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1.
Article in Chinese | WPRIM | ID: wpr-911718

ABSTRACT

Objective:To investigate the clinical features and associated chronic pain in corticobasal syndrome (CBS).Methods:Clinical data of 8 patients diagnosed as probable CBS or possible CBS admitted to Beijing Hospital during January 2010 to June 2020 were retrospectively analyzed. The clinical information included sex, age, course of disease, chief complaint, neurological examination, blood biochemistry, tumor marker, infection and other laboratory tests; the neuropsychological evaluation included Mini-Mental State Examination (MMSE) scale and Hamilton Depression Scale (HAMD); the imaging studies included cranial magnetic resonance imaging (MRI) and/or 18F-Fluorodeoxyglucose positron emission tomography ( 18F-FDG PET). Results:The main clinical manifestations were asymmetrical movement disorders, including rigidity, tremor, myoclonus and abnormalities in posture and gait. Patients showed poor response to levodopa treatment. Among 8 patients, 7 had apraxia, 5 patients had alien hand, and 5 patients had various degrees of cognitive dysfunction. The cranial MRI demonstrated mild cerebral atrophy which was slightly more severe in the contralateral side of the initially affected limb in 7 of the 8 patients. The 18F-FDG PET scan revealed asymmetric decreased metabolism in the frontal, parietal, temporal, and occipital lobe, as well as in basal ganglia, which was more severe in the contralateral side of the initially affected limb in 5 of the 8 patients. Six of the 8 patients were associated with pain, including dystonic pain in 3 patients, neuropathic pain in 1 patient, musculoskeletal pain in 1 patient, and unexplained pain in 1 patient. Pain was the onset symptom in 1 patient and pain was relieved by taking levodopa in another patient. Conclusions:CBS is characterized by asymmetric dyskinesia and cognitive impairment, and often associated with apraxia, cortical sensory deficits, and alien limb. The MRI and PET are helpful for CBS diagnosis. Pain may be one of the common non-motor symptoms in CBS.

2.
Chinese Journal of Geriatrics ; (12): 627-631, 2020.
Article in Chinese | WPRIM | ID: wpr-869441

ABSTRACT

Objective:To explore the clinical value of mean platelet volume/platelet count ratio(MPV/PLT)in predicting short-term prognosis of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 226 elderly patients with AECOPD admitted to our hospital from January 2017 to January 2019 were retrospectively enrolled as research subjects.All cases were divided into the survival group(n=175)and the death group(n=51), based on prognosis 28-day after admission.General data and laboratory test results were compared between the two groups.The relevant factors for death were analyzed by the Logistic regression equation.The receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of MPV/PLT, and the Kaplan-Meier survival curve was drawn according to the cut-off.Methods:Compared with the survival group, Acute Physiology and Chronic Health Status Evaluation(APACHEⅡ)score, levels of procalcitonin(PCT), high-sensitivity C-reactive protein(hs-CRP), creatinine, neutrophil count(NEU), lymphocyte count(LYM)and MPV were elevated, and levels of albumin and PLT decreased in the death group( P<0.05). Hospital stay lengths and costs were higher in the death group than in the survival group( P<0.05). The level of MPV/PLT was higher in the death group than in the survival group(0.065±0.016 vs.0.054±0.013, t=5.036, P<0.01). Multivariate Logistic regression showed that MPV/PLT was an independent risk factor for recent death( OR=2.331, 95% CI: 1.772-8.224, P<0.01). ROC curve analysis showed that the area under the curve(AUC)of MPV/PLT was 0.829, the sensitivity was 83.41%, the specificity was 82.80%, and the cut-off was 0.061.Optimal cut-off value analysis showed that APACHEⅡ score, PCT and hs-CRP levels and mortality were higher in patients with MPV/PLT≥0.061 than in patients with MPV/PLT<0.061( P<0.05). The Kaplan Meier survival curve showed that the cumulative survival rate was lower in those with MPV/PLT≥0.061 than in those with MPV/PLT<0.061( Log- rank=6.323, P<0.05). Conclusions:The increase of MPV/PLT may be an independent risk factor for recent death in elderly patients with AECOPD and has good clinical value in predicting poor prognosis.

