Clinical Comparison of the Efficacy of Systemic Thrombolysis,Catheter-Directed Thrombolysis,and AngioJet Percutaneous Mechanical Thrombectomy in Acute Lower Extremity Deep Venous Thrombosis / 中国医学科学院学报

Objective To compare the clinical effects of three treatment methods including systemic thrombolysis(ST),catheter-directed thrombolysis(CDT),and AngioJet percutaneous mechanical thrombectomy(PMT)in acute lower extremity deep venous thrombosis(LEDVT). Methods The data of 82 patients diagnosed with LEDVT in the Department of Vascular and Gland Surgery of the First Affiliated Hospital of Hebei North University from January 2017 to December 2020 were collected.The patients were assigned into a ST group(n=50),a CDT group(n=16),and a PMT group(n=16)according to different treatment methods.The efficacy and safety were compared among the three groups. Results Compared with that before treatment,the circumferential diameter difference of both lower limbs on days 1,2,and 3 of treatment in the ST,CDT,and PMT groups reduced(all P<0.001).The PMT group showed smaller circumferential diameter difference of lower limbs on days 1,2,and 3 of treatment than the ST group(all P<0.001)and smaller circumferential diameter difference of the lower patellar margin on day 1 of treatment than the CDT group(P<0.001).The PMT group showed higher diminution rate for swelling of the affected limb at the upper and lower edges of the patella than the ST group(P<0.001)and higher diminution rate for swelling at the upper edge of the patella than the CDT group(P=0.026).The incidence of complications after treatment showed no significant differences among the three groups(all P>0.05).The median of hospital stay in the PMT group was shorter than that in the ST and CDT groups(P=0.002,P=0.001).The PMT group had higher thrombus clearance rate than the ST group(P=0.002)and no significant difference in the thrombus clearance rate from the CDT group(P=0.361).The vascular recanalization rates in the PMT(all P<0.001)and CDT(P<0.001,P=0.002,P=0.009)groups 3,6,and 12 months after treatment were higher than those in ST group,and there were no significant differences between PMT and CDT groups(P=0.341,P=0.210,P=0.341). Conclusions ST,CDT,and PMT demonstrated significant efficacy in the treatment of LEDVT,and PMT was superior to ST and CDT in terms of circumferential diameter difference of the lower limbs,diminution rate for swelling of the affected limb,thrombus clearance rate,length of hospital stay,and long-term vascular recanalization.There was no obvious difference in safety among the three therapies.

Pictorial Review of Mediastinal Masses with an Emphasis on Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) has become a crucial tool for evaluating mediastinal masses considering that several lesions that appear indeterminate on computed tomography and radiography can be differentiated on MRI. Using a three-compartment model to localize the mass and employing a basic knowledge of MRI, radiologists can easily diagnose mediastinal masses. Here, we review the use of MRI in evaluating mediastinal masses and present the images of various mediastinal masses categorized using the International Thymic Malignancy Interest Group’s three-compartment classification system. These masses include thymic hyperplasia, thymic cyst, pericardial cyst, thymoma, mediastinal hemangioma, lymphoma, mature teratoma, bronchogenic cyst, esophageal duplication cyst, mediastinal thyroid carcinoma originating from ectopic thyroid tissue, mediastinal liposarcoma, mediastinal pancreatic pseudocyst, neurogenic tumor, meningocele, and plasmacytoma.

Tau-Induced Ca/Calmodulin-Dependent Protein Kinase-IV Activation Aggravates Nuclear Tau Hyperphosphorylation / 神经科学通报·英文版

