Objective To investigate the prevalence of anxiety and depression in patients with epilepsy (PWE) in West China, and to explore the related risk factors. Methods The Chinese version of Generalized Anxiety Disorder (GAD)-7 and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scales were used to evaluate the anxiety and depression in 176 PWE patients between December 2016 and February 2017. Univariate analysis was used to screen the factors that may cause anxiety and depression in PWE, and then logistic regression analysis was performed on the possible risk factors. Results In the 176 PWE, about 27.3% had anxiety, and about 28.4% had depression. Multivariate logistic regression analysis showed that seizure occurrence in the recent six months [odds ratio (OR)=3.481, 95% confidence interval (CI) (1.292, 9.380),P=0.014], seizure occurring more than once in a month [OR=3.231, 95%CI (1.468, 7.111),P=0.004], and focal seizures with conscious disorders [OR=2.416, 95%CI (1.082, 5.397),P=0.031] were risk factors for anxiety in PWE. Unmarried status [OR=0.428, 95%CI (0.195, 0.940),P=0.035], seizure occurring more than once in a month [OR=2.685, 95%CI (1.206, 5.979),P=0.016], focal seizures with conscious disorders [OR=2.541, 95%CI (1.112, 5.808),P=0.027] and seizure occurrence in the last six months [OR=7.582, 95%CI (2.416, 23.794),P=0.001] were risk factors for depression in PWE. Conclusions Anxiety and depression are common comorbidities in PWE. For patients with risk factors, early identification and intervention should be performed.
ObjectiveTo investigate the effectiveness of selectively thinning of the free anterolateral thigh flap in repair of the heel skin and soft tissue defect.MethodsBetween April 2013 and August 2015, 8 patients with tissue defect of heel caused by different reasons were recruited. There were 6 males and 2 females with an average age of 31.2 years (range, 15-49 years). The size of wound ranged from 14 cm×10 cm to 19 cm×14 cm. All the wounds were repaired with the contralateral free anterolateral thigh flap. The partial flap which was going to repair the defects of the heel and non-weight-bearing area of planta pedis was selectively thinned. The size of flap ranged from 14 cm×10 cm to 19 cm×14 cm. The donate site was repaired by skin grafting.ResultsAll flaps survived after operation, and wounds healed by first intention. The marginal necrosis of skin graft occurred in 2 cases, and healed after changing the dressing. The other skin grafts survived. All patients were followed up 8-20 months (mean, 12.3 months). All patients could walk normally. During follow-up, 2 flaps were injured and cured after symptomatic management. The appearance of flap was good in 7 cases with no influence in wearing shoes. Only 1 patient received the second-stage surgery of thinning the flap after 1 year.ConclusionApplication of the selectively thinning of the free anterolateral thigh flap can repair the heel skin and soft tissue defects, and achieve an ideal appearance and function.
Objective To systematically review the CT characteristic differences between pulmonary cryptococcosis (PC) and lung cancer presenting as solitary nodules. Methods PubMed, Embase, Web of Science, Cochrane Library, Wanfang, China National Knowledge Infrastructure and SinoMed were searched to collect case-control studies of the patients with PC and lung cancer presenting as solitary nodules on CT. The search period was from databases establishment to December 2023. We conducted a meta-analysis on the included studies. Results A total of 7 studies were included, 342 PC patients, and 370 lung cancer patients. The meta-analysis results showed that compared with lung cancer, PC patients were more likely to have the following characteristics in CT (P<0.05): nodules located in the lower lobe of the lung [odds ratio (OR)=1.91, 95% confidence interval (CI) (1.39, 2.62)], presence of bronchial inflation sign [OR=5.79, 95%CI (1.45, 23.21)], and halo sign [OR=6.64, 95%CI (2.87, 15.38)]. Compared with PC, lung cancer patients were more likely to have the following characteristics in CT (P<0.05): nodules located in the upper lobe of the lung [OR=0.52, 95%CI (0.35, 0.78)], presence of lobulation sign [OR=0.15, 95%CI (0.08, 0.27)], spiculation sign [OR=0.48, 95%CI (0.35, 0.65)], pleural indentation sign [OR=0.15, 95%CI (0.04, 0.50)], and vascular bundle sign [OR=0.20, 95%CI (0.05, 0.77)]. There was no statistically significant difference in CT between PC patients and lung cancer patients in terms of lesion size, relationship with pleura, vacuolar sign, cavity, and whether the broad base was connected to pleura (P>0.05). Conclusions For CT showing solitary nodules, PC nodules are more likely to be distributed in the lower lobe of the lungs, with bronchial inflation sign and halo sign. Lung cancer nodules are more likely to be distributed in the upper lobe of the lungs, with lobulation sign, spiculation sign, pleural indentation sign and vascular bundle sign.