3.
Article in Chinese | WPRIM | ID: wpr-837554

ABSTRACT

@#Objective    To explore the predictive value of myocardial vitality in the improvement of cardiac function after coronary artery bypass grafting (CABG) in patients with ischemic heart failure. Methods    From December 8, 2015 to November 12, 2018, 46 patients with ischemic heart failure who underwent CABG operation alone were collected retrospectively. There were 41 males and 5 females with an average age of 60.4±8.0 years. The myocardial vitality and number of different types of myocardium were measured. The clinical data of patients in the left ventricular ejection fraction (LVEF) improvement group (≥5%) and non-improvement group (<5%) were compared and analyzed. The  correlation between each index and LVEF improvement was analyzed by logistic multivariate regression analysis, and the boundary value of hibernating myocardium between LVEF improvement and non-improvement was obtained by receiver operating characteristic (ROC) curve. Results    There were significant differences in the number of hibernating myocardium (15.0%±12.3% vs. 4.3%±4.5%, P=0.000), the number of normal myocardium (74.7%±13.7% vs. 82.4%±8.6%, P=0.027), and cardiac function classification (NYHA) development (−0.7±0.7 vs. −0.3±0.5, P=0.047) between the two groups, but there was no significant difference in other indexes between the two groups (P>0.05). Logistic regression analysis showed that the number of hibernating myocardium was an independent factor affecting the improvement of LVEF after CABG in patients with ischemic heart failure (OR=1.366, 95%CI 1.033-1.807, P=0.029). The ROC curve showed that the threshold value, sensitivity and specificity of hibernating myocardium were 15.0%, 43.8% and 100.0%, respectively. Conclusion    The percentage of hibernating myocardium to left ventricular wall area ≥15.0% can accurately predict the improvement of LVEF in patients with ischemic heart failure after CABG. Preoperative myocardial vitality assessment has important diagnostic value in predicting the improvement of cardiac function in patients with ischemic heart failure after simple CABG.

4.
Chinese Journal of Neurology ; (12): 806-811, 2019.
Article in Chinese | WPRIM | ID: wpr-796852

ABSTRACT

Objective@#To investigate the relationship between educational level and cognitive function in patients with non-dementia Parkinson′s disease (PD).@*Methods@#Forty non-dementia PD patients and forty healthy controls (HC) enrolled in Beijing Hospital from January to December 2018 were collected for the study. The two groups were divided into three subgroups (low, medium and high) according to their years of education. HC group and PD group were matched in age, gender, years of education, and Mini-Mental State Examination score. All subjects underwent three tests of executive function: the Trail Making Test (TMT-A and TMT-B), the Verbal Fluency Test (VFT) and the WAIS digital span test (forward and backward).@*Results@#There were statistically significant differences in the error number of TMT-A (0.00 (0.00, 1.00), 0.00 (0.00, 0.00), 0.00 (0.00, 0.00); χ2=10.11, P=0.006), the time of TMT-B ((81.17±36.83) s, (52.10±27.88) s, (47.72±23.18) s; F=5.16, P=0.011), the error number of TMT-B (3.00 (0.00, 4.00), 1.00 (0.00, 3.50), 0.00 (0.00, 0.00); χ2=7.16, P=0.028) and the number of backward (3.17±0.72, 3.50±1.08, 4.00±0.77; F=3.68, P=0.035) among the three subgroups of PD group. There were statistically significant differences between the PD group and the HC group in the time of TMT-A (PD: (64.03±15.96) s, HC: (53.00±19.50) s; t=2.77, P=0.007), the time (PD: (58.85±31.91) s, HC: (37.35±19.42) s; t=3.64, P=0.001) and error number (PD: 0 (0, 4), HC: 0 (0, 0); Z=-3.15, P=0.002) of TMT-B, the number of backward (PD: 3.63±0.90, HC: 4.98±1.21; t=-5.67, P=0.000) and VFT (PD: 14.48±3.37, HC: 16.15±2.03; t=-2.69, P=0.009). In the low and medium education level subgroups, the PD group showed worse results in three tests of executive function than the HC group, some with statistically significant differences (P<0.05). There was no statistically significant difference in the results of three tests of executive function between two subgroups of high education in the PD group and the HC group (P>0.05).@*Conclusions@#Executive functions of non-dementia PD patients are impaired. Education level may have a certain impact on cognitive function of PD patients.

