Microvascular decompression is an effective treatment for hemifacial spasm. Hemorrhage is oneof the complications of microvascular decompression. However, delayed hemorrhage is very rare.Here, we report a case of ipsilateral cerebellar hemorrhage at day seven following microvasculardecompression. A 45-year-old woman presented with left HFS for the previous two years. Diagnostictesting demonstrated the presence of neurosyphilis. Brain magnetic resonance image was unremarkableon presentation. She received microvascular decompression and her hemifacial spasm completelyresolved after surgery. At day seven post-operatively, the patient presented with a sudden onsetheadache. Emergency computed tomography scan showed a cerebellar hemorrhage. A suboccipitalcraniotomy was performed and a cerebellar hematoma was evacuated. The delayed hemorrhage wasattributed to possible microaneurysm from syphilis.

Metastatic brain lymphomas, which belong to secondary central nervous system lymphomas, usually originate from primary tumors of the bone marrow, testis, or orbit. Gastrointestinal lymphomas commonly metastasize to the lung or heart. We report here a case of brain hemorrhage due to metastasis from primary gastrointestinal diffuse large B-cell lymphoma (DLBCL). A 30-year-old male presented with headache. He was diagnosed to have gastrointestinal lymphoma 6 months earlier, and treated with gastrointestinal surgery. Pathological diagnosis was DLBCL. A PET-CT scan immediately after gastrointestinal surgery demonstrated no brain metastasis. On admission to the ward, imaging of the brain showed right temporoparietal hematoma. In the ward, the patient deteriorated with impaired consciousness. Repeat brain imaging showed enlargement of the hematoma. He underwent right temporoparietal craniotomy for the removal of a hematoma, and tumor nodules adherent to the cortex was found. Pathology confirmed a metastatic DLBCL in the brain. Literature review showed that this was the first reported case of brain hemorrhage from metastatic lymphoma. Metastatic central nervous system lymphoma should be considered as a differential diagnosis in patients with a history of gastrointestinal lymphoma presenting with neurological symptoms.

Adenocarcinoma ; genetics ; Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; genetics ; Male ; Middle Aged ; Mutation ; Receptor, Epidermal Growth Factor ; genetics

Objective To analyze the risk factors for renal function deterioration in patients with lupus nephritis. Methods Clinical data of patients with lupus nephritis admitted to the Third and the First Affiliated Hospital of Zunyi Medical College from June 2013 to June 2015 were reviewed and retrospectively analyzed. Of them ,62 lupus nephritis patients with the rapid deterioration of renal function were selected as an observation group ,and 62 patients were selected randomly from 200 lupus nephritis patients with normal renal function and were considered as a control group.Risk factors for the rapid deterioration of renal function in patients with lupus nephritis were analyzed by univariate analysis. Furthermore ,multivariate Logistic regression analysis was used to identify the independent risk factors for the rapid deterioration of renal function in patients with lupus nephritis. Results Univariate analysis revealed that infection , lupus activity , anemia , hypoproteinemia and hypertriglyceridemia were risk factors for the rapid deterioration of renal function in patients with lupus nephritis (P ＜ 0.05).Multivariate logistic regression analysis showed that infection ,lupus activity and hypoproteinemia were the independent risk factors for the rapid deterioration of renal function in patients with lupus nephritis(OR=3.109 ,3.669 and 2.691 ,P=0.003 ,0.004 and 0.033 , respectively ). Conclusions Infection ,lupus activity and hypoproteinemia are the independent risk factors for the rapid deterioration of renal function in patients with lupus nephritis. Early prevention and intervention can improve clinical outcome and quality of life in lupus nephritis patients.

OBJECTIVECleidocranial dysplasia (CCD) is a rare skeletal disease with autosomal dominant inheritance associated with mutation in RUNX 2. The authors report a Chinese girl with CCD in whom the mutation in RUNX 2 was identified.

METHODSClinical diagnosis was based on physical examination, radiological findings, and biochemical tests. For mutation detection, genomic DNA was extracted from peripheral blood using standard method. All 7 coding exons of RUNX 2 and their flanking intronic sequences were amplified by polymerase chain reaction (PCR), and the PCR products were then subjected to automatic DNA sequencing.

RESULTSThe affected girl showed typical clinical manifestations of CCD, including patent fontanelles, absent clavicles, short stature and dental anomalies. Direct sequencing of PCR-amplified fragments revealed a recurrent missense mutation, R190W (568 C > T), in RUNX 2. The mutation was further confirmed by Hae III restriction analysis.

CONCLUSIONA Chinese case of CCD was confirmed and the disease-causing mutation was linked to a recurrent point mutation in RUNX 2.

