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@#Branch atheromatous disease(BAD) refers to cerebral infarction that occurs at the opening or bifurcation of the perforating artery and is caused by the stenosis or occlusion of the lumen of the perforating artery due to atherosclerosis. Since BAD was proposed,it has attracted wide attention due to its characteristic imaging manifestations and clinical features of early neurological deterioration. However,since it is unable to visualize the perforating artery on conventional imaging,it is difficult to clarify and unify the diagnostic criteria and therapeutic strategies for BAD. The application of high-resolution magnetic resonance and high-field magnetic resonance can help to display the hemodynamics and luminal plaques of the perforating artery,which will provide assistance for the development of more high-level BAD studies. This article reviews the epidemiology,clinical and imaging manifestations,diagnostic criteria,and treatment of BAD,so as to improve the early identification of this disease among clinicians and provide a reference for the diagnosis and treatment of this diseases.
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Polypoidal choroidal vasculopathy (PCV) occurs in the middle-aged and elderly population and is characterized by abnormal intrachoroidal vascular patterns such as branching choroidal vascular networks and polypoidal dilatation of vessel terminals, subretinal orange nodular lesions and hemorrhagic or plasma retinal pigment epithelial detachment (PED), which can cause retinal hemorrhage or vitreous hematopoiesis and is one of the major blinding fundus lesions.Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs is currently the main method of PCV treatment, and has certain advantages in eliminating abnormal vascular networks and removing polypoidal lesions, reducing vascular exudation and promoting exudate absorption, and improving visual prognosis.However, frequent intravitreal drug injections increase the risk of infection and the treatment burden for patients.In addition, the high recurrence rate after treatment poses a significant challenge to clinical practice, so the search for new therapeutic agents that are durable and less costly is a focus of clinical research in PCV.The literature from abroad suggests that brolucizumab is a novel small-molecule anti-VEGF humanized monoclonal antibody with the advantages of high tissue penetration, high local drug concentration and bioavailability, small injectable dose, long-lasting efficacy and long injection interval, which brings new hope for the clinical treatment of PCV and improving the prognosis of affected eyes.Although the efficacy and safety of brolucizumab in the treatment of PCV have been well documented, the literature is mainly from Japan, India and Korea, and clinical practice data from China are still lacking.With the approval of the drug in several countries, it is believed that more PCV patients could benefit from this treatment in the near future.Ophthalmologists and researchers in China should closely follow the progress of brolucizumab in the treatment of PCV.
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Objective:To analyze the clincial characteristics and laboratory findings of patients with neurobrucellosis (NB).Methods:Using retrospective analysis, clinical diagnosed patients with NB from June 2016 to February 2019 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analyze the general characteristics, clinical symptoms, laboratory examination results [white blood cell (WBC), hemoglobin(Hb), c-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), cerebrospinal fluid routine and biochemical, serum tube agglutination test (SAT), blood culture and cerebrospinal fluid culture of Brucella] , diagnosis and treatment effect. Results:A total of 25 patients were diagnosed with NB, including 19 males and 6 females, with an average age of (41.7 ± 14.2) years old, ranged from 11 to 70 years old. The main clinical symptoms were fever, headache, joint pain, vomiting and sweating, which accounted for 92.0% (23/25), 88.0% (22/25), 76.0% (19/25), 64.0% (16/25), and 64.0% (16/25), respectively. Positive neck ankylosis and mumbness of lowerlimbs were both 9 cases (36.0%), and mental disorders were 7 cases (28.0%). In 25 patients with NB, the WBC increased in 5 cases (20.0%), Hb decreased in 4 cases (16.0%), CRP increased in 13 cases (52.0%), ALT and AST both increased in 6 cases (24.0%), TP decreased in 21 cases (84.0%); SAT was positive in 25 cases (100.0%), cerebrospinal fluid SAT positive in 7 cases (28.0%); and blood culture was positive in 2 cases (8.0%). Cerebrospinal fluid changes were mainly manifested in 14 cases (56.0%) of chloride reduction, 13 cases (52.0%) of gluose reduction and 19 cases (76.0%) of protein increase. In 25 patients with NB, 17 cases were treated with doxycycline + rifampicin + ceftriaxone, 7 cases with etimicin + rifampicin + ceftriaxone, and 1 case with doxycycline + rifampicin + piperacillin sulbactam. After 6 to 12 months follow-up, 21 cases recovered well, whereas mild sequelae were observed in 4 patients.Conclusion:Clinical features of NB are hetorogeneous, and nerurological symptoms and cerebrospinal fluid examination are of great value in the diagnosis of NB.
