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【Objective】 To effectively differentiate adrenal adenoma (AA) and small diameter pheochromocytoma (PCC) by establishing a clinical-radiomic nomogram model before surgery. 【Methods】 A total of 132 pathologically confirmed patients (45 PCC cases, 87 AA cases) were enrolled. After the features of enhanced CT were assessed, the radiomic features and related clinical indicators were extracted. Based on multiple Logistic regression, a clinical-radiomic nomogram with radiomic features and independent clinical predictors was developed. The area under the receiver operating characteristic (ROC) curve (AUC) was used for internal evaluation to compare the diagnostic effectiveness of the three models. The clinical effectiveness of the nomogram was verified with decision curve analysis (DCA). 【Results】 One of the 108 candidate features was used to construct the radiological feature score. Individualized clinical-radiomic nomogram included independent clinical factors (24 h urinary vanmandelic acid/renin/angiotensin I) and original first-order median radiological feature scores. Internal evaluation of the prediction model showed that the AUC was 0.945 (95%CI:0.906-0.984), superior to the single clinical model or radiological model in precise differentiation. DCA showed that the nomogram had the best clinical use. 【Conclusion】 The clinical-radiomic nomogram model can effectively differentiate adrenal adenoma from small diameter pheochromocytoma, which can improve the preoperative differential diagnosis and preparation.
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Objective:To explore the clinical characteristics of superior mesenteric artery ischemic diseases.Methods:The clinical and followup data of 141 hospitalized patients with ischemic disease of superior mesenteric artery in the Affiliated Hospital of Southwest Medical University from 1999 to 2021 were reviewed.Results:There were 99 males (70.2%) and 42 females (29.8%). The average age of the patients was (63.75±13.16) years; 127 patients (90.1%) complained abdominal pain.The number of all-cause deaths in the perioperative period was 27 (19.1%). ROC curve analysis showed that the optimal cutoff value of the age with predictive value was 64.5 years. The results of multivariate COX regression analysis showed that age ≥65 years old ( HR=3.855, 95% CI: 1.739-8.545), neutrophil count ( HR=1.072, 95% CI: 1.018-1.130), heart failure ( HR=2.863, 95% CI: 1.332-6.154), creatinine ( HR=1.009, 95% CI: 1.003-1.015), D-Dimer ( HR=1.112, 95% CI: 1.025-1.205) was an independent risk factor for all-cause death from superior mesenteric artery ischemic disease. Long-term survival rate of SMAD group was significantly higher than that of other SMAID; By comparing the clinical characteristics of different SMAID, neutrophil count, neutrophil ratio, D-dimer of SMAE group and SMAT group were significantly higher than that of SMAD group and ASSMA group. Conclusions:SMAID usually occurs in elderly men over 65 years old, with abdominal pain as the main symptom and often accompanied by hypertension. Risk factors included age, increased WBC count and D-dimer; The neutrophil count, neutrophil ratio, D-dimer in SMAE and SMAT group were significantly higher than that of SMAD and ASSMA group.
