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Objective:To identify the prevalence of pulmonary micro nodule (PMN) in osteosarcoma, investigate radiologic features of progressive PMN, and provide evidence for early diagnosis of pulmonary metastasis of osteosarcoma.Methods:Electronic articles published in PubMed, EMBASE, Web of Science and the Cochrane Library databases between January 1, 2000, and September 1, 2022, were searched and critically evaluated. The authors independently reviewed the abstracts and extracted data on the prevalence of PMN in osteosarcoma and radiologic features of progressive PMN. Seven high quality studies were finally included in the meta-analysis with evidence level III.Results:The pooled prevalence of PMN in osteosarcoma was 36.0%, 95% CI (14.6%, 57.3%). The pooled progressive rate of PMN was 52.5%, 95% CI (37.7%, 67.2%). As for a specific PMN, it was more likely to progress which had a larger Dmax, HR=2.40, 95% CI (1.06, 5.42), P=0.035. No significant difference was found in number, component, and border. Conclusion:PMN is quite common in patients with osteosarcoma. About half of the patients suffered the progression of PMN, and it is related to several risk factors.
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As a chronic liver inflammation disease caused by the lack of immune tolerance, autoimmune hepatitis is regulated by various signaling pathways, such as the NF-κB/NLRP3 pathway, the SIRT1/Nrf2/HO-1 pathway, the Hippo-YAP/TAZ pathway, the JAK/STAT pathway, the PI3K/Akt pathway, and the TRAF6/JNK pathway. These pathways can play a role against autoimmune hepatitis by participating in the processes including the proliferation and apoptosis of cytokines, immune response, and oxidative stress. In view of the problems of suboptimal response, obvious adverse reactions, and high recurrence rate in the clinical application of hormones and immune preparations for the treatment of autoimmune hepatitis, this article summarizes the research articles on autoimmune hepatitis-related signaling pathways and the mechanism of effective constituents (glycosides, terpenoids, flavonoids, quinones, and phenols) in traditional Chinese medicine intervening against the disease process of autoimmune hepatitis through the above signaling pathways, in order to provide a theoretical basis for scientific and effective utilization of effective constituents in traditional Chinese medicine to develop anti-autoimmune hepatitis drugs.
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AIM:To investigate the current situation of myopia in a primary school in Jinhua city and the intervention effect of knowledge, belief and practice.METHODS: From September to December 2022, a total of 1 482 primary school students who met the inclusion criteria were selected for myopia test and education intervention based on cluster sampling method. The questionnaire was designed based on relevant references. The main contents of the questionnaire include students' general information, low vision and knowledge, belief and practice before and after intervention and prevention of myopia.RESULTS: A total of 1 482 primary school students were investigated and tested, among which myopia was detected out of 657 students, with a myopia rate of 44.33%. Specifically, mild myopia accounted for 54.64%(359); moderate myopia accounted for 23.90%(157); severe myopia accounted for 21.46%(141). A total of 1 468 valid questionnaires were collected before intervention, and 1 457 valid questionnaires were collected after intervention. The overall knowledge rate of myopia prevention and control knowledge before intervention was 62.57%(7348/11744), and it was 81.20%(9465/11656)after intervention, with statistical significance before and after intervention was statistically significant(P<0.001). The behavior attendance rate before intervention was 82.48%(9687/11744), and it was 93.73%(10925/11656)after intervention, with statistical significance comparison before and after intervention(P<0.001).CONCLUSION: The results of this survey showed that the myopia situation of primary students in Jinhua city was not optimistic, and some students were not aware of prevention knowledge and correct behavior before intervention. After intervention, the knowledge, belief and practice of myopia prevention and control have achieved remarkable results.