Hyperphosphorylated tau is the major protein component of neurofibrillary tangles in the brains of patients with Alzheimer's disease (AD). However, the mechanism underlying tau hyperphosphorylation is not fully understood. Here, we demonstrated that exogenously expressed wild-type human tau40 was detectable in the phosphorylated form at multiple AD-associated sites in cytoplasmic and nuclear fractions from HEK293 cells. Among these sites, tau phosphorylated at Thr205 and Ser214 was almost exclusively found in the nuclear fraction at the conditions used in the present study. With the intracellular tau accumulation, the Ca concentration was significantly increased in both cytoplasmic and nuclear fractions. Further studies using site-specific mutagenesis and pharmacological treatment demonstrated that phosphorylation of tau at Thr205 increased nuclear Ca concentration with a simultaneous increase in the phosphorylation of Ca/calmodulin-dependent protein kinase IV (CaMKIV) at Ser196. On the other hand, phosphorylation of tau at Ser214 did not significantly change the nuclear Ca/CaMKIV signaling. Finally, expressing calmodulin-binding protein-4 that disrupts formation of the Ca/calmodulin complex abolished the okadaic acid-induced tau hyperphosphorylation in the nuclear fraction. We conclude that the intracellular accumulation of phosphorylated tau, as detected in the brains of AD patients, can trigger nuclear Ca/CaMKIV signaling, which in turn aggravates tau hyperphosphorylation. Our findings provide new insights for tauopathies: hyperphosphorylation of intracellular tau and an increased Ca concentration may induce a self-perpetuating harmful loop to promote neurodegeneration.

Comparison of perioperative and recent efficacy of different mitral valve treatment strategies for mitral regurgitation caused by infective endocarditis / 中国医师进修杂志

Objective To compare the perioperative and recent efficacy of different mitral valve treatment strategies for mitral regurgitation caused by infective endocarditis. Methods From January 2009 to December 2014, 168 patients with mitral regurgitation caused by infective endocarditis underwent surgical treatment. Among them, mitral valve repair was performed in 65 patients (group A) and mitral valve replacement was performed in 103 patients (group B). Preoperative clinical profiles, perioperative details and follow-up data were reviewed retrospectively. Results There was no operative death in both groups. The cardiopulmonary bypass time and aorta clamp time were similar between the two groups. Intensive care stay was significantly shorter in group A [(1.4 ± 0.6) d] compared with group B [(1.9 ± 0.9) d](P＜0.05), and hospital stay had no significant difference between two groups (P＞0.05). Perioperative cerebral hemorrhage was observed in no patient in group A and 2 patients (1.9%) in group B. There was no in-hospital death in group A, and 2 patients (1.9%) in-hospital deaths occurred in group B. The difference was not statistically significant (P＞0.05). The incidence of heart-related adverse events in group A and group B was 6.2%(4/65) and 7.9%(8/101), and the incidence of infection related events was 0 and 3.0% (3/101) 3 years after operation (P＞0.05). Conclusions Mitral valve repair for patients with mitral regurgitation caused by infective endocarditis is safe and reliable, and the short-term effect is satisfactory. However, infection tissue should be eliminated thoroughly, and the related complications of valve replacement can be avoided and the risk of anticoagulation can be reduced.

Genome-wide Identification, Classification and Expression Analysis of the Mildew Resistance Locus O ( MLO ) Gene Family in Sweet Orange ( Citrus sinensis )

ABSTRACT Mildew resistance Locus O (MLO), a gene family specific to plants, plays significant roles in the resistance to powdery mildew (PM) and response to a variety of abiotic stresses, plant growth and development. Despite their importance as barley, rice, wheat, few studies are reported in dicots except Arabidopsis; no global analysis has been performed in the burgeoning model fruit plant sweet orange (Citrus sinensis). The recent release of the genome sequences of C. sinensis provides an opportunity to conduct a comprehensive overview the evolution and features of the MLO gene family in sweet orange. In this study, amount to 14 members of the Citrus sinensis MLO gene (CisMLO) family according to their gene structures, conserved motifs, and similitude among their presumptive Arabidopsis and rice orthologs were identified in silico. Based on these analyses, all CisMLOs were grouped into six clades and expanded partly due to one tandem duplication and two segmental duplication events. Survey of their chromosomal distributions uncovered that 14 CisMLOs are localized across 6 chromosomes. Multiple-sequence alignments showed that 11 of them shared seven highly conserved transmembrane domains (TMs), while all of the sweet orange MLO proteins except CisMLO4/14 had a calmodulin-binding domain for MLO function. Expression analysis demonstrated that the MLO gene family has a diverse tissue-specific expression profiles in the sweet orange development and plays potential critical roles in stress responses. These findings will facilitate further studies of evolutionary pattern and biological functions of MLO genes in sweet orange.