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Objective:To observe the characteristics of macular telangiectasia (MacTel) in multi-color and multi-mode fundus images.Methods:An abservational case series study was conducted.Sixteen eyes of 12 patients diagnosed with MacTel by fluorescein fundus angiography (FFA) from January to November 2019 in Shandong Eye Hospital were analyzed.There were 8 cases (8 eyes) with MacTel type Ⅰ, among which 4 cases were male and 4 cases were female, with an average age of (62.3±12.5) years.The other 4 cases (8 eyes) had MacTel type Ⅱ, all of which were female, with an average age of (58.7±10.5) years.Best corrected visual acuity, slit lamp microscopy, color fundus photography, multicolor scanning laser imaging, FFA, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were carried out in all the patients.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shandong Eye Institute (No.2019S003).Results:In color fundus images of MacTel type Ⅰ eyes, annular macular exudation with macular edema occurred in 6 eyes, macular edema without hard exudates in 1 eye, and hard macular exudates without macular edema in 1 eye.However, the transparency of retina in temporal fovea in MacTel type Ⅱ eyes decreased, showing a gray color.In multi-color fundus images of MacTel type Ⅰ eyes, punctate granular yellow macular exudation and yellow-green macular edema were observed, which were clearer than those in color fundus images.Punctate exudation was seen in both the blue and green reflectance images, which was clearest in green reflectance image, followed by blue reflectance image and then the infrared reflectance image.In OCT images of MacTel type Ⅰ eyes, cystoid edema of inner retina or uneven reflection signal of outer plexiform retina were observed.Loss of inner and outer retinal structures and cavities were observable in MacTel type Ⅱ eyes, and outer retinal atrophy appeared in 2 eyes.In OCTA images, the destruction of superficial and deep capillary plexus in macular area were observed in both MacTel typeⅠand type Ⅱ eyes, and the destruction of deep capillary plexus was more obvious.In addition, more obviously increased vascular space, decreased vessel density, and increased foveal avascular zone were found in MacTel type Ⅱ eyes.In early stage of FFA, delayed capillary filling near fovea was seen in MacTel typeⅠeyes, and dilated temporal vessels in fovea, some of which showed tumor-like dilation, and the limited tumor-like dilation was enhanced in the later stage.Different degrees of dilated parafoveal blood vessels in the early stage, and the capillary in the temporal side of the macula showing diffuse strong fluorescence in the late stage of FFA was observed in MacTel type Ⅱ eyes.Conclusions:Multi-color scanning laser imaging can be used to observe the morphological characteristics of MacTel, and the imaging features of different types of MacTel are significantly different.
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Objective:To explore the efficacy and safety of transvaginal anterior pelvic floor reconstruction with mesh in treatment of patients with cystocele and lower urinary tract symptoms.Methods:A retrospective analysis of 32 patients who underwent transvaginal anterior pelvic reconstruction with mesh from June 2015 to February 2019 was performed. The age of the patients was 57-86 years old, with an average of (67.8±7.6) years; body mass index(BMI) (22.6±3.0) kg/m 2; mean duration of disease (2.9±2.3) years; delivery 1-7 times, mean(3.0±1.5) times. All patients underwent transvaginal anterior pelvic reconstruction. The anterior wall of the vagina was incised, and the space between the pelvic floor and the bladder was bluntly separated. The mesh was placed under the guidance of the puncture needle after locating marks of body surface. Patients underwent the American Urological Association Symptom Scoring (AUASS) with (14.2±3.5) points, the residual urine (71.3±53.0) ml and the maximum urine flow rate (16.9 ± 3.8) ml/s were measured preoperative. The Pelvic Organ Prolapse Distress Inventory(POPDI-6), Urogenital Distress Inventory(UDI-6) and Pelvic Floor Impact Questionnaire(PFIQ-7) were recorded as the value of (48.0±7.3) points, (41.7 ± 8.2) points and (62.5 ± 16.4) points, respectively. Thirty-two patients were divided into 2 groups as the group of urinary storage symptom (22 patients) and the group of voiding symptom (10 patients) according to the preoperative lower urinary tract symptoms. The operative time, intraoperative bleeding volume and average hospital stay were recorded. The patients were followed up with AUASS, maximum urine flow rate, residual urine, POPDI-6, UDI-6, PFIQ-7 and complications during and after operations. Results:All the operations of 32 cases were successfull. The average operation time was (61.1±18.6) min, the average intraoperative blood loss was (41.5±12.3)ml, and the average hospital day was (9.1±1.8)d. There were no major organ injuries such as bladder, ureter, iliac vessels and rectum. 27 patients were followed up for 3 to 36 months, with an average of (24.7±10.8) months. There significant improvement of LUTS. At the last follow-up, the AUASS storage phase score (3.4±1.9) points in the urinary storage symptom group(19 patients) and the AUASS urinating phase score (3.9±1.7) points in the voiding symptom group(8 patients) were compared with the preoperative AUASS scores (11.6±1.9) points and (13.9±1.2) points which were significantly reduced. By the last follow up of all the 27 patients, residual urine (23.4±11.0)ml, POPDI-6(3.1±5.4) points, UDI-6 (3.2±5.1) points and PFIQ-7 (12.4±1.7) points were significantly lower than preoperative data. The maximum urinary flow rate(22.4±4.1)ml/s, was significantly higher than that before the operation. All the differences were statistically significant ( P<0.05). All patients had no recurrence of cystocele. One patient had anterior vaginal wall mesh exposure 3 months after surgery. After removing excess mesh in the outpatient clinic, she was cured by smearing with estrogen ointment. One patient experienced frequent urination and urgency who was cured by oral tolterodine tartrate. One patient with de novo mild SUI during the 1-year follow-up. The symptoms were improved in the outpatient clinic after pelvic floor muscle exercise. At 2-year follow-up, one patient was observed de novo mild posterior wall prolapse with no clinical manifestations and no treatment was carried out. Conclusions:Transvaginal anterior pelvic reconstruction with mesh could be effective in treating cystocele with lower urinary tract symptoms with less surgical trauma, fewer complications and lower recurrence rate. It could effectively improve lower urinary tract symptoms such as frequent urination, urgency and difficulty urinating.However, safety issues such as the incidence of long-term de novo SUI and mesh exposure still require further long-term follow-up.