5.
Chinese Journal of Neurology ; (12): 806-811, 2019.
Article in Chinese | WPRIM | ID: wpr-791911

ABSTRACT

Objective To investigate the relationship between educational level and cognitive function in patients with non?dementia Parkinson′s disease (PD). Methods Forty non?dementia PD patients and forty healthy controls (HC) enrolled in Beijing Hospital from January to December 2018 were collected for the study. The two groups were divided into three subgroups (low, medium and high) according to their years of education. HC group and PD group were matched in age, gender, years of education, and Mini?Mental State Examination score. All subjects underwent three tests of executive function: the Trail Making Test (TMT?A and TMT?B), the Verbal Fluency Test (VFT) and the WAIS digital span test (forward and backward). Results There were statistically significant differences in the error number of TMT?A (0.00 (0.00, 1.00),0.00 (0.00, 0.00), 0.00 (0.00, 0.00); χ2=10.11, P=0.006), the time of TMT?B ((81.17±36.83) s, (52.10 ± 27.88) s, (47.72 ± 23.18) s; F=5.16, P=0.011), the error number of TMT?B (3.00 (0.00, 4.00), 1.00 (0.00, 3.50), 0.00 (0.00, 0.00); χ2=7.16, P=0.028) and the number of backward (3.17±0.72, 3.50±1.08, 4.00± 0.77; F=3.68, P=0.035) among the three subgroups of PD group. There were statistically significant differences between the PD group and the HC group in the time of TMT?A (PD: (64.03±15.96) s, HC: (53.00± 19.50) s; t=2.77, P=0.007), the time (PD: (58.85±31.91) s, HC: (37.35±19.42) s; t=3.64, P=0.001) and error number (PD: 0 (0, 4), HC: 0 (0, 0); Z=-3.15, P=0.002) of TMT?B, the number of backward (PD: 3.63±0.90, HC: 4.98±1.21; t=-5.67, P=0.000) and VFT (PD: 14.48±3.37, HC: 16.15±2.03; t=-2.69, P=0.009). In the low and medium education level subgroups, the PD group showed worse results in three tests of executive function than the HC group, some with statistically significant differences (P<0.05). There was no statistically significant difference in the results of three tests of executive function between two subgroups of high education in the PD group and the HC group (P>0.05). Conclusions Executive functions of non?dementia PD patients are impaired. Education level may have a certain impact on cognitive function of PD patients.

6.
Article in Chinese | WPRIM | ID: wpr-707696

ABSTRACT

Objective To explore the feasibility of establishing an acute pericardial effusion animal model guided by ultrasound. Methods Six experimental pigs were anesthetized. A PTC needle was injected and guided to the right ventricular anterior wall under real-time high frequency ultrasound,40 ml and 80 ml normal saline were respectively infused into the pericardial cavity within 5 minutes. Ultrasonography and pathologic examination were applied to confirm this porcine model. The amount of the fluid was estimated by ultrasound at 1 hour and 8 hours after infusion. Results With ultrasound guidance,the PTC needle smoothly entered the pericardial cavity and the saline was successfully injected. The fluid dispersed from local to the entire pericardial cavity. Pericardial effusion last within 8 hours and no significant change of the fluid amount was found (all P >0.05). This acute pericardial effusion model was successfully established with a rate of 100%. Conclusions It is feasible to establish an animal model of acute pericardial effusion under the guidance of ultrasound. This method is safe,rapid and effective. It can provide a suitable animal model for the study of acute pericardial effusion.

