize high-resolution chromosome analysis and microarray detection to determine the genetic etiology of infertility of a 32-year old female patient. METHODS: The peripheral blood of the patient was cultured for high-resolution chromosome G and C banding karyotype analysis, and then 750K SNP-Array chip detection was performed. RESULTS: Karyotype analysis results showed that the patient's karyotype was 45,XX,-13 [7]/46,XX,r(13) (p13q34) [185]/46,XX,dic r(13;13)(p13q34;p13q34) [14]/ 47,XX,+der(13;13;13;13) (p13q34;p13q34;p13q34; p13q34), dic r(13;13) [1]/ 46,XX [3]. The microarray results showed that the patient had a 3.3 Mb deletion in the 13q34 segment of chromosome 13, which may be related to infertility. CONCLUSION Infertility of the patient reported in this article may be related to the deletion of chromosome segment (13q34-qter).
Adult ; Chimera ; Chromosome Banding ; Chromosome Deletion ; Chromosome Disorders/genetics* ; Dacarbazine ; Female ; Humans ; Infertility/genetics* ; Ring Chromosomes