Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipien...Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.展开更多
OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment o...OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival （PFS）. METHODS Data of 55 patients macroadenoma presented to the with non-functioning pituitary Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated. RESULTS The most common symptom was visual disturbance （38.2%） followed by headache （27.3%）. The presence of male predominance was observed （1.4：1）. Ten patients received radio-therapy （RT） only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment （14%）. The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT （up to 54 Gy）, treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex. CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarism in patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macro- adenoma with tolerable and acceptable morbidity.展开更多
Introduction: Despite the fact that non-functioning pituitary adenomas do not overproduce hormones, many will stain positive for a particular pituitary hormone, which can be used to differentiate these adenomas into s...Introduction: Despite the fact that non-functioning pituitary adenomas do not overproduce hormones, many will stain positive for a particular pituitary hormone, which can be used to differentiate these adenomas into subgroups. If these different sub-groups behave differently in terms of post surgical progression of disease (PSPD) rates or other clinical variables, then better treatment and prognosis could be predicted. Methods: This was a retrospective cohort study. Patients who have undergone surgery for removal of a non-functioning pituitary adenoma at Emory University Hospital served as the source for all data used in this study (n = 184). Data were collected from a database of electronic medical records (EMRs) for these patients in 2010 documenting clinical and demographic variables including treatment and PSPD. Results: Risk for PSPD did not differ by adenoma subtypes: follicle-stimulating hormone (FSH+), luteinizing hormone (LH+), or those that do not stain positive for any hormone (non-functioning, or NF?) (p = 0.971). There were two clinical characteristics statistically related to adenoma subtype: altered mental status and the anterior-posterior (AP) dimension of pre-operative adenomas. PSPD was related to several clinical characteristics, including gender, previous adenoma, post-operative residual, and follow-up time.展开更多
NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual i...NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual impairments, chronic headache, and pituitary insufficiency. The authors describe a 51-year-old woman who had a NFMA (35 × 24 × 25 mm). The vision was reduced to 7/10 in the both eyes. A transnasal transsphenoidal surgery was performed and the tumor was successfully resected. Postoperatively, the patient had visual (9/10) and headache improvement. This case highlights a rare presentation of non-functioning pituitary macroadenoma.展开更多
Requirements elicitation step is of paramount importance in the requirements engineering process. In the distributed environment of so-called inter-company cooperative information system, this step is a thorny issue. ...Requirements elicitation step is of paramount importance in the requirements engineering process. In the distributed environment of so-called inter-company cooperative information system, this step is a thorny issue. To elicit require-ments for an inter-company cooperative information system, we early proposed a methodology called MAMIE (from MAcro to MIcro level requirements Elicitation) with an accompanied tool. In MAMIE methodology, requirements are the result of composing functional and non-functional concerns. Before non-functional concerns composition, it’s primary to identify relationships between them. According to the most existing approaches, a non-functional concern may have a negative, positive or null contribution on the other non-functional concerns. In this paper, we argue that using only these three contributions types is not sufficient to express relationships which may exist between non-functional concerns. Thus, we propose a process which aims to identify non-functional concerns’ relationships and model them using a fuzzy cognitive map. The resulting model is composed of non-functional concerns, relationships between them and the weight of these relationships expressed with linguistics fuzzy values. Using fuzzy cognitive maps to model non-functional concerns relationships allows moving from the conventional modelling toward developing a computer based model. An example from the textile industry is used to illustrate the applicability of our process.展开更多