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Objective:To investigate the genomic manifestation and pathogenesis of osteosarcoma with different relapse pattens, which were respectively initially presented with bone metastasis or pulmonary metastasis.Methods:From May 1, 2021 to October 1, 2021, 38 fresh tumor specimens and some paraffin-embedded specimens of high-grade osteosarcoma were collected in Peking University People's Hospital, including 29 males and 9 females, aged 19.6±2.2 years (range, 6-61 years). Among the 38 cases, 12 cases had initial bone metastasis (group A) and 26 cases had initial lung metastasis (group B), of which 15 cases (40%, 15/38) had paired specimens of primary and metastatic lesions. Based on Illumina NovaSeq 6000, we analyzed whole-exome sequencing (WES) as well as transcriptome for osteosarcoma with paired samples in different relapse patterns. During all their treatment courses, we also collected their paired samples to reveal these tumors' evolution. We sought to redefine disease subclassifications for osteosarcoma based on genetic alterations and correlate these genetic profiles with clinical treatment courses to elucidate potential evolving cladograms.Results:We found that osteosarcoma in group A mainly carried single-nucleotide variations (83%, 10/12), displaying higher tumor mutation burden [4.9 (2.8, 12.0) & 2.4 (1.4, 4.5), P=0.010] and neoantigen load [743.0 (316.5, 1,034.5) & 128.5 (49.0, 200.5), P=0.003], while those in group B mainly exhibit structural variants (58%, 15/26). The mutation spectrum showed that there was a significant difference in age-related gene imprinting 1 between the bone metastasis group and the lung metastasis group ( P=0.005). Samples were randomly selected from group A (3 patients) to investigate immunologic landscape by multiplex immunohistochemistry, from which we noticed tertiary lymphatic structure from one patient from group A. High conservation of reported genetic sequencing over time was found in their evolving cladograms. Conclusion:Osteosarcoma with mainly single-nucleotide variations other than structural variants might exhibit biological behavior predisposing toward bone metastases with older in age as well as better immunogenicity in tumor microenvironment.
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Objective@#To investigate the awareness of and participation in Healthy City construction among residents in Hangzhou City, so as to provide insights into promotion of participation in Healthy City construction.@*Methods@#Residents at ages of 15 to 75 years were sampled using the multi-stage stratified random sampling method, from 30 townships in Jianggan, Xiaoshan and Tonglu counties of Hangzhou City from November 2019 to July 2020, and a questionnaire survey of 10 representative projects pertaining to Healthy City construction in Hangzhou City was performed to investigate the awareness of and participation in Healthy City construction.@*Results@#A total of 5 559 questionnaires were allocated, and 5 211 valid questionnaires were recovered, with an effective recovery rate of 93.74%. The respondents had a mean age of ( 43.82±17.25 ) years, and included 2 280 males ( 43.75% ) and 2 931 females ( 56.25% ). The overall standardized awareness and participation rates of Healthy City construction were 81.73% and 48.58% among the respondents. The projects with the three highest awareness included healthy environment improvements ( 92.67% ), travelling by public transportation ( 92.22% ) and tobacco control action ( 91.04% ), while the projects with the three lowest awareness included chronic disease management ( 75.57% ), maternal and child healthcare ( 72.73% ) and “Healthy Cell” Program ( 45.56% ). The projects with the three highest participation rates included travelling by public transportation ( 74.59% ), healthy environment improvements ( 65.17% ), tobacco control action ( 61.52% ), while the projects with the three lowest participation rate included chronic disease management ( 35.92% ), “Healthy Cell” Program ( 34.96% ) and maternal and child healthcare ( 33.20% ).@*Conclusions@# The overall proportion of participation in Healthy City construction is low among residents in Hangzhou City, and notably, the awareness rate of and the proportion of participation in chronic disease management, maternal and child healthcare and “Healthy cell” Program are both low.
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This study uses "virtual implant" technology combined with PBL and CBL teaching methods to carry out oral implantology teaching with "restoration as the goal". By instructing students to collect preoperative data and compare actual postoperative data, the continuous cycle verification between problems, objectives, methods, and results is performed. The continuous cycle verification can improve the enthusiasm and initiative of students to learn oral implantology. At the same time, it can allow students to develop the thinking habit of understanding oral implantology with a holistic and whole-process concept and provide strong educational guidance for clinical medical students.
