Objective To improve the awareness of acute exacerbation of idiopathic pulmonary fibrosis ( AEIPF) and discuss its clinical characteristics, diagnosis, treatment and outcome. Methods The clinical data of patients with AEIPF from June 2006 to June 2011 in 11 hospitals in Jiangsu were collected and analyzed. Resluts There were 18 males and 3 females in the AEIPF patients with mean age of ( 67.4 ± 8.1) years. The duration from IPF diagnosis was ( 7.4 ±8.2) months. The duration of acute symptom before admission was ( 7.0 ±5.3) days. The distribution pattern of new groud-glass opacity was peripheral in 3 patients,multifocal in 5 patients, and diffuse in13 patients. All patients were treated with corticosteroid pulse therapy. Nine patients survived and 12 patients died. The mortality rate was 57.1% . Conclusions AEIPF progresses quickly and the mortality rate is very high. Corticosteroid pulse therapy is the mainstay of therapy in AEIPF patients.
ObjectiveTo construct a map of cerebral cortex thickness in Idiopathic Generalized Epilepsy (IGE) diagnosed at the first visit, using T1-weighted brain magnetic resonance imaging and advanced image analysis software. MethodsHigh-resolution three-dimensional T1 images were obtained from 27 IGE patients diagnosed at the first visit and 29 normal controls in Shouguang People's Hospital from January 1, 2022 to December 31, 2021. The location recognition calculation system of the Freesurfer software was used to calculate the values of cortical thickness in each brain region, and the cortical thickness values were transformed into a brain atlas using the image analysis software. A differential brain atlas was generated using the two-sample t-test to analyze the difference in cortical thickness between IGE patients and normal controls. Paired t-test was used for within-group comparison to explore changes of cortical thickness laterality. ResultsIn the IGE brain atlas, the brain regions with higher cortical thickness were the right left temporal pole, the right left entorhinal cortex, the head of the right anterior cingulate gyrus, the right and left insular lobe, the right and left middle temporal gyrus, the right inferior temporal gyrus, the head of the left anterior cingulate gyrus, the left tail of the anterior cingulate gyrus, the left inferior temporal gyrus, the left and right fusiform gyrus, and the left frontal pole. The areas with lower cortical thickness were the right and left paracalcaric gyrus, the right and left cuneiform lobe, the left and right lingual gyrus, the left and right posterior central gyrus, the left lateral occipital gyrus, and the right and left superior parietal gyrus. The distribution of cortical thickness of the IGE group was comparable to the cortical thickness atlas of the normal control. Compared with normal control, the areas with changes of cortical thickness in the IGE group were bilateral superior frontal gyrus, bilateral posterior central gyrus, bilateral anterior central gyri, bilateral lingual gyri, left cuneiform lobe, bilateral entorhinal cortex and temporal pole. The brain areas with laterality of cortical thickness between hemispheres in the IGE group were the tail of anterior cingulate gyrus, cuneiform lobe, inferior parietal gyrus, lateral occipital gyrus, posterior central gyrus, head of anterior cingulate gyrus, and superior marginal gyrus. Compared with normal control, the IGE group has decreased number of brain regions with laterality of cortical thickness. ConclusionThe present study revealed the distribution and laterality of cerebral cortical thickness map in early idiopathic generalized epilepsy, which provides imaging structural basis for brain research in the future.
ObjectiveAlthough evidence links idiopathic pulmonary fibrosis (IPF) and diabetes mellitus (DM), the exact underlying common mechanism of its occurrence is unclear. This study aims to explore further the molecular mechanism between these two diseases. MethodsThe microarray data of idiopathic pulmonary fibrosis and diabetes mellitus in the Gene Expression Omnibus (GEO) database were downloaded. Weighted Gene Co-Expression Network Analysis (WGCNA) was used to identify co-expression genes related to idiopathic pulmonary fibrosis and diabetes mellitus. Subsequently, differentially expressed genes (DEGs) analysis and three public databases were employed to analyze and screen the gene targets related to idiopathic pulmonary fibrosis and diabetes mellitus. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed by Metascape. In addition, common microRNAs (miRNAs), common in idiopathic pulmonary fibrosis and diabetes mellitus, were obtained from the Human microRNA Disease Database (HMDD), and their target genes were predicted by miRTarbase. Finally, we constructed a common miRNAs-mRNAs network by using the overlapping genes of the target gene and the shared gene. ResultsThe results of common gene analysis suggested that remodeling of the extracellular matrix might be a key factor in the interconnection of DM and IPF. Finally, hub genes (MMP1, IL1R1, SPP1) were further screened. miRNA-gene network suggested that has-let-19a-3p may play a key role in the common molecular mechanism between IPF and DM. ConclusionsThis study provides new insights into the potential pathogenic mechanisms between idiopathic pulmonary fibrosis and diabetes mellitus. These common pathways and hub genes may provide new ideas for further experimental studies.