In the process of oxidative phosphorylation, protons are pumped into the intermembrane space to establish the mitochondrial membrane potential (MMP). Relying on the electrochemical gradient, protons can return to the ...In the process of oxidative phosphorylation, protons are pumped into the intermembrane space to establish the mitochondrial membrane potential (MMP). Relying on the electrochemical gradient, protons can return to the matrix through the ATP synthase complex with ATP generation. MitoQ, a lipophilic cation drug, can be bsorbed to the inner mitochondrial membrane with the cationic moiety staying at the intermembrane space[1].展开更多
In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and tr...In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat controversial.In response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert opinions.This consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.展开更多
目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选...目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选有关非侵入性脑刺激改善帕金森病患者步态和平衡障碍的随机对照试验,检索时限截止到2025-06-16。对纳入的研究进行数据提取,采用RevMan 5.4.1软件和Stata 17.0软件进行统计学处理。结果:①纳入47篇研究,共2767例患者,试验组1399例、对照组1368例;②传统Meta分析结果显示,高频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分(UPDRSⅢ)评分、冻结步态问卷(FOG-Q)评分,缩短起立-行走计时试验(TUGT)时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);经颅直流电刺激可以降低冻结步态问卷评分、缩短起立-行走计时试验时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);低频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分评分,与常规治疗比较有显著性差异(P<0.05);3种脑刺激方法对于步频的改善均无统计学意义(P>0.05),受限于研究数量少,需进一步验证;③网状Meta分析结果显示(以下排序均基于间接比较),在降低统一帕金森评定量表第三部分评分方面:高频重复经颅磁刺激选择初级运动皮质区(M1)+背外侧前额叶皮质区(DLPFC)双侧靶点联合刺激的累积概率排序最高(95.2%),在初级运动皮质区上刺激排序次之(72.5%);在缩短起立-行走计时试验时间方面:高频重复经颅磁刺激在背外侧前额叶皮质区刺激的累积概率排序最高(85.5%),在初级运动皮质区上刺激排序次之(69.0%);在改善步速方面:高频重复经颅磁刺激在背外侧前额叶皮质区的累积概率排序最高(92.5%),在初级运动皮质区上刺激排序次之(76.7%);在提高Berg平衡量表评分方面:高频重复经颅磁刺激在初级运动皮质区上刺激的累积概率排序最高(79.9%),经颅直流电刺激在小脑上刺激排序次之(79.8%);④GRADE证据质量评价结果显示,统一帕金森评定量表第三部分、冻结步态问卷评分、起立-行走计时试验、步长证据等级为中级,步速、步频、Berg平衡量表评分为低级。结论:不同类型非侵入性脑刺激都可以改善帕金森病患者的步态和平衡功能。背外侧前额叶皮质区靶向的高频重复经颅磁刺激对步态功能的改善优于初级运动皮质(中等证据),而初级运动皮质靶向的高频重复经颅磁刺激对平衡功能的改善优于小脑靶向的经颅直流电刺激(低级证据)。展开更多
BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,neces...BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,necessitating pathological validation.CASE SUMMARY We present a case report of a 35-year-old woman with an adrenal mass located on the left side,where endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)was performed after comprehensive diagnostic assessment.Our results are consistent with those of previously documented cases regarding tumor demographics and anatomical location.Given the limited number of reports on this condition,long-term follow-up is crucial to enhance our understanding of its prognosis.CONCLUSION For patients with adrenocortical oncocytoma,EUS-FNA can enables collection of preoperative tissue specimens leading to suitable treatment strategies.展开更多
目的:研究表明,重复经颅磁刺激和经颅直流电刺激对改善脑瘫患儿粗大运动功能具有积极作用。采用网状Meta分析方法评价重复经颅磁刺激和经颅直流电刺激对脑瘫患儿下肢运动功能及步态改善的临床疗效。方法:检索中国知网、万方、维普、Sino...目的:研究表明,重复经颅磁刺激和经颅直流电刺激对改善脑瘫患儿粗大运动功能具有积极作用。采用网状Meta分析方法评价重复经颅磁刺激和经颅直流电刺激对脑瘫患儿下肢运动功能及步态改善的临床疗效。方法:检索中国知网、万方、维普、SinoMed、PubMed、Web of Science、Medline数据库,搜索关于重复经颅磁刺激与经颅直流电刺激改善脑瘫患儿下肢运动功能及步态的随机对照试验,检索时限均为数据库建库至2024-10-05。筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata 15.0软件进行网状Meta分析,使用GRADE证据分级系统进行质量评价。结果:最终纳入19篇研究,涉及常规治疗、高频重复经颅磁刺激、低频重复经颅磁刺激、阳极经颅直流电刺激4种治疗方案。网状Meta分析结果显示,与常规治疗相比,低频重复经颅磁刺激改善脑瘫患儿粗大运动功能方面的疗效最佳[MD=9.48,95%CI(6.61,12.34),P<0.05],在缓解痉挛方面,高频重复经颅磁刺激的疗效最佳[MD=-0.63,95%CI(-1.72,0.45),P<0.05],经颅直流电刺激改善脑瘫患儿踝关节活动度和步速方面的疗效最佳[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]。结论:现有临床证据表明,对于脑瘫患儿,在改善下肢粗大运动功能方面,低频重复经颅磁刺激展现出最佳疗效;对于降低肌痉挛程度,高频重复经颅磁刺激的效果更为显著;在步态改善方面,经颅直流电刺激则表现出明显优势。展开更多
基金supported by grants from the National Nat-ural Science Foundation of China (81570587 and 81700557)the Guangdong Provincial Key Laboratory Construction Projection on Organ Donation and Transplant Immunology (2013A061401007 and 2017B030314018)+3 种基金Guangdong Provincial Natural Science Funds for Major Basic Science Culture Project (2015A030308010)Science and Technology Program of Guangzhou (201704020150)the Natural Science Foundations of Guangdong province (2016A030310141 and 2020A1515010091)Young Teachers Training Project of Sun Yat-sen University (K0401068) and the Guangdong Science and Technology Innovation Strategy (pdjh2022b0010 and pdjh2023a0002)。
文摘Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.
