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OBJECTIVE To explore the way to re-use epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） in patients with EGFR-TKI-induced interstitial pneumonia （IP）， using osimertinib as an example. METHODS The IP treatment regimen and re-use of EGFR-TKI regimen in a patient who developed IP after the use of osimertinib were analyzed. And a literature review was made by combining the characteristics of the cases which reported in the literature and the characteristics of this case. RESULTS The patient’s IP symptoms due to treatment with osimertinib had resolved after treatment. The patient’s IP symptoms also did not worsen after using almonertinib in combination with hormones as re-use of EGFR-TKI regimen. However， almonertinib was discontinued as the patient experienced disease progression. The adverse reactions of IP needed to be dealt with in time， the EGFR-TKI should be discontinued and symptomatic treatment should be given. CONCLUSIONS EGFR-TKI targeted therapy could be re-selected by replacing EGFR-TKI， adjusting the dose of EGFR-TKI， and using hormones in combination. EGFR-TKI-induced adverse drug reactions of IP are rare， but need to be observed closely. If other EGFR-TKI is used， close monitoring of adverse reactions and curative effects are also required in order to adjust the patient’s treatment plan in time.
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Objective:To evaluate the efficacy of endoscopic ultrasound-guided drainage (EUS-GD) and percutaneous drainage (PD) for the treatment of pancreatic pseudocyst (PPC) by meta-analysis.Methods:The key words were pancreatic pseudocyst, endoscopic ultrasonography, percutaneous drainage, endoscopic ultrasound-guided, EUS and EUS-guided, and the databases of CNKI, Wanfang, PubMed and Web of science were searched from the establishment to October 1, 2021 for the retrospective cohort studies on PD, endoscopic ultrasonography and PPC. The article were screened and the quality was evaluated according to the pre-set inclusion and exclusion criteria; and important data were extracted. The software REVMAN5.3 was used for meta-analysis.Results:14 articles were finally included, and a total of 843 patients with PPC were enrolled (485 in the EUS-GD group and 358 in the PD group). Mesh meta-analysis showed that in the incidence of technical success rate, clinical success rate and complication rate, there were no significant differences between PD group and EUS-GD group ( OR=0.69, 95% CI 0.32-1.46; OR=1.31, 95% CI 0.88-1.95; OR=1.01, 95% CI 0.70-1.47, all P value >0.05); but the incidence of the recurrence rate and reintervention rate in EUS-GD group were significantly lower than those in the PD group and the differences were statistically significant ( OR=0.45, 95% CI 0.23-0.85; OR=0.51, 95% CI 0.28-0.93, all P value <0.05). Conclusions:Compared with PD, EUS-GD can significantly reduce recurrence rate and complication rate, and it has more advantages than PD for the treatment of PPC.