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@#Objective To explore the levels of peripheral blood IL-33 and the difference of arteriovenous fistula glucose (Da-jvGlu) after giving Shenqi glucose injection in acute cerebral infarction patients.Methods The levels of plasma IL-33 and Da-jvGlu were detected in 126 patients of acute cerebral infarction and 10 normal controls.The correlation between IL-33 and cerebral infarction was analyzed.Results Compared with those in normal control group and the pretherapy groups,the levels of IL-33 in large volume were significantly higher (P<0.05).After giving Shenqi glucose injection,the level of IL-33 in mid volume and small volume were significantly higher between groups (P<0.05).Compared with those in normal control group and the pretherapy groups,the level of Da-jvGlu in large volume was significantly higher (P<0.05).After giving Shenqi glucose injection,there was no significant difference of Da-jvGlu in statics between groups (P>0.05).Conclusion Shenqi glucose injection can affect the levels of IL-33 to protect nerve cells and stabilize blood glucose concentration.
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Objective:To investigate the clinical significance of six serological methods for diagnosis of brucellosis.Methods:Totally 160 cases of brucellosis patients were selected as the case group and 235 cases of health medical examiners were selected as the control group from January to June 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital. Six methods were used for detection of brucellosis, including Rose Bengal plate agglutination test (RBPT), fluorescence polarization assay (FPA), indirect enzyme linked immunosorbent assay (iELISA), cysteine agglutination test, standard tube agglutination test (SAT), and anti-globulin test (Coomb's). The consistency of the 4 preliminary screening methods (RBPT vs FPA, iELISA, cysteine agglutination test), and 2 diagnosis methods (SAT vs Coomb's) was compared, and the sensitivity, specificity, rates of missed diagnosis and misdiagnosis were analyzed. Results:In the preliminary screening methods, the consistency of RBPT with FPA and iELISA was relatively consistent (Kappa = 0.872, 0.784), and the consistency with cysteine agglutination test was generally consistent (Kappa = 0.543). In the diagnosis methods, the consistency between SAT and Coomb's was relatively consistent (Kappa = 0.861). The sensitivity of FPA, iELISA, cysteine agglutination test and Coomb's was 91.03%, 75.00%, 56.41% and 80.14%, respectively. The specificity was 95.81%, 100.00%, 98.74% and 100.00%, respectively. The rates of missed diagnosis were 8.97%, 25.00%, 43.59% and 19.86%, respectively. The rates of misdiagnosis were 4.19%, 0, 1.26%, and 0, respectively.Conclusions:FPA and iELISA have high sensitivity and specificity, and are suitable for clinical promotion. The combined detection of multiple serological methods will reduce the probability of misdiagnosis and missed diagnosis of brucellosis, thereby improving the diagnostic level of brucellosis.
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Objective@#To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis.@*Methods@#In-patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis.@*Results@#There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3-6 years old of age had the highest incidence (64.44%, 29/45). The patients were mainly rural residents (97.78%, 44/45). The onset time was mainly from March to June of the year (46.67%, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78% (44/45) and 57.78% (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22% (19/45) and 35.56% (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t=4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00%, 36/45) had positive blood culture, which turned negative after the treatment.@*Conclusions@#The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.
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Objective@#To investigate the efficacy and safety of 99Technetium-methylenediphosphonate injection (99Tc-MDP) in the treatment of thyroid associated ophthalmopathy (TAO).@*Methods@#The trail was conducted in Affiliated Zhongshan Hospital of Dalian University. Patients were recruited from October 2016 to October 2018. Fifty patients with active moderate to severe TAO were randomly assigned to receive 99Tc-MDP (n = 25) or methylprednisolone administered intravenously (n = 25), the final completion of treatment and follow-up were 21 and 20 cases, respectively. In 99Tc-MDP group, 30 sets of 99Tc-MDP were applied to each course of treatment for 10 d, with a course interval of 20 d, a total of 3 courses of treatment. Patients in methylprednisolone group were given a pulse regimen, once every week for a total of 12 infusions, altogether 4.5 g in 12 weeks. The clinical activity score (CAS) and exophthalmos were assessed in a patient at weeks 12 and 24, respectively. A response was defined as a reduction of 2 points or more in CAS and reduction of 2 mm or more in exophthalmos. Safety was assessed according to the incidence of adverse events at week 12.@*Results@#At week 12 treatment, no significant difference was observed in CAS and exophthalmos between the two groups [CAS: (2.48 ± 0.60) , (2.20 ± 0.62) points, exophthalmos: (2.57 ± 1.02), (2.20 ± 1.09) mm, P > 0.05]. Adverse events in 99Tc-MDP group was significantly lower than that in methylprednisolone group [4.8%(1/21) vs 40.0%(8/20), P < 0.05]. At week 24, the reduction in the CAS in 99Tc-MDP group was significantly greater than that in methylprednisolone group [CAS: (3.86 ± 0.67), (3.05 ± 0.59) points, P < 0.05]. The difference in exophthalmos of patients between the two groups was not statistically significant [(3.17 ± 0.60), (2.88 ± 0.57) mm, P > 0.05]. The difference in total effective rate of patients between the two groups was not statistically significant (P > 0.05).@*Conclusion@#99Tc-MDP regimen could provide similar benefit to methylprednisolone pulse therapy for those patients with TAO, but with longer reduction in CAS and less adverse events.
