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Objective:To investigate the prognostic value of neuroelectromyography in peripheral facial paralysis and its correlation with House-Brackman classification.Methods:Seventy-eight patients with peripheral facial paralysis who received treatment in Yiwu Central Hospital, China between January 2016 and January 2019 were included in this study. All patients underwent neuroelectromyography. Bilateral nerve conduction velocity, latency, amplitude, and the needle electrode electrogram of orbicularis oris muscles, rbicularis oculi muscles and frontal muscles were analyzed and recorded. After 3 months of treatment, the correlation between prognosis and House-Brackman classification was analyzed.Results:Electromyography examination of 78 patients revealed among 68 patients presenting with prolonged latency, the latency on the affected side was significantly longer than that on the healthy side [(3.78 ± 0.33) ms vs. (2.89 ± 0.35) ms], t = 15.256, P < 0.001]. Among 73 patients presenting with decreased M amplitude, M amplitude on the affected side was significantly lower than that on the healthy side [(0.60 ± 0.27) mV vs. (1.83 ± 0.29) mV, t = 26.522, P < 0.001]. Among 78 patients, normal electromyography findings were observed in 2 patients and abnormal findings in 76 patients, with an abnormal rate of 97.44%. Among 78 patients, 46 patients presented with fibrillation potentials and positive sharp waves in the resting state, 40 patients presented with long duration and multiphase wave percentage of motor unit action potential in mild contraction, and 52 patients presented with abnormal recruitment potential in severe contraction. Three months of follow-up revealed that 23 out of 25 patients with mild peripheral facial paralysis had a complete recovery, with the cure rate of 92.00% (23/25), 28 out of 36 patients with moderate peripheral facial paralysis had a complete recovery, with the cure rate of 77.78% (28/36), 7 out of 10 patients with mild and moderate peripheral facial paralysis had a complete recovery, with the cure rate of 70.00% (7/10), and 3 out of 5 patients with severe peripheral facial paralysis had a complete recovery, with the cure rate of 60.00% (3/5). Conclusion:Neuroelectromyography can improve the accuracy in the identification of injury degree of peripheral facial paralysis and has a strong correlation with House-Brackman classification. Therefore, neuroelectromyography can provide a reference for diagnosis and treatment of peripheral facial paralysis.
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Objective To investigate the safety and efficacy of endoscopic varices ligation(EVL) plus endoscopic varices sclerotherapy(EVS)for esophageal varices hemorrhage in patients with liver cirrhosis. Methods Fifty?two liver cirrhosis patients with esophageal varices bleeding were randomly divided into EVL group(n=24)and EVLS group(n=28)according to random numbers generated by computer after first EVL. The EVL group continued undergoing EVL, and the EVLS group was treated by EVS. The interval of treatment was 2 weeks till varices disappeared. All patients were followed up for 18 months with endoscopy and endoscopic ultrasonography(EUS). The efficacy,changes of esophageal varices and perforating veins, varices recurrence and rebleeding were observed. Results There was no significant difference of complete cure rate between EVLS group and EVL group[67.9%(19/28)VS 62.5%(15/24),P>0.05]. The mean session of treatment(2.68±1.0 VS 1.83±0.7,P<0.05), and perforating veins obliteration rate after treatment in EVLS group was higher than that in EVL group[70.8%(17/24)VS 23.8%(5/21),P<0.05]. During 18 months of follow?up,there was no significant difference of rebleeding rate between the two groups[3.6%(1/28)VS 12.5%(3/24),P>0.05],and the varices recurrence rate was higher in EVL group than that in EVLS group[77.3%(17/22)VS 44.0%(11/25), P<0.05]. Child?Pugh class B patients in EVL group had a higher varices recurrence rate compared to that in EVLS group[75.0%(9/12)VS 31.5%(5/16), P<0.05]. Endoscopic recurrences occurred in patients with non?occlusive perforating veins. Conclusion EVL plus EVS sequential procedure is safe and effective for treatment of esophageal varices hemorrhage,especially for Child?Pugh class B patients.Perforating veins may play a key role in the development of esophageal varices and recurrence after endoscopic therapy. EUS findings can direct the endoscopic therapy and predict the variceal recurrence.
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Objective To explore the correlation between the levels of uric acid(UA),plasma total cholesterol(TC),triglyceride (TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C),lipoprotein A(LPL)and hyper-sensitive C-reactive protein(hs-CRP)with type 2 diabetes mellitus(T2DM)complicating gout.Methods The levels of UA,TC, TG,HDL-C,LDL-C,LPL and hs-CRP in the T2DM complicating gout group,the T2DM without gout group and the gout group were measured and statistically analyzed to evaluate whether the differences of these indicators among 3 groups having statistical significance.Results Compared with the T2DM without gout group,the TG,LDL-C,hs-CRP and UA levels in the T2DM compli-cating gout were increased (P <0.05),while the HDL-C level was decreased(P <0.05).Ccompared with the gout group,the GLU, TG,LDL-C,LPL,hs-CRP and UA levels in the T2DM complicating gout group were significantly increased (P <0.05 )and the HDL-C level was decreased(P <0.05).The UA level in the T2DM complicating gout group was positively correlated with GLU, TC,TG,LDL-C,LPL and hs-CRP levels(P <0.05),the correlation coefficient were 0.313,0.283,0.422,0.297 and 0.436 respec-tively,which was negatively correlated with HDL-C(P <0.05),the correlation coefficient was -0.523.Conclusion The UA,TC, TG,HDL-C,LDL-C,LPL and hs-CRP levels have close correlation with T2DM complicating gout,detecting these biochemical indi-cators is helpful to monitor and control the occurrence and the development of T2DM complicating gout.
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Objective To observe the shenqifuzheng injection (SFI) combined with PG therapy (gemcitabine and cisplatin) in patients with non-small cell lung cancer (NSCLC). Method 76 patients with NSCLC were selected from August 2011 to August 2013 and randomly divided into observation group and control group. Each group had 38 cases. The control group received gemcitabine and cisplatin, observation group were gave SFI on the basis of control group. The total efficiency, disease control rate, quality of life and incidence of adverse reactions were observed after treatment in each group. Results The total effective rate was 47.37%in observation group , 42.11%in control group, there was no significant difference between two groups. The disease control rate in observation group was 81.58%higher than 57.89%in control group, the difference was statistically significant (χ2=3.990, P<0.05). The improvement rate in quality of life was 60.53%in observation group better than 31.58%in the control group , the difference was statistically significant (χ2=5.296, P<0.05).The decrease incidence of white blood cell (χ2=4.491, P<0.05) and platelets (χ2=4.491, P<0.05) in observation group were significantly lower compared with the control group, while, there were no difference of liver damage and gastrointestinal reactions between two groups. Conclusion SFI is helpful to improve the efficacy of PG therapy in patients with NSCLC and relieve the side effects of chemotherapy.
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In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schonlein purpura nephritis (HSPN), 31 children with IgA nephropathy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 %children with IgA nephropathy, but only 10 % in HSPN (P＜0.05). The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia,compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6% of HSPN and 29 % of IgA nephropathy (all P＜0.01). Thin basement membrane nephropathy was only found in 6.5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, loose and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2 %of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits,moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71.9 % of HSPN had IgG deposits in glomeruli and only 19.4 % of IgA nephropathy showed glomerular IgG deposits (P＜0.01). No IgG deposit was observed in 81.6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn't be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5 % of HSPN, but only 19.4 % in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16.1% had active nephritides (P＜0.05). It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn't support the one disease entity hypothesis.HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.
