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Objective:To explore the clinical characteristics and treatment strategies for Chlamydia psittaci pneumonia confirmed using metagenomic next-generation sequencing (mNGS). Methods:A total of 26 patients with Chlamydia psittaci pneumonia admitted to the Huizhou Municipal Central People′s Hospital and Huizhou First People′s Hospital from January 2020 to December 2021 were enrolled. The clinical data were collected, including basic information, clinical manifestations, laboratory examinations, chest computed tomography (CT) findings, mNGS results, treatment outcomes and prognosis. Results:Twenty (76.9%) of the 26 cases with Chlamydia psittaci pneumonia had a definite bird or poultry contact history. The onset season was mostly in winter (57.7%, 15/26). All 26 cases had symptoms of high fever, chill, fatigue, anorexia and cough, 21 cases (80.8%) had dyspnea, 19 cases (73.1%) had relative infrequent pulse, 12 cases (46.2%) had headache, myalgia, and seven cases (26.9%) had disturbance of consciousness. Among the 26 cases, the white blood cell count was normal in 17 cases (65.4%), and the lymphocyte count was decreased in 21 cases (80.8%). All 26 cases had increased hypersensitive C-reactive protein and procalcitonin. D-dimer was elevated in 24 cases (92.3%), aspartate aminotransferase was elevated in 18 cases (69.2%), and alanine aminotransferase was elevated in 15 cases (57.7%). Chest CT mainly showed lung consolidation, and 20 cases (76.9%) had multiple lobes of the lungs involved, 18 cases (69.2%) had the lower lobe of the lung as the main lesion. Among the results of mNGS of 26 cases, nine cases (34.6%) had only Chlamydia psittaci detected, and 17 cases (65.4%) had other pathogenic microorganisms detected. After targeted anti-infection treatment, two cases died of multiple organ failure and the remaining 24 patients recovered. Conclusions:The common manifestations of Chlamydia psittaci pneumonia are high fever, dyspnea, relative bradycardia, normal white blood cell count, and lung consolidation. mNGS is helpful for early diagnosis of disease, and appropriate treatment can improve the prognosis.
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Purpose@#Knowing the distinction between benign and borderline/malignant phyllodes tumors (PTs) can help in the surgical treatment course. Herein, we investigated the value of magnetic resonance imaging-based texture analysis (MRI-TA) in differentiating between benign and borderline/malignant PTs. @*Methods@#Forty-three women with 44 histologically proven PTs underwent breast MRI before surgery and were classified into benign (n = 26) and borderline/malignant groups (n = 18 [15 borderline, 3 malignant]). Clinical and routine MRI parameters (CRMP) and MRI-TA were used to distinguish benign from borderline/malignant PT. In total, 298 texture parameters were extracted from fat-suppression (FS) T2-weighted, FS unenhanced T1-weighted, and FS first-enhanced T1-weighted sequences. To evaluate the diagnostic performance, receiver operating characteristic curve analysis was performed for the K-nearest neighbor classifier trained with significantly different parameters of CRMP, MRI sequence-based TA, and the combination strategy. @*Results@#Compared with benign PTs, borderline/malignant ones presented a higher local recurrence (p = 0.045); larger size (p < 0.001); different time-intensity curve pattern (p = 0.010); and higher frequency of strong lobulation (p = 0.024), septation enhancement (p = 0.048), cystic component (p = 0.023), and irregular cystic wall (p = 0.045). TA of FS T2-weighted images (0.86) showed a significantly higher area under the curve (AUC) than that of FS unenhanced T1-weighted (0.65, p = 0.010) or first-enhanced phase (0.72, p = 0.049) images. The texture parameters of FS T2-weighted sequences tended to have a higher AUC than CRMP (0.79, p = 0.404). Additionally, the combination strategy exhibited a similar AUC (0.89, p = 0.622) in comparison with the texture parameters of FS T2-weighted sequences. @*Conclusion@#MRI-TA demonstrated good predictive performance for breast PT pathological grading and could provide surgical planning guidance. Clinical data and routine MRI features were also valuable for grading PTs.
