Clinical and endoscopic analysis of gastric Dieulafoy’s lesion

AIM:To investigate the incidence,location,clinical presentation,diagnosis and effectiveness of endoscopic treatment of gastric Dieulafoy's lesion(DL)in China. METHODS:All patients who received emergency upper gastrointestinal(GI)endoscopy due to gastric DL from February 2000 to August 2008 at GI endoscopy center of Renmin Hospital of Wuhan University were included in this study.The clinical presentation,medical history,location and characteristics of DL methods and effectiveness of therapy of patients with DL were retrospectively analysed by chart reviews.Long-term follow-up data were collected at outpatient clinics or telephone interviews. RESULTS:Fifteen patients were diagnosized with DL,which account for 1.04%of the source of bleed- ing in acute non-variceal upper GI bleeding.Common comorbidities were found in one patient with hypertension and diabetic mellitus.Hemoclip or combined therapy with hemoclip produced primary hemostasis in 92.8%(13/14) of patients. CONCLUSION:DL is uncommon but life-threatening in China.Hemoclip proved to be safe and effective in controlling bleeding from DL.

A clinical analysis of acute pancreatitis in pregnancy

To the Editor： Acute pancreatitis in pregnancy （APIP） is one of the acute abdomen in pregnancy. Once the disease deterio- rated rapidly, it could be a serious threat to gravida and fetus. Although the incidence of APIP has been gradually increasing due to the life style change, it is still a rare disease and the mechanism is not clear. Patients with APIP were often misdiagnosed and not managed properly.

Clinical Analysis of 73 Cases of Intraspinal Nerve Sheath Tumor

Seventy-three patients with spinal nerve sheath tumor who were surgically treated in our hospital during the years 2004-2010 were retrospectively reviewed with respect to recovery of neurological function, recurrence of the tumor and occurrence of kyphotic deformities. Preoperative clinical manifestations, imaging data, surgical records and follow-up results were comprehensively analyzed. The follow-up duration was 12-60 months with an average of 32.0 months. Out of the 73 cases enrolled, 69 had gradual recovery of sensation, motor and sphincter functions 1 week to 3 months after operation. Forty-six cases had incomplete paralysis, whose American Spinal Injury Association （ASIA） grades, however, were gradually increased during the follow-up period, 4 cases had no significant improvement of the clinical symptoms and no change in ASIA grades during the follow-up period. Two cases had postoperative recurrence of the tumor. There were no deaths, no spinal instability, and no kyphotic malformations fotmd in any cases. Our study indicated that complete removal of the tumor is important for good recovery, and an ideal surgical method may reduce the recurrence of the tumor or the occurrence of complications.

Clinical characteristics of myotonia congenita in China Literature analysis of the past 30 years

AIM： To understand the distinct, clinical features of myotonia congenita in China. METHODS： Case reports of myotonia congenita were retrieved from the Chinese Journal Full-text database, dating between 1980 and 2007, and analyzed for clinical characteristics of myotonia congenita. RESULTS： There were 35 published reports and 258 cases about myotonia congenita. Six reports （62 cases） were excluded due to lack of clinical data, imprecise diagnosis, or duplication. Finally, 29 published reports and 196 cases （140 males and 56 females） were included in this analysis. About 78.6% of patients were diagnosed with myotonia congenita before the age of 20, and among these, 86.1% were classified as dominant inheritance. Lower and upper extremities were frequently affected with severe symptoms. Eyelids, mouth and lingual muscles, and trunk muscles and cervical muscles were less frequently involved. However, muscles for swallowing, sphincter muscles, and smooth muscles were not involved. There were no reports of cataracts, cardiac conduction block, or dyscrinism. myotonia congenita symptoms were induced or aggravated by cold temperatures in 71.9% of the patients and warming-up effect occurred in 95.6% of the patients. Muscle hypertrophy was observed in 69.6% and percussion of muscles in 76.5% of the patients. Myotonia potential or myotonia-like potential was detected in all patients using electromyography. Muscle fiber swelling or hypertrophy was frequently detected through muscular biopsy. CONCLUSION： Myotonia congenita frequently occurs in males before the age of 20, in particular as the autosomal dominant form of myotonia congenita. Skeletal muscles throughout the body, especially the lower and upper extremities, are involved. However, muscles for swallowing, sphincter muscles, and smooth muscles are not involved. Warming-up effect is the main characteristic of myotonia congenita.