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Objective To evaluate the anti-inflammatory effects of LCA, which is the active component from Litsea cubeba (Lour.) Pers. Methods Pharmacodynamic evaluations of ear swelling and cotton ball granuloma models were used in animal experiments. In vitro experiment, lipopolysaccharide (LPS) stimulated monocyte macrophage RAW264.7 cells were used to evaluate the anti-inflammatory activity of LCA by detecting the secretions of nitric oxide (NO), tumor necrosis factor-α (TNF-α), the expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) protein. Results In ear swelling experiment, the extent of ear swelling was significantly lower in the LCA treated group than the model group. The inhibition rate was greater in the high LCA concentration group than the positive drug group. In addition, LCA reduced the weight of cotton ball granuloma markedly. At the cell level, LCA significantly inhibited the secretions of NO, TNF-α and reduced the expressions of iNOS and COX-2 in LPS-stimulated RAW 264.7 cells. Conclusion LCA has significant anti-inflammatory effects in vitro and in vivo. The further studies are warranted for the development of anti-inflammatory drugs.
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Objective To explore the molecular mechanism of dipeptidyl peptidase-4 ( DPP4) in the calcification of human vascular smooth muscle cells(HVSMCs). Methods The osteogenic differentiation of HVSMCs was induced by 200 ng/ ml DPP4 as calcification model. The differentially expressed long non-coding RNAs (lncRNAs) between DPP4 group and control group were analyzed by microarray, and the microarray results of LincRNA ENST00000540293 were validated by real-time PCR. After HVSMCs were incubated with LincRNA ENST00000540293 silencing positive reagent for 48 h, the expressions of calcification-related proteins osteoprotegerin (OPG) and bone morphogenetic protein 2(BMP-2) were detected by Western blotting and the formation of calcified nodules was observed by Alizarin red staining. Results The protein expressions of OPG and BMP-2 in HVSMCs were significantly increased after DPP4 intervention (P <0.05), with the increased formation of calcified nodules. RTqPCR showed that LincRNA ENST00000540293 expression was significantly decreased in DPP4 group as compared with the control group(P<0.05). The expressions of calcification-related proteins OPG and BMP-2 were significantly increased after LincRNA ENST00000540293 silence(P<0.05). Conclusion DPP4 may promote the calcification of HVSMC through inhibiting LincRNA ENST00000540293 expression.
