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Objective To evaluate the clinical characterisitics of polyarteritis nodosa (PAN) patients with acromelic gangrene,and to improve the understanding of this disease by clinicians.Methods The clinical and laboratory data of PAN patients with acromelic gangrene admitted to Peking Union Medical College Hospital (PUMCH) between November 1986 to October 2016 were collected and summarized.According to the ratio of 1∶2,PAN patients without acromelic gangrene during the same period were randomly selected and compared with patients with acromelic gangrene.The comparison of the demographic data,system involvement,laboratory and other auxiliary examination results,the treatment were included in this study.All data were analyzed by SPSS 19.0 statistical software.T test,Mann Whitney U test,x2 test were used for statistical analyses.Results Among 204 PAN patients admitted to PUMCH during this period,22 cases were complicated with gangrenes.In PAN patients with gangrenes,-male/female ratio was 4.5/1,the mean age was (43±19) years,and the disease duration (from onset of disease to gangrene) was 3.5 months (ranged from 1 week to 20 years).Simple finger gangrenes occurred in 7 cases(32％),simple toe gangrenes in 8 cases (36％),both gangrenes in 7 cases (32％).In the involvements of limb arteries,15 cases (68％) were posterior tibial artery involvement,12 cases (55％) were anterior tibial artery involvement,10 cases (45％) were radial artery involvement,7 cases (32％) were ulnar artery involvement,5 cases (23％) were peroneal artery involvement,5 cases (23％) were superficial femoral artery involvement,4 cases (18％) were dorsal foot artery involvement,3 cases (14％) were popliteal artery involvement,1 case (5％) was anterior interosseous artery involvement.There were significant difference in PAN patients with and without acromelic gangrene as patients with acromelic gangrene were more prone to arthritis/pain (45％ vs 2％;x2=16.71,P＜0.01),new-onset hypertension (41％ vs 7％;x2=9.28,P＜0.01),intestinal bleeding/perforation (41％ vs 14％;x2=6.21,P=0.01),increased eosinophils (55％ vs 7％;x2=19.02,P＜0.01),artery (91％ vs 27％;x2=23.78,P＜0.01) involvement in extremities,head and neck (41％ vs 18％;x2=3.96,P=0.05),arteriovenous thrombosis (27％ vs 2％;x2=7.21,P=0.007),glucocorticoid pulse therapy (73％ vs 14％;x2=23.05,P＜0.01).Conclusion PAN patients with acromelic gangrene have significant increase of eosinophils and widespread internal organ ischemia.Aggressive treatment should be taken in these patients.
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As one of the most important treatment strategies in clinic, surgery has improved to be more and more efficient and safe. However, the infection risk of incision caused by surgery is still the main concern of patients. In our research, we found extract of Rheum rhabarbarum [rhubarb] could be used to diminish this risk through promoting the healing of the incision. Using MTT assay, flow cytometry and clinical statics, we also tried to explore the mechanism of rhubarb's effect. The data showed that rhubarb extract decreased the number of leukocytesand neutrophils and inhibited the growth of bacteria. Moreover, the vascular endothelial cells cultured in medium containing rhubarb extract grow faster than control. The flow cytometry also demonstrates that the ratio of cells in S and G2/M phase increase after treated with rhubarb extract. There after, we hypothesize that rhubarb extract can promote incision healing through relieving inflammation and stimulating angiogenesis
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Objective To sudy the changes in mTOR signaling pathway in childhood aplastic anemia(AA) by detecting the expression levels of the molecules of mTOR signaling pathway in T cells,and to explore immunologoical pathogenesis of AA in children from T cell intracellular signal transduction pathway.Methods Peripheral blood samples were collected from 16 newly diagnosed severe AA(SAA) patients and 8 patiens treated with effective immunosuppressive therapy,and the findings were compared with those of 17 healthy children (normal controls) and CEM cells (positive controls).The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K in CD3 + T cells in peripheral blood were detected by flow cytometry(FCM).Results 1.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,pp70S6K of the newly diagnosed SAA group were higher than those of the normal control group (P ＜ 0.05),but were lower than the postive control group (CEM group) (P ＜ 0.05).The mean fluorescence intensity (MFI) of p-Akt of three groups was 8.04 ± 3.78,2.59 ± 1.01 and 20.23 ± 8.98 respectively ;p-TSC2 was 49.73 ± 19.49,16.10 ± 8.04 and 101.05 ± 29.78 respectively ; p-mTOR was 13.90 ± 9.32,2.92 ± 1.09 and 34.3 ± 19.03 ;p-4EBP1 was 142.69 ± 53.36,26.91 ± 13.70,256.01 ± 53.79 ; p-p70S6 K were 17.67 ± 10.48,3.69 ± 2.22,31.73 ± 12.85 respectively.2.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K of the effective treatment groups were lower than those of the newly diagnosed SAA group (P ＜ 0.05) ; the expressions of p-Akt,p-TSC2,p-mTORC1,p-p70S6K were similar to those of the normal control group(P ＞ 0.05),but the expressions of p-4EBP1 were higher(P ＜ 0.05).The MFI was followed by 3.28 ± 1.27,16.50 ± 10.91,3.54 ± 1.66,74.89 ± 49.69 and 4.21 ± 1.69.Conclusions 1.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K were increased in the newly diagnosed SAA patients,the mTOR signaling pathway was activated in SAA patients.2.The expressions of p-Akt,p-TSC2,p-mTORC1,p4EBP1,p-p70S6K were lower than those of the newly diagnosed SAA patients.The degree of activation of mTOR signaling pathway was associated with disease status.The signaling pathways may be involved in the T cells of AA of the immune abnormalities.