Intracranial Hypertension Syndrome in Systemic Lupus Erythematosus: Clinical Analysis and Review of the Literature

In order to better understand the clinical manifestation of systemic lupus erythematosus （SLE） with intracranial hypertension syndrome （IHS）, we analyzed the clinical features and treatment of a typical SLE patient with IHS. SLE is one of the most unpredictable autoimmune diseases involving multiple organ systems that is defined clinically and associated with antibodies directed against cell nuclei. IHS is an uncommon manifestation of neuropsychiatric SLE （NPSLE） and is characterized by an elevated intracranial pressure, papilledema, and headache with occasional abducens nerve paresis, absence of a space-occupying lesion or ventricular enlargement, and normal cerebrospinal fluid chemical and hematological constituents. IHS has been reported in a few sporadic cases in patients with SLE worldwide, but rarely has been reported in China. In this study, a 34-year-old female SLE patient with IHS was. reported and pertinent literature reviewed. The clinical presentation, image logical features, and investigatory findings were discussed.

FEMALE LARYNGOCARCINOMA (CLINICAL ANALYSIS OF 267 CASES)

Two hundred and sixty-seven cases of female laryngocarcinoma, treated in our hospital in the past 33 years, were analysed. It is suggested that a relating preponderance of male sex hormonal influence after menopause should be a contributing factor responsible for the high prevalemce of laryngeal cancer in women. The other etiological factor was cigarette smoking. The pathological types and patterns of metastasis to cervical lymphnodes in the female laryngocarcinoma were similar to those observed in male patients but the superglottic cancer was more common than the flottic type. However, no significant difference in prognosis was observed between superglottic and glottic cancers. Provided indications are strictly adhered to, partial laryngectomy that can give therapeutic resulrs similar or even superior to total laryngocarcinoma.

Clinical comparative analysis of the outcomes with a yellow- and a violet-tinted intraocular lens

Dear Sir,I am Dr. Peter Mojzis from Premium Clinic in Teplice （Czech Republic）. I write to present the results of a comparative study of clinical outcomes obtained with two different types of tinted intraocular lenses （IOLs）, yellow-vs violet-tinted IOLs. IOLs containing a yellow chromophore that filters simultaneously ultra violet （UV） and blue light were developed several years ago in the attempt of avoiding that blue and violet visible light reached the retina in the pseudophakic eye.

Study of Behavioral Changes and Photosynthetic Activity of <i>Euglenas gracilis</i>in the Presence of Effluents from the Laboratory of Clinical Analysis

Healthcare waste has now been increasingly studied in terms of the risks or dangers that can cause the environment and human health. Waste generated in clinical analysis laboratories (CALs) deserves attention, because, due to the advent of the concept of emergent pollution, it is doubtful if the materials or reagents are disposed in the sewage by CALs, which are currently considered non-contaminated or with low risk potential, under current legislation, may actually impact the environment with actions not yet understood. This study was experimental and conducted at the Environmental Laboratory of the University of the Region of Joinville. It was used Euglena gracilis (primary trophic level) algae exposed to effluents from five sectors of a CAL: Biochemistry, Hematology, Viral Load, Tuberculosis and Immunochemistry. Samples were collected from the siphons attached to the wash sinks of the CAL materials. To verify changes in algae that denote environmental danger, behavioral changes were analyzed via NGTOX, and chlorophyll concentration was calculated by chlorophyll extraction according to Mendel’s method. Viral Load (VL) and Hematology (HT) sectors were the ones that most affected algae (Tukey test). In both sectors, there was inhibition of algae mobility and gravitaxy: in VL, due to the presence of chaotropic agents that denature organic structures;and in HT, due to the change in membrane permeability attributed to methylene blue. Also in HT, there was a search for algae adaptation by increasing the rise to the surface in order to overcome the lower luminosity due to the coloration of the environment, which also affects photosynthesis. Regarding the concentration of a-chlorophyll, the VL and HT were the most affected as well, being the first one the one that had more concentration reduction because of the presence of chaotropic agents. Considering new parameters evaluated, the discarded compounds need to be better evaluated for risk, as they affect algal photosynthesis. Procedures for removal of these compounds should be considered.

