ObjectiveTo analyze the clinical characteristics and epidemiological characteristics of patients with coronavirus disease 2019 treated early in Jiangxi province.MethodsFour-night patients with coronavirus disease 2019 treated in this hospital from January 21st to 27th, 2020 were included in this study. The epidemiological and clinical data of patients after admission were collected, and laboratory tests such as blood routine, urine routine, stool routine, liver and kidney function, electrolytes, myocardial enzymes, erythrocyte sedimentation (ESR), C-reactive protein (CRP), calcitonin, coagulation, T cell subset and Chest CT were reviewed. The clinical results of common and severe/critically ill patients were compared.ResultsOf the 49 patients, 40 were common and 9 were severe/critical. Fourty-six patients had a clear history of contact with Wuhan or other areas of Hubei. The sex ratio was 2.06∶1, and the average age was 42.9 years. The symptoms were mainly fever (78.7%), cough (38.8%), and fatigue (18.4%). 28.6% (14 cases) of patients had hypertension and diabetes. Serum lymphocyte count and calcium concentration of the patients were decreased, but lactate dehydrogenase, ESR, CRP and serum amyloid A were increased in these patients. T lymphocyte subsets (CD3+, CD4+, CD8+) decreased significantly in these patients. Forty-seven patients (95.9%) had single or scattered patchy ground glass density shadows on the chest CT. Compared with common patients, the patients with severe/critical patients were older (P=0.023), hospitalized later (P=0.002), and had higher comorbidities (P=0.017). ESR (P=0.001）, CRP (P=0.010) and the serum amyloid A (P=0.040) increased significantly, while CD3+ (P<0.001), CD4+ (P=0.012), CD8+ (P=0.006) decreased significantly in severe/critical patients.ConclusionsThe patients with coronavirus disease 2019 in Jiangxi province are commonly imported from Wuhan. Severe/critical patients are older, hospitalized later, and have more medical complications and more severe systemic inflammatory reactions than common patients.
Objective To investigate the clinical manifestations, CT and prognosis of pontine hemorrhage. Methods Analyze the summarized clinical data of 21 patients with pontine hemorrhage retrospectively. Results The period of 46-70 years old was vulnerable to pontine hemorrhage,and hypertension was the major risky factor of it. The death rate of pontine hemorrhage inceases when the bleeding beyond 5 ml. Nine of the 21 patients survived. Conclution The prognosis was highly related to the bleeding amount, the position of bleeding and the complication.
ObjectiveTo summarize the clinical manifestations and treatment of plasma cell mastitis. MethodsWe retrospectively analyzed the diagnosis and treatment of 53 patients with plasma cell mastitis admitted into the hospital between January 2008 and December 2014. ResultsTwelve patients with nipple discharge underwent mammary gland segment resection in which the complete discharging tube system and part of the normal gland were resected. In the 26 patients with inflammatory masses, 12 had acute inflammation with mass formation who were treated with abscess incision drainage and silver alginate wound dressing before second-stage lesion resection. Fourteen patients with only local swelling, tenderness and no abscess formation underwent lesion resection after the abscesses were reduced by combined traditional Chinese medicine (TCM) and western medical treatment. Seven patients with painless mass all had abscesses in the areola area, among whom 5 had complete inflammatory capsule and they underwent lumpectomy. Two patients had cheese-like tissue beside the abscess, and they underwent segmental resection. In the 8 patients with chronic fistula, one at the age of 51 was cured by simple mastectomy after recurrence, and the other 7 underwent lesion resection after combined TCM and western medical treatment. All the 53 patients were diagnosed to have plasma cell mastitis by surgical biopsy, and they were all cured with no recurrence 6 months after surgery. Conclusions Plasma cell mastitis is usually misdiagnosed because of its diversified clinical manifestations. For patients whose lesion is large and not confined, it's better for them to receive combined TCM and western medical treatment. Surgical time and approach should be chosen appropriately. Surgical lesion resection is the only method for complete treatment in patients with plasma cell mastitis.
