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Endovascular treatment of ruptured lobulated anterior communicating artery aneurysms:A retrospective study of 24 patients

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World Journal of Clinical Cases 2024年第15期12卷 2529-2541页

作者： Sheng-Xuan Huang Xun-Ping Ai Ze-Hui Kang Zhi-Yong Chen Ren-Man Li Zu-Chao Wu Feng Zhu Department of Neurosurgery Sanming First Hospital Affiliated to Fujian Medical UniversitySanming 365000Fujian ProvinceChina

BACKGROUND Lobulated intracranial aneurysm is a special type of aneurysm with at least one additional cyst in the neck or body of the aneurysm.Lobulated intracranial aneurysm is a complex aneurysm with complex morphology and structure and weak tumor wall,which is an independent risk factor for rupture and hemorrhage.Lobular aneurysms located in the anterior communicating artery complex account for 36.9%of all intracranial lobular aneurysms.Due to its special anatomical structure,both craniotomy and endovascular treatment are more difficult.Compared with single-capsule aneurysms,craniotomy for lobular intracranial aneurysms has a higher risk and complication rate.AIM To investigate the efficacy and safety of endovascular treatment for ruptured lobulated anterior communicating artery aneurysm(ACoAA).METHODS Patients with ruptured lobulated ACoAA received endovascular treatment in Sanming First Hospital Affiliated to Fujian Medical University from June 2020 to June 2022 were retrospectively included.Their demographic,clinical and imaging characteristics,endovascular treatment methods and follow-up results were collected.RESULTS A total of 24 patients with ruptured lobulated ACoAA were included,including 9 males(37.5%)and 15 females(62.5%).Their age was 56.2±8.9 years old(range 39-74).The time from rupture to endovascular treatment was 10.9±12.5 h.The maximum diameter of the aneurysms was 5.1±1.0 mm and neck width were 3.0±0.7 mm.Nineteen patients(79.2%)were double-lobed and 5(20.8%)were multilobed.Fisher's grade:Grade 2 in 16 cases(66.7%),grade 3 in 6 cases(25%),and grade 4 in 2 cases(8.3%).Hunt-Hess grade:Grade 0-2 in 5 cases(20.8%),grade 3-5 in 19 cases(79.2%).Glasgow Coma Scale score:9-12 in 14 cases(58.3%),13-15 in 10 cases(41.7%).Immediately postprocedural Raymond-Roy grade:grade 1 in 23 cases(95.8%),grade 2 in 1 case(4.2%).Raymond-Roy grade in imaging follow-up for 2 wk to 3 months:grade 1 in 23 cases(95.8%),grade 2 in 1 case(4.2%).Followup for 2 to 12 months showed that 21 patients(87.5%)had good functional o

关键词： Intracranial aneurysm Anterior cerebral artery Endovascular surgery Embolism treatment outcome

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treatment outcome,cognitive function,and psychopathology in methamphetamine users compared to other substance users

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World Journal of Psychiatry 2022年第7期12卷 944-957页

作者： Nina Behle Felicia Kamp Lisa Proebstl Laura Hager Marlies Riebschläger Maik Schacht-Jablonowsky Willem Hamdorf Stefanie Neumann Daniela Krause Kirsi Manz Andreas Guenter Franke Gabriele Koller Michael Soyka Department of Psychiatry and Psychotherapy Ludwig Maximilians UniversityMunich 80336Germany MEDIAN Clinic MecklenburgVitense 19217Germany Institute for Medical Information Processing Ludwig Maximilians UniversityMunich 81377Germany University of Applied Labour Studies of the Federal Employment Agency Mannheim 68163Germany Department of Psychiatry Ludwig Maximilians UniversityMunich 80336Germany