7.
Article in Chinese | WPRIM | ID: wpr-807018

ABSTRACT

Objective@#To survey the prevalence and distribution of sleep disorders in patients with Parkinson disease (PD) and to analyze the influencing factors.@*Methods@#The prevalence and distribution of sleep disorders were surveyed with Parkinson Disease Sleep Scale (PDSS) among 206 PD patients. The association of sleep disorders with age, course of disease, cognitive function, motor function, depression, and the equivalent dose of levodopa (LED) was analyzed.@*Results@#The overall PDSS score in 206 patients was (116.9±21.4). The three most frequent items of sleep disorders were the overall sleep quality(181/206, 87.9%), difficulty in maintaining sleep(160/206, 77.7%)and nocturnal enuresis(151/206, 73.3%); the three least frequent items were early awaking(87/206, 42.2%), urinary incontinence(56/206, 27.2%)and hallucination(44/206, 21.4%). The three items with the lowest average scores were nocturnal enuresis(6.9±3.1), difficulty in maintaining of sleep(7.1±2.7)and overall sleep quality(7.1±2.0); three items with the highest average scores were audiovisual illusion(9.3±1.8), incontinence caused by motion disability(9.0±2.1) and early awaking with upper and lower limb pain(8.7±2.1). PD patients were divided into group 1 [Hoehn-Yahr(H&Y) stage 1.0-1.5], group 2 (H&Y stage 2.0-2.5) and group 3 (H&Y stage 3.0-4.0). One-way analysis of variance or non-parametric test showed that there were significant differences in the course of disease(F=21.91, P=0.00), total score and the subscale scores of Unified Parkinson Disease Rating Scale(UPDRS, UPDRS Ⅰ-Ⅳ) (F=90.67, χ2=12.86, F=31.20, F=60.17, χ2=24.01, all P<0.01), the Hamilton Rating Scale for Depression(HAMD) scores (χ2=11.06, P=0.00), LED (F=14.93, P=0.00) and Minimum Mental State Examination(MMSE) scores (χ2=9.81, P=0.01) among three groups. There was no significant difference in age and PDSS scores among three groups. The results showed that there were significant differences in terms of restless state and nocturnal dysphoria (F=5.12, P=0.01; F=3.27, P=0.04) between group 1 and group 3. The linear regression analysis showed that the HAMD and the LED scores had the greatest influence on PDSS score (R2=0.142, 0.196).@*Conclusion@#PD patients have a variety of sleep symptoms. The treatment of large doses of dopamine and depression contribute to the occurrence of PD sleep disorders.

8.
Article in Chinese | WPRIM | ID: wpr-614535

ABSTRACT

Objective To sum up the nursing experience of injection of sulphur hexafluoride microbubbles as contrast agent for thyroid contrast-enhanced ultrasound (CEUS).Methods The clinical data of 413 cases who injected sulphur hexafluoride microbubbles as a contrast agent for CEUS were retrospectively analyzed.Nursing observation and coordination were done on the CEUS examination process,venous puncture technique,the correct configuration and use of sulphur hexafluoride microbubbles as contrast agents,operating process,the correct treatment of adverse reactions.Results The success rate of thyroid CEUS in 413 cases was 100%.After completion of the CEUS procedure,2 cases revealed slight dizziness,1 case with the contrast agent extravasation,others did not have adverse reactions such as dizziness,the contrast agent extravasation,skin rashes,itching,pain at the injection site.Conclusion The key nursing points including mastery of the whole CEUS process,operator's qualified venous puncture technique,the correct configuration and use of sulphur hexafluoride microbubbles for injection as contrast agent,careful nursing observation in the operating process and correctly treatment of adverse reactions are significant for enhancing success rate of thyroid CEUS and relieving relevant adverse effects.

9.
Journal of Clinical Hepatology ; (12): 785-789, 2017.
Article in Chinese | WPRIM | ID: wpr-610442

ABSTRACT

Infectious pancreatic necrosis (IPN) is a challenging complication of acute pancreatitis and can lead to poor prognosis.Over the years,open necrosectomy has become the main treatment modality for IPN,but it will cause high incidence rate of complications and mortality rate.In recent years,with the rapid development of minimally invasive surgery,many scholars have performed minimally invasive treatment for IPN patients and achieved good outcomes.This article introduces five minimally invasive treatment techniques,i.e.,percutaneous catheter drainage,minimally invasive retroperitoneal necrosectomy,endoscopic drainage + necrosectomy,laparoscopic necrosectomy,and advanced therapeutic strategy,pointed out that different minimally invasive techniques had different indications,and minimally invasive therapies should be selected based on IPN patients' general conditions to improve their outcome.