Objective To observe the clinical characteristics and influencing factors of post-stroke epilepsy. Methods Our research wasaretrospective study, the data came from the information of patients diagnosed with post-stroke epilepsy from our hospital on October 2000 to December 2014 withatotal of 160 cases. With the general collection of clinical data, including gender, past history, clinical manifestations, laboratory examinations and treatment informations. Results The shortest time of post-stroke seizures were occur immediately, the longest was 15 years after the stroke. Peak onset is as early as onset of stroke immediately, late-onset seizures after stroke peaks between 6 months to 1.5 years. 59 patients occurred early epileptic seizures, partial seizures were the most common, accounting for 47.46%; 101 patients occurred late epilepsy, generalized tonic-clonic seizures were the most common, accounting for 56.44%. 25% of patients wereasingle-site lesions, the most common site was temporal lobe; 75% of patients were multifocal lesions. Most were located in the temporal lobe, frontal lobe and the basal ganglia. 42 cases of patients performed EEG, 30 patients (71.43%) of the EEG abnormalities, including 22 cases (73.33%) recurrent epileptic seizures; 12 cases (28.57%) patients with an edge or normal EEG, including 3 cases (25%) relapsed. 54.38% patients with drug therapy to single-agent therapy, two patients with refractory epilepsy to be combination therapy. Conclusions This group of post stroke epilepsy patients were more common as late-onset epilepsy, early onset of stroke peaks is the first day, and delayed the onset of the peak after stroke is within 6 months to 18 months. Lesions in the cortex:alarge area and multiple lesions were risk factors for post-stroke epilepsy, cortical damage to the temporal lobe is most prevalent. 71.43% of patients may have abnormal EEG, EEG abnormalities have higher relapse rate in patients with epilepsy.
目的 分析主动脉夹层的临床及病理特点。 方法 回顾性分析1998年1月－2011年10月26例主动脉夹层致死的临床及法医尸检病理资料，对其发病、死亡经过、诊断、死因进行总结。 结果 26例主动脉夹层平均发病年龄为39.2岁，男女比例为3.3︰1；26例中6例无临床诊断，17例误诊，3例疑似诊断。26例主动脉夹层中，夹层破裂致心包填塞死亡20例，夹层破裂致失血性休克死亡5例，主动脉夹层未破裂1例系心衰致死；26例按DeBakey分类标准9例为Ⅰ型，14例为Ⅱ型，3例为Ⅲ型。 结论 临床应警惕主动脉夹层的特殊临床表现并采取必要的辅助检查，有助于主动脉夹层的诊治和减少医疗纠纷的发生。
ObjectiveTo summarize the clinical pathologic features of primary tonsil tumor, in order to provide reference for its diagnosis and treatment. MethodsWe retrospectively analyzed the clinical data from January 2002 to April 2012, and found 810 cases of malignant tumor and 113 cases of benign tumor. The pathologic patterns and clinical manifestations of these cases were recorded for analysis. ResultsMost tonsil tumors were unilateral, and the malignant types were much more than the benign. The most common malignant tonsil tumors were lymphoma (610 cases), followed by squamous cell carcinoma (172 cases); inverted papilloma was the most common benign tumor (87 cases). Paresthesia in the pharynx was the most common clinical manifestation that existed in almost all cases. ConclusionTonsil tumor pathological type is very important for its diagnosis, treatment and prognosis. Laying emphasis on pathological diagnosis and differential diagnosis could avoid missed diagnosis, misdiagnosis and improper treatment, which is particularly important for clinical physicians of the otolaryngology, head and neck surgery.