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Objective: To examine the efficacy and safety of anlotinib as firstline therapy to treat locally advanced or metastatic soft-tissue sarcoma. Methods: This is a single-arm trial. Treatment-naive patients (≥14 years) with locally advanced or metastatic soft tissue sarcoma were eligible. Each treatment cycle lasted for 3 weeks, and included liposomal doxorubicin (40-50 mg/m2) on day 1 and anlotinib (12 mg) on days 8-21. Starting from the 9th cycle, treatment consisted of only anlotinib. Treatment continued until disease progression or intolerable toxicities. The primary efficacy end point was progression-free survival (PFS). Results: Eight patients were enrolled between July 25, 2019 and January 8, 2020. The median number of treatment cycles was 5.5. Within 5.9 months median follow-up, PFS events occurred in 4 (4/8, 50%) patients. The median PFS was 11.3 months and the 6-month PFS rate was 56%. No patients attained complete response and 2 patients (fibrosarcoma, 1 patient and undifferentiated pleomorphic sarcoma, 1 patient) achieved partial response. Three patients (fibrosarcoma, 2 patients and synovial sarcoma, 1 patient) had stable disease. The objective response rate was 25% (2/8) for the study population, and the disease control rate was 75% (6/8). No new safety concerns emerged. Conclusions: Anlotinib plus liposomal doxorubicin demonstrated antitumor activities in previously untreated locally advanced or metastatic soft tissue sarcomas. Due to the small sample size, further investigations with a larger population should be undertaken to confirm the study findings.
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Objective: To examine the efficacy and safety of anlotinib as firstline therapy to treat locally advanced or metastatic soft-tissue sarcoma. Methods: This is a single-arm trial. Treatment-naive patients (≥14 years) with locally advanced or metastatic soft tissue sarcoma were eligible. Each treatment cycle lasted for 3 weeks, and included liposomal doxorubicin (40-50 mg/m2) on day 1 and anlotinib (12 mg) on days 8-21. Starting from the 9th cycle, treatment consisted of only anlotinib. Treatment continued until disease progression or intolerable toxicities. The primary efficacy end point was progression-free survival (PFS). Results: Eight patients were enrolled between July 25, 2019 and January 8, 2020. The median number of treatment cycles was 5.5. Within 5.9 months median follow-up, PFS events occurred in 4 (4/8, 50%) patients. The median PFS was 11.3 months and the 6-month PFS rate was 56%. No patients attained complete response and 2 patients (fibrosarcoma, 1 patient and undifferentiated pleomorphic sarcoma, 1 patient) achieved partial response. Three patients (fibrosarcoma, 2 patients and synovial sarcoma, 1 patient) had stable disease. The objective response rate was 25% (2/8) for the study population, and the disease control rate was 75% (6/8). No new safety concerns emerged. Conclusions: Anlotinib plus liposomal doxorubicin demonstrated antitumor activities in previously untreated locally advanced or metastatic soft tissue sarcomas. Due to the small sample size, further investigations with a larger population should be undertaken to confirm the study findings.
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ObjectiveTo explore the mechanism of Wutou Chishizhi Wan in regulating autophagy and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/glycogen synthase kinase-3β （GSK-3β） signaling pathway in rats with myocardial ischemia-reperfusion injury （MIRI）. MethodSixty male SD rats were randomly assigned into the normal group （normal saline）， model group （normal saline）， positive control （trimetazidine， 5.4 mg·kg-1） group， and low-， medium-， and high-dose （1.63， 4.9， 14.7 g·kg-1， respectively） Wutou Chishizhi Wan groups， with 10 rats in each group. The rats in other groups except the normal group underwent left anterior descending coronary artery ligation for modeling. Electrocardiogram was employed to detect the ST-segment elevation to evaluate the modeling. Hematoxylin-eosin （HE） staining was performed to reveal the damage of myocardial tissue. The levels of aspartate aminotransferase （AST） and creatine kinase （CK） were determined by colorimetry， and those of cardiac troponin T （cTnT） and