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Objective To evaluate the value of MRI texture analysis based on gray level co-occurrence matrix to predict cervical lymph node metastasis in patients with tongue carcinoma. Methods A total of 70 patients with tongue carcinoma confirmed by pathology were analyzed retrospectively. The patients were divided into cervical lymph node (LN) metastasis group (unilateral LN+, n=18;bilateral LN+,n=22) and no cervical lymph node metastasis(LN-,n=30). T1W, T2W and contrast-enhanced T1W images of the largest section of tumor were selected. ROI of the lesion was manually drew and GLCM texture parameters (energy, contrast, correlation, inverse difference and entropy) were extracted. The tumor length, thickness and para-lingual distance between tumor and tongue midline were also measured.Differences of all parameters were compared between LN+ group and LN- group, unilateral and bilateral cervical lymph node metastasis group, the parameters with statistically significant difference in predicting the efficiency of cervical lymph node metastasis were analyzed. The diagnostic efficiency of lymph node metastasis was calculated. Results The correlation, inverse difference and entropy based on T2WI showed significant difference (Zcor elation=2.97, tinverse dif erence=5.14, tentropy=2.41; P<0.05), entropy showed the best diagnostic efficiency, the area under the ROC curve (AUC) was 0.90, the cut off value was 7.19, the sensitivity was 80.0％, specificity was 86.7％. Only entropy showed significant difference between unilateral LN+group and bilateral LN+group (P<0.05), the AUC was 0.82, the cut off value was 7.47, the sensitivity was 90.9％, specificity was 78.8％. The index of tumor length, thickness and para-lingual distance between tumor and tongue midline all showed significant difference between LN+group and LN-group (P<0.05), the thickness showed the best diagnostic efficiency, the AUC value was 0.81, the cut off value was 11.19, the sensitivity was 78.0％, specificity was 81.7％. The index of tumor length, thickness and para-lingual distance between tumor and tongue midline showed no significant difference between unilateral LN+ group and bilateral LN+ group (P>0.05). The diagnostic sensitivity of radiologists was 65.0％ (26/40), the specificity was 80.0％ (24/32) on cervical lymph node metastasis. Conclusion Texture analysis based on T2WI can predict cervical lymph node metastasis in patients with tongue carcinoma. Entropy has certain value in predicting bilateral cervical lymph node metastasis.
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Objective To observe the application value of MRI in diagnosis and clinical management of abdominal pregnancy.Methods MRI and clinical data of 5 patients with abdominal pregnancy proved surgically were analyzed retrospectively.MRI performances were analyzed and compared with findings in operation.Results Prenatal MRI correctly diagnosed abdominal pregnancy in all 5 patients,including 1 case of primary and 4 cases of secondary abdominal pregnancy.The position of uterine rupture was revealed in all 4 cases of secondary abdominal pregnancy.MRI performances of placenta conformed to operative findings in all 5 patients.A lot of fresh intra-abdominal hemorrhage was found in 1 case,oligohydramnion in 2 cases,and abnormalities of placenta and fetus in 2 patients,which were consistent with findings of operation.Conclusion Prenatal MRI offers a high accuracy rate in diagnosis of abdominal pregnancy.MRI can show fetus,placenta and the relationship with surrounding tissue,therefore being helpful to clinical management of abdominal pregnancy.
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Objective To measure middle cerebral artery (MCA) hemodynamic parameters of chronic cerebral ischemia in middle aged and elderly people with phase contrast magnetic resonance imaging (PCMRI),and to explore cerebral blood flow dynamic pattern in different degrees of chronic cerebral ischemia patients.Methods Middle aged and elderly people underwent conventional MRI scan,and were divided into 12 cases of the normal group,16 cases of mild cerebral ischemia group and 13 cases of obvious cerebral ischemia group.All groups underwent bilateral MCA PCMRI.Bilateral MCA hemodynamic parameters and phase-velocity curve in a heartbeat cycle were obtained by QFLOW analysis software on the workstation for post-processing.Bilateral MCA vascular area,peak velocity (PV),mean velocity (MV) and mean flow (MF) were recorded.The differences of bilateral MCA hemodynamic parameters among the three groups were compared by SPSS17.0 software.Results Bilateral MCA vascular area,MV,MF and right MCA PV among three groups were statistically significant by one-Way ANOVA (P＜0.05).Compared with normal group,systolic peak of bilateral MCA phase-velocity curve was low,dull,widen,and the connection between the diastolic peak and systolic peak became flattened in chronic cerebral ischemia patients.Conclusion PCMRI can reflect the differences of the cerebral blood flow dynamic change pattern between different degrees of chronic cerebral ischemia.