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OBJECTIVE To explore the possible role and mechanism of vitamin D on the pathogenesis of allergic rhinitis by adjuvant therapy with vitamin D3. METHODS A total of 60 allergic rhinitis patients and 30 healthy subjects were selected as the combination therapy group, standard treatment group and control group. Vitamin D3 nasal drops to nasal cavity and oral Desloratadine Citrate Disodium at the same time 8.8 mg once a day were given in combined treatment group patients. Standard treatment group patients received oral Desloratadine Citrate Disodium 8.8 mg once a day. The total course of treatment was 4 weeks and then to assess the changes of serum 25(OH)D concentration, eosinophils, IL-4 levels and the therapeutic effect before and after treatment. RESULTS The serum 25(OH)D levels before and after treatment in combination therapy group were(23.67±4.47)ng/ml and (47.57±2.83)ng/ml, the IL-4 levels were (14.576 ± 4.472)pg/ml and (10.381 ± 3.41l)pg/ml, and the eosinophils of peripheral blood counts were (0.71±0.14)× 109/L and (0.34 ± 0.09)×109/L. The total effective rate was 97％. The serum 25(OH)D levels before and after treatment in standard treatment group were (23.42±3.83)ng/ml and(31.51 ±2.95)ng/ml, the IL-4 levels were (15.187±5.144)pg/ml and (12.794 ±5.396)pg/ml, and the eosinophils of peripheral blood counts were (0.67±0.12)×109/L and (0.41 ±0.10)×109/L. The total effective rate was 84％. CONCLUSION Nasal vitamin D3 drops combined with antihistamines for allergic rhinitis can effectively improve the clinical symptoms and reduce the related inflammatory markers.
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Objective To evaluate the curative effect of endovascular treatment for Leriche syndrome.Methods The clinical data of 57 patients with Leriche syndrome,who were admitted to authors' hospital during the period from September 2010 to October 2014,were retrospectively analyzed.The curative effect of percutaneous transluminal angioplasty (PTA) was analyzed.Results Among the 57 patients (65 diseased limbs in total),simple PTA was employed in 2,catheter directed thrombolysis (CDT) with subsequent PTA and stenting in 5,and PTA plus stenting in 50.A total of 97 stents were implanted,the technical success rate was 100％.After the treatment,the ankle brachial index (ABI) increased from preoperative (0.42±0.22) to postoperative (0.83±0.15),the difference between the two data was statistically significant (P＜0.01).Thepatients were followed up for (9.8±2.8) months.The 6-month and 12-month primary patency rates were 95.4％ and 90.7％ respectively,the postoperative secondary patency rate was 96.4％.After the treatment,the symptoms of lower limb ischemia were improved in all patients.During perioperative period,iliac artery rupture due to balloon dilatation occurred in 2 patients,pseudoaneurysm at brachial aaery puncture point in one patient,hematoma at puncture point in 3 patients,cerebral infarction in 2 patients and myocardial infarction in one patient.One patient developed contrast-induced nephropathy and finally died of multiple organ dysfunction syndrome.The perioperative mortality was 1.75％.One patient developed in-stent obstruction in 3 months after two stage treatment,and artificial vascular bypass grafting had to be carried out.Conclusion For the treatment of Leriche syndrome,PTA is safe and reliable,it carries less complications and lower perioperative mortality with satisfactory short-term patency rate.(J Intervent Radiol,2017,26:221-224)
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Objective To explore the application and implementation of narrow band imaging (NBI) in fiberscope.Methods NBI color filter in the light source gifted the host machine with NBI function,and the application of DBI technique in fiberscope was implemented with a compatible HD camera.Results NBI technique involved in fiberscope decreased the costs in hospital and departments,relieved patient pain and increased the diagnosis rate.Conclusion NBI technique can be applied to electron mirror and fiberscope,and gains advantages in the future.
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Objective To investigate the effect of protein kinase B on calcifition of human aorta vascular smooth muscle cells(HASMCs) stimulated by advanced glycation end products (AGEs). Methods HASMCs were cultured in vitro and randomly divided into control group,DMSO group,AGEs group and AGEs+LY294002 group. The calcification of each group was examined by von Kusaa;the expression of protein was detected by west-ern blot and ALP levels in each group by Elisa. Results The expression of bone morphogenetic protein-2(BMP-2)and osteoprotegerin(OPG)in AGEs group was significantly higher than that in control group(P < 0.05). The expression of phosphorylated AKT in AGEs group was significantly higher than that in control group (P < 0.05), and it was time and concentration dependent. Compared with that in AGEs group ,the expression of BMP and OPG in AGEs + LY294002 group was significantly decreased (P < 0.01). Conclusion AKT signaling pathway may play an important role on calcifition of HASMCs caused by AGEs.