myoglobin （MYO） by enzyme-linked immunosorbent assay （ELISA）. Western blot was carried out to determine the protein levels of microtubule-associated proteins 1 light chain 3 （LC3）， autophagy-related gene Beclin-1， PI3K， Akt， GSK-3β， p-GSK-3β， and p-Akt. ResultCompared with the normal group， the modeling elevated the serum levels of AST， CK， cTnT， and MYO （P<0.01）， destroyed the arrangement of myocardial cells abd nucle， twisted and broken myocardial fibers， up-regulated the protein levels of LC3Ⅱ/Ⅰ and Beclin-1 （P<0.01）， and down-regulated the protein levels of PI3K， p-Akt， and p-GSK-3β （P<0.01）. Compared with the model group， trimetazidine and Wutou Chishizhi Wan （all the doses） lowered the levels of AST， CK， cTnT， and MYO in serum （P<0.01）， restored the arrangement of myocardial cells and muscle fibers， reduced necrosis， down-regulated the protein level of Beclin-1 （P<0.01）， and up-regulated the protein levels of PI3K， p-Akt， and p-GSK-3β （P<0.01）. Additionally， Wutou Chishizhi Wan （all the doses） down-regulated the protein level of LC3Ⅱ/Ⅰ （P<0.05， P<0.01）. Compared with those in the trimetazidine group， the serum AST level rose in the low-dose Wutou Chishizhi Wan group （P<0.05） and declined in the high-dose group （P<0.01）， and the protein level of Beclin-1 was down-regulated in the medium-dose group （P<0.01）. Additionally， the trimetazidine group had higher protein level of LC3Ⅱ/Ⅰ than medium- and high-dose Wutou Chishizhi Wan groups （P<0.05， P<0.01）， higher protein level of PI3K than low-， medium-， and high-dose groups （P<0.01）， lower protein level of p-Akt than low- and medium-dose groups （P<0.01）， and higher p-GSK-3β protein level than the medium-dose group （P<0.01）. ConclusionDifferent doses of Wutou Chishizhi Wan can ameliorate MIRI， and the high dose has the best effect. Wutou Chishizhi Wan can reduce the activity of myocardial injury markers AST， CK， cTnT， and MYO， and alleviate the pathological damage of myocardial tissue. It can down-regulate the protein levels of beclin-1， LC3Ⅱ/Ⅰ， and up-regulate those of PI3K， p-Akt， and p-GSK-3β. In summary， Wutou Chishizhi Wan may inhibit excessive autophagy and regulate the PI3K/Akt/GSK-3β signaling pathway to exert protective effect on MIRI rats.
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Objective:To explore the clinical application value of sound touch elastography (STE) in the evaluation of the curative effect of acupuncture and moxibustion in the treatment of stroke patients with upper limb spasm.Methods:Fifty-five patients with upper limb spasm after stroke were selected as stroke group, and thirty healthy volunteers matched with age, gender and body mass index (BMI) were selected as control group between September 2020 and March 2021. The shear wave velocity (SWV) of biceps brachii and triceps brachii were measured in both groups. In stroke group, the SWVs of biceps brachii and triceps brachii on spastic side and non-spastic side were measured before and after acupuncture treatment, and the correlations between SWV and spastic grade (X), muscle response angle (R1), passive range of motion (R2), spastic angle (R2-R1) of modified Tardieu scale (MTS) were analyzed.Results:At 0 degree, the SWV of spastic biceps brachii (3.85±0.62)m/s was significantly higher than those of the non-spastic side [(3.34±0.35)m/s] and control group [(3.15±2.66)m/s] (all P<0.001), and decreased [ (3.45±0.47)m/s] after acupuncture treatment ( P<0.001). At 90 degree, the SWV of non-spastic biceps brachii was larger than those of spastic side and control group [1.98(1.92, 2.14)m/s vs 1.98(1.92, 2.11) m/s, 1.95(1.86, 2.05)m/s, all P<0.05], and there was no significant difference between the SWV of spastic side and control group ( P>0.05). There were no significant differences in SWV of triceps brachii between the spastic side and control group at both 0 degree or 90 degree ( P>0.05). At 0 degree, SWV positively correlated with MTS (x) ( rs=0.639, P<0.001) and negatively with R1 ( rs=-0.527, P<0.001) and R2 ( rs=-0.825, P<0.001) on the spastic biceps brachii. Conclusions:STE can provide quantitative index for the objective evaluation of the curative effect of acupuncture in upper limb spasm after stroke, and it is proposed to be an effective means of clinical diagnosis and efficacy evaluation in patients with upper limb spasm after stroke.