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Objective To compare the clinical effect and scoring of nervous system in treatment with Parkin-son's disease by two treatment methods.Methods 80 cases with Parkinson's disease,using a random number table were randomly divided into Madopar treatment ( control group ) 40 cases and Madopar combined with traditional Chinese medicine treatment (observation group) 40 cases;The cutative effect and score of PDSS,ESS,HAMD,VAS and BI index before and after treatment of the two groups were observed.Results The score of PDSS ( 122.5 ± 16.5)point,(125.7 ±17)point before treatment in observation group and the control group were significantly lower after treatment (138.5 ±16.4)point,(135 ±15)point (t=3.45,4.01,all P<0.05);The score of HAMD (13 ± 7)point,(13.5 ±18.5)point were obviously higher than that after treatment (7.5 ±3.2)point,(7.4 ±5.2)point (t=2.41,2.31,all P<0.05);The BI index (25.44 ±9.11)point,(25.99 ±9.55)point were significantly lower af-ter treatment (60.11 ±9.85)point,(61.22 ±9.99)point (t=4.01,4.03,all P<0.05);The efficiency 87.5%after treatment in observation group were higher than 70%in the control group (χ2 =13.25,P<0.05);The adverse reac-tion 5 cases (12.5%) in observe group were significantly lower than that 10 cases (25.0%)in control group(χ2 =16.21,P<0.05).Conclusion It is safe and effective treatment method in Parkinson's disease by Madopar combined with traditional Chinese medicine treatment.
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Objective To observe the effect and safety of bFGF auxiliary fractional Er :YAG laser in the treatment of facial a-trophic acne scar .Methods After fractional Er :YAG laser treatment ,64 cases of facial atrophic acne scar patients were randomly divided into two groups ,the observation group was applied facial ice collagen dressing and sprayed fibroblast growth factor ,the con-trol group was only applied facial ice collagen dressing .Treatment in two groups last for 10 consecutive days .Postoperative to ob-serve the wound healing time ,adverse reactions ,using B .Dreno′s ECCA grading scale to identify and quantify facial atrophic scars before and after treatment and statistics the satisfactory rate of patients .Results The wounds of two groups were conventional healing ,in the observation group the average healing time was 7 .2 days ,and that of control group was 10 .4 days ,there was signifi-cant difference (P<0 .05) .For all patients at the end of treatment and followed-up 3 months later ,scar were all improved ,with an efficiency of 100% .Conclusion Fractional Er :YAG laser combined with bFGF is a safe and effective treatment method for treat-ment of facial atrophic acne scars .
