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Objective:To determine the expression of Sprouty in skin lesions of patients with psoriasis vulgaris, and to investigate its correlation with the severity of psoriasis.Methods:From May 2018 to November 2018, 15 lesional skin samples and 10 normal skin samples were collected from patients with psoriasis vulgaris and healthy controls respectively in Dermatology Hospital of Southern Medical University. Immunohistochemical study was performed to determine the distribution of Sprouty1, 2 and 4 proteins in psoriatic lesions and normal skin tissues, Western blot analysis to determine the protein expression of Sprouty1, 2 and 4, reverse transcription (RT) -PCR to measure the mRNA expression of Sprouty1, 2 and 4. Pearson correlation analysis was used to analyze the correlation between Sprouty protein expression and psoriasis area and severity index (PASI) scores.Results:Immunohistochemical study showed that Sprouty1, 2 and 4 were all expressed in psoriatic lesions and normal skin tissues. Sprouty1 was strongly expressed in the cell membrane and cytoplasm of granular layer cells in the control group, but slightly expressed in the cell membrane of granular layer cells in the psoriasis group. Sprouty4 was more strongly expressed in the psoriasis group than in the control group, and Sprouty2 was slightly expressed in both the 2 groups. RT-PCR and Western blot analysis showed that Sprouty1 mRNA and protein were both expressed in the psoriasis group and control group, and significantly lower in the psoriasis group (0.844 ± 0.169, 0.148 ± 0.141 respectively) than in the control group (0.972 ± 0.105, 0.413 ± 0.108 respectively, both P < 0.05) ; the Sprouty1 protein expression was negatively correlated with the PASI score in the psoriasis group ( r = -0.628, P = 0.012) . The psoriasis group showed significantly increased protein and mRNA expression of Sprouty4 (1.306 ± 0.283, 1.727 ± 1.017 respectively) compared with the control group (0.584 ± 0.304, 0.714 ± 0.615, t = 6.063, 2.814, respectively, both P < 0.05) , and the Sprouty4 protein expression was positively correlated with the PASI score in the psoriasis group ( r = 0.812, P < 0.001) . The Sprouty2 protein and mRNA were slightly expressed in the 2 groups, and no significant difference was observed between the 2 groups (both P > 0.05) ; there was no significant correlation between the Sprouty2 protein expression and PASI score ( r = 0.436, P = 0.104) . Conclusion:The protein expression of Sprouty1 and 4 in the psoriatic lesions is correlated with the PASI score, suggesting that Sprouty1 and 4 are related to the occurrence of psoriasis.
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Objective:To report on 3 patients who presented with rupture of hepatic artery pseudoaneurysm after liver transplantation.Methods:From April 2010 to April 2019, 3 patients with hepatic artery pseudoaneurysm rupture after liver transplantation treated at the Department of Hepatobiliary and Pancreatic Surgery, Henan Provincial People's Hospital were studied. The possible causes, clinical manifestations, diagnosis and treatment were retrospectively analyzed.Results:Rupture of hepatic artery pseudoaneurysm occurred on the19th, 28th and 63th days after transplantation. The 3 patients all presented with hematochezia and abdominal pain, while 2 patients presented with hematemesis. Two patients had bile leakage and abdominal infection. All the 3 patients presented with fever. Patient 1 who was diagnosed by laparotomy died of liver failure. Patient 2 underwent interventional embolization of hepatic artery and died of liver failure also. Patient 3 underwent surgical resection of the pseudoaneurysm followed by hepatic artery reconstruction, but died of repeat abdominal hemorrhage.Conclusion:Hepatic artery pseudoaneurysm after liver transplantation has a long latent period and is difficult to diagnose at an early stage. Early detection of this life-threatening complication is the key to improve survival. Early treatment of biliary leakage, abdominal infection and other complications help to prevent development of pseudoaneurysms.
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To evaluate the clinical effect of digital assisted chimeric deep circumflex iliac artery perforator flap (DCIAPF) in the reconstruction of mandibular composite defects. Methods From January, 2018 to January, 2019, 6 cases of mandibular tumor patients with postoperative defect within side were treated. Preoperative CTA was used to evaluate the deep branches of spin iliac artery.Digital simulation software and 3D printing technolo-gy was taken, vascularized iliac flap of the design guide of bone was made, and the rebuilding effect was simulated. DCIAPF was used to repair the defect of lower jawbone. The donor sites were sutured directly. The patients were fol-lowed-up in outpatient department for 3-6 months to evaluate the recovery of the patient′s shape, jaw height and oc-clusal function, as well as the complications in the donor area. Results Postoperation pathological examination re-sults: ameloblastoma in 2 cases, 4 cases of gingival cancer. The length of cut out ilium was 6.0-13.0 cm, carrying the flap area of 3.0 cm×1.0 cm-6.0 cm×5.0 cm.Six cases of DCIAPF and iliac bone flap survived.The shape, mandibular height and occlusal function were satisfactory.And no obvious complications were found in the donor area. Conclu-sion The blood supply of DCIAPF is rich with enough bone mass and height. The position of terminal skin perfora-tors is invariant. The complications of donor sites is less. With the help of digital technology, the accuracy of mandibular defect repair and the 3-dimensional wound repair can be realized, and provides an advantage condition for subsequent dental implant.It is one of the ideal method of reconstruction of mandibular defect.