Objective To elucidate the new development and effects of three-dimensional correction techniques of idiopathic scol iosis (IS). Methods The related home and abroad l iterature concerning three-dimensional correction techniques of IS was extensively reviewed. Results With more and more attention to three-dimensional correction of IS, all kinds of surgery and developed techniques of correction are applied to the correction of IS. The effects of three-dimensional correction of IS are satisfied. Conclusion With more knowledge about IS and more developed theory of correction, more safe and effective techniques of correction is therefore the hot spot for future study.
【摘要】 目的 探讨影响糖皮质激素治疗特发性血小板减少性紫癜疗效的主要因素。 方法 回顾分析2008年1月-2010年7月173例特发性血小板减少性紫癜患者的临床资料，采用χ2检验及Logistic回归分析影响糖皮质激素疗效的相关临床因素。 结果 单因素χ2检验分析显示性别、骨髓巨核细胞计数水平、骨髓产板巨核细胞比例、乙型肝炎表面抗原（HBsAg）、血清免疫球蛋白水平对糖皮质激素疗效的影响有统计学意义（Plt;0.05）。脾脏长大、抗核抗体（ANA）阳性、补体C3水平降低与糖皮质激素疗效无关。多因素Logistic回归分析显示性别、HBsAg是影响糖皮质激素疗效的相关因素。 结论 男性、骨髓巨核细胞计数增多、产板巨比例降低者对糖皮质激素治疗反应较好。女性、血清免疫球蛋白水平异常、骨髓巨核细胞不增多者及HBsAg阳性的患者对糖皮质激素治疗反应相对较差。性别、HBsAg是影响糖皮质激素疗效的主要因素。【Abstract】 Objective To discuss the influencing factors associated with the efficacy of glucocorticoid for idiopathic thrombocytopenic purpura. Methods We retrospectively analyzed the clinical data of 173 patients with idiopathic thrombocytopenic purpura who accepted their first treatment in West China Hospital between January 2008 and July 2010. The affecting factors on the efficacy of the treatment were analyzed by means of Chi-square test and binary logistic regression analysis. Results The results of Chi-square test showed that gender, bone marrow megakaryocyte count, the percentage of platelet-producing megakaryocytes, HBsAg, and the level of serum immunoglobulin could have a significant influence on the outcome of glucocorticoid treatment (Plt;0.05), while splenomegaly, positive ANA and decreasing of the level of complement C3 were not correlated with the outcome of glucocorticoid treatment. The results of multivariate logistic regression analysis showed that gender and HBsAg were correlated with the glucocorticoid treatment for patients with idiopathic thrombocytopenic purpura. Conclusion Male patients, patients with increasing bone marrow megakaryocytes and patients with decreasing percentage of platelet-producing megakaryocytes have better responses to glucocorticoid, while female patients, patients with abnormal serum immunoglobulin level and patients with non-increasing number of bone marrow megakaryocytes have poor responses toward glucocorticoid treatment. Gender and HBsAg are the main influencing factors for the response to glucocorticoid.
目的 探讨腹腔镜下脾切除术（LS）治疗特发性血小板减少性紫癜(ITP)的临床效果。方法 我院2003年1月至2008年8月期间行LS治疗ITP患者20例，将术前与术后1、2、7、14、30、90及180 d的血小板计数进行比较。结果 20例ITP患者均顺利完成LS，平均手术时间为156 min，术中出血平均50 ml，平均住院时间为9 d。完全停用药物14例； 4例患者术后需继续服用激素治疗，但激素用量较前明显减少； 无效2例。总有效率为90%。术后1、2、7、14、30、90及180 d的血小板数量分别为(251.6±91.4)×109/L、(312.6±90.1)×109/L、(343.2±103.7)×109/L、(300.0±98.2)×109/L、(175.6±42.6)×109/L、(151.8±42.1)×109/L及(207.0±53.4)×109/L,分别与术前〔(38.3±19.4)×109/L〕比较，经t检验，差异均有统计学意义（P＜0.001）。结论 LS治疗ITP是可行和安全的，手术效果满意。