文摘OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival （PFS）. METHODS Data of 55 patients macroadenoma presented to the with non-functioning pituitary Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated. RESULTS The most common symptom was visual disturbance （38.2%） followed by headache （27.3%）. The presence of male predominance was observed （1.4：1）. Ten patients received radio-therapy （RT） only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment （14%）. The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT （up to 54 Gy）, treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex. CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarism in patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macro- adenoma with tolerable and acceptable morbidity.
文摘Introduction: Despite the fact that non-functioning pituitary adenomas do not overproduce hormones, many will stain positive for a particular pituitary hormone, which can be used to differentiate these adenomas into subgroups. If these different sub-groups behave differently in terms of post surgical progression of disease (PSPD) rates or other clinical variables, then better treatment and prognosis could be predicted. Methods: This was a retrospective cohort study. Patients who have undergone surgery for removal of a non-functioning pituitary adenoma at Emory University Hospital served as the source for all data used in this study (n = 184). Data were collected from a database of electronic medical records (EMRs) for these patients in 2010 documenting clinical and demographic variables including treatment and PSPD. Results: Risk for PSPD did not differ by adenoma subtypes: follicle-stimulating hormone (FSH+), luteinizing hormone (LH+), or those that do not stain positive for any hormone (non-functioning, or NF?) (p = 0.971). There were two clinical characteristics statistically related to adenoma subtype: altered mental status and the anterior-posterior (AP) dimension of pre-operative adenomas. PSPD was related to several clinical characteristics, including gender, previous adenoma, post-operative residual, and follow-up time.
文摘NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual impairments, chronic headache, and pituitary insufficiency. The authors describe a 51-year-old woman who had a NFMA (35 × 24 × 25 mm). The vision was reduced to 7/10 in the both eyes. A transnasal transsphenoidal surgery was performed and the tumor was successfully resected. Postoperatively, the patient had visual (9/10) and headache improvement. This case highlights a rare presentation of non-functioning pituitary macroadenoma.
文摘Requirements elicitation step is of paramount importance in the requirements engineering process. In the distributed environment of so-called inter-company cooperative information system, this step is a thorny issue. To elicit require-ments for an inter-company cooperative information system, we early proposed a methodology called MAMIE (from MAcro to MIcro level requirements Elicitation) with an accompanied tool. In MAMIE methodology, requirements are the result of composing functional and non-functional concerns. Before non-functional concerns composition, it’s primary to identify relationships between them. According to the most existing approaches, a non-functional concern may have a negative, positive or null contribution on the other non-functional concerns. In this paper, we argue that using only these three contributions types is not sufficient to express relationships which may exist between non-functional concerns. Thus, we propose a process which aims to identify non-functional concerns’ relationships and model them using a fuzzy cognitive map. The resulting model is composed of non-functional concerns, relationships between them and the weight of these relationships expressed with linguistics fuzzy values. Using fuzzy cognitive maps to model non-functional concerns relationships allows moving from the conventional modelling toward developing a computer based model. An example from the textile industry is used to illustrate the applicability of our process.
基金Key Program of National Natural Science Foundation of China (U1432248), National Natural Science Foundation of China (11505245), Western Talent Program of Chinese Academy of Sciences (Y460040XB0)
文摘In the process of oxidative phosphorylation, protons are pumped into the intermembrane space to establish the mitochondrial membrane potential (MMP). Relying on the electrochemical gradient, protons can return to the matrix through the ATP synthase complex with ATP generation. MitoQ, a lipophilic cation drug, can be bsorbed to the inner mitochondrial membrane with the cationic moiety staying at the intermembrane space[1].
基金supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)2021-I2M-1-002.
文摘In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat controversial.In response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert opinions.This consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.
