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Objective To investigate the rehabilitation promoting factors in stroke patients and to provide references for the design and implementation of effective intervention for rehabilitation of stroke patients.Methods In-depth interviews were conducted among eight stroke patients,and interview data were collected and analyzed.Results Five themes were identified through analysis and classification of the interview data:practical rehabilitation goals,effective rehabilitation training behaviors,overcoming abandonment behaviors and negative emotions,suitable support system,and proper self-adjustment.Conclusion The rehabilitation promoting factors for stroke patients are performing effective rehabilitation training towards effective rehabilitation goals.In this process,patients need to rely on appropriate social support and patients' self-adjustment to overcome abandonment behaviors and negative emotions.These factors form a force to promote rehabilitation during the process of rehabilitation.
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Objective To investigate histopathological and ultrastructural differences between melasma tissues and normal skin tissues around pigmented nevus. Methods Eight patients with melasma and 16 patients with facial pigmented nevus were included in this study. Two millimeter punch biopsies were taken from melasma lesions and adjacent normal skin of facial pigmented nevus. Biopsy specimens were then subjected to hematoxylin?eosin (HE) staining, Fonton?Masson staining, Verhoeff?van Gieson staining, and immunohistochemical staining with monoclonal antibodies HMB45 and NKI/beteb. Transmission electron microscopy was used to observe the tissue specimens. Semi?quantitative analysis was performed under a light microscope, and quantitative analysis by using a computerized image analysis system. Results Histopathological study revealed increased number of melanin granules mainly in the basal and prickle cell layers, sometimes in the dermis, in melasma tissues compared with normal skin tissues. Melanocytes were only observed in the epidermis of melasma tissues. Compared with normal skin tissues, melasma tissues showed no significant difference in the quantity of melanocytes, but a significant increase in the volume, staining intensity and dendrite number of melanocytes. In all of the 8 patients with melasma, mild to moderate lymphocytic infiltration was observed in the superficial dermis and around capillaries, with moderate telangiectasis in the superficial dermis. Electron microscopy revealed that there were more melanosomes in melanocytes and keratinocytes, and melanocyte dendrites extended into the dermis in melasma tissues. Conclusions Among the 8 patients, there were only two types of melasma, i.e., epidermal melasma and mixed melasma, and no dermal melasma was found. Inflammation and telangiectasis may induce or aggravate melasma.
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Melasma is a common cutaneous disorder of pigment metabolism with complex etiology and pathogenesis.Combination therapy has been preferred by dermatologists for better therapeutic effects and less adverse reactions compared with monotherapy.At present,the treatment of melasma is diversiform,mainly including oral or topical drugs,lasers or photon therapy and combination therapy,etc.Individualized treatment is recommended based on etiology,clinical course and types of melasma,as well as previous treatment history.Combination therapy,sequential therapy or supplement therapy should be included in the treatment of melasma.
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Objective To explore the anti-inflammatory mechanisms of purslane by evaluating its effects on the expression of tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule 1 (ICAM-1).Methods A model of inflammation was developed in 45 mice by painting xylene to the auricle of the right ears,which were then divided into 3 groups to receive no treatment (negative control group),be topically treated with the extraction of purslane from South Korea (positive control group) or Yunnan province (experimental group).Fifteen mice receiving no sensitization nor treatment served as the blank control group.Two hours after the single topical treatment,skin tissue samples were obtained from the site of experimental inflammation and subjected to pathological examination by using hematoxylin and eosin (HE) staining.Immunohistochemistry was performed to quantify the expression of TNF-α and ICAM-1 in the tissue samples.Results Pathological examination showed blood vessels and a small quantity of lymphocytes in murine dermis of the blank control group as well as loose and edematous dermis infiltrated with massive lymphocytes in the negative control group.However,there was only mild edema and perivascular infiltration with some inflammatory cells in the dermis of the positive control group and experimental group.Neither TNF-α nor ICAM-1 was expressed in the skin tissue of the blank control group,but an intense expression was observed for TNF-α in the vascular endothelial cell membrane and for ICAM-1 in the vascular endothelial cell membrane and lymphocyte membrane in the negative control group,which was significantly downregulated by the purslane from South Korea in the positive control group and by the purslane from Yunnan province in the experimental group (all P ＜ 0.01).Rank sum test showed a statistical difference in the expression level of TNF-α and ICAM-1 between the blank control group and experimental group (both P ＜0.01).Conclusion The purslane from Yunnan province may counteract inflammation by affecting the expression of TNF-α and ICAM-1.