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<p><b>BACKGROUND</b>Mechanical stress plays an important role in the maintenance of bone homeostasis. Current hypotheses suggest that interstitial fluid flow is an important component of the system by which tissue level strains are amplified in bone. This study aimed to test the hypothesis that the short-term and appropriate fluid shear stress (FSS) is expected to promote the terminal differentiation of pre-osteoblasts and detect the expression profile of microRNAs in the FSS-induced osteogenic differentiation in MC3T3-E1 cells.</p><p><b>METHODS</b>MC3T3-E1 cells were subjected to 1 hour of FSS at 12 dyn/cm(2) using a parallel plate flow system. After FSS treatment, cytoskeleton immunohistochemical staining and microRNAs (miRNAs) were detected immediately. Osteogenic gene expression and immunohistochemical staining for collagen type I were tested at the 24th hour after treatment, alkaline phosphatase (ALP) activity assay was performed at 24th, 48th, and 72 th hours after FSS treatment, and Alizarin Red Staining was checked at day 12.</p><p><b>RESULTS</b>One hour of FSS at 12 dyn/cm(2) induced actin stress fiber formation and rearrangement, up-regulated osteogenic gene expression, increased ALP activity, promoted synthesis and secretion of type I collagen, enhanced nodule formation, and promoted terminal differentiation in MC3T3-E1 cells. During osteogenic differentiation, expression levels of miR-20a, -21, -19b, -34a, -34c, -140, and -200b in FSS-induced cells were significantly down-regulated.</p><p><b>CONCLUSION</b>The short-term and appropriate FSS is sufficient to promote terminal differentiation of pre-osteoblasts and a group of miRNAs may be involved in FSS-induced pre-osteoblast differentiation.</p>
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Animals , Mice , Actins , Chemistry , Alkaline Phosphatase , Metabolism , Cell Differentiation , Cells, Cultured , Collagen Type I , Core Binding Factor Alpha 1 Subunit , Genetics , Cyclooxygenase 2 , Genetics , Gene Expression Profiling , MicroRNAs , Physiology , Osteoblasts , Cell Biology , Osteogenesis , Stress, Mechanical , Stress, PhysiologicalABSTRACT
BACKGROUND:Bone morphogenetic proteins are associated with the formation and development of scars. Fibroblasts are closely related to the proliferation and maturation of scars. However, the expression of bone morphogenetic proteins in fibroblasts in different stage of hypertrophic scars remains poorly understood. OBJECTIVE:To observe the expression of bone morphogenetic protein 2/4, bone morphogenetic protein 7, bone morphogenetic protein receptor IA in fibroblasts in different stage of hypertrophic scars. METHODS:The immunohistochemical SP method was employed to detect the expression of bone morphogenetic protein 2/4, bone morphogenetic protein 7, bone morphogenetic protein receptor IA in fibroblasts in 20 cases of proliferative stage hypertrophic scar and 20 cases of maturation stage hypertrophic scar. Al samples were obtained from the Department of Plastic and Aesthetic Surgery, the People’s Hospital of Guangxi Zhuang Autonomous Region, China. RESULTS AND CONCLUSION:The expression of bone morphogenetic protein 2/4 in fibroblasts in proliferative hypertrophic scars significantly elevated compared with mature hypertrophic scars (P0.05). Results demonstrated that bone morphogenetic protein 2/4 expression down-regulated during the development from proliferative stage to maturation stages in fibroblasts in hypertrophic scars. However, there was no change in the expression of bone morphogenetic protein 7 and bone morphogenetic protein receptor IA.
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<p><b>BACKGROUND</b>Bone morphogenetic protein (BMP)-2, alkaline phosphatase (ALP), and collagen type I are known to play a critical role in the process of bone remodeling. However, the relationship between mechanical strain and the expression of BMP-2, ALP, and COL-I in osteoblasts was still unknown. The purpose of this study was to investigate the effects of different magnitudes of mechanical strain on osteoblast morphology and on the expression of BMP-2, ALP, and COL-I.</p><p><b>METHODS</b>Osteoblast-like cells were flexed at four deformation rates (0, 6%, 12%, and 18% elongation). The expression of BMP-2 mRNA, ALP, and COL-I in osteoblast-like cells were determined by real-time quantitative reverse transcription polymerase chain reaction, respectively. The results were subjected to analysis of variance (ANOVA) using SPSS 13.0 statistical software.</p><p><b>RESULTS</b>The cells changed to fusiform and grew in the direction of the applied strain after the mechanical strain was loaded. Expression level of the BMP-2, ALP, and COL-I increased magnitude-dependently with mechanical loading in the experimental groups, and the 12% elongation group had the highest expression (P < 0.05).</p><p><b>CONCLUSION</b>Mechanical strain can induce morphological change and a magnitude-dependent increase in the expression of BMP-2, ALP, and COL-I mRNA in osteoblast-like cells, which might influence bone remodeling in orthodontic treatment.</p>