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Objective To investigate the effect of protein kinase B on calcifition of human aorta vascular smooth muscle cells(HASMCs) stimulated by advanced glycation end products (AGEs). Methods HASMCs were cultured in vitro and randomly divided into control group,DMSO group,AGEs group and AGEs+LY294002 group. The calcification of each group was examined by von Kusaa;the expression of protein was detected by west-ern blot and ALP levels in each group by Elisa. Results The expression of bone morphogenetic protein-2(BMP-2)and osteoprotegerin(OPG)in AGEs group was significantly higher than that in control group(P < 0.05). The expression of phosphorylated AKT in AGEs group was significantly higher than that in control group (P < 0.05), and it was time and concentration dependent. Compared with that in AGEs group ,the expression of BMP and OPG in AGEs + LY294002 group was significantly decreased (P < 0.01). Conclusion AKT signaling pathway may play an important role on calcifition of HASMCs caused by AGEs.
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Objective To study the relationship between lumbar and proximal femoral bone mineral density (BMD) with gender,age and body mass index (BMI) in adolescents ranged from 12 to 19 years of age in Tianjin city,and provide preliminary reference to understand the bone health status of adolescent in the city.Methods The BMD values of lumbar spine (L1-L4,),femoral neck and total hip were detected by the dual-energy X-ray absorptiometry (DXA) in 221 adolescents from Tianjin Hospital,and the Z value was used for clinical diagnosis standard.Simultaneously the height and weight of adolescents were measured,and BMI was calculated.The differences of BMD values in the lumbar,femoral neck and total hip were compared between different age,gender and BMI groups.Results The BMD values of femoral neck and total hip were significantly higher in males than those in females (P ＜ 0.01).The BMD values of lumbar spine,femoral neck and total hip were gradually increased with age.The BMD was correspondingly increased in adolescents with higher BMI in the lumbar spine,femoral neck and total hip.Conclusion There is a close relationship between BMD with age,gender and BMI in adolescents.We should pay more attention to the nutrition health and the level of BMI in adolescents.
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Objective To investigate the effects of different cyclic tensile strains on the proliferation and expression of bone marrow stromal cells (BMSCs)-cocultured human degenerated anulus fibrosus (AF) cells. Methods AF cells were isolated from a patient with degenerated intervertebral disc degeneration (IVD), which were co-cultured with BMSCs. The solely cultured AF cells were used as control group. The two groups of cells were expanded in monolayer, and cyclically strained for 3 hours, which were applied 0, 5%, 10%, 15%and 20%strains at a frequency of 0.25 Hz using BioDynamic test instrument. A flow cytometry method was used to examine the AF cell proliferation at 24 hours followed the application of cyclic tensile strains. After the total RNA was extracted, real-time PCR technology was used to detect the gene expression of collagenⅠand aggrecan. Results Under the same appropriate stress, the proliferative index (PI), the proportion of cells in the period of DNA synthesis, the expression of collagenⅠand aggrecan were significantly higher in the co-cultured group than those of control group (P<0.05). However, the best mechanical stimulation was different in the two groups. For the AF cells, the peaks of PI, the proportion of cells in the period of S period, the expression of collagenⅠand aggrecan were found in the 10% strain group, while for the co-cultured cells, they were found in the 15% strain group. Conclusion Co-culturing with BMSCs has a positive effect on the proliferation and expression of human degenerative fibrous ring cells, which can protect AF cells from bad stress stimulation.
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Estrogen is involved in the process of postmenopausal osteoporosis, and the main functional cells are osteoclasts. However, the mechanism of estrogen on the osteoclasts is not yet fully understood. Here we demonstrate the effects of estrogen on osteoclasts in three aspects: morphology and structure, apoptosis of osteoclasts and differentiation of preosteoclasts, which give an overall explanation for effects of estrogen on osteoclasts.