10.
Chinese Journal of Pathophysiology ; (12): 1520-1523, 2017.
Article in Chinese | WPRIM | ID: wpr-608872

ABSTRACT

AIM: To evaluate the effect of GYY4137, a novel hydrogen sulfide (H2S) donor, on cytosolic lipid decomposition in mouse primary steatosis hepatocytes.METHODS: Oleic acid (OA) was used to induce hepatic steatosis model in vitro.The C57BL/6 mouse primary hepatocytes isolated and cultured by 2-step in situ perfusion were divided into 4 groups: the cells in control group were incubated with normal medium for 54 h;the cells in model group were incubated with OA at 1.2 mmol/L for 48 h followed by serum-free phenol red-free RPMI-1640 for 6 h;the cells in H2S group or DL-propar-gylglycine (PAG;an inhibitor of cystathione γ-lysase, inhibiting H2S synthesis) group were incubated with OA at 1.2 mmol/L for 48 h followed by serum-free phenol red-free RPMI-1640 which contained 1 mmol/L GYY4137 or 200 μmol/L PAG for 6 h.The glycerin release and the protein expression of hormone-sensitive lipase (HSL) in the cells were mea-sured.RESULTS: Compared with model group, the glycerin release and the protein expression of phosphorylated HSL (p-HSL) in H2S group decreased significantly, while those increased significantly in PAG group.CONCLUSION: In steatosis hepatocytes, exogenous H2S possibly decreases cytosolic lipid decomposition by decreasing the protein level of p-HSL.

11.
Chongqing Medicine ; (36): 5121-5125, 2016.
Article in Chinese | WPRIM | ID: wpr-506313

ABSTRACT

Objective To investigate the association between Has‐miRNA‐149 polymorphism and susceptibility of digestive tract cancer .Methods A systematic search of Pubmed ,EMBASE and Web of Science ,CNKI ,Wanfang was conducted for relevant studies .The odds ratios(OR) and 95% confidence intervals(95% CI) calculated by Stata12 .0 software were used to assess the asso‐ciation between Has‐miRNA‐149 polymorphism and risk of digestive tract cancer .The Q test ,I2 value and funnel plot were conduc‐ted to examine heterogeneity and publication bias ,respectively .Results A total of thirteen eligible studies containing 4 424 cases and 5 290 controls were included in this Meta analysis .There were significant relationships between Hsa‐miRNA‐149 polymorphism and susceptibility of digestive tract cancer (Domina model CT+CC vs .TT ,OR=0 .915 ,95% CI:0 .840-0 .996 ,P=0 .040 ;Hetero‐zygous model CT vs .TT ,OR=0 .880 ,95% CI:0 .803 -0 .965 ,P=0 .007) .In the stratified analysis ,it was found that the risk of colorectal cancer decreased in patients carrying CC/CT genotypes(OR=0 .834 ,95% CI:0 .715-0 .972 ,P=0 .021) ,especially in A‐sians (CT+CC vs .TT ,OR=0 .894 ,95% CI:0 .818-0 .977 ,P=0 .013) ,while that was not found in the Caucasoids .Conclusion Has‐miRNA‐149 polymorphism is associated with the susceptibility of digestive tract cancer .The CC/CT genotypes may decrease the risk of digestive tract cancer ,especially in Asians .

12.
Chinese Pharmacological Bulletin ; (12): 945-950,951, 2015.
Article in Chinese | WPRIM | ID: wpr-600618

ABSTRACT

Aim To investigate the effect of hydrogen sulfide on hepatic lipid accumulation in obese mice. Methods C57 BL/6 J mice were randomly divided into control group, model group, and NaHS group. The mice of the control group were fed with normal diet. The mice of the model group and the NaHS group were fed with high-fat diet. From the thirteenth week, the mice of NaHS group were injected intraperitoneally with NaHS (H2S donor) in a dose of 50 μmol·kg-1 per day for 4 weeks and the mice of the model group were injected with the same volume of saline. All mice were sacrificed at the end of the 16th week. The tis-sues of liver were homogenized and centrifugated. The supernatants were used for the determination of triglyc-eride and cholesterol in liver. The morphology of liver was tested by H&E staining. Liver lipid accumulation was determined by oil red staining. Total RNA was ex-tracted from frozen tissue of liver. PCR was used to de-tect CPT-1 , FAS gene expression and ELISA method was used to detect CPT-1,FAS activity in mice liver. Results The body weight of the mice from NaHS group and model group was bigger than that of the mice from control group. Compared with the model group, the body weight of the mice from NaHS group was less;the content of triglyceride and cholesterol in liver was lower; the degree of liver tissue pathological changes and lipid accumulation were alleviated; CPT-1 expres-sion and activity were increased; FAS expression and activity were decreased. Conclusions These data in-dicate that hydrogen sulfide can reduce the lipid con-tent of liver tissue in obese mice and alleviate fatty liv-er. The mechanism may be associated with the in-creased expression of CPT-1 and the decreased expres-sion of FAS in liver.