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Background The positive rate of sputum bacteria in patients with pneumoconiosis complicated with pulmonary tuberculosis is lower than that in patients with simple tuberculosis, which makes the disease assessment more difficult. Objective To compare the differences of blood test indexes between patients with pneumoconiosis complicated with bacteriologically negative and bacteriologically positive pulmonary tuberculosis, so as to provide a basis for the assessment of lesions in patients with pneumoconiosis complicated with pulmonary tuberculosis. Methods The relevant information of 329 patients with pneumoconiosis complicated with tuberculosis diagnosed from 2010 to 2020 was retrospectively collected, including 260 cases of pneumoconiosis complicated with bacteriologically negative tuberculosis (B-TB) and 69 cases of pneumoconiosis complicated with bacteriologically positive tuberculosis (B+TB). The demographic characteristics and blood test indexes of the two groups of patients were analyzed and compared, and logistic regression analysis was conducted to identify factors associated with pneumoconiosis complicated with bacteriologically positive tuberculosis. Results Body mass index (BMI) was significantly different between the two groups (P<0.05), and the proportion of BMI≤18.5 kg·m−2 in the pneumoconiosis cases with B+TB was higher than those with B-TB. The levels of platelet count, fibrinogen, white blood cell count, neutrophil count, monocyte count, C-reactive protein, erythrocyte sedimentation rate, and D-dimer in the pneumoconiosis cases with B+TB were higher than those in the pneumoconiosis cases with B-TB (P<0.05); the levels of mean platelet volume, hemoglobin, albumin to globulin ratio, and high-density lipoprotein in the pneumoconiosis with B+TB group were lower than that in the pneumoconiosis with B-TB group (P<0.05). The abnormal rates of other indicators except mean platelet volume, fibrinogen, and high-density lipoprotein were higher in the pneumoconiosis with B+TB group than in the pneumoconiosis with B-TB group (P<0.05). The results of multiple logistic regression showed that C-reactive protein (OR=1.006, 95%CI: 1.001-1.010), platelet count (OR=1.004, 95%CI: 1.002-1.007), and monocyte count (OR=3.461, 95%CI: 1.370-8.745) were associated with positive sputum smear in patients with pneumoconiosis complicated with pulmonary tuberculosis (P<0.05). Conclusion Some blood test indexes show differences between pneumoconiosis complicated with bacteriologically positive patients and pneumoconiosis complicated with bacteriologically-negative tuberculosis patients. C-reactive protein, platelet count, and monocyte count are factors associated with sputum positivity in pneumoconiosis complicated with tuberculosis patients. Monitoring selected indicators of blood test have a certain reference value for the assessment of lesions in patients with pneumoconiosis complicated with tuberculosis.
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T-cell acute lymphoblastic leukemia (T-ALL) is one of the most dangerous hematological malignancies, with high tumor heterogeneity and poor prognosis. More than 60% of T-ALL patients carry NOTCH1 gene mutations, leading to abnormal expression of downstream target genes and aberrant activation of various signaling pathways. We found that chidamide, an HDAC inhibitor, exerts an antitumor effect on T-ALL cell lines and primary cells including an anti-NOTCH1 activity. In particular, chidamide inhibits the NOTCH1-MYC signaling axis by down-regulating the level of the intracellular form of NOTCH1 (NICD1) as well as MYC, partly through their ubiquitination and degradation by the proteasome pathway. We also report here the preliminary results of our clinical trial supporting that a treatment by chidamide reduces minimal residual disease (MRD) in patients and is well tolerated. Our results highlight the effectiveness and safety of chidamide in the treatment of T-ALL patients, including those with NOTCH1 mutations and open the way to a new therapeutic strategy for these patients.
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Humans , Aminopyridines , Benzamides , Cell Line, Tumor , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/metabolism , Proto-Oncogene Proteins c-myc/metabolism , Receptor, Notch1/metabolism , Signal Transduction , T-Lymphocytes/metabolismABSTRACT
Objective:To evaluate the influencing factors of inconsistency between γ-interferon release test QFT-GIT and etiological results in tuberculosis patients.Methods:The clinical data of 1 398 patients with positive Mycobacterium tuberculosis infection confirmed by pathogen culture after QFT-GIT test who were admitted to Hangzhou Chest Hospital Affiliated to Zhejiang University School of Medicine from September 2017 to August 2021 were retrospectively analyzed. There were 1 242 cases in whom both the pathogenic culture and QFT-GIT results were positive(consistent result group) and 156 cases in whom the QFT-GIT test results were negative or indeterminate(inconsistent result group). Logistic regression was used to analyze the influencing factors of inconsistent results between QFT-GIT and tuberculosis pathogenic tests. SPSS 25.0 software was used to analyze the data. Results:The overall incidence of inconsistency between QFT-GIT and tuberculosis etiological results was 11.16% (156/1 398). The incidence of inconsistency was 0, 7.09% (63/889) and 19.58% (93/475) in patients aged <18, 18-<65 and ≥65 years old, respectively; the incidence of inconsistency in age group ≥65 was higher than that in age groups <18 and 18-<65 ( χ2=6.584 and 36.762, P<0.01). Multivariate Logistic regression analysis showed that age ( OR=1.026, 95% CI 1.016-1.037), smoking ( OR=1.649, 95% CI 1.159-2.347), chronic liver disease ( OR=1.868, 95% CI 1.213-2.876), cardiovascular disease ( OR=2.353, 95% CI 1.361-4.069) and blood albumin level ( OR=0.956, 95% CI 0.928-0.985) were independent influencing factors for the inconsistency between the results of QFT-GIT and tuberculosis etiology. Conclusion:Patients with advanced age, smoking, chronic liver disease, cardiovascular disease and low albumin level are more likely to have inconsistent results between QFT-GIT and tuberculosis etiological tests.
