Objective To understand the latest research developments of the formation mechanism of psammoma body in human tumors and related issues. Methods Related domestic and foreign literatures were widely referred, analyzed, and reviewed. Results Psammoma body is unique pathological calcification in some tumors, which is arranged in concentric, laminar circles microscopically. Psammoma body is commonly seen in thyroid papillary carcinoma, meningiomas, ovarian serous papillary carcinoma, and so on. Conclusions Although arranged in concentric, laminar circles microscopically in tumor, the formation process of psammoma body is not entirely the same in different tumors. A comprehensive and objective understanding of psammoma body would be useful in cancer diagnosis and treatment.
ObjectiveTo investigate the technique and efficacy of left atrial appendage (LAA) occlusion during off-pump coronary artery bypass grafting (OPCABG) in elderly patients with coronary artery disease (CAD) and atrial fibrillation (AF).MethodsFrom 2013 to 2018, 84 elderly patients with CAD and AF with reduced left ventricular ejection fraction (LVEF< 50%) underwent OPCABG in our department. There were 54 males and 30 females at age of 70-82 years. They were divided into a left atrial appendage (LAA) occlusion group (n=56) and a non-LAA occlusion group (n=28). Postoperative antithrombotic therapy: the LAA occlusion group was given warfarin + aspirin + clopidogrel “triple antithrombotic therapy” for 3 months after operation, then was changed to aspirin + clopidogrel “dual antiplatelet” for long-term antithrombotic; the non-LAA occlusion group was given warfarin + aspirin + clopidogrel “triple antithrombotic” for long-term antithrombotic after operation. The clinical effectiveness of the two groups was compared.ResultsAll patients underwent the surgery successfully. There were 56 patients in the LAA occlusion group, including 44 patients of LAA exclusion and 12 patients of LAA clip. The time of LAA occlusion was 3 to 8 minutes. There was no injury of graft vessels and anastomotic stoma. Early postoperative death occurred in 2 patients (2.4%). There was no statistical difference between the two groups in postoperative hospital stay (P=0.115). Postoperative LVEF of the two groups significantly improved compared with that before operation (P<0.05). There was no stroke or bleeding in important organs during hospitalization. During follow-up of 1 year, no cerebral infarction occurred in both groups, but the incidence of bleeding related complications in the LAA occlusion group was significantly lower than that in the non-LAA occlusion group (3.6% vs. 18.5%, P=0.036).ConclusionFor elderly patients with CAD and AF with reduced LVEF, LAA occlusion during OPCABG can effectively reduce the risk of stroke and bleeding related complications, and without increasing the risk of surgery.
【摘要】 目的 探讨粟粒性脑结核及与其需要鉴别疾病的MRI特点。 方法 2007年12月-2009年10月,对11例粟粒性脑结核患者的MRI平扫及增强表现进行分析,总结其MRI特征性表现。 结果 病史上粟粒性脑结核多存在血行播散型肺结核,平扫表现为多发小片影,增强后表现为弥漫分布的小环状或结节状强化灶,大小趋向一致,多为2 mm左右,可合并结核性脑膜炎及脑积水。 结论 粟粒性脑结核的MRI平扫表现不典型,增强表现有一定特征性,认识其特点可以和其它常见的颅内多发病变进行鉴别。【Abstract】 Objective To analyze the MRI appearances of cerebral military tuberculosis and other diseases that need to differentiate. Methods From December 2007 to October 2009, the MRI appearances of 11 cases on the plain scan and the enhanced MRI scan after injection of Gd-DTPA were reviewed and summarized. Results The cases of cerebral military tuberculosis usually had the history of military pulmonary tuberculosis, showed multiple lesions in fragments on plain scan, and the lesions distributed diffusely after enhancement, showed as ring form or nodosity. The size tended to be uniform, often 2 mm in diameter approximately. Tuberculosis meningitis and hydrocephalus could accompany. Conclusion The manifestation of plain MRI is not typical, and the enhancement MRI is imperative. Some characteristic appearances can be found after injection of Gd-DTPA, and these characteristic appearances could be helpful to differentiate with other multiple intracranial diseases.
The incidence of tinnitus is very high, which can affect the patient’s attention, emotion and sleep, and even cause serious psychological distress and suicidal tendency. Currently, there is no uniform and objective method for tinnitus detection and therapy, and the mechanism of tinnitus is still unclear. In this study, we first collected the resting state electroencephalogram (EEG) data of tinnitus patients and healthy subjects. Then the power spectrum topology diagrams were compared of in the band of δ (0.5–3 Hz), θ (4–7 Hz), α (8–13 Hz), β (14–30 Hz) and γ (31–50 Hz) to explore the central mechanism of tinnitus. A total of 16 tinnitus patients and 16 healthy subjects were recruited to participate in the experiment. The results of resting state EEG experiments found that the spectrum power value of tinnitus patients was higher than that of healthy subjects in all concerned frequency bands. The t-test results showed that the significant difference areas were mainly concentrated in the right temporal lobe of the θ and α band, and the temporal lobe, parietal lobe and forehead area of the β and γ band. In addition, we designed an attention-related task experiment to further study the relationship between tinnitus and attention. The results showed that the classification accuracy of tinnitus patients was significantly lower than that of healthy subjects, and the highest classification accuracies were 80.21% and 88.75%, respectively. The experimental results indicate that tinnitus may cause the decrease of patients’ attention.