BACKGROUND The rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group.Evidence-based research on the efficacy of treatment programs for methamphetamine users is limited.Due to specific characteristics of methamphetamine users,the question arises whether established treatment methods for individuals using other substances can be effective for the treatment of methamphetamine dependence as well.We hypothesize that there are significant differences between the two groups that may affect the effectiveness of treatment and worsen the prognosis of treatment outcomes for methamphetamine users compared to consumers of other substances.AIM To investigate potential differences in cognitive functioning and psychopathology between methamphetamine users and other substance users and possible correlations with treatment outcomes.METHODS A total of 110 subjects were recruited for an observational,longitudinal study from a German inpatient addiction treatment center:55 patients with methamphetamine dependence and 55 patients with dependence of other substances(“OS group”).Both groups were examined at beginning(baseline)and end of treatment(after 6 mo)with regard to treatment retention,craving,cognitive functioning,psychosocial resources,personality traits,depression,and other psychiatric symptoms.Instruments used were Raven’s IQ test,Mannheimer craving scale,cognitrone cognitive test battery,NEO personality factors inventory,Hamilton depression scale,Becks depression inventory,and a symptom checklist.The statistical methods used were χ^(2)-test,t-test and multiple mixed ANOVAs.RESULTS A total drop-out rate of 40%(methamphetamine-group:36.4%;OS-group:43.6%)was observed without significant differences between groups.At baseline,methamphetamine-group subjects significantly differed from OS-group individuals in terms of a lower intelligence quotient,fewer years of education,slower working speed,and decreased working accuracy,as well as less cannabinoid and cocaine use.M

关键词： treatment outcome Cognitive function Psychopathology Methamphetamine Substance use Comparison

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Comparison of clinical features and outcomes of proliferative,fibrotic,and mixed subtypes of IgG4-related disease:A retrospective cohort study

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Chinese Medical Journal 2024年第3期137卷 303-311页

作者： Linyi Peng Xinlu Zhang Jiaxin Zhou Jieqiong Li Zheng Liu Hui Lu Yu Peng Yunyun Fei Yan Zhao Xiaofeng Zeng Wen Zhang Department of Rheumatology and Clinical Immunology Peking Union Medical College HospitalNational Clinical Research Center for Dermatologic and Immunologic DiseasesState Key Laboratory of Complex Severe and Rare DiseasesThe Ministry of Education Key LaboratoryBeijing 100730China Institute of Clinical Medicine Peking Union Medical College Hospital(PUMCH)Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Background:Immunoglobulin G4-related disease(IgG4-RD)is a recently recognized immune-mediated disorder that can affect almost any organ in the human body.IgG4-RD can be categorized into proliferative and fibrotic subtypes based on patients’clinicopathological characteristics.This study aimed to compare the clinical manifestations,laboratory findings,and treatment outcomes of IgG4-RD among different subtypes.Methods:We prospectively enrolled 622 patients with newly diagnosed IgG4-RD at Peking Union Medical College Hospital from March 2011 to August 2021.The patients were divided into three groups according to their clinicopathological characteristics:proliferative,fibrotic,and mixed subtypes.We compared demographic features,clinical manifestations,organ involvement,laboratory tests,and treatment agents across three subtypes.We then assessed the differences in treatment outcomes among 448 patients receiving glucocorticoids alone or in combination with immunosuppressants.Moreover,risk factors of relapse were revealed by applying the univariate and multivariate Cox regression analysis.Results:We classified the 622 patients into three groups consisting of 470 proliferative patients,55 fibrotic patients,and 97 mixed patients,respectively.We found that gender distribution,age,disease duration,and frequency of allergy history were significantly different among subgroups.In terms of organ involvement,submandibular and lacrimal glands were frequently involved in the proliferative subtype,while retroperitoneum was the most commonly involved site in both fibrotic subtype and mixed subtype.The comparison of laboratory tests revealed that eosinophils(P=0.010),total IgE(P=0.006),high-sensitivity C-reactive protein(P<0.001),erythrocyte sedimentation rate(P<0.001),complement C4(P<0.001),IgG(P=0.001),IgG1(P<0.001),IgG4(P<0.001),and IgA(P<0.001),at baseline were significantly different among three subtypes.Compared with proliferative and mixed subtypes,the fibrotic subtype showed the lowest rate of relapse(log-rank P=0.014).Conclus

关键词： IgG4-related disease Proliferative subtype Fibrotic subtype Clinical features treatment outcome

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treatment outcome in children with central nervous system-positive Burkitt lymphoma using only intrathecal and systemic chemotherapy combined with rituximab