目的确定常用于脑卒中康复结局测量内容,主要是关于活动和参与的,并与《国际功能、残疾和健康分类》(ICF)对照。方法将以下量表的结构与ICF建立联系:Barthel指数(BI)、Berg平衡功能量表(BBS)、Chedoke Mc Master脑卒中评定量表(CMSA)、Euroqol-5D欧洲生活质量量表(EQ5D)、FI M功能独立性测量、Frenchay活动指数、Nottingham健康测验(NHP)、Rankin量表(RS)、Rivermead动作测量(RMA)、Rivermead移动指数(RMI)、中风影响测验-30(SASIP30)、医学结局研究简表(SF36),卒中影响量表(SIS)、脑卒中特定生存质量量表(SSQOL)和站立行走测验(TUG)。结果功能性结局测量中的绝大多数结构可与ICF分类建立联系。这些测量工具可以归入活动和参与的成份,活动是测量工具中最常见的类目内容。虽然测量工具的选择是基于它们主要关注的"活动"与"参与"内容,但有27%的结构属于身体功能类目,也有大约10%的结构与ICF不相关。结论在脑卒中的康复中,ICF是一种有效的工具来检测和比较脑卒中各测量工具的内容。这些内容上的比较使得临床医生和研究者们选择最符合他们兴趣和要求的测量。

Objective To evaluate the relationship between iodine intake level and the occurrence and development of thyroid diseases.Methods During the period of 1999-2004,a cross-sectional survey in 1999 and a 5-year follow-up survey were conducted in the 3 communities with different iodine intake levels in China:Panshan (mild deficiency),Zhangwu (more than adequate) and Huanghua (iodine excess).A total of 3 761 subjects were included in 1999 and 80.24% of them participated in the 5-year follow-up survey in 2004.The levels of serum thyroid hormones and thyroid autoantibodies were measured,and thyroid B ultrasound was performed.Results (1) The prevalence of overt hypothyroidism in 1999 in Zhangwu and Huanghua was 3.5 and 7.3 times,and that of subclinical hypothyroidism was 3.2 and 6.6 times as high as in Panshan,respectively.The 5-year cumulative incidence of subclinical hypothyroidism was 11.3 and 12.6 times as high as in Panshan,but no difference of incidence of overt hypothyroidism was found.(2) The prevalence of autoimmune thyroiditis (AIT) in 1999 in Zhangwu and Huanghua was 3.8 and 6.2 times,and the S-year cumulative incidence of AIT was 4.4 and 5.5 times as high as in Panshan.(3) During the 5-year follow-up period,the incidences of hypothyroidism in subjects with positive thyroid peroxidase antibody and euthyreidism in Zhangwu and Huanghua were 4.2 and 10.3 times as high as in Panshan.(4) No significant differences in both prevalence in 1999 and 5-year cumulative incidence of overt hyperthyroidism were found in the 3 communities.(5) The incidence of thyroid cancer was 19.37/100 000 per year in Huanghua,and all of the cases were papillary thyroid cancer,and no thyroid cancer was found in Zhangwu and Huanghua.Conclusion More than adequate or excessive dietary iodine intake may induce and promote the occurrence and development of hypothyroidism and AIT,therefore,median urinary iodine excretion (MUI)more than 200?g/L in the population appears not safe.The observation that a higher incidence of thyroid cancer occurred in the iodine excessive areas with MUI 600?g/L deserves further investigation.

This paper analyzed the clinical data of 17 patients with inhalation dimethyl sulfate poisoning in Changzhou Third People's Hospital, in order to understand the clinical characteristics, treatment and prognosis of patients with inhalation dimethyl sulfate poisoning, and guide clinicians to make effective measures in time. Dimethyl sulfate poisoning progresses rapidly and dangerously. The prognosis is usually better if the patients are separated from the toxic environment as soon as possible, given glucocorticoids in early and short-term, closely observed respiratory tract injury, and treated with endotracheal intubation and invasive mechanical ventilation when necessary.
Humans ; Respiration, Artificial ; Sulfuric Acid Esters

Humans ; Kidney/pathology*

The advancement and popularization of molecular diagnostic techniques has challenged and redefined the traditional concept of genetic metabolic disease. Regardless of disease origin, all genetic defects that lead to hepatobiliary dysfunction or structural abnormalities are termed as genetic liver disorders. Online Mendelian Inheritance in Man (OMIM) is a database consisting 693 genetic diseases with clear molecular mechanism of liver related phenotypes. Moreover, the effective measures to control infectious liver disease have strengthened the importance of research in the field of (adult and children) genetic liver disorders at home and abroad by well-recognized hepatologists. Notably, all patients with unexplained hepatopathy and multiple system diseases involving liver and gallbladder needs screening for genetic liver disorders, except for factors such as infection, immunity, drug-related, and anatomical abnormalities. We hope more patients with complicated liver disorders will benefit from definitive diagnosis and effective treatment in the near future with clear explanation of clinical phenotype, genotype, and metabolomics.
Child ; Databases, Genetic ; Genetic Diseases, Inborn ; Genotype ; Humans ; Liver Diseases/therapy* ; Phenotype