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Venous thromboembolism (VTE) is a kind of venous disorder that the abnormal condensation of blood within the vein,leading to complete or incomplete vein obstruction.VTE is mainly a combination of deep vein thrombosis (DVT)and pulmonary embolism (PE) and is an important complication after major orthopedic surgery (total hip arthroplasty,total knee arthroplasty,hip fracture surgery).Foreign literature reported that incidence rate of VTE after arthroplasty was as high as 42％-57％.Conventional notion was that DVT and PE were two different but interrelated types of VTE,while the latest research reported that the formation of DVT and PE after arthroplasty may be two events individually.Prevention of VTE after major orthopedic surgery includes general,pharmacological and mechanical methods.The efficacy of physical combined with pharmacological methods was better than drug prevention alone in preventing distal DVT.Dabigatran,apixaban,rivaroxaban and other new oral anticoagulants were better than low molecular weight heparin and other traditional medicines in effectiveness and safety.The effects of low molecular weight heparin are remarkable,while it cannot take orally.A recent study found that staged VTE prophylaxis,namely patients received low molecular weight heparin injection in hospital,and received aspirin,rivaroxaban or dabigatran orally after discharge is safe and effective in prevention of VTE.
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Objective To investigate the effect of ERK1/2 phosphorylation on the proliferation of human aorta vascular smooth muscle cells (HAVSMCs) stimulated by advanced glycation end products (AGEs) Methods CCK8 was used to test the effect of AGEs with different concentration on the proliferation of HAVSMCs, and the effect of PD98059, a specific inhibitor of ERK1/2, on HAVSMCs proliferation stimulated by AGEs was also detected. Flow Cytometer (FCM) was used to detect the cell cycle transformation induced by AGEs. Western Blot was used to detect the expression of relative proteins. Results 10 mg/L AGEs observably facilitated the proliferation and the DNA synthesis of HAVSMCs and PD98059 (40 umol/L) markedly inhibited the proliferation and cell cycle evolution of HAVSMCs induced by AGEs. Furthermore, ERK1/2 phosphorylation, and PCNA were regulated by AGEs and thus it showed time and dose dependent. Conclusion AGEs participates in the proliferation of HAVSMCs by activating ERK1/2 signal path.
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Objective To explore the angiogenesis&neovascularization effects of naringin treatment in ovariectomized rats’fracture healing. Methods Upper 1/3 transverse tibial fracture model 4 weeks later after ovariectomized were estimated and randomly divided into the naringin group and control group. Microfil perfusion technique was used to analysis the angiogene?sis situation at two weeks after bone fracture. HE staining was used to evaluate the level of angiogenesis&neovascularization of tis?sue from histological point of view. The relative expression of VEGF in the callus was identified by real?time polymerase chain re?action. Immunohistochemical technique was used to observe the vessel endothelial growth factor?2 in the callus of the two groups. Maximum fracture load was tested by three?point bend test. Results The vascular volume and vascular density were more in nar?ingin group than control group. The HE staining of the 2 week group slices shows that the VA, VN2 of the unit of high magnifica?tion vision of the naringin group was significantly larger compared to the control group. Real?time PCR revealed that the compara?tive expression of VEGF is more in naringin group than in control group; the positive number of VEGFR?2 is more in naringin group than in control group. Naringin can promote the maximum load of the callus. Conclusion Naringin can promote ovariecto?mized rats’angiogenesis&neovascularization in the early process of fracture healing. It may be act on the signaling pathway of VEGF/VEGFR?2.
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Objective To investigate the role of Wnt signaling pathway hypofunction mediated by dephosphorylation ofβ-catenin in the impaired wound healing of type 1 diabetic rats. Methods The back skin defect wounds were produced in rats with type 1 diabetes. These rats were divided into control, diabetes, lithium chloride treatment, and epidermal growth factor ( EGF) treatment groups. The situation of back wound healing, the ratio ofβ-catenin positive cells,β-catenin, phosphorylatedβ-catenin, and vascular endothelial growth factor ( VEGF) levels were detected. Results Compared to diabetes group, the wound granulation tissue was more mature, wound healing time was shorter, and healing rate, as well as the ratio ofβ-catenin positive cells, dephosphorylatedβ-catenin, and VEGF levels, were higher in normal group, lithium chloride treatment group, and EGF treatment group ( P<0. 05 or P<0. 01). Conclusion The hypofunction of Wnt signaling pathway is involved in the process of wound healing in type 1 diabetic rats, of which the dephosphorylation ofβ-catenin is the key point. EGF may play a beneficial role in the wound healing of type 1 diabetic rat models via Wnt pathway.