13.
Chinese Journal of Neurology ; (12): 293-297, 2015.
Article in Chinese | WPRIM | ID: wpr-469056

ABSTRACT

Objective To investigate emotion recognition in music in patients with idiopathic Parkinson's disease (PD),and to further explore its relationship with executive function and related factors.Methods Twenty-four PD patients enrolled from the Department of Neurology,Beijing Hospital between January and June 2014 and 24 matched healthy controls were tested using 24 musical excerpts that expressed happiness,sadness,fear or anger.The two groups were tested for executive function using a simplified trail making test and a clock drawing test.All the patients were rated on the Hoehn-Yahr stage,the Unified Parkinson' s Disease Rating Scale (UPDRS) Ⅲ,the Hamilton Rating Scale for Anxiety (HAMA) and the Hamilton Rating Scale for Depression (HAMD).Results In trail making test,PD patients worked slower ((51.58 ±33.14) s) than controls ((34.46 ± 19.64) s) (t =2.178,P =0.036).PD patients got more errors (0 (QL =0,QU =2.5)) than controls (0 (QL =0,QU =0);Z=-2.372,P =0.018).In clock drawing test,PD patients got lower score (2.63 ±0.65) than controls (2.96 ±0.20)(t =-2.407,P =0.023).The difference between two groups was not statistically significant in the recognition of happy,sad,fear or anger music (all P > 0.05).In PD group,the scores of the recognition of happy,sad music and the total score of musical emotion recognition were associated with the time of trail making test (r =-0.560,-0.572,-0.530,P =0.004,0.003,0.008),while not related to age,disease duration,education duration,the scores of Minimum Mental State Examination,the scores of UPDRS Ⅲ,Hoehn-Yahr stage,the scores of HAMA,the scores of HAMD,LDE,the scores of clock drawing test or musical background (all P > 0.05).Conclusions PD patients are not impaired in emotion recognition in music in this study.The relationship between musical emotion recognition and executive function is unclear.

14.
Chinese Journal of Surgery ; (12): 340-344, 2015.
Article in Chinese | WPRIM | ID: wpr-336631

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical value of high-field-strength intraoperative magnetic resonance imaging (iMRI) combined with optic radiation neuro-navigation for the resection of temporal lobe low-grade gliomas.</p><p><b>METHODS</b>From April 2009 to September 2013, 65 patients with temporal lobe low-grade gliomas (WHO grade II) involving optic radiation were operated with iMRI and functional neuro-navigation. Diffusion tensor imaging (DTI) based fiber tracking was used to delineate optic radiation. The reconstructed optic radiations were integrated into a navigation system, in order to achieve intraoperative microscopic-based functional neuro-navigation. iMRI was used to update the images for both optic radiations and residual tumors. Volumetric analyses were performed using 3D Slicer for pre- and intra-operative tumor volumes in all cases. All patients were evaluated for visual field deficits preoperatively and postoperatively. The Student t test was used to evaluate the average rate of extent of resection between groups. Spearman rank correlation analysis was used to assess correlations between predictors and epilepsy prognosis.</p><p><b>RESULTS</b>Preoperative tumor volumes were (78±40) cm3. In 29 cases, iMRI scan detected residual tumor that could be further resected, and extent of resection were increased from 76.2% to 92.7% (t=7.314, P<0.01). In 19 cases (29.2%), gross total resection was accomplished, and iMRI contributed directly to 8 of these cases. Postsurgical follow-up period varied from 13 months to 59 months, mean (33±13) months. Tumor progression were observed in 3 patients, newly developed or deteriorated visual field defects occurred in 4 patients (6.2%). For patients with pre-operative seizures, Engel Class I were achieved for 89.7% of them. Spearman rank correlation analysis revealed that seizure outcome (Engel Class) was related to increased excision of ratio (r=-0.452, P=0.004, 95% CI: -0.636--0.261) and larger tumors (r=0.391, P=0.014, 95% CI: 0.178-0.484).</p><p><b>CONCLUSIONS</b>With iMRI and functional neuro-navigation, the optic radiation can be accurately located, while extent of resection can be evaluated intra-operatively. This technique is safe and helpful for preservation of visual field for the resection of temporal lobe low-grade gliomas involving optic radiation.</p>