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The CD19-targeting bispecific T-cell engager blinatumomab has shown remarkable efficacy in patients with relapsed/refractory B-cell precursor acute lymphoblastic leukemia. However, several studies showed that blinatumomab has a short plasma half-life due to its low molecular weight, and thus its clinical use is limited. Furthermore, multiple trials have shown that approximately 30% of blinatumomab-relapsed cases are characterized by CD19 negative leukemic cells. Here, we design and characterize two novel antibodies, A-319 and A-2019. Blinatumomab and A-319 are CD3/CD19 bispecific antibodies with different molecular sizes and structures, and A-2019 is a novel CD3/CD19/CD20 trispecific antibody with an additional anti-CD20 function. Our in vitro, ex vivo, and in vivo experiments demonstrated that A-319 and A-2019 are potent antitumor agents and capable of recruiting CD3 positive T cells, enhancing T-cell function, mediating B-cell depletion, and eventually inhibiting tumor growth in Raji xenograft models. The two molecules are complementary in terms of efficacy and specificity profile. The activity of A-319 demonstrated superior to that of A-2019, whereas A-2019 has an additional capability to target CD20 in cells missing CD19, suggesting its potential function against CD19 weak or negative CD20 positive leukemic cells.
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Humans , Antigens, CD19/therapeutic use , Antineoplastic Agents/pharmacology , Immunotherapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , T-LymphocytesABSTRACT
BACKGROUND: Zinc, an inorganic antibacterial material, has a suitable degradation rate and good antibacterial property. Adding alloying elements can improve the mechanical properties and biocompatibility of the material, which is the development direction of novel medical biodegradable metal materials. There is still lack a comparable research on the antibacterial properties among zinc-based materials. OBJECTIVE: To investigate the antibacterial properties of pure zine and zinc-based alloys in vivo. METHODS: Eighty Sprague-Dawley rats, SPF grade, were randomized into two groups (n=40/group) , and all rats were injected with Staphylococcus aureus or Escherichia coli solution to prepare infection models. Different materials (Zn, ZnAl, ZnSr, Zn3 Mg, Zn3 Ag, Zn3 Ca and Zn4 Cu; five rats for each material) were implanted into the medullary cavity of femur. The control group without any material was set. At 1, 4, 7 and 14 days after implantation, the changes of body temperature, white blood cell count, serum tumor necrosis factor α and serum zinc content in rats were detected. The secretions and tissues of the surgical site were collected to identify the bacterial species. RESULTS AND CONCLUSION: (1) The body temperature in all the rats was increased to different extents after bacterial infection, but the temperature of the rats implanted with zinc and zinc alloys was always lower than that in the control group at 7 and 14 days (P < 0.05) . The temperature in the Zn3 Ag group was significantly lower than that in the other groups at 7 and 14 days (P < 0.05) . (2) The white blood cell count and tumor necrosis factor α level in the zinc and zinc alloys groups were significantly lower than those in the control group at 7 and 14 days after implantation (P < 0.05) . The white blood cell count and tumor necrosis factor α level in the Zn3 Ag group were significantly lower than those in the other groups (P < 0.05) . (3) The serum zinc content in all groups has no significant difference (P> 0.05) . (4) The bacterial culture results showed S.aureus (+) in the Staphylococcus aureus infection group and E.coli (+) in the Escherichia coli infection group. (5) To conclude, degradable zinc-based alloys exert marked antibacterial effects, and Zn3 Ag alloys have the best antibacterial activity.