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Chinese Medical Journal 2021年第11期134卷 1329-1334页

作者： Shuang Huang Lin Jin Jing Yang Yan-Long Duan Meng Zhang Chun-Ju Zhou Yong-Hong Zhang Beijing Key Laboratory of Pediatric Haematology Oncology National Discipline of PediatricsMinistry of EducationMOE Key Laboratory of Major Diseases in ChildrenHaematology Oncology CenterBeijing Children’s HospitalBeijing 100045China Pathology Department Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijing 100045China

Background:With current chemotherapy treatment,>90%of survival has been obtained for Burkitt lymphoma(BL).In this study,the demographic characteristics and treatment outcomes are presented for 78 children in China with central nervous system-positive(CNS+)BL.Methods:This retrospective study consecutively enrolled 78 CNS+BL patients in Beijing Children’s Hospital(BCH)from 2007 to 2019 who received the BCH B-cell non-Hodgkin’s lymphoma regimen(modified by French-American-British mature lymphoma B-cell 96[FAB/LMB96]C1 arm±rituximab).Clinical characteristics,methods of disease detection in the CNS,and outcomes were evaluated.Univariate and multivariate analyses were used to assess prognostic factors.Results:The median age of 65 boys and 13 girls at the time of diagnosis was 5.7 years(ranging from 1 to 14 years).Patients were followed up for a median time of 34 months(ranging from 1 to 72 months).Bone marrow invasion was found in 38(48.7%)patients.There were 48(61.5%),44(56.4%),and 25(32%)patients with cranial nerve palsy,intracerebral mass(ICM),and parameningeal extension,respectively.Abnormal cerebrospinal fluid(CSF)morphology and CSF immunophenotype appeared in 15(19.2%)and 15(19.2%)patients,respectively.There were 69(88.5%)patients treated with chemotherapy combined with rituximab,and nine patients were treated solely with chemotherapy.Finally,five patients died of treatment-related infection,recurrence occurred for 13,and one developed a second tumor.The 3-year overall survival and event-free survival rates were 78.9%±4.7%and 71.4%±6.0%,respectively.treatment with chemotherapy only,ICM positivity,and>4 organs involved at diagnosis were independent risk factors.Conclusions:Rituximab combined with a modified LMB96 regimen has greatly increased the efficacy of treatment for Chinese children with CNS+BL,and with the continuous collection of outcome data,treatment-related complications are decreasing.For further verification,a large sample multicentre randomized controlled study should be performed to explore a treatm

关键词： Burkitt lymphoma Central nervous system disease Rituximab treatment outcome

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Root Canal treatment outcome and Restorative Condition of Teeth Treated by Undergraduates—A Clinical and Radiographic Evaluation

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Open Journal of Stomatology 2023年第9期13卷 257-270页

作者： Gabriela Tonet Bassani Bartelle Dianeia Miranda dos Reis Thiago Oliveira Gamba Fabiana Vieira Vier-Pelisser School of Dentistry UCS—Caxias do Sul University Caxias do Sul Brazil School of Dentistry UFRGS—Federal University of Rio Grande do Sul Porto Alegre Brazil

Background: The aim was to evaluate the nonsurgical Root Canal treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treated by undergraduates at the University of Caxias do Sul School of Dentistry (UCS-SD), Brazil, between 2019 and 2021. Materials and Methods: Data from the endodontically treated cases were retrieved, and the patients were recalled for a follow-up appointment at the university. The endodontic diagnosis, radiographs, and the presence of definitive restorations were analyzed in the clinical records. During the follow-up appointment, endodontically treated teeth were classified as present or absent. The nRCT was classified as successful (complete or incomplete healing) or failure (uncertain or unsatisfactory healing). Coronal restoration was classified as absent or present. When it was present, it was classified as permanent or temporary, and its quality as adequate or inadequate restoration. The results were presented as percentages. Results: A total of 257 teeth were endodontically treated. The most prevalent diagnosis was Chronic Apical Periodontitis (33.33%) and the most commonly treated teeth were premolars (46.15%). A total of 52 (21%) treated teeth were clinically and radiographically reexamined. The success rate for the nRCT was 98.08%. About 61.54% of this sample had a definitive composite resin restoration. Conclusion: The nRCT success rate was high. Special attention should be given to the presence and quality of the definitive restoration. Clinical Implications: There was no statistically significant impact between the coronal restoration and the nRCT success (P > 0.05).