Objective To systematically evaluate the effectiveness of frequently-used bariatric surgery versus conventional medical therapy for obese patients with type 2 diabetes. Methods Such databases as The Cochrane Library (Issue 12, 2012), PubMed, CNKI, CBM, VIP and WanFang Data were searched to collect the randomized controlled trails (RCTs) about frequently-used bariatric surgery vs. conventional therapy for obese patients with type 2 diabetes. The retrieval time was from inception to May, 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality. Then the meta-analysis was performed using RevMan 5.1.2 software. Results A total of three RCTs involving 340 patients were included finally. The results of meta-analysis showed that, compared with conventional medical therapy, bariatric surgery could improve the diabetes remission, decrease both glycated hemoglobin level and patient’s weight. At the same time, the postoperative complications were fairly mild. Conclusion Frequently-used bariatric surgery is superior to conventional medical therapy when treating obese patients with type 2 diabetes, and it deserves to be recommended in clinic. However more studies are required to further confirm this conclusion because of the quality and quantity limitation of the included studies.
【Abstract】 Objective To study the short-term effects of thoracoscopic anterior spine release combined with posterior correction on the pulmonary function in patients with idiopathic scoliosis (IS). Methods Between April 2004 and June 2008, 21 cases of IS underwent thoracoscopic anterior spine release combined with posterior correction. There were 9 males and 12 females with a mean age of 15.6 years (range, 12 to 24 years). Of 11 patients, 2 had left protrusion deformity and 19 had right protrusion deformity, including 12 cases of Lenke type I and 9 cases of Lenke type II, with an average coronal Cobb’s angle of 79.6° (range, 65-125°). The disease duration ranged from 1 year and 6 months to 9 years (mean, 2.5 years). The results of pulmonary function tests (PFTs) were compared between pre-operation and postoperative 6th month, including lung capacity, ventilation function, and thoracic compliance. Results The opening time of the chest was 90 to 150 minutes (mean, 127 minutes) at the thoracoscopic anterior spine release and all incisions healed by first intention with no chest cavity infection. All the patients were followed up from 6 to 36 months (mean, 13.5 months). The average coronal Cobb’s angle was 43.7° (range, 36-75°) at 1 week after posterior correction. At 6 months after operation, the vital capacity and total capacity were significantly increased (P lt; 0.05), but no significant change was observed in the percentage of actual value and expected one when compared with pre-operation (P gt; 0.05). The functional residual capacity and the percentage of actual value and expected one of residual volume was significantly decreased when compared with those at pre-operation (P lt; 0.05). The forced expiratory volume in one second (FEV1) and FEV1/FEV were not significantly improved (P gt; 0.05) , but the maximum ventilatory volume was significantly increased when compared with the preoperative value (P lt; 0.05). In addition, the Raw Total, Raw Insp, and Raw Exp decreased significantly after operation (P lt; 0.05). Conclusion Although the thoracoscopic anterior spine release combined with posterior correction might disturb the function of the thoracic cavity, the PFTs of the patients could be improved at different aspects because of the shape changes of the thoracic cavity, and the pulmonary function still needed further observation.
ObjectiveA competing endogenous RNA (ceRNA) regulatory network associated with long non-coding RNA (lncRNA) specific for lung adenocarcinoma (LUAD) was constructed based on bioinformatics methods, and the functional mechanism of actinfilament-associated protein 1-antisense RNA1 (AFAP1-AS1) in LUAD was analyzed, in order to provide a new direction for the study of LUAD therapeutic targets. MethodsThe gene chip of LUAD was downloaded from the Gene Expression Omnibus (GEO), and lncRNA and mRNA with differential expression between LUAD and normal tissues were screened using GEO2R online software, and their target genes were predicted by online databases to construct ceRNA networks and perform enrichment analysis. In cell experiments, AFAP1-AS1 was genetically knocked down and siRNA was constructed and transfected into LUAD cells A549 by cell transfection. CCK8, transwell, scratch assay and flow cytometry were used to detect the ability of cells to proliferate, invade, migrate and apoptosis. ResultsA total of 6 differentially expressed lncRNA and 494 differentially expressed mRNA were identified in the microarray of LUAD. The ceRNA network involved a total of 6 lncRNA, 22 miRNA, and 55 mRNA. Enrichment analysis revealed that mRNA was associated with cancer-related pathways. In cell assays, knockdown of AFAP1-AS1 inhibited cell proliferation, invasion, and migration, and AFAP1-AS1 promoted apoptosis. ConclusionIn this study, we construct a lncRNA-mediated ceRNA network, which may help to further investigate the mechanism of action of LUAD. In addition, through cellular experiments, AFAP1-AS1 is found to have potential as a therapeutic target for LUAD.
According to their seizure patterns and EEG findings, status epilepticus can be divided into convulsive status epilepticus (CSE) and nonconvulsive status epilepticus (NCSE). Patients with NCSE have well-established EEG abnormalities without typical convulsive convulsions and only altered mental status or mild motor symptoms. Due to its atypical clinical symptoms, NCSE is prone to delayed diagnosis, misdiagnosis, or missed diagnosis, resulting in irreversible brain tissue damage, severe impairment of consciousness, function, and behavior, and even death in NCSE patients. It is of great significance to actively prevent seizures, identify symptoms early, and standardize treatment to improve the prognosis of NCSE patients. At present, there is no relevant standard and consensus on NCSE diagnosis and care. Here, we reported a patient with NCSE who admitted to the Epilepsy Center of Beijing Tiantan Hospital on June 21, 2024. After precise treatment and nursing, the patient's symptoms were well controlled, his condition was stable, and he was followed up for 1 month after discharge, and the prognosis was good. This case report aimed to provide some clinical suggestions to related disease.