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The incidence of osteoporotic vertebral fractures (OCVF) has increased year by year.MRI is noninvasive and nonradiative,which can be used to observe the type,pathological stage and severity of OCVF.In recent years,MRI has become an important method to evaluate OCVF,which can provide imaging basis for clinical choice of treatment.The research progresses of MRI in OCVF were reviewed in this article.
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Objective To discover the significance of neurofilament light (NFL) chain of cerebrospinal fluid (CSF), an axonal injury biomarker, in diagnosis and prognosis prediction of neuromyelitis optica spectrum disorders(NMOSD).Methods Sixty-one NMOSD patients and 24 other patients such as neurosis, migraine and so on, with lumbar puncture were enrolled as NMOSD group and normal control (NC) group from in and out patients of Department of Neurology of Navy General Hospital from January 2014 to August 2016. The clinical and neuroimaging features of NMOSD group and CSF samples of both groups were collected,and the NFL levels of CSF were measured by enzyme linked immunosorbent assay. The CSF NFL levels in different subtypes of NMOSD patients were compared, and the influence factors of the NFL levels in CSF were calculated by multiple linear regression analysis. Results The NFL levels of CSF in NMOSD group (2 729.00(14 862.00) pg/ml) were significantly higher than that in NC group ((299.50(308.00) pg/ml, t=8.588, P=0.000;t test of NFL levels was performed after logarithmicly transforming based on 10). There were no statistically significant differences of CSF NFL levels among optic neuritis, longitudinally extensive transverse myelitis and neuromyelitis optica. In NMOSD group, age (b=0.017, P<0.01), Expanded Disability Status Scale score (b=0.078, P<0.05) and enhancement in gadolinium-magnetic resonance imaging (b=0.478, P<0.01) were correlated with the NFL levels of CSF, while gender, courses of diseases and aquaporin 4 antibody in serum were not related to the NFL levels. Conclusion The NFL levels of CSF are conducive to assess the severity and probable progress of NMOSD.
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Objective To explore the clinical characteristics of infratentorial primary angiitis in central nervous system (PACNS).Methods A total of 5 cases diagnosed as infratentorial PACNS in the neurology department of Navy General Hospital of PLA in 2015 were enrolled in the study.The clinical,imaging and pathological data were collected and analyzed.Results All the 5 cases were male with the median onset age of thirty-four.Five cases presented with dizziness,two with headache,three with walking unstable,two with facial numbness and one with dysarthria.Rising pressure of cerebrospinal fluid (CSF) (190-245 cmH2O,1 cmH2O =0.098 kPa) was found in 4 cases by the lumbar puncture,mildly increased number of leukocyte in 2 cases [(12-28) × 106/L],increased CSF protein in 3 cases(540-979 mg/L) and increased IgG index in 3 cases (0.84-1.45).Pons lesions were revealed by magnetic resonance imaging(MRI) in 4 cases,brachium pontis lesions in 2 cases,cerebellum lesions in 2 cases,one with midbrain lesion in 1 case,unilateral lesions in 4 cases and bilateral lesion in 1 case.Different degree of edema and mass effect were shown in all lesions by MRI.Patch like enhancement was found by contrast MRI in 5 cases and meningeal enhancement in 2 cases.Elevation of choline (Cho) peak was found by magnetic resonance spectroscopy (MRS) in 4 cases,reduction of N-acetyl aspartate (NAA) peak in 3 cases,appearance of lactate peak in 1 case and lipid peak in another case.Arterial spin labeling (ASL) was performed in 4 cases and no hyperperfusion was found.Susceptibility weighted imaging(SWI) was performed in 3 cases and microhemorrhage in the lesions was found in 2 cases and normal in 1 case.Magnetic resonance arteriography(MRA) was performed in 1 case and no stenosis was found.Digital subtraction arteriography(DSA) was performed in 1 case and multiple stenosis of the intracranial arteries was showed.Two cases had taken the stereotactic brain biopsy and the histopathologic diagnosis was angiitis.Five cases were treated with methylprednisolone and cyclophosphamide was added on in 1 case.Good prognosis was found in all cases.Conclusions Infratentorial PACNS mostly attacks middle-aged males.The lesions tend to locate in unilateral pons,brachium pontis,cerebellum and midbrain.Hemorrhage or microhemorrhage in lesions is often found by SWI and no hyperperfusion is shown by ASL,which would be useful to distinguish PACNS from malignant tumors.Given the limitations of brain biopsy in clinical practice,clinical and imaging features would be helpful to diagnose PACNS.