关键词： Periapical Periodontitis Permanent Dental Restoration Permanent Dental Filling Root Canal Obturation treatment outcome

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Radiotherapy enhances efficacy of PD-1 inhibitors in advanced hepatocellular carcinoma: A propensity-matched real-world study

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中华医学杂志(英文版) 2024年第11期137卷 2024 May 9页

作者： Hsu Shujung Chao Yencheng Hu Yong Zhang Yang Hong Weifeng Chen Yixing Chen Rongxin Zeng Zhaochong Du Shisuo Department of Radiation Oncology Zhongshan Hospital Fudan University Shanghai China Department of Pulmonary Medicine Zhongshan Hospital Fudan University Shanghai China Department of Liver Cancer Institute Zhongshan Hospital Fudan University Shanghai China

Background: To address the need for immunotherapy in patients with advanced primary hepatocellular carcinoma (HCC), combination with radiotherapy (RT) has emerged as a promising strategy. In preclinical studies, irradiated tumors released tumor antigens to synergistically increase the antitumor effect of immunotherapy. Hence, we investigated whether RT enhances the efficacy of anti-programmed death receptor-1 (PD-1) inhibitors in advanced HCC in real-world practice.Methods: Between August 2018 and June 2021, 172 patients with advanced primary HCC were enrolled in the tertiary center (Zhongshan Hospital of Fudan University); 95 were treated with a combination of RT and the inhibitor of PD-1 (RT-PD1 cohort), and 77 were administered anti-PD-1 therapy (PD1 cohort). The first cycle of PD-1 inhibitors was administered within 60 days or concurrently with RT. Propensity score matching for bias reduction was used to evaluate the clinical outcomes.Results: Among 71 propensity-matched pairs, median progression-free survival was 5.7 months in the RT-PD1 cohortvs. 2.9 months in the PD1 cohort (P outcomes without increased toxic effects.

关键词： Radiotherapy Immune checkpoint inhibitor Programmed cell death receptor-1 Hepatocellular carcinoma Propensity score matching treatment outcome Adverse effects

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Efficacy and Safety of Iron Isomaltoside Compared with an Oral Iron Supplement in the Management of Patients with Iron Deficiency Anemia

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Open Journal of Blood Diseases 2024年第1期14卷 17-30页

作者： Zhimin Wu Chunxiao Zhou Chunyan Wu Qiao Song Shilyu Chen Wen Zhang Shaoling Wu Department of Medicine Qingdao University Qingdao China Department of Hematology The Affiliated Hospital of Qingdao University Qingdao China

Objective: To evaluate the treatment outcome of iron isomaltoside compared with an oral iron supplement in the management of iron deficiency anemia (IDA). Methods: The study included patients with IDA who visited the Outpatient Clinic of the Department of Hematology, the Affiliated Hospital of Qingdao University from October 2021 to August 2022 and met the inclusion and exclusion criteria. According to the actual application of iron supplementation, the patients were divided into two groups: iron isomaltoside treatment group and oral iron treatment group. Baseline measurements were collected before the start of treatment, and measurements were collected subsequently at intervals of 1 week, 1 month, and 3 months. The hematological parameters analyzed included Hemoglobin (Hb), Mean corpuscular hemoglobin (MCH), Mean Hemoglobin content (MCH), Mean corpuscular Hemoglobin concentration (MCHC), and Platelet (Plt). Safety data and adverse event profiles were recorded. Results: Intra-group comparisons: After 1 month of treatment, the Hb significantly improved (P 0.05). Inter-group comparisons: The biochemical parameters were significantly improved (P 0.05) in the iron isomaltoside group compared with those in the oral iron group after 1 month of iron supplementation in patients with mild and moderate anemia. Adverse reactions were tolerable for the patients in both iron isomaltoside group and oral iron group. Only 1 patient in iron isomaltoside group developed anaphylactic shock during medication and recovered after aggressive rescue. Conclusions: Iron isomaltoside which increases Hb more rapidly compared with the oral iron supplementation has few adverse reactions and good acceptance.