Subject(s)
Brain Neoplasms , Pathology , General Surgery , Glioma , Pathology , General Surgery , Humans , Magnetic Resonance Imaging , Neuronavigation , Temporal Lobe , General Surgery
15.
Article in Chinese | WPRIM | ID: wpr-468938

ABSTRACT

Objective To analyze clinical characteristics of migraine complicated with cerebral edema.Methods We first time reported a case of familiar hemiplegic migraine complicated with diffuse cerebral edema in China,another 19 cases of migraine complicated with cerebral edema were reported in literature.The clinical characteristics of these 20 cases were analyzed.Results In 20 cases,the male:female ratio was 1.2∶ 1,the mean age of onset was (16.0 ± 10.2) years.All 20 cases were complicated with cerebral edema,among whom 8 (40%) were familiar hemiplegic migraine,8 (40%) were sporadic hemiplegic migraine,4 (20%) were migraine with aura.Common neurological symptoms and signs included paralysis (75%),aphasia (65%),disturbance of consciousness (60%),disordered vision (40%),Paresthesia (35%).Eleven cases (55%) had permanent neurological deficit.Conclusions The clinical manifestations of migraine with cerebral edema are complicated,the neurological disturbance is severe and usually has a long duration.The early diagnosis and treatment is beneficial,and preventive treatment in intermittent period is recommended.

16.
Chinese Journal of Surgery ; (12): 280-284, 2014.
Article in Chinese | WPRIM | ID: wpr-314710

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the feasibility, reliability and accuracy of the automated magnetic resonance spectroscopy ((1)H-MRS) guided frameless brain biopsy with intraoperative magnetic resonance imaging (iMRI).</p><p><b>METHODS</b>Between July 2011 and July 2013, a consecutive series of 93 patients were prospectively enrolled. All the patients had intracranial lesions which need biopsy to confirm the diagnosis. Among them, 48 patients were male, 45 patients were female. Their age range from 7 years to 76 years, the median age was 47 years. All patients underwent MRS examination. With MRS automatic fusion technique, the metabolic images were integrated into a standard navigation system (Vario Guide) to guide frameless biopsy. High-field iMRI (1.5 T) was used for target inspection, brain shift correction, and intra-operative exclusion of intra-cerebral hemorrhage and other complications.</p><p><b>RESULTS</b>For all the 93 patients, (1)H-MRS based metabolic images could be automatically integrated into a standard navigation system and average fusion procedure could be taken 5 minutes 6 seconds. For (1)H-MRS guided stereotactic biopsy of intracranial lesions, the diagnosis yield rate was 94.6% (88/93). Four cases did not get a clear pathological diagnosis, while 1 case did not match the pathological diagnosis result which obtained by following craniotomy. Technical related complication rate was 2.2% (2 cases, intra-cerebral hemorrhage), which were intra-operatively depicted with iMRI, and managed properly. Among them, 1 case with small volume (5 ml) intracerebral hematoma fully recovered 10 days after surgery without second surgical intervention. One case with large volume intracerebral hematoma (32 ml) was depicted with iMRI, followed by craniotomy and hematoma evacuation in the same session. This case had no new or worsened neurologic deficit post-operatively.</p><p><b>CONCLUSIONS</b>(1)H-MRS based metabolic imaging can be automatically integrated into a standard navigation system and used for frameless brain biopsy. The target can be selected according to the metabolic status of the lesion. Hence, the target can be more accurate. And the pathological diagnosis yield rate is higher. With iMRI, the method is safe, and has high clinical efficacy.</p>


Subject(s)
Adolescent , Adult , Aged , Biopsy , Methods , Brain , Pathology , Brain Neoplasms , Pathology , Child , Female , Humans , Male , Middle Aged , Neuronavigation , Methods , Prospective Studies , Proton Magnetic Resonance Spectroscopy , Stereotaxic Techniques , Young Adult
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