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Objective To investigate the efficacy of dexmedetomidine as an adjunct to combined intravenous-inhalational anesthesia for removal of foreign body in the trachea in children.Methods Sixty ASA Ⅰ or Ⅱ children,aged 1-4 yr,weighing 8-23 kg,were randomly divided into 2 groups(n =30 each):combined intravenous-inhalational anesthesia group(group Ⅰ)and dexmedetomidine as an adjunct to combined intravenous-inhalational anesthesia group(group Ⅱ).In group Ⅱ,8％ sevoflurane was inhaled by mask to induce sleep after entering the operating room,and the concentration was reduced to 4％ after the children sere asleep.Anesthesia was maintained with iv infusion of dexmedetomidine 0.5 μg/kg,and then iv injection of propofo1 2 mg/kg,followed by iv infusion of propofol at 6 rag· kg-1· h-1 and remifentanil at 0-15 μg· kg-1 ·min-t.In group Ⅰ,dexmedetomidine was not used and the other procedures were the same as those in group Ⅱ.Sevoflurane inhalation was stopped 2 min later and the rigid bronchoscope was inserted.HR and SpO2 were monitored and recorded before insertion and at 1 and 5 min after insertion.Complications such as respiratory depression,laryngeal edema,and bradycardia were reconded.The amount of propofol and remifentanil consumed,satisfactory level of bronchoscopy,and emergence time were recorded after operation.Results Compared with group Ⅰ,HR was significantly decreased at 1 and 5 min after insertion,SpO2 was significantly increased at 1 min after insertion,the amount of propofol and remifentanil consumed was significantly reduced,the operation time was significantly shortened,the emergence time was significanlly prolonged,the satisfactory level of bronchoscopy was significandy increased,and the incidence of respiratory depression and laryngeal edema was significantly decreased in grmp Ⅱ(P ＜ 0.05).Conclnslon The efficacy of dexmedetomidine as an adjunct to combined intravenous-inhalational anesthesia is better than that of combined intravenous-inhalational anesthesia for removal of foreign body in the trachea in children,with fewer complications.
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Objective To study the function of vascular endothelial growth factor (VEGF) in type 2 diabetes model rats and its effect on focal cerebral ischemia induced by middle cerebral artery occlusion in these rats. Methods Focal cerebral ischemia was induced by middle cerebral artery occlusion for 6 hours in type 2 diabetes rats and normal control rats.Blood vessels morphology was examined by ink perfusion,infarct size was measured by TTC and expression of VEGF and CD34 were evaluated by immunohistochemistry staining. Results Ink perfusion revealed increased number of small vessels in type 2 diabetes rats. Infarct size was significantly smaller in type 2 diabetes rats ( ( 80. 07 ± 11.21 ) mm3 ) than that in normal controls ((98. 91 ± 14. 86) mm3,t = 2.48,P = 0. 0326). There were more hemorrhage lesions in the ischemic hemisphere in type 2 diabetes rats when comparing with the controls. VEGF and CD34 showed significantly higher expression in type 2 diabetes rats than in normal controls. Conclusions High expression of VEGF and CD34 are found in type 2 diabetes rats after middle cerebral artery occlusion. There is cerebrolvascular remodeling in diabetes rats. While this diabetes-induced remodeling appears to prevent infarct expansion,the changes also increase the risk of hemorrhagic transformation. The latter may result in poor prognosis.
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OBJECTIVE@#Audiometric configuration distribution of hearing loss was analyzed for public policy efforts of hearing loss prevention and rehabilitation.@*METHOD@#According to the archived records of the Clinical Audiology Center of Beijing Tongren Hospital, Capital Medical University, audiometric configuration distribution was analyzed by different type,degree of hearing loss and age factor.@*RESULT@#1. Overall audiometric configuration distribution: the percentages of "sloping", "rising", "flat", "U-shaped", and other type of audiometric configuration distributions are 52.8%, 7.6%, 15.4%, 13.2% and 11.0%, respectively. No difference was found between male and female in the audiometric configuration distribution; 2. Audiometric configuration distribution by type of hearing loss: sloping hearing loss dominants sensorineural and mixed hearing loss; 3. Audiometric configuration distribution by degree of hearing loss: sloping hearing loss dominants mild, moderate and severe hearing loss, U-shaped hearing loss dominants profound hearing loss; 4. Audiometric configuration distribution by age: for age group 5 to 7, the highest prevalence of audiometric configuration is "sloping", followed by "flat", "U-shaped", other type and "rising"; with the age increasing, the percentage of sloping hearing loss increased dramatically.@*CONCLUSION@#Audiometric configuration distribution shows obvious characteristic of on the type, degree of hearing loss and age factor. "sloping" hearing loss dominates the audiometric configuration.