ObjectiveTo investigate the clinical features of Hirayama disease (HD). MethodsWe analyzed the clinical manifestations and assistant examination results of one patient with HD diagnosed in November, 2010. In addition, we reviewed the related literatures. ResultsThe patient was a young man, and the main symptoms were bilateral hand weakness with muscular atrophy. The muscle bundles trembled when he stretched his fingers. The electromyography showed neurogenic damage of both the thenar muscles and the first interosseous muscles. Brain magnetic resonance imaging (MRI) showed normal; cervical spine flexion MRI showed thinning cervical spinal cord with spinal canal narrowing at C5-C7 plane. In addition, epidural fat gap widened at C4-T1 plane, and enhanced scan showed cord-like changes, patchy strengthening and blood flow void shadow. ConclusionWhen asymmetric distal upper limb muscle weakness with muscle atrophy appears in adolescents, HD should be considered. The combination of neuroelectrophysiological examination and cervical spine flexion MRI scan is helpful for diagnosis. Wearing cervical collar may slow disease progression.
Model-based meta-analysis (MBMA) is a new type of quantitative analysis method, random effects in statistics will be found and put into the model as well as covariates. The final model has a strong predictive ability, can be conducted to make clinical decisions and evaluation. For its complexity, MBMA study is difficult to perform which restricted its application. By summarizing current published MBMA studies as well as the authors' experience, this article introduced the principle, method and status of MBMA.
Objective To investigate the effect of imatinib mesylate on radiation-induced lung injury mice and its influence on the oxidative stress and transforming growth factor-β1 (TGF-β1) expression in mice. Methods Forty-five C57BL/6 mice were divided into a treatment group, a control group and a model group. The treatment group and model group were given radiation of 18 Gy delivered in the thorax. After 4 h daily of the radiation, the treatment group received imatinib mesylate of 0.081 g/kg, while the other groups were given normal saline solution. The experiments were continued for 30 days. After the experiments, the lungs of mice were divided into 4 parts. The haematoxylin and eosin and immunohistochemical stain were prepared to observe the situation of pathology and TGF-β1. The lung homogenate was prepared and the levels of superoxide dismutase (SOD), malondialdehyde (MDA), total antioxidant capacity (T-Aoc) and glutathione peroxidase (GSH-PX) were detected. Results The levels of GSH-PX, T-Aoc and SOD were (173.15±12.21) U, (119.33±11.06) U/mgprot and (1.73±0.33) nmol/mgprot in the treatment group, significantly higher than the control group, while the levels of MDA was (0.68±0.08) nmol/mgprot, significantly lower than the control group (P<0.05). The HE and immunohistochemical stain showed that there were mild alveolar inflammatory changes in the treatment group while such changes were serious in the model group. The scores of HE and immunohistochemical were 1.26±0.12 and 0.31±0.12 in the treatment group, significantly lower than those in the control group (P<0.05). Conclusion The imatinib mesylate can effectively ameliorate the oxidative stress and inhibite TGF-β1 expression in radiation-induced lung injury mice.
Objective To explore the awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke. Methods From January to August 2012, using self-designed questionnaire, trained neurologists conducted the face to face investigation in 500 inpatients with a high risk of stroke, including those with a history of stroke in Department of Neurology in the Second Affiliated Hospital of Chongqing Medical University. Results A total of 467 valid questionnaires were recovered. Only 16.1% (75/467) patients were aware of thrombolytic therapy for acute stroke, of whom 50.7% (38/75) knew the time window of thrombolytic therapy. Awareness of thrombolytic therapy was higher in patients aged 56-70 years, with a higher level of education and income, and in those who knew at least 3 stroke warning signs and those with a history of stroke. While awareness of the time window of thrombolytic therapy was higher in those unmarried or widowed and with a history of stroke. Multiple logistic regression analysis showed that awareness of thrombolytic therapy was independently associated with age, education level, knowledge of stroke warning signs and a history of stroke; awareness of the time window was associated with marital status and a history of stroke (P<0.05). Conclusions Inpatients with a history of stroke and with a high risk of stroke in the Department of Neurology have poor awareness of thrombolytic therapy for acute ischemic stroke. It is necessary to improve the level of patients’ knowledge about thrombolytic therapy for acute stroke by health education.
ObjectiveTo observe the efficacy of platelet-rich fibrin (PRF) membrane tamponade combined with air filling for giant macular hole (MH). MethodsA prospective case-control study. From January 2019 to February 2021, 56 patients (56 eyes) diagnosed with giant MH from Eye Center of Renmin Hospital of Wuhan University were enrolled. Among them, there were 17 males with 17 eyes and 39 females with 39 eyes. The average age of the patients was 64.23±9.30 years old. The average MH minimum diameter was 827.36±83.16 μm. The best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) examination were performed before surgery. The Chinese version of 25-item National Eye Institute visual functioning questionnaire (NEI VFQ-25) was used to investigate patient's visual-related quality of life. There were 28 eyes of 28 cases receiving PRF membrane covering, as PRF group, another 28 eyes of 28 cases receiving inverted internal limiting membrane (ILM) insertion into giant MH, as ILM group. The differences of the age (t=－1.588), sex ratio (χ2=0.760), BCVA (Z=－0.400), macular hole minimum diameter (t=－0.604), choriocapillary blood flow area (CBFA) (t=1.331) and NEI VFQ-25 score (t=0.921) were not statistically significant (P＞0.05). All eyes underwent 23G minimally invasive vitrectomy. In the PRF group, PRF membrane was used to fill the hole, and in the ILM group, the hole was filled with ILM inversion, and filled with sterile air after full gas-liquid exchange. The follow-up time after surgery was ≥6 months. The same equipment and methods as before surgery were used to conduct related examinations, and the changes of BCVA, the shape of hole closure, CBFA and the improvement of vision-related quality of life were compared between the two groups. For comparison between groups, independent samples t-test was used for data with normal distribution, and Mann-Whitney U test was used for data with non-normal distribution. For intra-group comparisons, paired-samples t-test was used for data with normal distribution, and Wilcoxon rank-sum test was used for non-normally distributed data. ResultsSix months after surgery, in the eyes of PRF group and ILM group, the hole of 27 (96.4%, 27/28) and 26 (92.6%, 26/28) eyes were closed; the median BCVA was 0.70 and 0.70, respectively; CBFA were 1.99±0.20 and 1.91±0.18 mm2; NEI VFQ-25 scores were 81.36±12.39 and 78.39±10.12, respectively. Compared with before surgery, the BCVA (Z=－4.636,－4.550) and CBFA (t=－27.115,－31.135) of the affected eyes in the PRF group and ILM group were significantly improved after surgery, and the NEI VFQ-25 scores (t=－15.557, －10.675) was significantly increased, and the difference was statistically significant (P＜0.05). There was no significant difference in BCVA (Z=－0.167), CBFA (t=1.554), and NEI VFQ-25 scores (t=0.980) between the two groups after interocular surgery (P=0.726, 0.126, 0.331). ConclusionPRF membrane insertion with air filling has the same efficacy as ILM insertion in the treatment of giant MH, which can improve the closure rate of MH, patients' vision and vision-related quality of life, and increase choroidal blood perfusion.