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Immune cell infiltration is of great significance for the diagnosis and prognosis of cancer. In this study, we collected gene expression data of non-small cell lung cancer (NSCLC) and normal tissues included in TCGA database, obtained the proportion of 22 immune cells by CIBERSORT tool, and then evaluated the infiltration of immune cells. Subsequently, based on the proportion of 22 immune cells, a classification model of NSCLC tissues and normal tissues was constructed using machine learning methods. The AUC, sensitivity and specificity of classification model built by random forest algorithm reached 0.987, 0.98 and 0.84, respectively. In addition, the AUC, sensitivity and specificity of classification model of lung adenocarcinoma and lung squamous carcinoma tissues constructed by random forest method 0.827, 0.75 and 0.77, respectively. Finally, we constructed a prognosis model of NSCLC by combining the immunocyte score composed of 8 strongly correlated features of 22 immunocyte features screened by LASSO regression with clinical features. After evaluation and verification, C-index reached 0.71 and the calibration curves of three years and five years were well fitted in the prognosis model, which could accurately predict the degree of prognostic risk. This study aims to provide a new strategy for the diagnosis and prognosis of NSCLC based on the classification model and prognosis model established by immune cell infiltration.
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Humans , Algorithms , Carcinoma, Non-Small-Cell Lung , Diagnosis , Lung Neoplasms , Diagnosis , Machine Learning , PrognosisABSTRACT
Although classic morphology is the cornerstone for the diagnosis of bone tumors, the rapidly developed molecular pathology based on Next Generation Sequencing (NGS) has evolved current diagnostic techniques. At the same time, new disease entities based on molecular abnormalities were constantly reported, which converted the morphological pathological classifications into molecular categories. At present, bone tumors could be roughly classified as tumors with simple karyotypes and those with complex karyotypes by molecular alterations. The previous classification can be subclassified as tumors that carry specific translocations, somatic gene mutations, or those with specific amplifications. However, the later groups usually lack specific alterations. The present review discusses various updates on molecular pathology in detail based on new categories of bone tumors proposed by World Health Organization (WHO) in 2019 aiming to further provide guidance for evidenced-based treatment. Some examples are included, such as giant cell tumor of bone (H3F3A p.G34W), chondroblastoma (H3F3B p.K36M), chondrosarcoma (IDH1/2 mutation), aneurysmal bone cyst (USP6 rearrangements) and so on. All mutual alterations play an increasingly important role in reaching a diagnosis and in patients management.
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Objective:To investigate the clinical manifestations, imaging features, histopathological features, diagnostic pitfalls, treatment and prognosis of clear cell chondrosarcoma (CCCS).Methods:23 cases of CCCS admitted and operated from January 2010 to January 2020 were analyzed retrospectively. Among the 23 cases, 21 were males and 2 were females. There were 8 cases (35%) aged 21-40, 10 cases (43%) aged 41-60 and 5 cases (23%) aged 61-80. There were 8 femurs, 7 pelvis, 4 thoracolumbar spine, 3 sacrum and 1 tibia. The specimens were fixed with 10% phosphate-buffered formalin, decalcified with 5% nitric acid, embedded in paraffin and stained with hematoxylin and eosin (HE) and immunohistochemistry (Envision). The preoperative imaging and clinical symptoms, and the postoperative histopathological and immunophenotype under the microscope were collected. And the relevant literature was reviewed to summarize the clinical, imaging and pathomorphological characteristics of CCCS.Results:23 cases of CCCS showed bone destruction in imaging, some cases were well-circumscribed lytic lesions, some cases had sclerotic margin. The serum alkaline phosphatase was increased in 7 patients before operation. The tumor tissue was gray-white and gray-red in general and some cases showed porcelain white cartilage-like areas. Microscopically, the tumor cells are round or polygonal, some of them have clear cytoplasm and boundary, some of them are eosinophilic, some of them have round and centrally located nuclei, and mitotic image is rare. It is often seen that there are nodular distribution of cartilage-like matrix and immature woven bone, multinucleated osteoclast-like giant cell scattered in those components. Immunohistochemical staining: S-100, D2-40, EMA, Vimentin, p16, SATB2 can be positive in varying degrees. The surgical treatment is mainly through en bloc excision. 10 patients had recurrence and no distant metastasis.Conclusion:CCCS is a rare subtype of chondrosarcoma, which has low-grade malignant biological behavior and is easy to be misdiagnosed clinically and pathologically. Pathological diagnosis needs to be careful. Careful observation of microscopic histology is necessary in order to avoid over-diagnosis of osteosarcoma leading to clinical treatment errors. Once the biopsy is confirmed, it needs en bloc excision in order to reduce the recurrence rate. Long-term follow-up is needed after the operation, the overall prognosis was good.