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Objective:To optimize the formula of 5-aminosalicylic acid enema in situ gel. Methods:5-Aminosalicylic acid ene-mas in situ gel was prepared using a cold dissolution method with carbomer as the gel matrix and xanthan gum as the thickener. A 32 full factorial design was used to investigate the effects of the concentrations of carbomer and xanthan gum on the viscosity before and af-ter the gelling, duration of inversion tube and sedimentation rate. Response surface methodology was used to optimize the formula. Re-sults:The quantitative relationships between the two factors and the four evaluation indices were obtained. The optimum formula was as follows:the concentration of carbopol and xanthan gum in the enema was 0. 7% and 0. 15%, respectively. The viscosity before and af-ter the gelling was 500-1 000 mPa·s and 2 200-2 700 mPa·s, respectively. The duration of inversion tube test was 40-80 min and the sedimentation rate was more than 98. 5%. Conclusion:The multi-objective simultaneous optimization of the formula of 5-aminosal-icylic acid enema in situ gel is accomplished by factorial design and response surface methodology.
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<p><b>OBJECTIVE</b>To identify risk factors of hepatocellular carcinoma (HCC) in cirrhotic patients with chronic hepatitis B (CHB).</p><p><b>METHODS</b>A total of 715 cirrhotic patients with CHB were recruited from the Zhongshan Hospital Affiliated to Fudan University and enrolled in this case-control study between January 2009 and September 2014. All participants were Chinese Han residing in Shanghai and the surrounding areas. The patients were divided into a cirrhosis group (n =281) and a HCC group (n=434). History of hepatitis B infection and HCC, as well as clinical data from serological, imaging and pathological examinations were collected for analysis.SPSS software, version 19.0, was used for all statistical comparisons.</p><p><b>RESULTS</b>Single factor analysis indicated that development of HCC in cirrhotic patients with CHB was significantly associated with male sex, age of 50 years or more, family history of HCC, alcohol consumption,fatty liver, detectable levels of hepatitis B virus (HBV) DNA, and history of HBV infection without effective antiviral treatment. Multivariate logistic regression analysis indicated that age of 50 years or more (P =0.005, odds ratio [OR] =1.766), history of alcohol consumption (P =0.002, Or = 2.570), family history of HCC (P =0.014, Or = 2.268), fatty liver (P =0.023, Or = 3.390), and history of HBV infection without effective antiviral treatment (P < 0.001,Or = 5.389) were risk factors of HCC.The risk factors for development of HCC in cirrhotic patients with hepatitis B after achieving sustained virologic suppression (SVS) were family history of HBV infection (P =0.014, Or = 2.537), family history of HCC (P =0.037,Or = 3.339) and fatty liver (P =0.018, Or = 11.646).</p><p><b>CONCLUSION</b>Risk factors of HCC in cirrhotic patients with CHB include age,drinking history,family history of HCC, fatty liver, and ineffective antiviral treatment of CHB.Family history of HBV infection or HCC, and fatty liver disease, were significantly associated with HCC development after SVS in patients with hepatitis B-related cirrhosis.</p>
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Humans , Male , Alcohol Drinking , Antiviral Agents , Carcinoma, Hepatocellular , Case-Control Studies , China , Fatty Liver , Hepatitis B virus , Hepatitis B, Chronic , Liver Cirrhosis , Liver Neoplasms , Odds Ratio , Risk FactorsABSTRACT
Objective:To establish an HPLC method to determine 5-amino salicylic acid (5-ASA) and its related substances in the enemas. Methods:The liquid chromatograph was equipped with a Hypersil ODS C18 column (250 mm × 4. 6 mm,5. 0 μm) with gradient elution. The mobile phase A was composed of pH 7. 5 phosphate buffer ( PBS), tetrabutyl ammonium hydroxide solution (TBAH), methanol and water (600∶50∶50∶300), the mobile phase B was composed of pH 7. 5 PBS, TBAH, methanol and water (200∶50∶300∶450). The wavelength was 208nm, the column temperature was 40 ℃ and the injection volume was 20μl. Results:5-ASA and its two degradation products could be completely separated. The concentration of 5-ASA and the corresponding peak area had a good linear relationship within the range of 1-250μg·ml-1(r=0. 999 5). The average recovery was 99. 44%(RSD=0. 94%,n=9). Conclusion:The method is simple, sensitive and reproducible, and can be used in the determination of the content and related substances in the enemas.