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Objective To investigate changes in serum levels of antinuclear antibody(ANA), anti?double?stranded DNA(dsDNA)antibody and anti?extractable nuclear antigen(ENA)antibody before and after anti?tumor necrosis factor?α(TNF?α)therapy in psoriatic patients. Methods Clinical data obtained from 32 patients with psoriasis were analyzed retrospectively. Of the 32 patients, 13 received intravenous injection of 5 mg/Kg infliximab at week 0, 2, 6 for 3 sessions, then once every 8 weeks(infliximab group), while other 19 received subcutaneous injection of 25 mg etanercept twice every week(etanercept group). The treatments in the 2 groups both lasted more than 3 months. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody and changes of clinical symptoms were detected and observed respectively before each treatment in the infliximab group, as well as every 3- 6 months in the etanercept group. The 75%reduction in psoriasis area and severity index(PASI75)and disease activity score of 28 joints(DAS28) were used to evaluate clinical efficacy. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody were measured by indirect immunofluorescence(IIF)assay, Western blot analysis combined with enzyme?linked immunosorbent assay(ELISA), and Western blot analysis, respectively. Results After 3?month treatment, the 32 patients achieved clinical remission to different extents. Of 32 patients receiving anti?TNF?αtherapy, 7(21.9%)developed new autoantibodies. Concretely speaking, 4 patients in the infliximab group developed autoantibodies in 8.3 ± 5.1 months, including 3 cases positive for ANA and 3 for anti?ENA antibody. Three patients in the etanercept group developed autoantibodies in 9.0 ± 3.0 months, including 3 cases positive for ANA and 1 for anti?ENA antibody. Conclusion Partial patients with psoriasis may develop autoantibodies after anti?TNF?αtherapy.
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Objective To investigate microRNA(miRNA)expression profiles in peripheral blood and skin lesions of patients with psoriasis vulgaris(PV), and to seek miRNAs consistently expressed in peripheral blood and skin lesions. Methods A miRNA microarray was used to screen differentially expressed miRNAs in skin lesions and peripheral blood samples between 17 patients with PV and 4 healthy human controls, and real?time fluorescence?based quantitative PCR(RT?qPCR)to verify the differentially expressed miRNAs. The correlations of these differentially expressed miRNAs with psoriasis area and severity index(PASI)score were assessed by Pearson correlation analysis. Results The Agilent human miRNA microarray profiling revealed 15 miRNAs consistently expressed in skin lesions and peripheral blood of patients with PV. Of the 15 miRNAs, 7 were verified as consistently expressed miRNAs by RT?qPCR. Among the 7 miRNAs, the expression intensity of miR?30e?5p, miR?192?5p, miR?17?3p and miR?1227?5p was negatively correlated with PASI scores(all P0.05). Conclusion Some miRNAs are consistently expressed in skin lesions and plasma of PV patients, which are expected to serve as biomarkers for evaluation of psoriasis severity.
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Objective To determine the frequency of T helper type 22 (Th22) cells and expression level of interleukin-22 (IL-22) in peripheral blood of patients with psoriasis vulgaris,and to investigate their relationship with disease severity and clinical course.Methods Peripheral blood samples were obtained from 40 patients with psoriasis vulgaris and 30 healthy human controls.Five-color flow cytometry was performed to determine the percentage of Th22 cells in peripheral blood,and enzyme-linked immunosorbent assay (ELISA) to measure the expression of serum IL-22.Statistical analysis was carried out by t test and Pearson correlation analysis.Results Both the percentage of Th22 cells and serum level of IL-22 in peripheral blood were significantly higher in patients with psoriasis vulgaris than in healthy human controls (Th22 cells:0.65％ ± 0.48％ vs.0.33％ ± 0.15％,t =3.89,P ＜ 0.01; IL-22:(67.96 ± 14.32) vs.(40.59 ± 9.91) ng/L,t =9.45,P ＜ 0.01).Further more,Th22 cell percentage and IL-22 serum level in peripheral blood were both positively correlated with psoriasis area and severity index (PASI) in these patients (r =0.38,0.94,P ＜ 0.05 and 0.01,respectively),but neither of them correlated with clinical course of psoriasis vulgaris (r =0.20,0.10,respectively,both P ＞ 0.05).Conclusions The percentage of Th22 cells and level of IL-22 are increased in peripheral blood of patients with psoriasis vulgaris,and both of them are correlated with disease severity.