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Objective:To investigate the protective effect of Wutou Chishizhi Wan on myocardial ischemia reperfusion injury （MIRI） in rats， and observe its effect on such mechanisms as coagulation function， vascular endothelial cells and oxidative stress in rats. Method:A total of 40 SD rats were randomly divided into normal group， model group， positive drug group （Urokinase group） and Wutou Chishizhi Wan group， with 10 rats in each group. Except for the normal group， rat myocardial ischemia-reperfusion injury models were established. The changes of heart rate （HR） at 10 min before ischemia， 30 min after ischemia and 30， 60， 120 min （T0，T1，T2，T3，T4）， and the change of electrocardiogram （ECG） J point after modeling in rats were observed. The pathological changes of rat myocardial tissue were observed by hematoxylin-eosin （HE） staining. The changes of four indexes of coagulation ［prothrombin time （PT）， activated partial thromboplastin time （APTT）， thrombin time （TT）， fibrinogen content decreased significantly （FIB）］ in rats were observed. The contents of endothelin-1 （ET-1）， thromboxane A2 （TXA2） and prostacyclin （PGI2） in serum and myocardium levels of superoxide dismutase （SOD）， malondialdehyde （MDA） and glutathione peroxidase （GSH-Px） of MIRI rats were observed. Western blot assay was used for the detection of oxidative stress protein Keap1 and transcription factor-E2-related factor （Nrf2） expression levels in rat myocardial tissue. Result:Compared with the normal group， the ECG of MIRI rats showed significant myocardial ischemic injury-like changes， ST segment was significantly elevated， J point was significantly increased， and the incidences of HR in T1， T2， T3 and T4 were significantly reduced （P<0.05， P<0.01）. Compared with the model group， Wutou Chishizhi Wan significantly reduced ECG J-point changes in MIRI rats， while increased the incidence of HR in T1， T2， T3 and T4 （P<0.05， P<0.01）. Compared with the normal group， PT， APTT and TT in the model group were significantly shortened （P<0.01）， FIB content was significantly increased （P<0.01）， and the serum PGI2 level decreased and TXA2 and ET-1 levels increased significantly in the model group （P<0.01）. SOD content and GSH-Px activities of myocardial tissue in the model group were significantly reduced （P<0.01）， whereas the MDA content was increased （P<0.01）. Compared with the model group， PT of the Wutou Chishizhi Wan group was prolonged （P<0.05） and APTT slightly prolonged， TT significantly prolonged （P<0.01）， FIB content decreased （P<0.05）， serum PGI2 increased （P<0.05）， TXA2 and ET-1 decreased significantly in the Wutou Chishizhi Wan group （P<0.01）， myocardial MDA content decreased， and SOD content and GSP-Px activity increased significantly （P<0.01）. Meanwhile， the Wutou Chishizhi Wan group was able to activate the Keap1/Nrf2 signaling pathway， which significantly increased Nrf2 expression and significantly decreased Keap1 expression （P<0.01）. Conclusion:Wutou Chishizhi Wan group can protect myocardial injury in MIRI rats. The specific mechanism is to protect MIRI by regulating vascular endothelial cell homeostasis and oxidative stress levels and activating Keap1/Nrf2 signaling pathway.
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MSC transplantation has been explored as a new clinical approach to stem cell-based therapies for bone diseases in regenerative medicine due to their osteogenic capability. However, only a small population of implanted MSC could successfully reach the injured areas. Therefore, enhancing MSC migration could be a beneficial strategy to improve the therapeutic potential of cell transplantation. Catharmus tinctorius volatile oil (CTVO) was found to facilitate MSC migration. Further exploration of the underlying molecular mechanism participating in the pro-migratory ability may provide a novel strategy to improve MSC transplantation efficacy. This study indicated that CTVO promotes MSC migration through enhancing ROCK2 mRNA and protein expressions. MSC migration induced by CTVO was blunted by ROCK2 inhibitor, which also decreased myosin light chain (MLC) phosphorylation. Meanwhile, the siRNA for ROCK2 inhibited the effect of CTVO on MSC migration ability and attenuated MLC phosphorylation, suggesting that CTVO may promote BMSC migration via the ROCK2/MLC signaling. Taken together, this study indicates that C. tinctorius volatile oil could enhance MSC migration via ROCK2/MLC signaling in vitro. C. tinctorius volatile oil-targeted therapy could be a beneficial strategy to improve the therapeutic potential of cell transplantation for bone diseases in regenerative medicine.