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Objective To compare skin barrier function among patients with facial acne,subacute eczema,melasma and solar dermatitis.Methods Three hundred patients,including 80 patients with facial acne,60 subacute facial eczema,80 facial melasma and 60 facial solar dermatitis,as well as 60 healthy controls were recruited in this study.Skin sebum content and transepidermal water loss (TEWL) were measured by a sebmeter and Tewameter TM 210 (Courage and Khazaka,Germany),respectively.Stratum comeum hydration was measured with a Scalar Moisture Checker (Scalar Corporation,Japan).Statistical analysis was carried out using analysis of variance and t test.Results Compared with the healthy controls,patients with facial acne showed increased skin sebum content and TEWL value but decreased stratum corneum hydration (all P ＜ 0.01),and patients with subacute eczema,solar dermatitis and melasma displayed lower sebum content and stratum corneum hydration but higher TEWL value (all P ＜ 0.01).Skin sebum content was significantly higher in patients with facial acne than in patients with subacute eczema,solar dermatitis and melasma ((184.65 ± 83.07) vs.(21.86 ± 18.94),(25.10 ±14.22) and (36.05 ± 32.84) μg/cm2,all P ＜ 0.01),but was similar between the patients with subacute eczema,solar dermatitis and melasma (P ＞ 0.05).In terms of stratum corneum hydration,patients with subacute eczema and solar dermatitis were statistically lower than those with acne and melasma (18.66％ ± 7.85％ and 20.91％ ± 8.05％ vs.24.32％ ± 8.16％ and 28.02％ ± 4.67％,all P ＜ 0.01),patients with facial subacute eczema were similar to those with solar dermatitis (P ＞ 0.05),and patients with facial acne were statistically lower than those with melasma (P ＜0.01).TEWL value was significantly higher in patients with melasma than in patients with acne,solar dermatitis and subacute eczema ((13.80 ± 4.t 3) vs.(20.86 ± 8.78),(22.85 ± 9.84) and (22.48 ± 10.37) μg/m2 h,all P ＜ 0.01),but similar between patients with acne,solar dermatitis and subacute eczema (P ＞ 0.05).Conclusions Skin barrier function is somewhat impaired in patients with facial acne,subacute eczema,melasma and solar dermatitis.Therefore,to recover skin barrier function may facilitate the treatment of these diseases.
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ObjectiveTo explore the effects of epidermal proteins and lamellar bodies on skin barrier in glucocorticoid-dependent dermatitis.MethodsTotally,60 patients with glucocorticoid-dependent dermatitis and 40 normal human controls were eligible for this study.A noninvasive method using TewameterTM was applied to determine transepidermal water loss (TEWL) value in these subjects.Tissue specimens were obtained from the lesions of 13 patients with glucocorticoid-dependent dermatitis and normal skin of 10 human controls.Subsequently,haematoxylin and eosin(HE) staining was performed to observe the histopathological changes,immunohistochemistry to detect the protein expressions of K6,K10,K14,K15,loricrin,filaggrin,involucrin in epidermis,and electron microscopy(EM) to estimate the density of lamellar bodies in tissue specimens.ResultsCompared with the normal controls,the patients displayed an elevated TEWL value (P ＜ 0.05),which suggested an impaired epidermal barrier.Histopathology of lesions revealed nonspecific inflammatorychanges withmarkeddifferencesbetweendifferentclinicaltypesofglucocorticoid-dependentdermatitis.Immunohistochemistry revealed an attenuated expression of K10,K14,loricrin,filaggrin,involucrin and abnormal expression of K15 in lesional epidermis compared with the normal epidermis (all P ＜ 0.05),hinting a suppression of epidermal differentiation and proliferation as well as an impairment of cornified envelope structure.The number and density of lamellar bodies were also reduced in lesional epidermis compared with the control epidermis.ConclusionsCompared with normal skin,the structure of skin barrier is impaired in lesions of glucocorticoid-dependent dermatitis,to restore skin barrier is essential for the treatment of this entity.
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ObjectiveTo seek experimental evidence of epidermal barrier dysfunction in psoriasis,and to provide a basis for adjuvant therapy of psoriasis.MethodsPhysiometric methods were used to determine the value of sebum content,transepidermal water loss(TEWL) and water content of stratum corneum in 60 patients with psoriasis and 48 normal human controls.The ultrastructure of lamellar bodies was observed with transmission electron microscopy,and the expression of acid ceramidase in normal skin and psoriatic lesions was detected by using immunohistochemical techniques.ResultsCompared with the normal skin,TEWL value was increased(P ＜ 0.01),but water content of stratum corneum decreased(P ＜ 0.01 ) in psoriatic lesions,and sebum content was similar between normal skin and psoriatic lesions.As electron microscopy showed,lamellar bodies in keratinocytes were reduced in number with a disorganized arrangement and irregular size in psoriatic lesions.The expression of acid ceramidase also decreased in psoriatic epidermis.Conclusions The function of epidermal barrier in psoriasis is impaired,and to restore epidermal barrier function and enhance hydration may serve as an important adjuvant therapy of psoriasis.