The real-time monitoring of cerebral hemorrhage can reduce its disability and fatality rates greatly. On the basis of magnetic induction phase shift, we in this study used filter and amplifier hardware module, NI-PXI data-acquisition system and LabVIEW software to set up an experiment system. We used Band-pass sample method and correlation phase demodulation algorithm in the system. In order to test and evaluate the performance of the system, we carried out saline simulation experiments of brain hemorrhage. We also carried out rabbit cerebral hemorrhage experiments. The results of both saline simulation and animal experiments suggested that our monitoring system had a high phase detection precision, and it needed only about 0.030 4s to finish a single phase shift measurement, and the change of phase shift was directly proportional to the volume of saline or blood. The experimental results were consistent with theory. As a result, this system has the ability of real-time monitoring the progression of cerebral hemorrhage precisely, with many distinguished features, such as low cost, high phase detection precision, high sensitivity of response so that it has showed a good application prospect.
The electroencephalogram (EEG) signal is a general reflection of the neurophysiological activity of the brain, which has the advantages of being safe, efficient, real-time and dynamic. With the development and advancement of machine learning research, automatic diagnosis of Alzheimer’s diseases based on deep learning is becoming a research hotspot. Started from feedforward neural networks, this paper compared and analysed the structural properties of neural network models such as recurrent neural networks, convolutional neural networks and deep belief networks and their performance in the diagnosis of Alzheimer’s disease. It also discussed the possible challenges and research trends of this research in the future, expecting to provide a valuable reference for the clinical application of neural networks in the EEG diagnosis of Alzheimer’s disease.
ObjectivesTo systematically review the efficacy of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation of unilateral neglect in stroke patients.MethodsPubMed, The Cochrane Library, PEDro, EMbase, CNKI, WanFang Data and VIP databases were searched online for randomized controlled trials (RCTs) of rTMS on rehabilitation of unilateral neglect in stroke patients from inception to March 2017. Two reviewers independently screened literature, extracted data and assessed the quality of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 12 RCTs involving 303 patients were included. The results of meta-analysis showed that: the stimulate group was superior to the control group in line bisection test (MD=–5.54, 95%CI –6.79 to –4.29, P<0.000 01), line cancellation test (MD=–3.75, 95%CI –4.60 to –2.90,P<0.000 1) and star cancellation test (MD=–22.94, 95%CI –26.52 to –19.35,P<0.000 01). However, there was no significant difference in the score of the modified Barthel index between two groups (MD=3.91, 95%CI–9.52 to 17.34,P=0.57).ConclusionsrTMS appears to improve the symptoms of unilateral neglect in stroke patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
Stroke is one of the most health-threatening diseases in the world, with high incidence and high morbidity. Despite the development of stroke therapy and improved systems to recognize stroke symptoms and deliver care promptly, only a minority of patients with acute stroke receive thrombolytic therapy, and many of them remain with residual functional deficits. Thus, the need for effective stroke rehabilitation is likely to remain an essential part of the continuum of stroke care for the foreseeable future. This review summarizes and analyzes the results of literatures on stroke rehabilitation in recent years, briefly describes the rehabilitation techniques and progress in dyskinesia, speech barrier, dysphagia, emotional disorder and spasticity after stroke, to provide some references for the optimization of rehabilitation treatment.
ObjectiveTo analyze the clinical characteristics of cerebral shock after intracerebral emorrhage (ICH) to enhance the understanding of cerebral shock after ICH. MethodsA total of 136 patients with ICH admitted to hospital from February 2010 to December 2011 were enrolled in this study.Barthel index (BI) and NIH Stroke Scale (NIHSS) were finished within 48 hours.All the patients were divided into cerebral shock group and no cerebral shock group.All of the 136 patients were matched to shock group (39 cases) and no shock group (39 cases) by the baseline NIHSS score.After 6 months,we judged the prognosis of stroke patient by mRS and compared the prognosis between the two groups. ResultsIn 136 patients,95 had cerebral shock (69.85%),and 41 didn't.The NIHSS score in the shock group was higher than that in the no shock group,but the BI score was lower in the shock group.Six months later,2 patients died in shock group,in which lost follow up was in 1,good prognosis in 11,and poor prognosis in 25.In no shock group,1 patient died,2 were lost of follow up,and the prognosis was good in 29 and poor in 7.The prognosis in the shock group was poorer than that in the no shock group. ConclusionThere are neurological deficit symptoms and poor self-care ability in ICH patients associated with brain shock.The period of brain shock impact the prognosis of the patients with cerebral hemorrhage;early functional rehabilitation for stroke patients with brain shock is expected to improve the prognosis of patients with cerebral stroke.