A CLINICAL ANALYSIS OF 7878 PATIENTS WITH TUMORS IN THE HEAD AND NECK

7878 patients with tumors in the head and neck were analyzed in a period of twenty years. All the diagnosis were confirmed by pathologic examination. There were 5485 cases (69.62%) of malignant tumors. Nearly an half of malignant tumors were in the nasopharynx (49.32%). Among the malignant tumors of the nasopharynx, 2698 were carcinoma (99.34%) and only 18 (0.66%) sarcoma. Nine of them were under 10 years of age, the youngest patient was 3 years old, and this is rare in our county. The incidence of head and neck tumors was 37.66% and that of the head and neck malignancies was 26.22% of tumors in the whole body. This study indicates that incidence of malignant tumor in head and neck was rather higher, it is worth to improve ths procedure of treatment and prevention.

Clinical Analysis of 60 Cases of Children's Anorexia Treated with Massage

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Retrospective Clinical Analysis of 38 Cases of Pulmonary Embolism

Objectives To investigate the clinical feature of acute pulmonary embolism. Methods Retrospective clinical analysis was performed according to the data of 38 cases of pulmonary embolism. Results There were ground diseases and predisposing factors in 36 cases of pulmonary embolism among 38 cases, the ratio was 94. 7%, among the total predisposing factors, tumor, cardiovascular disease, venous thrombosis of lower extremity, smoking and long-term bed were common. There was no specificity in clinical feature, physical sign and rout chest X ray, electrocardiography, and their appearances were diversified. There were specificity and sensitivity in echocardiogram （UCG） and D-dimer to some extent. But, the final diagnosis must depend on some special examinations, such as selective pulmonary arteriography, CTPA, MRA and so on. Conclusions The special examinations must be done to make a definite diagnosis to confirm pulmonary embolism when the high risk factors and ground diseases are existing. It is necessary to some cases when the clinical feature can not be explained by other diseases.

Clinical metabolic analysis combined with traceability of biosynthetic pathway:a new approach to quality marker of Chinese materia medica

Quality marker(Q-marker)of Chinese materia medica(CMM)plays an important role in quality control of CMM products.However,its research strategy and technique remain unclear.Based on the fact that quality standard of CMM should be associated with clinical efficacy,taking Jinqi Jiangtang tablet treating type 2 diabetes as an example,the Q-marker related to activity via the reverse analysis of drug metabolism in clinic and traceability of botanic biosynthetic pathways is discovered and validated.Therefore,we proposed a new research strategy of Q-marker of CMM with"Discovery of clinical active constituents as guidance,Reverse analysis of metabolic transformations as link,and Traceability of biosynthesis pathways as key",to improve quality control of CMM products.

A clinical analysis of risk factor with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy

Objective To investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy. Methods The subjects were 82 patients with pN0 esophagea cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005. By using RT-PCR,VEGF C mRNA was detected in tumor issues,and Mucin (MUC1) mRNA was detected in lymph nodes. The Kaplan-Meier method was used to calculate the survival

Clinical Analysis of 42 Patients With Hypertrophic Cardiomyopathy

Objectives To investigate the clinical manifestations of hypertrophic cardiomyopathy (HCM), and to find out the clinical clues to avoid misdiagnosis and provide reference for future clinical diagnosis and treatment. Methods A retrospective analysis of 42 consecutive patients with HCM hospitalized in our hospital between January 1995 and December 2002 was explored. Based on the family history of HCM, clinical manifestations, electrocar-diogram, echocardiogram, coronary angiography and left ventriculography, the clinical characteristics between HCM patients with left ventricular outflow tract obstruction (HOCM) and HCM patients without obstruction (HNOCM) were compared. The causes of misdiagnosis and losing diagnosis were analysis. Results 13 patients were in HOCM group and 29 patients were in HNOCM group. More patients with syncope were in HOCM group than in HNOCM group (6/13 vs. 2/29, P < 0.05). Patients with ejective murmur were in HOCM group only (P < 0.01). Left ventricular outflow tract pressure gradient (LVOTPG) only observed in HOCM group (P < 0.01). Ventricular tachycardia was seen in both groups. 28 out of 42 patients (66.67%) had misdiagnosis, and 4 out of 42 patients (9.53%) had losing diagnosis. Thus, coronary heart disease (CHD) had the highest rate of misdiagnosis. There were 20 CHD patients (71.43%) among 28 patients with misdiagnosis. Hypertension was in 3, congenital heart in 2, cerebro-embolism in 2, and myocarditis in 1. Conclusions For a patient with family history or sudden death history of HCM, unexplained syncope episodes, chest pain (angina), especially in young, an ejection murmur along the left sternum border, the presence of narrow and deep Q waves, or inversion of giant T waves in V3-V6, atrial fibrillation and /or cerebra-embolism echocardiogram should be given. CAG and LVG are necessary only if the result of echo is negative, and the patients with suspected HCM or CHD.