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Objective To investigate the efficacy and safety of 99Technetium-methylenediphosphonate injection (99Fc-MDP) in the treatment of thyroid associated ophthalmopathy (TAO).Methods The trail was conducted in Affiliated Zhongshan Hospital of Dalian University.Patients were recruited from October 2016 to October 2018.Fifty patients with active moderate to severe TAO were randomly assigned to receive 99Tc-MDP (n =25)or methylprednisolone administered intravenously (n =25),the final completion of treatment and follow-up were 21 and 20 cases,respectively.In 99Tc-MDP group,30 sets of 991c-MDP were applied to each course of treatment for 10 d,with a course interval of 20 d,a total of 3 courses of treatment.Patients in methylprednisolone group were given a pulse regimen,once every week for a total of 12 infusions,altogether 4.5 g in 12 weeks.The clinical activity score (CAS) and exophthalmos were assessed in a patient at weeks 12 and 24,respectively.A response was defined as a reduction of 2 points or more in CAS and reduction of 2 mm or more in exophthalmos.Safety was assessed according to the incidence of adverse events at week 12.Results At week 12 treatment,no significant difference was observed in CAS and exophthalmos between the two groups [CAS:(2.48 ± 0.60),(2.20 ± 0.62) points,exophthalmos:(2.57 ± 1.02),(2.20 ± 1.09) mm,P ＞ 0.05].Adverse events in 99Tc-MDP group was significantly lower than that in methylprednisolone group [4.8％(1/21) vs 40.0％(8/20),P ＜ 0.05].At week 24,the reduction in the CAS in 99Tc-MDP group wassignificantly greater than that in methylprednisolone group [CAS:(3.86 ± 0.67),(3.05 ± 0.59) points,P ＜ 0.05].The difference in exophthalmos of patients between the two groups was not statistically significant [(3.17 ± 0.60),(2.88 ± 0.57) mm,P ＞ 0.05].The difference in total effective rate of patients between the two groups was not statistically significant (P ＞ 0.05).Conclusion 99Tc-MDP regimen could provide similar benefit to methylprednisolone pulse therapy for those patients with TAO,but with longer reduction in CAS and less adverse events.
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Objective To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis. Methods In - patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis. Results There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3 - 6 years old of age had the highest incidence (64.44％, 29/45). The patients were mainly rural residents (97.78％, 44/45). The onset time was mainly from March to June of the year (46.67％, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78％ (44/45) and 57.78％ (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22％ (19/45) and 35.56％ (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t = 4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00％, 36/45) had positive blood culture, which turned negative after the treatment. Conclusions The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.