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Objective To investigate a new technique for small wound repairs on the faces.Methods 71 skin lesions of 42 patients were selected in the study and removed with ring-cutting drills.The new formed small wounds were treated with nature repair technique under the help of bFGF and hyaluronic acid (HA).The bFGF and HA were applied on the wounds 3 times a day until the wounds were healed completely.The early and long-term healing effects were estimated.Results The wounds were all cured with very small scars.The wounds were healed within 15 days for the size of 7 mm × 7 mmand25 days for the size of 15 mm × 15 mm.63 lesion spots from 35 patients were followed up 12 months later.Compared with original skin lesion,the small scar contracted about 50％in size with flat appearance and similar skin color.Conclusions The tissue regeneration and nature repair technique is an ideal surgical procedure for small wounds on the faces with good appearance in quality and aesthetics.
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Objective To investigate the clinical efficacy of one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach the medial edge of rectus abdominis in treating severe lumbosa-cral tuberculosis .Methods 17 cases with L4-S1 tuberculosis were treated by internal fixation with pedicle screw ,anterior debride-ment through the extraperitoneal approach the medial edge of rectus abdominis ,and application of allogenic bone from January 2008 to December 2011 .All patients performed X-ray ,CT and MRI examinations before surgery .L5-S1 were involved in 8 cases ,L4-5 were involved in 6 cases ,and L4-S1 were involved in 3 cases;unilateral psoas abscess was found in 6 cases ,while bilateral psoas ab-scess was found in 3 cases ;Among the 17 cases ,8 cases had intraspinal invasion ,and 5 cases were combined with neurological dys-functions ,however ,according to Frankel grade ,4 cases were grade D ,and 1 case was grade C .Regular anti-tuberculosis treatment was given for more than 2 weeks before surgery ,and regular supportive treatment and anti-tuberculosis treatment were given for 9-12 months after surgery .As for regular follow-up(3 ,6 ,9 ,and 12 months after surgery ,and every 6 months later on) ,patients had examinations including ESR and X-ray to evaluate the tuberculosis activity and the condition of bone graft fusion ;while accord-ing to Frankel grade of nerves function ,changes in nerve function before and after surgery were evaluated in patients ,and changes of lumbosacral angle were also comparatively studied before and after surgery .Results There were no great vessel injuries and no nerve injuries except one case who had intraoperative ureteral injury which was repaired in time .The 17 patients were all followed up for 10-36 months(18 months average) ,and all reached clinical healing without complications such as tuberculous peritonitis ,e-rectile dysfunction and retrograde ejaculation .During the follow-up period ,there were no tuberculosis recurrence ,no loosening of in-ternal fixation ,and no break of rod and nail ;the grafted bones were fused in all patients with an average time of 7 .5 months ;accord-ing to Frankel grade of nerves function ,only one patient was grade D ,while the other four cases recovered to grade E .The lumbosa-cral angle of patients was corrected from 23 .8° ± 4 .0°(19 .8°-27 .8°) before surgery to 29 .1° ± 3 .6°(25 .5°-32 .7°) after surgery , and the change was statistical significance(P<0 .05) .Conclusion The one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach inside of rectus abdominis is a safe and effective meth-od ,which can thoroughly remove the focus ,reconstruct the lumbosacral stability ,and prevent the loosening of bone grafting .