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Background and purpose: Regional lymph node metastasis was significantly associated with the prognosis of patients with non-small cell lung cancer (NSCLC). This study was designed to compare paclitaxel liposome plus cisplatin (LP) with gemcitabine and cisplatin (GP) in patients with regional lymph node metastasis of advanced NSCLC as a ifrst-line treatment. Methods:A total of 55 patients were randomly assigned to receive either liposomal paclitaxel (175 mg/m2) and cisplatin (75 mg/m2) or gemcitabine (1 000 mg/m2) and cisplatin (75 mg/m2) every 3 weeks. Results:Objective response rate (ORR) of lung primary foci was 37.9%in the LP arm and 30.8%in the GP arm (P>0.05) and the disease control rate (DCR) was 91.3%and 80.8%respectively (P>0.05);ORR of regional metastasis lymph node was higher in the LP arm (44.8%vs 15.4%, P0.05). Conclusion: Liposomal paclitaxel plus cisplatin is superior to gemcitabine plus cisplatin with less toxicity and better tolerated, it deserves further research and clinic application for patients with regional lymph node metastasis of advanced NSCLC.
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BACKGROUND:The incidence of intestinal necrosis during liver transplantation is low, and most of them abandon transplantation and thus leading to death. OBJECTIVE:To retrospectively analyze the reasons which result in smal intestinal necrosis during liver transplantation, and to explore the viable treatment options. METHODS:The clinical data of 207 patients were reviewed, two patients complicated with smal intestinal necrosis during liver transplantation. Case 1 underwent liver transplantation combined with necrotic smal bowel resection. Case 2 abandoned liver transplantation, and received conservative treatment. RESULTS AND CONCLUSION:Both of the two patients had preoperative portal system thrombosis. In Case 1, there was upper gastrointestinal bleeding before transplantation, and repeated application of hemostatic drugs could increase the thrombosis and thus resulting smal intestinal necrosis. At 10 days after liver transplantation, the patients complicated with intestinal fistula and were treated with fistulation. After fistulation, the patient suffered from abdominal cavity and lung infections. At 7 days after anti-infection treatment and immunosuppressant stopped, the infections were cured. At 40 days after fistulation, the intestinal fistula was healed and the patient was discharged after rehabilitation. After fol owed-up for 2 years, the patient was stil healthy living. The Case 2 suffered with mass ascites which lead to abdominal compartment syndrome, the intestinal venous disorders lead to extensive smal bowel necrosis. At 2 days after abandon the liver transplantation, the patient was dead because of multiple organ failure. The patients who waiting for liver transplantation had preoperative portal system thrombosis, abdominal pain and abdominal distention, should be pay attention to intestinal necrosis. Patients with smal bowel necrosis during liver transplantation can be cured with liver transplantation combined with necrotic smal bowel resection.
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Objective To detect the quantity of Th17 cells and expressions of related cytokines including interleukin (IL)-17 and IL-22, in peripheral blood and skin lesions of patients with psoriasis vulgaris, and to analyze their correlation with disease severity and clinical course. Methods Peripheral blood was obtained from 44 patients with progressive psoriasis vulgaris and 28 normal human controls. Three-color flow cytometry was carried out to detect the quantity of Th17 cells, and ELISA to examine the levels of serum IL-17 and -22.Skin samples were obtained from 20 patients with psoriasis vulgaris and 8 normal human controls, and a quantum dot-based double labled immumofluorescence method was used to determine the quantity of Th17 cells.Results The percentage of peripheral blood Th17 cells was higher in patients with psoriasis vulgaris than in normal human controls (4.71% ± 2.55% vs. 0.55% ± 0.39%, P ＜ 0.01 ). Elevated expressions of IL-17 and IL-22 were noted in the patients compared with the normal human controls (24.02 ± 12.31 ng/L vs. 7.16 ±4.04 ng/L, P ＜ 0.05; 18.32 ± 8.14 ng/L vs. 6.52 ± 4.15 ng/L, P ＜ 0.01 ). The percentage of peripheral blood Th17 cells and serum levels of IL-17 and IL-22 were positively correlated with psoriasis area and severity index (r= 0.53, 0.47, 0.53, respectively, all P ＜ 0.01 ), but unrelated to the clinical course of psoriasis (r = 0.09,0.03, 0.19, respectively, all P ＞ 0.05). There was an infiltrate of Th17 cells in psoriatic lesions, which was mainly distributed around the blood vessels in superficial dermis, whereas there were only a small number of CD4+ T cells in the normal control skin with the absence of Th17 cells. Conclusions Th17 cells are involved in the development of psoriasis, and Th17 cell-secreted cytokines, such as IL-17 and IL-22, may serve as a new therapeutic target for psoriasis.