关键词： Anemia Iron-Deficiency Drug Therapy Iron Isomaltoside 1000 treatment outcome

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Effect of nonoperative treatment on the outcome of patients with posttraumatic hydrocephalus

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中华创伤杂志(英文版) 2002年第1期5卷 8-12页

作者：伏林山汤云海王世余 Department of Neurosurgery The Fourth Affiliated Hospital of Nantong Medical College The First People's Hospital of Yancheng Yancheng 224001 China. y8598115@***

Objective: To compare the outcome of non-operative treatment with the outcome of surgical intraventricular drainage for patients with posttraumatic hydrocephalus including complications, mortality and favorable outcome. Methods: Thirty-nine patients were assigned to a nonoperative treatment group and 38 patents to a surgical intraventricular drainage group. Each patient’s outcome was evaluated 3 years after treatment by using Glasgow outcome Scale. Results: In the nonoperative treatment group the rate of favorable outcome (good recovery or mild disability) was 89.74% (35 of 39 patients) and the mortality was 2.56% (1 of 39 patients). In the surgical intraventricular drainage group the rate of favorable outcome was 71.05% (27 of 38 patients) and the mortality was 13.16% (5 of 38 patients; Ptreatment may be better than surgical intraventricular drainage for patients with posttraumatic hydrocephalus.

关键词： Hydrocephalus Wounds and injuries treatment outcome Nonoperative therapy

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High-frequency oscillations detected by electroencephalography as biomarkers to evaluate treatment outcome,mirror pathological severity and predict susceptibility to epilepsy

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Acta Epileptologica 2021年第1期3卷 205-213页

作者： Yueqian Sun Guoping Ren Jiechuan Ren Qun Wang Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Beijing Institute of Brain Disorders Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina Beijing Key Laboratory of Neuromodulation BeijingChina

High-frequency oscillations(HFOs)in the electroencephalography(EEG)have been extensively investigated as a potential biomarker of epileptogenic zones.The understanding of the role of HFOs in epilepsy has been advanced considerably over the past decade,and the use of scalp EEG facilitates recordings of HFOs.HFOs were initially applied in large scale in epilepsy surgery and are now being utilized in other applications.In this review,we summarize applications of HFOs in 3 subtopics:(1)HFOs as biomarkers to evaluate epilepsy treatment outcome;(2)HFOs as biomarkers to measure seizure propensity;(3)HFOs as biomarkers to reflect the pathological severity of epilepsy.Nevertheless,knowledge regarding the above clinical applications of HFOs remains limited at present.Further validation through prospective studies is required for its reliable application in the clinical management of individual epileptic patients.

关键词： High-frequency oscillations Epilepsy Electroencephalography treatment outcome Seizure prediction Pathology

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outcome of Cox Maze procedure concomitant with mitral valve operation in treatment of atrial fibrillation

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Chinese Medical Journal 2006年第16期119卷 1392-1395页

作者： ZHANG Sai CHEN Ru-kun DONG Ai-qiang WANG Yong-qin CHEN Suo-cheng LI Zhi-jun Department of Cardiothoracic Surgery Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310009 China Department of Cardiothoracic Surgery Sir Run Run Shao Hospital Zhejiang University School of Medicine Hangzhou 310016 China Department of Cardiothoracic Surgery First People＇s Hospital Zhenjiang 212000 China

Atrial fibrillation （AF） is fairly common in patients with chronic mitral valve disease and a markedly dilated left atrium. These patients rarely return to sinus rhythm spontaneously, even after a successful mitral valve operation. The Maze procedure, developed by Cox and associates,15 has been used in patients undergoing a mitral valve operation. Restoration of normal sinus rhythm and atrial contraction in such patients have been reported by some groups. This study will summarize retrospectively a group of patients who underwent the Cox Maze procedure for the treatment of AF associated with rheumatic mitral valve disease in China.

关键词： atrial fibrillation rheumatic heart disease cardiac surgery procedures mitral valve retrospective study treatment outcome

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