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Objective To evaluate the effects of Prinsepia utilis Royle oil (PURO) on the synthesis of ceramide and expression of acid ceramidase N-acylsphingosine amidohydrolase 1 (ASH1),and to explore the mechanisms underlying its moisturizing and skin barrier-repairing effects.Methods Keratinocytes from human foreskin tissue were classified into 2 groups to be cultured in keratinocyte-serum free medium (K-SFM) with or without the presence of PURO.Enzyme linked immunosorbent assay (ELISA) was performed to measure the level of ceramide in the culture supernatant of keratinocytes at 0,3,8,24 and 48 hours.The back of nude mice was divided into 4 areas,i.e.,test area,matrix area,blank control area and negative control area.Acetone and ether were used to destroy the epidermal barrier in the test,matrix,and blank control areas,then,the former 2 areas were topically treated with emulsions containing 1％ PURO and matrix,respectively,and the blank control area remained untreated.The epidermal barrier remained intact and untreated in the negative control area.Noninvasive methods were used to determine transepidermal water loss (TEWL),epidermal moisture content and skin lipid content in these areas on day 0,1,3,and 7.Skin tissue was obtained from these areas on day 0 and 7 followed by an immunohistochemical study for the quantification of ASH1 expression.Results The level of supernatant ceramide increased with time in the PURO-treated keratinocytes,which was significantly higher at 24 hours and 48 hours than at 0 hour (1.3817 ± 0.100 and 1.3737 ± 0.047 vs.0.7630 ± 0.143,both P ＜ 0.05).The supernatant ceramide was also elevated in the PURO-treated keratinocytes compared with untreated keratinocytes at 24 and 48 hours (both P ＜ 0.05).Noninvasive skin tests showed a gradual decrease in the TEWL,but an increase in the epidermal moisture content and skin lipid content with time in the 3 epidermal barrier-destroyed areas.As far as the test area was concerned,TEWL value was significantly lower on day 3 and 7 than on day 0 (10.85 ± 0.64 and 8.01 ± 0.58 vs.12.65 ± 0.71,both P ＜ 0.05),while a significant increment was observed in the skin lipid content on day 3 and 7 compared with day 0 (29.14 ± 0.40 and 31.30 ± 0.88 vs.27.02 ± 0.65,both P ＜ 0.05),as well as in the epidermal moisture content on day 1,3 and 7 compared with day 0 (13.98 ± 0.28,15.00 ± 0.38 and 15.86 ± 0.18 vs.11.74 ± 0.62,all P＜ 0.05).On day 7,there was a statistical decline in TEWL value,but an elevation in epidermal moisture content,skin lipid content and ASH1 expression in the test area compared with the matrix area and blank control area (all P ＜ 0.05).Also,the expression of ASH1 was upregulated on day 7 compared with day 0 in the 3 barrier-destroyed areas (all P ＜ 0.05).Conclusion PURO may exert skin-moisturizing and barrier-repairing effects by enhancing the synthesis of ceramide and expression of acid ceramidase ASH1.
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<p><b>BACKGROUND</b>Bleb-associated endophthalmitis (BAE) is a rare but severe complication of trabeculectomy with poor outcome. Various surgical methods were explored to treat such patients. However, there is no defined protocol. The aim of this study was to describe a new combined operation, and to demonstrate the outcome of the treatment.</p><p><b>METHODS</b>Nine patients with BAE were enrolled in our study. The combined operation including pars plana vitrectomy (PPV), sclera patch graft (SPG) and endoscopic cyclophotocoagulation (ECP) was used to treat these patients.</p><p><b>RESULTS</b>In the follow-up of 18 - 24 months, all patients with the endophthalmitis were cured, the useful visual acuity was preserved in 7 patients, and the intraocular pressure (IOP) of 8 patients was controlled just after first operation, only one needed another trans-scleral cyclophotocoagulation.</p><p><b>CONCLUSION</b>This combined operation is a useful method for treating the patients with BAE, with SPG and vitrectomy to control the endophthalmitis and ECP to balance the postoperative IOP.</p>
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Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Endophthalmitis , General Surgery , Glaucoma , General Surgery , Trabeculectomy , Visual Acuity , Physiology , Vitrectomy , MethodsABSTRACT