Clinical analysis of 251 cases of soft tissue sarcomas

Objective To explore the therapeutic principles and prognostic factors of soft tissue sarcoma. Methods Two hundred and fifty-one patients with soft tissue sarcoma (STS) treated at Shanghai Cancer Hospital during 1986 -1990 were reviewed retrospectively. Results The 1-, 3 - , 5 - , 10 - year tumor-free survival rates were 67. 74% , 57. 16% , 52, 41% , 38. 60% , respectively.The overall survival rates for 1,3,5 and 10 years were 81. 01 % ,67.75% ,60.79% ,and 49.23% respectively. Log-rank test showed that the patients with different pathological findings, histological grades,mass location and size, anatomical depth, and surgical margin showed different outcomes. Whether the sarcomas invaded the vessels or metastasized would influence the survival rates. The patients who underwent different interventions or operations also had different outcomes. The prognosis of STS was associated with age,histological type,histological grade, tumor size, surgical margin and metastasis according to the Cox regression

Clinical analysis of symmetry peripheral entrapment neuropathies of upper extremity

Objective To discuss the etiology,course of diseases and prognosis of symmetry peripheral entrapment enuropathies of upper extremity. Methods The etiology, clinical scale and resluts of 14 cases were analyzed betwen 1999 and April 2002. Results In the bilateral tunnel syndrome, the excellent and good rate was 60% at the original side and 80% at the contralateral side occurred later. In the bilateral carpal tunnel syndrome, the excellent and good rate was 67% at the original side and 89% at the contralateral side occurred later. Conclusion The main etiological factor of the bilateral cubital tunnel syndrome was the elbow eversion deformity. The lesions of synovium contributed mainly to the symmetry carpal tunnel syndrome. The symmetry peripheral entrapment neuropathies of upper extremity should be operated on as soon as possible when diagnosis had been made for enhancement of treatment outcome. 5 refs,2 tabs.

Clinical analysis of squamous cell carcinoma of renal pelvis

Objective To review the diagnosis and treatment of squamous cell carcinoma of renal pelvis. Methods The clinical data,from October 1991 to May 2009,of eight cases of squamous cell carcinoma of renal

Clinical analysis of 100 cases of lung transplantation for end-stage palmonary disease

Objective To estimate the indications,operative technique,perioperative treatment,postoperative complications and the outcome of lung transplantation ( LTx) for end - stage pulmonary diseases. Methods The clinical data of 100 patients with end - stage lung diseases receiving LTx in our hospital were retrospectively ana-

Clinical analysis of different periods of liver transplantation at an organ transplantation centre

Objective To summarize our clinical experience in liver transplantation while considering the background in this filed in China. Methods Ninety-five patients who had received liver transplantation from April 1993 to March 2002 were analyzed retrospectively. Three periods were defined objectively as period Ⅰ(1993-1997),Ⅱ(1999) and Ⅲ(2000 -2002). Operative techniques, recipients, original diseases, complications and survival rates were compared among the three periods. Results Malignant liver lesions were the main cause for liver transplantation in period Ⅰ and Ⅱ. The ratio of number of malignant disease to total recipients decreased gradually from period Ⅰ to Ⅱ (100%, 53% and 35%, respectively). The 1-year survival rate in patients with benign liver disease was 85 % and the total operative mortality was 5% in period Ⅲ. The incidence of hepatitis B virus reactivation or reinfection was 24% twelve months after liver transplantation. Vascular complication decreased but biliary complications did