ObjectiveTo investigate the video-electroencephalography (VEEG) characteristics of old patients with epilepsy (OPWE). MethodsBetween June 2013 and July 2014, 57 OPWE at an age over 60 years were assigned to research group and 65 adults between 16 and 60 years old with epilepsy were regarded as controls. All the subjects underwent VEEG for 24 hours covering awake state and sleep with hyperventilation test being applied. Chi square was used to compare occurrence rate of epileptic wave and abnormal response rate after hyperventilation between the two groups of patients. Additionally, ictal elcetroencephalograph (EEG) was analyzed. ResultsCommon features of waves on EEG for patients in both the two groups during the ictal period included widespread low amplitude fast wave (2 cases in the research group, 7.4%; 4 cases in the control group, 12.5%), focal low amplitude fast wave (5 cases in the research group, 18.5%; 6 cases in the control group, 18.8%), widespread spike or spike slowing complex (3 cases in the research group, 11.1%; 7 case in the control group, 21.8%), focal spike or spike slowing complex (5 cases in the research group, 14.9%; 8 cases in the control group, 25.0%), and focal rhythmic slow wave (6 cases in the research group, 18.5%; 6 cases in the control group, 18.8%). In the research group, there were two following cases:single abnormal background activity in 5 cases (18.5%), and neither abnormal background activity nor epileptic discharge in 1 case (3.7%). Ictal focal epileptic discharges were found in 16 cases in the research group and 8 in the control group (59.3% vs 25.0%), with statistical difference (P<0.05). Inter-ictal epilepsy discharges were found in 57 patients of the research group (awake, 15.8%; sleep, 52.6%), which was less than that in the control group (awake, 46.2%; sleep, 83.1%) with statistical difference (P<0.05), accompanied by focal slow wave (temporal intermittent rhythmic delta activity, TIRDA) in 9 cases. In natural sleep period, epilepsy discharge occurrences increased (65.3%). Abnormal response rate in the research group (14.0%) was lower than that in the control group (64.6%) with statistical difference (P<0.05). ConclusionEarly onset EEG of the old and the adult are similar except those with single abnormal background activity and those with neither abnormal background activity nor epileptic discharge. Focal onset on EEG is more frequently seen in OPWE than in APWE. In natural sleep, epileptic discharge increases among OPWE, and abnormal response during hyperventilation is less likely to happen in OPWE.
ObjectiveTo investigate the effect of indocyanogen green retention rate (ICGR) measurement and Child-Pugh classification of liver function in the preoperative evaluation of hepatic functional reservation. MethodsThe level of ICGR at 15 min (ICGR15) and the percentage of liver fibrosis in 103 patients with liver cancer were measured before hepatectomy, and the Child-Pugh classification of liver function was evaluated before and after the operations, and their connections were analyzed. ResultsAs the rise of Child-Pugh classification of liver function, the percentage of liver fibrosis increased gradually, there were significant differences between any two Child-Pugh classification (Plt;0.05). There was a linear correlation between the ICGR15 and the liver fibrosis percentage (rs=0.960, Plt;0.05). The value of preoperative ICGR15 in patients with postoperative Child-Pugh classification from grade A to grade B or grade B to grade C was gnificantly higher than that in patients with stabilization of Child-Pugh classification before and after operations (Plt;0.05). ConclusionICGR15 combined with Child-Pugh classification can improve the accuracy for the evaluation of preoperative hepatic functional reservation.