Subject(s)
Animals , Mice , Alkaline Phosphatase , Metabolism , Analysis of Variance , Bone Morphogenetic Protein 2 , Metabolism , Cell Line , Collagen , Metabolism , Collagen Type I , Metabolism , Osteoblasts , Cell Biology , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapeutic effect of scalp flaps pedicled with superficial temporal vessel and hair removal for reconstruction of facial skin defects.</p><p><b>METHODS</b>From Jan. 2010 to Dec. 2011, 6 cases with large facial skin defects were treated with scalp flaps pedicled with superficial temporal vessel and hair removal. At the first stage, the skin expanders were implanted subcutaneously at the homolateral side according to the defect size. After the expansion was finished, the expanded flaps pedicled with superficial temporal vessel were used to reconstruct the facial skin defects at the second stage. 2 weeks after operation, hair removal was performed to remove the hair on flaps. 4-6 treatments were needed.</p><p><b>RESULTS</b>Seven flaps in 6 cases were survived completely. The wounds at donor sites were closed directly. The effect of hair removal was reliable. The patients were followed up for 6 months to 1 year. The flap color, texture and thickness had a good match with surrounding skin tissue.</p><p><b>CONCLUSIONS</b>It is a good option to reconstruct facial skin defects with scalp flaps pedicled with superficial temporal vessel and hair removal.</p>
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Adolescent , Humans , Face , General Surgery , Hair Removal , Plastic Surgery Procedures , Scalp , Transplantation , Surgical Flaps , TransplantationABSTRACT
<p><b>BACKGROUND</b>Animal models are needed for the study of rapid tooth movement into the extraction socket through distraction osteogenesis of the periodontal ligament.</p><p><b>METHODS</b>Modified distraction devices were placed on eight dogs between the first and third mandibular premolars on the left sides; similar placement of traditional straight wise appliances on the right sides served as the control. The experimental distractors were activated (0.25 mm/d) twice a day and the control devices were activated (100 g) for two weeks with consolidation periods at weeks two, three, six, and ten. Two dogs were sacrificed at each consolidation time point; rates and patterns of tooth movement, loss of anchorage, and periapical films were evaluated, and the affected premolars and surrounding periodontal tissues were decalcified and examined histologically. General observations, X-ray periapical filming and histology examination were performed.</p><p><b>RESULTS</b>Distal movement ((3.66+/-0.14) mm) measured two weeks after modified distraction exceeded that achieved using the traditional device ((1.15+/-0.21) mm; P<0.05). Loss of anchorage was minimally averaged (0.34+/-0.06) mm and (0.32+/-0.07) mm in the experimental and control sides, respectively. By radiography, apical and lateral surface root resorptions on both sides were minimal. Alveolar bone lesions were never evident. Fibroblasts were enriched in periodontal ligaments and bone spicules formed actively along directions of distraction.</p><p><b>CONCLUSIONS</b>The canine model is suitable for the study of rapid tooth movement through distraction osteogenesis of the periodontal ligament. The technique accelerates tooth movement, periodontal remodeling, alveolar bone absorption, and may induce fibroblast formation, as compared to the traditional orthodontic method, without adversely affecting root absorption, bone loss, tooth mobility and anchorage loss.</p>
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Animals , Dogs , Male , Osteogenesis, Distraction , Methods , Periodontal Ligament , Physiology , General Surgery , Root Resorption , Tooth Movement Techniques , MethodsABSTRACT
<p><b>OBJECTIVE</b>To inquire into the reason why the postoperative complications of augmentation mammaplasty by injecting polyacrylamide hydrogel took place and to find the best method to deal with the complications.</p><p><b>METHODS</b>12 patients who accepted polyacrylamide hydrogel injection for augmentation mammaplasty were included in this study. Operations were performed to remove the polyacrylamide hydrogel.</p><p><b>RESULTS</b>All patients didn't argue with the result, but the outside shape of mamma was not good post-operation.</p><p><b>CONCLUSIONS</b>So-called standard injection method can't avoid the postoperative complications. The considerable therapy for the complications of polyacrylamide hydrogel was removing it by operation.</p>