Reconstruction of Regions Below the Knee Using Island Flaps

PURPOSE: The lower leg often has poor vascularity, proximity to bone, and insufficient soft tissue. The island flaps offer a feasible one stage reconstruction and has a remarkable vascularization and high quality results for soft tissue defect with or without bony problems to occur on regions below the knee. So we reported our experience of island flaps with review of the literatures. METHODS: We reconstructed 29 cases of soft tissue and 2 cases of bony defect on regions below the knee by using various island flaps at our hospital from December, 1991 to January, 2006. We used 2 fibular osteocutaneous island flaps, 15 reverse sural island flaps, 6 extensor digitorum brevis muscular island flaps, 2 medial plantar island flaps, 5 saphenous island flaps, and a dorsalis pedis island flap. RESULTS: Partial necrosis was developed in 4 out of 15 reverse sural island flaps and 1 out of 5 saphenous island flaps, but they were healed with secondary skin graft. There was partial loss of skin graft on the donor sites in 2 cases. CONCLUSION: Island flaps are very useful for reconstruction of regions below the knee because island flaps have good vascularity and less risk of infection. Generous flap size, easy operative technique, lower cost, shorter operative time, and minimal morbidity at the donor site are other advantages. We attained satisfactory results.

A Case of Elastofibroma

PURPOSE: Elastofibroma is a rare benign tumor that is characterized histologically by the presence of abnormal elastic fibers within a stroma of fibroadipose tissue. Usually it is slow-growing, solid, ill-defined mass occurring chiefly in elderly woman and arising from the soft tissue around the inferior angle of the scapula. METHODS: We experienced a representative case of elastofibroma. A 73-year-old women complained of a soft-tissue mass, which measured 6x6cm, at the inferior angle of the left scapula, which had been found incidentally 4 months before. When the arm was elevated, the mass projected out beneath the scapula. The entire mass was resected with a tumor-free margin. RESULTS: The resected tumor appeared to be nonencapsulated, fibrous and white mass, and it contained yellow fatty streaks. We confirmed that the histopathologic diagnosis of this tumor was elastofibroma. Follow- up examination revealed no evidence of local recurrence for 10 months. CONCLUSION: This entity is rarely reported in Korea. However, more patients could be diagnosed if physicians pay more careful attention to clinical and radiological features of elastofibroma. Moreover, recognizing the benign nature of this lesion is important to avoid an unnecessary operation.

The Effect of Low-power Laser on the Murine Hair Growth

Low-power laser(LPL) delivers a small amount of energy without elevation of tissue temperature. LPL has been reported to have biostimulation effects including anti-inflammatory, analgesic, regenerative, immunocorrective, and vasodilative effects. However, the effect of LPL on hair growth has rarely been studied. We investigated the effect of LPL on hair growth in the mouse. After depilation of back skin of mice, we classified the mice into 4 groups: control, laser irradiated group, MoandMore(R) applied group, and Spella 707(R) applied group. Laser irradiation or application of these drugs were performed on the back skin of the mice for 30 days. The results are summarized as follows. Hair growth of control was first observed at 13 days after depilation, and complete hair regrowth was observed at 25 days. Hair growth of both laser irradiation group and MoandMore(R) applied group was first observed at 9 days after depilation, and complete hair regrowth was observed at 20 days. Hair growth of Spella 707(R) applied group was firstly observed at the 9 days after depilation, and complete hair regrowth was observed at the 15 days. Hair growth started at the irradiation site in the laser irradiation group, but it started at the random sites in other groups. In conclusion LPL irradiation have a stimulating effect on the hair growth in the mouse.