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BACKGROUND: Bone tissue engineering materials/call complex has been able to live in the muscle, subcutanecus tissue, ano other heterotopic bones, or in small mammals to repair bone defect. However, there is still much practical and clinical gap, such as bone tissue engineering and technical ability to repair large bone defects in big mammals, as well as how to promote the in vivo tissue-angineerad bone revascularization process.OBJECTIVE: To observe the bone formation using beagle deep fascia pedicled flap and tissue-engineered bone.METHODS: Beagle bone marrow mesenchymal stem calls were isolated, cultured, and inoculated on poly-lactone (PCL).Bone/bone membrane defect was induced in middle tibia on the left side of beagle. Then, the defect was implanted with fascia-encapsulated bone marrow mesenchymal stem cells (BMSCs), considering as experimental group. The second defect was induced in the middle tibia on the right side of beagle and implanted with BMSCs/PCL, considering as control group. The third defect was induced in 2 additional beagles without any implantation, considering as blank control group. Gross observation, X-ray test, histology, and magnetic resonance perfusion imaging were performed on the models to observe growth and ostecblasts andvasculadzation. RESULTS AND CONCLUSION: There was no new bone formation and blood vessels growth in the blank control group, and the defect was filled by fiber scar tissues finally. After 8-16 weeks, the bone defect was gradually filled by bony tissue, and more calluses which grew in implants were observed. The broken ends of fractured bone were not intact, and pulp cavity was sclerotic.Bone formation in the experimental group was rapid than in the control group. After 6 weeks, a great quantity of calluses was observed; after 8 weeks, stant materials were completely degraded; after 12 weeks, bone defect was succassfully repaired. A greet quantity of cancallated bones was observed, the newborn cavitas medullaris was smooth, and cortical bone was successive and stable. The amount, pore diameter, and distribution of formed blood vessels in the experimental group were superior to those in the control group, suggesting that tissue-engineered bone was able to effectively and rapidly repair bone defect in some animal.Fascia flap could promote the revascularization in vivo of tissue-engineered bone.
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A 51-year-old man presented with multiple, disseminated dark erythematous maculopapules and nodules over the body surface for more than 1 year. Initially, the patient presented with dark erythematous macules on the trunk without discomfort. Then, lesions gradually spread over the whole body surface with the development of tenderness. Physical examination revealed multiple disseminated dark erythematous, well-demarcated maculopapules, infiltrative plaques and subcutaneous nodules on the face, neck, trunk, upper and lower limbs. Some lesions were tender on palpation. An enlarged cherry-like lymph node was detected on the right inguina. Bone marrow inspiration showed that lymphocytes amounted to 32.5%, and naive lymphocytes accounted for 10%. These lymphocytes varied in size with irregular shape, moderate amount of basophilic cytoplasm, irregular nuclei and granular chromatin. Histopathological examination revealed diffuse infiltrate of numerous medium-sized atypical blastic cells with irregular nuclei in superficial dermis and subcutaneous fat tissue. The blastic cells showed sparse fine-granular chromatin, obscure nucleoli and obvious karyokinesis. Immunophenotype examination showed that tumor cells were strongly positive for CD4, CD56 and CD43, weakly positive for CD68 and terminal deoxynucleotidyl transferase, but negative for L26, CD3, CD38, granzyme B and myeloperoxidase. The diagnosis of BPDCN is confirmed based on typical clinical features, histopathology and immunohistology findings.
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Objective To explore the changes of several sero-enzyme activity including lactate dehydrogenase (LDH),aspartate aminotransferase(AST),alanine aminotransferase (ALT),creeatine phosphatase kinase (CPK) and its isoenzyme (CK-MB),?-hdroxybutyrate dehydrogenase (HBDH) in patients with chronic cor disease and its clinical significance. Methods The sera LDH,AST,ALT,CPK,CPK-MB and HBDH from 15 healthy controls and 61 patients with chronic cor disease were examined before and after treatment.CPK-MB/CPK and HBDH/LDH were calculated and simultaneously the blood gas analysis was performed. Results In experimental group all the sera enzymes contents before treatment were significantly higher than those after treatment (P