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OBJECTIVE@#This study aims to observe the efficacy of vacuum sealing drainage (VSD) by continuous negative pressure drainage and saline irrigation in the treatment of oral and maxillofacial space infection.@*METHODS@#Retrospective analysis was conducted on 116 cases of maxillofacial space infection, and clinical data were collected to compare the therapeutic effects of routine incision with drainage treatment (traditional treatment group, 58 cases) and VSD treatment (VSD group, 58 cases).@*RESULTS@#The length of hospital stay, white blood cell count, scar length, frequency of dressing change, and pain degree of patients in the VSD group were all lower than those in the traditional treatment group. Moreover, the improvement degree of mouth opening in the VSD groups was better than that in the traditional treatment group (P<0.05).@*CONCLUSIONS@#VSD is a more effective method for the treatment of oral and maxillofacial space infection.
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Humans , Body Fluids , Drainage , Mouth Diseases , Therapeutics , Retrospective Studies , Surgical Wound Infection , Therapeutics , VacuumABSTRACT
Objective To investigate the in vitro antibacterial spectrum of silibinin and its isomers and the combined antibacterial effect of silibinin and commonly-used clinical antibiotics. Methods Micro-broth dilution method was used to determine the minimum inhibitory concentration (MIC) of silibinin and its isomers against six standard strains and six clinical isolates (74 strains) of common bacteria infections. Plate count method was used to measure the growth inhibition curves of different concentrations of silibinin against six standard strains. Checkerboard micro-broth dilution method was used to carry out the combined susceptibility test of silibinin and clinical antibiotics. The fractional inhibitory concentration (FIC) was calculated to determine the combined antibacterial effect of silibinin and antibiotics. Results The MICs of silibinin against standard strains of Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus faecalis, and Enterococcus faecium were between 50 μg/mL and 400 μg/mL, and those of silibinin for standard strains of Escherichia coli and Pseudomonas aeruginosa were both greater than 400 μg/mL. The MICs of silibinin for clinical strains, Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus faecalis, and Enterococcus faecium were all within the range of 100 μg/mL to 400 μg/mL, and MICs of silibinin against clinical strains of Escherichia coli and Pseudomonas aeruginosa were greater than 400 μg/mL. The MICs of other isomers of silibinin against six standard strains were greater than or equal to 400 μg/mL. Silibinin had a significant inhibitory effect on the growth curve of standard strains of Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus faecalis, and Enterococcus faecium, which increased with increasing drug concentration, and it had no effect on that of Escherichia coli and Pseudomonas aeruginosa. The FIC of silibinin combined with penicillin/erythromycin for gram-positive test bacteria was in the range of 0.5 2 or 1 < FIC ≤ 2. Conclusion Silibinin has a notable antibacterial activity to gram-positive bacteria with the best inhibitory effect on Staphylococcus epidermidis. The antibacterial activities of silibinin is higher than those of other isomers. The combined antibacterial effect of silibinin and penicillin/erythromycin is mainly additive and irrelevant, while that of silibinin and ciprofloxacin or gentamicin is mainly antagonistic or irrelevant.