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Objective To analyze the epidemiology and clinical characteristics of Brucella infection in Heilongjiang Province,and to provide experience and basis for clinical treatment and prevention of brucellosis.Methods Using retrospective analysis method,clinically diagnosed patients with brucellosis from December 2016 to December 2017 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms,laboratory examination results,diagnosis and treatment effect.Healthy subjects undergoing health check-up at the same period were randomly selected as control group for laboratory blood biochemical test.Results A total of 396 patients were included in the brucellosis group,including 298 males and 98 females,with an average age of (43.6 + 15.6) years old,ranged from 1 to 75 years old.The control group included 125 cases,including 83 males and 42 females,with an average age of (41.7 ±+ 18.0) years old,ranged from 7 to 71 years old.There were no significant differences in age and gender between the two groups (t =1.083,x2 =3.789,P ＞ 0.05).The patients of ＞ 14-64 years old of age had the highest incidence (90.15％,357/396).The patients were mainly rural residents (76.01％,301/396) and the majority of them were farms (50.51％,200/396).The onset time was mainly from March to June of the year (47.73％,189/396).Clinical symptoms were fever,joint or muscle pain and hyperhidrosis,which accounted for 91.16％ (361/396),76.26％ (302/396) and 44.19％ (175/396),respectively.The levels of C-reactive protein (CRP),seropropane alanine aminotransferase (ALT),aspartate transaminase (AST),γ-glutamyl transpeptadase (γ-GT),alkaline phosphatase (ALP),α-hydroxybutyrate dehydrogenase (HBDH),and lactate dehydrogenase (LDH) in patients with brucellosis were significantly higher than those in the control group (t =4.956,2.746,4.019,3.272,7.008,3.728,3.409,P ＜ 0.01 or 0.05),while total protein (TP) and albumin (ALB) levels were reduced (t =-7.252,-8.601,P ＜ 0.01).After treatment,the test results of CRP,ALT,AST,γ-GT,TP,ALB,ALP,HBDH and LDH were compared with those before the treatment,and the differences were statistically significant (t =2.291,4.393,3.382,2.608,-7.516,-4.710,3.509,4.585,4.473,P ＜ 0.01 or 0.05).Conclusions The patients with brucellosis in Heilongjiang Province are mainly male farmers,and the onset time is mostly concentrated in March-June.The clinical manifestations of brucellosis are varied,clinicians should strengthen discrimination and prevent misdiagnosis.Medicines for brucellosis might be cautiously used in clinical trial,and changes in liver function and myocardial enzyme activity should be monitored.
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Objective To analyze the diagnostic value of fluorescence polarization assay (FPA) for human brucellosis.Methods From April 2013 to August 2014,240 positive sera of brucella patients were collected as case group and 287 normal sera as control group in Heilongjiang Agricultural Reclamation Bureau General Hospital.Four milliliters of venous blood were withdrawn for separation of serum.Fluorescence polarization assay was used and the consistency,sensitivity and specificity were compared with those of four classical serological methods,including rose bengal plate agglutination test (RBPT),standard tube agglutination test (SAT),Coomb's test and cysteine test.Results The results of FPA were complied with those of the four conventional serological methods,Kappa ≥ 0.75.The sensitivity of FPA (89.17％) was higher than that of RBPT (87.08％),SAT (85.00％),Coomb's (74.17％) and cysteine test (75.83％).The specificity of FPA (94.08％) was higher than that of RBPT (89.90％) and Coomb's (81.53％),but lower than that of SAT (98.95％) and cysteine test (99.30％).Conclusion FPA can be used as a laboratory diagnostic method for human brucellosis,which is worthy to be widely used.
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Objective To investigate the differents of rapid enzyme-linked immunosorbent assay(IELISA) and the traditional serological methods in diagnosis of human brucellosis.Methods Brucella antibody was detected by IELISA,rose bangel plate test (RBPT),standard agglutination test (SAT),Coomb's test and cysteine test of serological methods in 430 confirmed and suspected patients and 300 healthy controls during the same period.The consistency was analyzed between IELISA and other tests.Results Positive rates of patients were significandy higher than those in healthy controls (IELISA:83.49％ vs.0;RBPT:86.97％ vs.0;SAT:76.27％ vs.0;Coomb's:65.58％ vs.0.02％;and cysteine test:67.91％ vs.0,x2 =535.05,412.47,437.66,339.22,489.49,all P ＜ 0.01).Positive consistency rates between IELISA and other tests were 87.19％,79.39％,71.59％ and 76.60％,the highest was between IELISA and RBPT,the lowest was between IELISA and Coomb's.Conclusions Brucella antibody is detected conveniently,quickly,and accurately by the joint application of RBPT and IEHSA,which provides important technical support for prevention and control of brucellosis.It is worthy of application extensively.
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Objective To investigate the change and its significance of blood level of myocardium zymogram in acute organophosphrus poisoning(AOPP) mice.Methods 152 eight-week-old male mice were divided into 3 groups randomly: normal control group(n=8);normal saline control group(n=10);AOPP group(n=135).The AOPP group mice were assigned by 9 time-points(30 min,2 h,4 h,12 h,1 d,2 d,3 d,4 d and 7 d after poisoning).15 mice were in per cage.The mice in AOPP group were introperitoneal injected Omethoate(50 mg/kg) and Atropine(10 mg/kg).Centhifugalizing the blood and the serum were taken,examined cholineesterase(CHE),creatine kinase(CK),aspartate aminotransferase(AST) and lactate dehydrogenase(LDH).The level of myocardium zymogram of myasthenia mice was compared with normal muscle mice in the AOPP group.Results Compared with normal control group and normal saline normal saline control group,CHE activity was persistent inhibition in the AOPP 30 min ~3 d subgroups(allP