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BACKGROUND:Currently, transplantation of bone marrow mesenchymal stem cel s into the spinal cord is very limited to the recovery of animals fol owing spinal cord injury. Methylcobalamin is a common drug for the treatment of neurological diseases and injuries, but its effects on bone marrow mesenchymal stem cel s are unclear. OBJECTIVE:To study the feasibility of bone marrow mesenchymal stem cel s differentiating into neuron-like cel s induced by methylcobalamin in vitro and to observe the cel viability and proliferation of differentiated cel s. Methods:Rat bone marrow mesenchymal stem cel s were isolated, cultured and purified by density gradient centrifugation and adherent culture. The fourth to fifth generation of bone marrow mesenchymal stem cel s were treated for 24, 48 and 72 hours with different concentrations (25, 50 and 100 mg/L) of methylcobalamin. The morphological changes and cel growth were continuously observed under an inverted phase constract microscope. The viability of induced cel s was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The expressions of Nestin and neuron-specific enolase were identified by reverse transcription PCR and western blot. RESULTS AND CONCLUSION:Most of bone marrow mesenchymal stem cel s could differentiate into neuron-like cel s after induction with methylcobalamin. The expressions of Nestin and neuron-specific enolase were up-regulated after 48 hours of methylcobalamin treatment at different concentrations, especial y after treatment with 100 mg/L methylcobalamin. Similarly, the expressions of Nestin and neuron-specific enolase could be increased significantly after 100 mg/L methylcobalamin treatment for 24, 48 and 72 hours, especial y for 72 hours. It is indicated that methylcobalamin can induce bone marrow mesenchymal stem cel s differentiating into neuron-like cel s, and the optimal concentration of methylcobalamin is 100 mg/L.
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<p><b>OBJECTIVE</b>To investigate a new technique for nasal reconstruction with total rib cartilage framework.</p><p><b>METHODS</b>The expanded frontal flap was fabricated by skin expansion and flap delay to cover the reconstructed nose. The dorsal flap was reversed as the lining of reconstructed nose. The whole framework was made by rib cartilage. Secondary revision operation was also performed to make the reconstructed nose more natural.</p><p><b>RESULTS</b>Total nasal reconstruction was performed successfully in 37 cases. Each patient underwent 4-7 operation during a period of 6-8 months. 32 patients were followed up for 12-24 months. The reconstructed nose had a natural skin color and symmetric appearance with good ventilation and less scar. Both doctors and patients were satisfied with the results.</p><p><b>CONCLUSION</b>Satisfactory cosmetic result and ventilation function can be achieved by nasal reconstruction with total rib cartilage framework.</p>
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Adult , Female , Humans , Male , Braces , Nose , General Surgery , Rhinoplasty , Methods , Ribs , Transplantation , Treatment OutcomeABSTRACT
Objective To develop a technique of aesthetic repair procedures for the skin and soft tissue defect after injury.Methods Nineteen cases of patients with skin and soft tissue defects after injury were chosen in this study,in which there were 19 wounds involved.Thirty-seven expanders were inserted into the subcutaneous pockets beside the wounds in the right time and were inflated by a fast expansion model (one time every two days). After completion of inflation,the expanded skin flaps were made and transferred to repair the wounds.Results All the 37 expanders were inflated successfully in duration of 46-63 days.Five expansion areas presented complications that were correctly controlled.All of the wounds were covered and healed well after the expanded skin flap transplantation.Twelve patients were followed up for 6 months after operation.The long-term results showed that the color and texture of the flaps matched the recipient sites well without swelling.The aesthetic appearance of the repaired sites looked satisfactory.Conclusions The rapid tissue expansion is a better option for repairs of some skin and soft tissue defects after injury in certain areas.
