目的 探讨腹腔镜全结肠切除术在家族性腺瘤性息肉病(FAP)中的应用价值。方法 回顾性分析我院2008年1月至2009年10月期间收治的行腹腔镜全结肠切除术的4例FAP患者的临床资料,对手术安全性和术后恢复情况进行分析。结果 4例患者均顺利行腹腔镜全结肠切除术,无中转开腹,无手术并发症及死亡。腹部切口长6.0 cm,手术时间300~380 min(平均330 min),术中出血量90~250 ml(平均160 ml)。术后2~3 d肛门开始排气,术后住院时间7~11 d(平均9 d)出院。出院后大便稀薄,8~12次/d,给予易蒙停治疗后缓解。随访2~22个月(平均14个月),无近期并发症发生。结论 腹腔镜全结肠切除术治疗FAP安全、有效,近期效果良好。
ObjectiveTo observe and explore the fundus characteristics and fundus fluorescein angiography of familial exudative vitreoretinopathy (FEVR) in different stages. MethodsA total of 15 patients (23 eyes) diagnosed as FEVR in the West China Hospital of Sichuan University from January 2007 to November 2013 were included. Clinical data and reports of fundus exams and fundus fluorescein angiography (FFA) were retrospectively analyzed. ResultsOne eye (4.35%) was classified as stage Ⅰ, 10 eyes (43.48%) were classified as stage Ⅱ, 8 eyes (34.78%) were classified as stage Ⅲ, and 1 eye (4.35%) and 3 eyes (13.04%) were classified as stage Ⅳ and V, respectively. The outcomes of fundus exams showed that the number of peripheral retinal blood vessels increased, and vessels straightened as well as narrowed, especially in the temporal area. FFA showed blood vessels suddenly shut in the equatorial retina and peripheral non-perfusion areas were observed. ConclusionTypical fundus characteristics and fundus fluorescein angiography changes of FEVR can be observed in different stages. Comprehensive fundus exams and family history are helpful to confirm relevant diagnosis.
ObjectiveTo observe the transthyretin (TTR) gene mutation, protein and mRNA expression in patients with familial vitreous amyloidosis. MethodsSubjects were divided into three groups: (1) illness group: seven patients with familial vitreous amyloidosis. (2) No-illness group: 9 unaffected family members. (3) Control group: 9 healthy individuals in same area. Subjects' peripheral venous blood were collected and DNA were extracted, 4 exons of TTR gene were amplified by reverse transcription polymerase chain reaction(RT-PCR), the gene fragments were sequencing by the fluorescence labelling method. Serum TTR protein expression was detected by Western blot, and TTR mRNA in leukocyte was assayed by RT-PCR. Results4 exons of TTR gene of all samples were amplified, and DNA sequencing data showed that 7 patients and 3 subjects DNA from unaffected family members had mutated in the 3rd exon of 107th base, changing from G to C. Heterozygous mutation occurred in codon of the 83th amino acid in exon 3, namely, Gly83Arg, resulted in the change of GGC to CGC. The protein and mRNA expression of TTR was lower in illness group than no-illness group and control groups(P < 0.05). Compared with control group, TTR mRNA expression in unaffected family members groups was significant decreased(P < 0.05). ConclusionHeterozygous mutation occurred in codon of the 83th amino acid in exon 3, namely Gly83Arg, and suggested that Gly83Arg is connected with the change of TTR mRNA and protein expression.
ObjectiveThe study aimed to investigate the clinical characteristics of epilepsy patients with DEPDC5 mutation, and to improve the understanding of familial hereditary focal epilepsy.MethodsThree families with familial hereditary focal epilepsy were enrolled in this study from September 2014 to September 2017 at the Sanjiu Brain Hospital of Guangdong Province. Epilepsy-related gene in peripheral blood was detected by the second generation sequencing. The medical history, family history, magnetic resonance imaging, electroencephalo-groph, treatment programs and other data were collected and aralyzed.ResultsThere were 8 patients in the three families, seizures of whom originate mostly from the frontal or temporal lobe. Cognitive function and other system function was basically normal fron patients treated with antiepilepsy drugs.ConclusionsThe mutations of DEPDC5 gene are common in familial hereditary focal epilepsy, which leads to the main clinical symptom of complex partial seizure. Antiepilepsy drug therapy is effective to most patients. However, to those drug resistant patients, prognosis can improved by surgical treatment.