BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We r...BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.展开更多
AIM To observe the effect of targeted therapy with 64-slice spiral computed tomography(CT) combined with cryoablation for liver cancer.METHODS A total of 124 patients(142 tumors) were enrolled into this study. Accordi...AIM To observe the effect of targeted therapy with 64-slice spiral computed tomography(CT) combined with cryoablation for liver cancer.METHODS A total of 124 patients(142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group(n = 56, 65 tumors) and 64-slice group(n = 8, 77 tumors). All patients were accepted and received targetedtherapy by an argon-helium superconducting surgery system. The guided scan times of the two groups was recorded and compared. In the two groups, the lesion ice coverage in diameter of ≥ 3 cm and < 3 cm were recorded, and freezing effective rate was compared. Hepatic perfusion values [hepatic artery perfusion(HAp), portal vein perfusion(p Vp), and the hepatic arterial perfusion index(HAp I)] of tumor tissues, adjacent tissues and normal liver tissues at preoperative and postoperative four weeks in the two groups were compared. Local tumor changes were recorded and efficiency was compared at four weeks post-operation. Adverse events were recorded and compared between the two groups, including fever, pain, frostbite, nausea, vomiting, pleural effusion and abdominal bleeding.RESULTS Guided scan times in the dual-slice group was longer than that in the 64-slice group(t = 11.445, p = 0.000). The freezing effective rate for tumors < 3 cm in diameter in the dual-slice group(81.58%) was lower than that in the 64-slice group(92.86%)(χ2 = 5.707, p = 0.017). The HAp and HAp I of tumor tissues were lower at four weeks post-treatment than at pretreatment in both groups(all p < 0.05), and those in the 64-slice group were lower than that in the dualslice group(all p < 0.05). HAp and p Vp were lower and HAp I was higher in tumor adjacent tissues at post-treatment than at pre-treatment(all p < 0.05). Furthermore, the treatment effect and therapeutic efficacy in the dual-slice group were lower than the 64-slice group at four weeks post-treatment(all p < 0.05). Moreover, pleural effusion and intraperitoneal hemorrhage occurred in patients in the dual-slice group, while no complications occurred in the 64-slice group(all p < 0.05). CONCLUSION64-slice spiral CT applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment, so it is worth being used.展开更多
The mutation in CNKSR2 leads to a broad spectrum of phenotypic variability and manifests as an X-linked intellectual disability. However, we reported that the male patient in this study not only had intellectual disab...The mutation in CNKSR2 leads to a broad spectrum of phenotypic variability and manifests as an X-linked intellectual disability. However, we reported that the male patient in this study not only had intellectual disability but also epileptic seizures. In addition, there were progressive language impairment, attention deficit hype-ractivity disorder and autism. Electroencephalograms showed continuous spike-and-wave during sleep. Genetic testing revealed a de novo mutation of the CNKSR2 gene(c.2185C >T, p.Arg729Ter) in the child that was not detected in the parents. Therefore, the child was diagnosed with X-linked epilepsy aphasia syndrome. Deletion of the CNKSR2 gene has been rarely reported in epilepsy aphasia syndrome, but no de novo mutation has been found in this gene. This report not only adds to the spectrum of epilepsy aphasia syndrome but also helps clinicians in diagnosis and genetic counseling.展开更多
Improving exercise tolerance is indisputably beneficial for long-term survival in patients treated with percutaneous coronary intervention(PCI).Although previous studies suggested that Yangxinshi tablets effectively i...Improving exercise tolerance is indisputably beneficial for long-term survival in patients treated with percutaneous coronary intervention(PCI).Although previous studies suggested that Yangxinshi tablets effectively improve exercise tolerance in patients with coronary heart disease,the evidence is limited due to the lack of high-quality randomized trials.The Effects of Yangxinshi Tablets on Exercise Tolerance Compared with Trimetazidine in Patients after PCI(HEARTRIP)trial is a multicenter,double-blind,double-dummy,active drug-controlled,randomized trial designed to test if the effects of Yangxinshi tablets on exercise tolerance are non-inferior to those of trimetazidine in patients undergoing PCI.A total of 668 patients who have undergone PCI for the first time and completed a cardiopulmonary exercise test(CPET)will be enrolled and randomly assigned,in a 1:1 ratio,to receive Yangxinshi tablets(3 tablets,3 times/d)plus trimetazidine-placebo or trimetazidine(20 mg,3 times/d)plus Yangxinshi-placebo for 24 weeks.The primary endpoint is metabolic equivalent of tasks(METs)measured by CPET at 24 weeks after randomization.The secondary endpoints include comprehensive CPET indicators,incidence of major adverse cardiac and cerebrovascular events,and depression(Patient Health Questionnaire-9),anxiety(Generalized Anxiety Disorder-7),and quality of life(Seattle Angina Questionnaire)scores.This study will appraise current clinical evidence on the beneficial effect of Yangxinshi tablets on improving exercise tolerance after PCI and may substantiate their use as an effective pharmacological option for cardiac rehabilitation patients.The HEARTRIP study protocol received approval from the ethics committee of the General Hospital of Northern Theater Command(Shenyang,China).The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines.The results will be published following the guidelines of the CONSORT statement in a peer-reviewed scientific journal(Trial registration number:NCT03809273).展开更多
Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (...Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (ACh) in the case of vascular dementia (VD) The purpose of this study was to explore the levels of ACh and choline (Ch) in the cerebrospinal fluid (CSF) of patients with AD and VD, and their possible relationship with cognitive impairment KH*2/5DMethods Twenty-two AD patients, twenty-two VD patients, and twenty normal controls were recruited and scored with a Mini-Mental State Examination (MMSE) CSF concentrations of ACh and Ch were measured using high-performance liquid chromatography with an electrochemical detector (HPLC-ECD) and the results were then compared to cognitive status Results ACh concentrations in CSF of AD patients [(10 7±5 1) nmol/L] and VD patients [(16 8±7 4) nmol/L] were both significantly lower than in controls [(34 5±9 0) nmol/L, t =10 67, P <0 001; t =6 91, P <0 001] Both results correlated positively with MMSE scores ( r s =0 88 and r s =0 85, respectively, P <0 01) The CSF concentration of Ch was significantly higher in VD patients [(887 4±187 4) nmol/L] compared to AD patients [(627 6±145 1) nmol/L, t =6 4, P <0 001] and controls [(716 0±159 4) nmol/L, t =4 2, P =0 002] CSF Ch concentration showed no difference between AD patients and normal controls, nor did it correlate with MMSE score in any of the three groups Conclusions The positive correlation between ACh deficit and cognitive impairment suggests that ACh is an important neurotransmitter for memory The similar decrease in ACh concentration in AD and VD patients may imply a similar pathogenesis for the process of cognitive impairment involved in these two disorders The elevated CSF levels of Ch in VD patients compared to AD patients may be useful diagnostically Cholinesterase inhibitors may be helpful not only for AD patients, but also for VD patients展开更多
To meet the requirement of extensive resection of pancreatic cancer with portal or mesenteric venous invasion,the innovation of Vascular Graft Bridged En Bloc Resection （VGBEBR） has been adopted to treat advanced bi...To meet the requirement of extensive resection of pancreatic cancer with portal or mesenteric venous invasion,the innovation of Vascular Graft Bridged En Bloc Resection （VGBEBR） has been adopted to treat advanced biliopancreatic cancer in the Department of Hepatobiliary Surgery of the PLA Rocket Force General Hospital since 2013.This attempt could not only broaden surgical indications of radical resection and lymphadenectomy but also increase R0 resection rate,especially for the case with severe invasion in the portal and mesenteric venous system.展开更多
基金Supported by Special TCM Innovation Project of Hebei Provincial Department of Science and Technology,No.223777130DScientific Research Project of Hebei Province Administration of Traditional Chinese Medicine,No.2024215.
文摘BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.
基金Supported by Hebei Province Health Department of Scientific Research fund project,No.20110157
文摘AIM To observe the effect of targeted therapy with 64-slice spiral computed tomography(CT) combined with cryoablation for liver cancer.METHODS A total of 124 patients(142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group(n = 56, 65 tumors) and 64-slice group(n = 8, 77 tumors). All patients were accepted and received targetedtherapy by an argon-helium superconducting surgery system. The guided scan times of the two groups was recorded and compared. In the two groups, the lesion ice coverage in diameter of ≥ 3 cm and < 3 cm were recorded, and freezing effective rate was compared. Hepatic perfusion values [hepatic artery perfusion(HAp), portal vein perfusion(p Vp), and the hepatic arterial perfusion index(HAp I)] of tumor tissues, adjacent tissues and normal liver tissues at preoperative and postoperative four weeks in the two groups were compared. Local tumor changes were recorded and efficiency was compared at four weeks post-operation. Adverse events were recorded and compared between the two groups, including fever, pain, frostbite, nausea, vomiting, pleural effusion and abdominal bleeding.RESULTS Guided scan times in the dual-slice group was longer than that in the 64-slice group(t = 11.445, p = 0.000). The freezing effective rate for tumors < 3 cm in diameter in the dual-slice group(81.58%) was lower than that in the 64-slice group(92.86%)(χ2 = 5.707, p = 0.017). The HAp and HAp I of tumor tissues were lower at four weeks post-treatment than at pretreatment in both groups(all p < 0.05), and those in the 64-slice group were lower than that in the dualslice group(all p < 0.05). HAp and p Vp were lower and HAp I was higher in tumor adjacent tissues at post-treatment than at pre-treatment(all p < 0.05). Furthermore, the treatment effect and therapeutic efficacy in the dual-slice group were lower than the 64-slice group at four weeks post-treatment(all p < 0.05). Moreover, pleural effusion and intraperitoneal hemorrhage occurred in patients in the dual-slice group, while no complications occurred in the 64-slice group(all p < 0.05). CONCLUSION64-slice spiral CT applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment, so it is worth being used.