Objective To investigate the trend of breast cancer treatment and prognosis in 30 years. Methods Total 1 092 patients with breast cancer treated in the Peking Union Medical College Hospital between 1975 and 2006 were reviewed in six time phases for therapy, metastasis, and survival rate. Six time phases were 1975-1980 years, 1985-1986 years, 1990-1991 years, 1995-1996 years, 2000-2001 years and 2005-2006 years. Results Radical operation was the major treatment (68.9%， 91/132) of breast cancer in 1975-1980 and then became less popular until it was totally abandoned after 2001. The number of modified radical operation begun to rise from 1980 and reached its peak in 1995-1996 (94.9%， 146/154). The number of lumpectomy had been increasing since 2000, and that of chemotherapy had been rising since 1985-1986. But there was no apparent change of the percentage of radiotherapy treatment. In 1975-1980, only 0.8% （1/126） patients received endocrine therapy, but in 1990-1991, the ratio was 66.0% （33/50）. The metastasis and recurrence ratio was declining gradually in the 6 time phases (P＜0.05). The 5-year and 10-year disease free survival rates in the groups of 1990-1991, 1995-1996, 2000-2001, and 2005-2006 were apparently higher than those in two earlier groups of 1975-1980 and 1985-1986 (P＜0.05). Conclusion The conclusions of laboratory experiments and clinical trials on breast cancer are critical for improving prognosis.
Objective To investigate the diagnostic value of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammatory body and sphingosine-1-phosphate (S1P) in early diabetic nephropathy and its progression. Methods A total of 600 diabetic patients who were treated in Shaanxi Provincial People’s Hospital between January 2018 and December 2020 were selected, and the patients were divided into simple diabetes group, early diabetic nephropathy group and clinical diabetic nephropathy group. The expression of NLRP3 messenger RNA (mRNA) in fasting venous blood mononuclear cells was detected by real-time fluorescence quantitative polymerase chain reaction, and the level of S1P was detected by enzyme-linked immunosorbent assay double-antibody sandwich method. Pearson correlation analysis was used to explore the correlation between blood NLRP3 mRNA and S1P levels. The receiver operating characteristic curve was used to evaluate the diagnostic value of blood NLRP3 mRNA and S1P levels in early diabetic nephropathy and clinical diabetic nephropathy. Results Among the 600 diabetic patients, 205 were in the simple diabetes group, 198 in the early diabetic nephropathy group and 197 in the clinical diabetic nephropathy group. There was no significant difference in age and gender among the three groups (P>0.05). The blood levels of NLRP3 mRNA and S1P in the clinical diabetic nephropathy group were higher than those in the early diabetic nephropathy group and the simple diabetes group, the blood NLRP3 mRNA and S1P levels in the early diabetic nephropathy group were higher than those in the simple diabetes group. The differences were statistically significant, and the blood NLRP3 mRNA levels of the three groups were 2.69±0.64 vs. 2.05±0.56 vs. 1.76±0.51, and the S1P levels were (1.49±0.27) vs. (1.16±0.13) vs. (0.89±0.07) μmol/L (P<0.05). There was a positive correlation between blood NLRP3 mRNA and S1P level in patients (r=0.455, P<0.001). Blood NLRP3 mRNA, S1P levels and their combined detection can be used to diagnose whether diabetic patients develop early diabetic nephropathy (area under the receiver operating characteristic curve were 0.645, 0.968, 0.971; P<0.001) and whether it progressed to clinical diabetic nephropathy (area under the receiver operating characteristic curve were 0.825, 0.918, and 0.945; P<0.001). Conclusion Blood NLRP3 mRNA and S1P levels can be used to diagnose early diabetic nephropathy and evaluate its disease progression.
目的 探讨妊娠期乳腺癌的诊断、治疗及预后。方法 回顾性分析1986年1月至2007年12月期间笔者所在医院收治的12例妊娠期乳腺癌患者的临床资料和随访资料。结果 12例妊娠期乳腺癌患者中，有8例患者于术前行B超检查，3例患者行钼靶检查，均有阳性发现。12例患者均行手术治疗，其中10例行乳腺癌改良根治术，2例行乳腺癌根治术；7例在妊娠期间确诊的患者中，仅1例行人流术，另外6例行剖宫产；所有患者乳腺癌术后并妊娠结束后均行化疗，5例化疗后再行放疗，1例在妊娠结束后行内分泌治疗。随访期间（平均随访时间35.8个月），1例患者出现胸壁结节，2例盆腔多发转移并死亡，余9例均未出现复发和转移。结论 妊娠期乳腺癌可行乳腺切除加腋窝淋巴结清扫术； 妊娠结束后可行化疗，妊娠期间不应行放疗及内分泌治疗。