文摘目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选有关非侵入性脑刺激改善帕金森病患者步态和平衡障碍的随机对照试验,检索时限截止到2025-06-16。对纳入的研究进行数据提取,采用RevMan 5.4.1软件和Stata 17.0软件进行统计学处理。结果:①纳入47篇研究,共2767例患者,试验组1399例、对照组1368例;②传统Meta分析结果显示,高频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分(UPDRSⅢ)评分、冻结步态问卷(FOG-Q)评分,缩短起立-行走计时试验(TUGT)时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);经颅直流电刺激可以降低冻结步态问卷评分、缩短起立-行走计时试验时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);低频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分评分,与常规治疗比较有显著性差异(P<0.05);3种脑刺激方法对于步频的改善均无统计学意义(P>0.05),受限于研究数量少,需进一步验证;③网状Meta分析结果显示(以下排序均基于间接比较),在降低统一帕金森评定量表第三部分评分方面:高频重复经颅磁刺激选择初级运动皮质区(M1)+背外侧前额叶皮质区(DLPFC)双侧靶点联合刺激的累积概率排序最高(95.2%),在初级运动皮质区上刺激排序次之(72.5%);在缩短起立-行走计时试验时间方面:高频重复经颅磁刺激在背外侧前额叶皮质区刺激的累积概率排序最高(85.5%),在初级运动皮质区上刺激排序次之(69.0%);在改善步速方面:高频重复经颅磁刺激在背外侧前额叶皮质区的累积概率排序最高(92.5%),在初级运动皮质区上刺激排序次之(76.7%);在提高Berg平衡量表评分方面:高频重复经颅磁刺激在初级运动皮质区上刺激的累积概率排序最高(79.9%),经颅直流电刺激在小脑上刺激排序次之(79.8%);④GRADE证据质量评价结果显示,统一帕金森评定量表第三部分、冻结步态问卷评分、起立-行走计时试验、步长证据等级为中级,步速、步频、Berg平衡量表评分为低级。结论:不同类型非侵入性脑刺激都可以改善帕金森病患者的步态和平衡功能。背外侧前额叶皮质区靶向的高频重复经颅磁刺激对步态功能的改善优于初级运动皮质(中等证据),而初级运动皮质靶向的高频重复经颅磁刺激对平衡功能的改善优于小脑靶向的经颅直流电刺激(低级证据)。
文摘BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,necessitating pathological validation.CASE SUMMARY We present a case report of a 35-year-old woman with an adrenal mass located on the left side,where endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)was performed after comprehensive diagnostic assessment.Our results are consistent with those of previously documented cases regarding tumor demographics and anatomical location.Given the limited number of reports on this condition,long-term follow-up is crucial to enhance our understanding of its prognosis.CONCLUSION For patients with adrenocortical oncocytoma,EUS-FNA can enables collection of preoperative tissue specimens leading to suitable treatment strategies.
文摘目的:研究表明,重复经颅磁刺激和经颅直流电刺激对改善脑瘫患儿粗大运动功能具有积极作用。采用网状Meta分析方法评价重复经颅磁刺激和经颅直流电刺激对脑瘫患儿下肢运动功能及步态改善的临床疗效。方法:检索中国知网、万方、维普、SinoMed、PubMed、Web of Science、Medline数据库,搜索关于重复经颅磁刺激与经颅直流电刺激改善脑瘫患儿下肢运动功能及步态的随机对照试验,检索时限均为数据库建库至2024-10-05。筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata 15.0软件进行网状Meta分析,使用GRADE证据分级系统进行质量评价。结果:最终纳入19篇研究,涉及常规治疗、高频重复经颅磁刺激、低频重复经颅磁刺激、阳极经颅直流电刺激4种治疗方案。网状Meta分析结果显示,与常规治疗相比,低频重复经颅磁刺激改善脑瘫患儿粗大运动功能方面的疗效最佳[MD=9.48,95%CI(6.61,12.34),P<0.05],在缓解痉挛方面,高频重复经颅磁刺激的疗效最佳[MD=-0.63,95%CI(-1.72,0.45),P<0.05],经颅直流电刺激改善脑瘫患儿踝关节活动度和步速方面的疗效最佳[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]。结论:现有临床证据表明,对于脑瘫患儿,在改善下肢粗大运动功能方面,低频重复经颅磁刺激展现出最佳疗效;对于降低肌痉挛程度,高频重复经颅磁刺激的效果更为显著;在步态改善方面,经颅直流电刺激则表现出明显优势。