<p><b>OBJECTIVE</b>To establish human bronchial epithelial cell lines over expressing oncogene and to investigate its application in detection of carcinogen-induced cell transformation.</p><p><b>METHODS</b>Mediated by retrovirus infection, human telomerase catalytic subunit, hTERT was introduced into immortal human bronchial epithelial cells (16HBE) and followed by introduction of the oncogenic allele H-Ras(V12), or c-Myc or empty vector, creating cell lines 16HBETR, 16HBETM and 16HBETV, respectively. Biological characteristics of these cell lines including morphology, proliferation, and chromosomal aberration were examined to access whether they were transformed. Soft agar experiment and nude mice subcutaneous injection were performed using pre-transformed 16HBE cells induced by known carcinogens, nickel sulfate (NiSO4) and 7, 8, -dihydrodiol-9, 10-epoxide benzo[a] pyrene (BPDE).</p><p><b>RESULTS</b>With detection of telomerase activity and Western blotting, the expression of target proteins was verified. Thus, the transgenic 16HBE cell lines were successfully established. Cells expressing oncogene H-Ras or c-Myc grew 30.3% or 10.4% faster than control cells. However, these cells failed to form colonies in soft agar or form tumor in nude mice. 16HBETR, 16HBETM cells obtained transformed phenotype at 5 wks, 11 wks, respectively after treatment with BPDE, which are 15 wks and 9 wks earlier than control cells 16HBETV (20 wks). Meanwhile, 16HBETR, 16HBETM cells obtained transformed phenotype at 11 wks, 14 wks, respectively after treatment with nickel sulfate, which are 21 wks and 18 wks earlier than control cells (32 wks).</p><p><b>CONCLUSION</b>With the advantage of shorter latency, transgenic human cell transformation models could be used in potent carcinogen screening and applied to chemical-carcinogenesis mechanism study.</p>
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Animals , Humans , Mice , 7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide , Toxicity , Carcinogenicity Tests , Cell Line , Cell Transformation, Neoplastic , Metabolism , Pathology , Epithelial Cells , Gene Expression , Gene Expression Regulation , Genes, myc , Genes, ras , Mice, Inbred BALB C , Mice, NudeABSTRACT
Objective To explore the clinical characteristics, surgical treatment and related factors of traumatic implantation cyst of the iris. Design Retrospective cases series. Participants Thirty-six cases of traumatic implantation cyst of the iris. Methods Thir- ty-six cases of traumatic implantation cyst of the iris were reviewed. Main Outcome Measures Age, surgical history, history of disease, surgical method of patients. Results All cases of traumatic implantation cyst of the iris were secondary to perforating injury. 10 cases had been undertaken cataract surgery. The histories of disease in 6 months～1 year and 1 year～10 years were 30.56% respectively. Sur- gical exicision was taken in all cases. There were 2 recurrence cases. Conclusion Traumatic implantation cyst of the iris is almost see- ondary to perforating injury. Surgical excision is an effective strategy to treat this disease.
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Objective To study clinical application and complication of heavy silicon oil (Densiron68) in the treatment of traumat- ic proliferative vitreoretinopathy.Design Non-comparatives,retrospective case series.Participants Twenty patients with proliferative vitreoretinopathy resulting from ocular trauma were recruited,whose retinal detachment arising from inferior or posterior retinal breaks. Methods Heavy silicon oil was applied to patients during vitrectomy.Silicone oil or gas was applied to patients with redetachment after heavy silicon oil was removed.Main Outcome Measures The rate of retinal attachment,vision,intraocular pressure,inflammatory re- action of anterior segment and silicone oil emulsification period.Results The rate of retinal attachment with one operation using heavy silicon oil was 50%(10/20 eyes)and 15%(3/20 eyes)with further surgery.The average follow-up time was 3.90?1.41 months.At the end of the follow-up,all tamponade agents were removed in 50% patients.Patients' logMAR vision after the surgery was 2.19?0.86,which was better than before the surgery (2.63?1.00) (P=0.037).There was little evidence of high intraocular pressure,excessive inflammatory reaction of anterior segment and cornea endothelial cell damage,but cataract became more serious without exception.Emulsification rate was 100% and the average emulsification period was 2.18?0.87 months.Conclusions Heavy silicon oil tamponade in vitreoretinal surgery for traumatic proliferative vitreoretinopathy has good efficacy and relatively few complications.However,its emulsification period is relatively short,which may constraint its application to a certain extent.
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Objective To investigate the effects of stimulation of CD40 on the growth,prolifera- lion and apoptosis of gastric cancer cell lines,and the change of gene expression profiles of gastric cancer cell AGS.Methods The growth and proliferation of AGS cells treated with different concentrations of soluble CD40 ligand were measured by MTT in order to choose optimum stimulating concentration of so- luble CD40 ligand.Cell cycle and apoptosis of AGS cells were analyzed by flow cytometry.Gene expres- sion profiles of AGS cells were analyzed by Affymetrix U133A 2.0 after treated with soluble CD40 ligand for 48 h.Results Two?g/ml of.soluble CD40 ligand was the optimum concentration.After being cul- tured with soluble CD40 ligand for 48h,the growth of AGS cell was inhibited and blockade in G1 phase. There were 414 alterative genes found in AGS cells including 209 up-regulated genes and 205 down-regu- lated genes.Forty-five genes varied significantly(P