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Objective To investigate the role of psychological intervention on cosmetic plastic surgery.Methods 600 cosmetic plastic surgery were collected from cosmetic plastic surgery of Jinan Military General Hospital,then randomly divided into control group(n=300) and study group (n=300) according to odd and even on the first visit.Conventional treatmentand care were applied to control group before,during and after operation.For study group,in addition to giving a general treatment and care,preoperative consultation talks were given to understand the beauty of the psychological characteristics,and motivations and expectations were given to adjust;music and psychological support were presented intraoperative; rehabilitation guidance were given after operation.Symptom checklist 90( SCL-90),general psychological problems of body image self-rating scale and postoperative satisfaction scale were used to assess the the mental state,body image question and satisfaction of plastic surgery.Results Before intervention,the scores of SCL-90 and the general body image self-rating scale were ( 187.5 ±52.61 ),(12.1 ± 2.2) in study group and (179.87 ± 53.33 ),(12.9 ± 2.0) in control group,there was no significant differences(P＞0.05).After intervention,the scores of SCL-90 and the general body image self-rating scale ( 159.6 ± 31.3 ),(5.6 ± 0.5 ) in study group were lower than those in control group ( 167.4 ± 38.2 ),( 6.2 ±1.1 )(P ＜ 0.01 ).Before and after treatment,50％ reduced rate of 26％,25％ reduced rate of 41.6％,body-negative rate of 97.1％,overall satisfaction rate of 89％ of surgery in study group were higher than 14％,27.6％,84.3％ and 53.67％ in the control group,the differences were significant (P＜0.01 ).Conclusion Psychological interventions can improve the psychological state,body image disturbance and operative satisfaction in cosmetic plastic surgery.Psychological interventions should pay more attention to irrmprove the efficacy of cosmetic plastic surgery.
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Objective To discuss the presentations, pathologic features, diagnosis and treatment of primary synovial sarcoma of the kidney. Methods One case of primary synovial sarcoma of the kidney was reported and the relevant literature was reviewed. A 55-year-old man was admitted with complaint of right abdomen and flank pain for 5 h. Computerized tomography revealed a 12.5 cm × 11.0 cm × 9. 0 cm mass located at the middle and lower pole of the right kidney. The patient was taken radical nephrectomy. Results The diagnosis of primary synovial sarcoma of the kidney in the patient was confirmed by postoperative pathology. Under microscope, tumor was typically mitotically active, monomorphic spindle cells growing in intersecting fascicles or in solid sheets with epithelial differentiation. In some areas a haemangiopericytoma-like pattern was found. Immunohistochemical staining showed that the tumor cells were positive for the markers Vimentin, CD99 and Bcl-2, but CK was negative. The patient died of local recurrence and multi-metastasis at 8 months after surgery. Conclusions Primary synovial sarcoma of the kidney is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features, Immunohistochemical studies and RT-PCR detection. Radical resection combined with chemicaltherapy is considered to be the most reliable treatment so far.