基金Supported by Jining Medical University,No.JYP201740
文摘The mutation in CNKSR2 leads to a broad spectrum of phenotypic variability and manifests as an X-linked intellectual disability. However, we reported that the male patient in this study not only had intellectual disability but also epileptic seizures. In addition, there were progressive language impairment, attention deficit hype-ractivity disorder and autism. Electroencephalograms showed continuous spike-and-wave during sleep. Genetic testing revealed a de novo mutation of the CNKSR2 gene(c.2185C >T, p.Arg729Ter) in the child that was not detected in the parents. Therefore, the child was diagnosed with X-linked epilepsy aphasia syndrome. Deletion of the CNKSR2 gene has been rarely reported in epilepsy aphasia syndrome, but no de novo mutation has been found in this gene. This report not only adds to the spectrum of epilepsy aphasia syndrome but also helps clinicians in diagnosis and genetic counseling.
基金supported by a nonprofit grant for external investigator-initiated research from SPH Qingdao Growful Pharmaceutical Co.,Ltd.(Qingdao,China).
文摘Improving exercise tolerance is indisputably beneficial for long-term survival in patients treated with percutaneous coronary intervention(PCI).Although previous studies suggested that Yangxinshi tablets effectively improve exercise tolerance in patients with coronary heart disease,the evidence is limited due to the lack of high-quality randomized trials.The Effects of Yangxinshi Tablets on Exercise Tolerance Compared with Trimetazidine in Patients after PCI(HEARTRIP)trial is a multicenter,double-blind,double-dummy,active drug-controlled,randomized trial designed to test if the effects of Yangxinshi tablets on exercise tolerance are non-inferior to those of trimetazidine in patients undergoing PCI.A total of 668 patients who have undergone PCI for the first time and completed a cardiopulmonary exercise test(CPET)will be enrolled and randomly assigned,in a 1:1 ratio,to receive Yangxinshi tablets(3 tablets,3 times/d)plus trimetazidine-placebo or trimetazidine(20 mg,3 times/d)plus Yangxinshi-placebo for 24 weeks.The primary endpoint is metabolic equivalent of tasks(METs)measured by CPET at 24 weeks after randomization.The secondary endpoints include comprehensive CPET indicators,incidence of major adverse cardiac and cerebrovascular events,and depression(Patient Health Questionnaire-9),anxiety(Generalized Anxiety Disorder-7),and quality of life(Seattle Angina Questionnaire)scores.This study will appraise current clinical evidence on the beneficial effect of Yangxinshi tablets on improving exercise tolerance after PCI and may substantiate their use as an effective pharmacological option for cardiac rehabilitation patients.The HEARTRIP study protocol received approval from the ethics committee of the General Hospital of Northern Theater Command(Shenyang,China).The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines.The results will be published following the guidelines of the CONSORT statement in a peer-reviewed scientific journal(Trial registration number:NCT03809273).
基金ThisworkwassupportedbyBeijingMedicalDevelopmentFunds (No .ZD199812 )
文摘Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (ACh) in the case of vascular dementia (VD) The purpose of this study was to explore the levels of ACh and choline (Ch) in the cerebrospinal fluid (CSF) of patients with AD and VD, and their possible relationship with cognitive impairment KH*2/5DMethods Twenty-two AD patients, twenty-two VD patients, and twenty normal controls were recruited and scored with a Mini-Mental State Examination (MMSE) CSF concentrations of ACh and Ch were measured using high-performance liquid chromatography with an electrochemical detector (HPLC-ECD) and the results were then compared to cognitive status Results ACh concentrations in CSF of AD patients [(10 7±5 1) nmol/L] and VD patients [(16 8±7 4) nmol/L] were both significantly lower than in controls [(34 5±9 0) nmol/L, t =10 67, P <0 001; t =6 91, P <0 001] Both results correlated positively with MMSE scores ( r s =0 88 and r s =0 85, respectively, P <0 01) The CSF concentration of Ch was significantly higher in VD patients [(887 4±187 4) nmol/L] compared to AD patients [(627 6±145 1) nmol/L, t =6 4, P <0 001] and controls [(716 0±159 4) nmol/L, t =4 2, P =0 002] CSF Ch concentration showed no difference between AD patients and normal controls, nor did it correlate with MMSE score in any of the three groups Conclusions The positive correlation between ACh deficit and cognitive impairment suggests that ACh is an important neurotransmitter for memory The similar decrease in ACh concentration in AD and VD patients may imply a similar pathogenesis for the process of cognitive impairment involved in these two disorders The elevated CSF levels of Ch in VD patients compared to AD patients may be useful diagnostically Cholinesterase inhibitors may be helpful not only for AD patients, but also for VD patients
文摘To meet the requirement of extensive resection of pancreatic cancer with portal or mesenteric venous invasion,the innovation of Vascular Graft Bridged En Bloc Resection （VGBEBR） has been adopted to treat advanced biliopancreatic cancer in the Department of Hepatobiliary Surgery of the PLA Rocket Force General Hospital since 2013.This attempt could not only broaden surgical indications of radical resection and lymphadenectomy but also increase R0 resection rate,especially for the case with severe invasion in the portal and mesenteric venous system.