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Objective To investigate the clinical efficacy of radiofrequency surgical therapy combined with ozone for patients with discogenic low back pain. Methods The clinical data were collected in 120 patients treated with radiofrequen?cy and ozone for lumbar disc herniation at Tianjin Hospital from October 2013 to October 2015. Pain visual analogue scale (VAS) was used to patients at preoperative and postoperative 1 week, 1, 3, 6 and 12 months. Health survey (SF-36) score was used at preoperative and postoperative six months. The efficacy was evaluated by MacNab curative effect evaluation. Re?sults The preoperative VAS score was (7.02±0.64) points. The postoperative VAS scores were (3.13±0.32) points, (2.11± 0.67) points,(2.62±0.89) points,(2.37±0.34) points and (2.31±0.50) points at one week, one month, three months, six months and twelve months, respectively. The VAS scores were significantly decreased after surgery (P<0.05). Preoperative SF-36 score was (48.32 ± 7.46) points, which reached to the (82.03 ± 5.89) points six months after surgery (P < 0.05). After six months, the fineness rate reached to 89.17%evaluated by MacNab curative effect evaluation. Conclusion Radiofrequency combined with ozone treatment is an effective and reliable method for discogenic low back pain.
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Objective To investigate the application efficacy of disposable circumcision stapler with compound lidocaine cream combined with lidocaine injection in the circumcision.Methods From September 2013 to November 2014,120 cases (11 cases of redundant prepuce phimosis patients), were divided into disposable circumcision suture group (S group, 60 cases) and conventional circumcision (T group, 60 eases) ,two groups had no statistically significant difference at patient age and wrapping case (6 cases phimosis of S group,5 cases phimosis of T group) (P ＞0.05.Patient's age ranged from 11 to 49 years.30 patients in each group were treated with lidocaine cream combined with lidocaine injection,and another 30 patients were treated with a local anesthetic lidocaine injection.Comparisons were conducted among the four groups on the operation time, anesthesia, intraoperative and postoperative pain score, blood loss and postoperative complications, postoperative appearance satisfaction, wound healing time.Results For the disposable circumcision stapler with lidocaine cream combined with lidocaine injection group, disposable circumcision stapler with lidocaine injection group, sleeve circumcision with lidocaine cream combined with lidocaine injection group and sleeve circumcision with lidocaine injection group, the operation time was (5.3 ± 1.5) min, (4.9 ± 1.4) min, (31.6 ± 3.4) min, (32.0 ± 3.3) min respectively, blood loss was (0.6 ± 0.4) ml, (0.8 ± 0.5) ml, (6.9 ± 2.4) ml, (7.5 ± 2.1) ml respectively, narcotic pain score was 0.6 ± 0.6,3.2 ±3.9,2.5 ± 1.0,0.5 ±0.6,intraoperative pain score was 0.8 ±0.9,1.4 ±0.8,2.2 ± 1.1,3.1 ± 1.1,postoperative 24 h pain score was 1.6 ±0.9,2.2 ±0.8,2.6 ± 1.3,4.4 ± 1.1, postoperative 48h pain score was 0.7 ±0.6,0.8 ±0.9,2.4 ±0.8,2.8 ±0.7, wound healing time was (13.7 ±1.5)d,(13.5 ± 1.7)d, (14.2 ± 1.3) d, (14.1 ± 1.6) d, the rate of postoperative complications was 6.6％ (2/30), 10.0％ (3/30),26.6％ (8/30), 33.4％ (10/30), satisfaction rate of appearance was 93.4％ (28/30), 96.7％ (29/30),70.4％ (22/30), 80.0％ (24/30).Compared with sleeve circumcision with lidocain injection group,disposable circumcision stapler with lidocaine cream combined with lidocaine injection had a shorter operation time, less pain, less bleeding, higher appearance satisfaction rate and lower incidence of complications (P ＜ 0.05), wound healing time had no significant difference (P ＞ 0.05).Conclusion Application of the disposable circumcision stapler with lidocaine cream combined with lidocaine injection on circumcision is safe and has got better clinical outcomes.