ObjectiveTo explore the effects of cytokines on Febrile seizures (FS) in children with febrile seizures (Febrile seizures), febrile seizures duration and prognosis, and to explore the correlation between cytokines and the clinical manifestations and prognosis of FS. MethodsA retrospective analysis was performed on 121 children with FS (77 cases in the simple FS group and 44 cases in the complex FS group) who were treated in the pediatrics department of the Maternal and Child Health Hospital of Inner Mongolia Autonomous Region from January 2021 to October 2022 as the experimental group, including 71 males and 50 females, with a male-to-female ratio of 1.42:1, according to the type of attack (93 cases in the comprehensive group, 44 cases in the complex FS group). The focal group (28 cases) and convulsion duration (91 cases in <5 min group and 30 cases in ≥5 min group) were divided into groups, and 127 cases of children with fever but no convulsions were compared with the control group. In addition, 121 children with FS were followed up for 1 year by neurology specialist outpatient department and telephone follow-up. According to the follow-up, they were divided into the first course group, the relapse group and the secondary epilepsy group, so as to further explore the correlation between cytokines and the prognosis of children with FS. ResultsExperimental group compared with control group: Serum IL-1β (1.38 pg/mL), IL-2 (2.26 pg/mL), IL-4 (1.53 pg/mL), IL-6 (10.51 pg/mL), IL-10 (3.09 pg/mL), IL-12p70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (46.56 pg/mL), IL-1β (1.38 pg/mL), IL-1β (1.26 pg/mL), IL-4 (1.53 pg/mL), IL-6 (10.51 pg/mL), IL-10 (3.09 pg/mL), IL-12P70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (46.56 pg/mL). IFN-α (25.92 pg/mL) levels were higher, and the differences were statistically significant (P<0.05). There was no significant difference between the simple group and the complex group (P>0.05). <5 min group compared with control group: serum levels of IL-2 (2.32 pg/mL), IL-4 (1.53 pg/mL), IL-6 (9.65 pg/mL), IL-12p70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (44.63 pg/mL), IFN-α (29.67 pg/mL) were higher, and the differences were statistically significant (P<0.05). Compared with control group, the levels of IL-2 (2.06 pg/mL), IL-6 (14.67 pg/mL), IL-12p70 (1.97 pg/mL), IFN-γ (58.56 pg/mL) and IFN-α (17.50 pg/mL) in ≥5 min group were higher, and the differences were statistically significant (P<0.05). ROC curve analysis showed that serum IFN-α had a high predictive value for FS onset, the cut-off point was 8.64pg/ml, and the sensitivity and specificity were 75.63% and 76.38%, respectively. There was no significant difference between the first course of disease group, relapse group and secondary epilepsy group. ConclusionSerum proinflammatory cytokines IL-1β, IL-2, IL-6, IL-12p70, TNF-α, IFN-γ, IFN-α and anti-inflammatory cytokines IL-4 and IL-10 are involved in the pathogenesis of FS. There was no correlation between the simplicity and complexity of serum cytokines. IL-2, IL-6, IL-12p70, IFN-γ, IFN-α were positively correlated with the duration of convulsion. When serum IFN-α>8.64 pg/ml, the possibility of FS attack increased.
Objective To understand pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of metaplastic breast cancer (MBC), and to provide some new ideas for clinical diagnosis and treatment, and exploration of scientific research for it. Method The relevant literatures of the latest research on MBC were reviewed and analyzed. Results At present, the pathogenesis of the MBC was still uncertain. The incidence of the MBC was lower, and it’s clinical manifestations were not specific. Compared with the invasive breast cancer, the tumor diameter was larger, the growth was faster, the differentiation degree was lower, the risks of the local and distant metastases were higher, while the lymph node metastasis was rare. Because of the clinical manifestation, auxiliary examination, and imaging examinations were lack of specificity, the diagnosis was difficult. Although the preoperative puncture could provide a reliable diagnosis evidence, it was difficult for distinguishing and accurate diagnosis due to it’s more subtypings. Some of the specific molecular targets could provide a help for it. At present, the modified radical mastectomy was often performed, the axillary lymph node metastasis was relatively rare in the MBC, so the sentinel lymph node biopsy was more important in the treatment of the MBC. The therapeutic effect was limited by the endocrine therapy, targeted therapy, or neoadjuvant chemotherapy and was poor by the systemic chemotherapy. Although the radiotherapy and chemotherapy could improve the overall survival and prolong the disease-free survival and control the local recurrence, the difference of it’s therapeutic effect was great due to the complex MBC typing. Conclusions MBC is a highly malignant and strongly invasive tumor, and it has more subtypings. Clinical manifestation and preoperative examination are lack of specificity, hence it is easy for misdiagnosis or missed diagnosis. Unified treatment guideline is lack of, prognosis is poor. So, it needs to explore some new treatment methods and formulate standardized treatment guidelines in order to achieve a better therapeutic effect.