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Objective: To evaluate whether clinical imaging findings of sarcomas after preoperative chemotherapy correlate with tumor responses by pathological evaluation using the rate of necrosis, so as to develop reliable and quantitative evaluation of clinical re-sponse. Methods: We retrospectively reviewed the medical records of 190 patients with high-grade sarcomas (mainly osteosarcomas and Ewing's sarcomas) that originated from the bone and who received neoadjuvant chemotherapy from June 1, 2014 to March 1, 2017 at Peking University People's Hospital. Finally, 157 lesions were evaluated by clinical imaging, including X-ray, computed tomogra-phy, magnetic resonance imaging, and bone scans or PET/CT. All patients underwent surgery at our center and pathological evaluation by tumor necrosis rates, which were graded by Huvos'classification, where gradeⅠis 0 to 49%, gradeⅡis 50% to 89%, gradeⅢis 90% to 99%, and gradeⅣis 100% necrosis. Statistical diversity analysis was performed by different pathological groups and receiver operating characteristic (ROC) curves. ROC curves were generated to determine the dividing clinical parameters (cut-off values) to dis-tinguish different pathological groups. Results: The cut-off values of the rate change in maximum diameters of tumors located in the extremities were 86%, 50.7%, and 0.02% for Huvos'Ⅳ,Ⅲ,Ⅱ, andⅠgroups, respectively. The differentiation was not obvious using bone scans to distinguish different pathological responses. The cut-off value for SUVmax for Huvos'Ⅲ,Ⅱ, andⅠgroups were 60.7% and 31.4%, respectively. We did not identify any valuable clinical parameters to evaluate the lesion restricted inside the bone. For sar-comas that originated from the axial skeleton, because of the small size of the sample, the differentiation was not so obvious. Conclu-sions: This study clearly defined the measuring methods for sarcomas primarily originating from the bone and attempted to determine meaningful cut-off values for multiple pathological response groups. A prospective multicenter trial is warranted to expand the sample size to make this clinical evaluation more precise and practical.
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Objective To investigate the effect of mild hypothermia on the myocardial and microcirculation dysfunction induced by epinephrine during early post-resuscitation in a rat model of cardiac arrest and cardiopulmonary resuscitation (CPR).Methods Transesophageal cardiac pacing was performed in order to elicit cardiac arrest for 5 min in SD male rats.Totally 40 rats were randomly (random number) divided into 4 groups (n=10):normothermic control group (N),normothermic epinephrine group (N+E),hypothermic control group (H),and hypothermic epinephrine group (H+E).Chest compression was then initiated.Epinephrine (0.02 mg/kg) or saline was administrated at 1 min during CPR.Restoration of spontaneous circulation (ROSC) was recorded,and the rates of ROSC were observed.Myocardial and microcirculatory function were observed at 1,2,3,and 4 h during early post-resuscitation.Serum lactate level was assessed at baseline and ROSC 4 h.Results The ROSC rates were 10/10 in the H+E group,9/10 in the N+E group,4/10 in the H group,and 1/10 in the N group,respectively.Ejection fraction (EF)and cardiac output (CO) in the H+E group were significantly higher than that of other groups (P＜0.05).Total vessel density,perfused vessel density,proportion of perfused vessels,and microvascular flow index in the H+E group were also significantly higher than those of other groups during early post-resuscitation.The serum lactate level in the H+E group was significantly lower than that in the N+E and H groups..Conclusions Both epinephrine and mild hypothermia can improve the success rate of resuscitation.However,mild hypothermia can improve the epinephrine induced myocardial and microcirculatory dysfunction during postresuscitation in the rat cardiac arrest.
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OBJECTIVE@#This study aimed to investigate the value of normalized iodine concentration (NIC), spectral attenuation curve slope (SACS), area under curve (AUC), and iodine concentration difference (ICD) generated from spectral CT in the assessment of parotid gland tumors.@*METHODS@#Ninety-two patients with pathologically confirmed parotid gland tumors underwent arterial phase- and venous phase-enhanced CT in spectral CT. The patients were divided into the pleomor-phic adenoma group (group A), Warthin tumor group (group B), basal cell tumor group (group C), and malignant tumor group (group D). The SACS, AUC, NIC, ICD were measured and analyzed. Statistical analyses were performed by one-way ANOVA, and statistical significance was set at P<0.05.@*RESULTS@#SACS(AP), AUC(AP), and NIC(AP) in group A were lower than those in other groups; SACS(VP) and AUC(VP) in group C were higher than those in other groups; NIC(AP) and NIC(VP) in group D were higher than those in other groups; and ICD in group B was a positive number. The difference in SACS(AP) and AUC(AP) in groups B and C, SACS(VP) and AUC(VP) in groups C and D, and ICD in groups A and C were not statistically significant. By contrast, the diffe-rence between the other groups was statistically significant (P<0.05). The difference in NIC(AP) between groups A and B and groups C and D and the difference in NIC(VP) between groups A and C, groups A and D, and groups B and C were statistically significant (P=0.005, 0.025, 0.002, 0.038, and 0.049, respectively).@*CONCLUSIONS@#Multi-quantitative parameters from spectral CT might be helpful in differentiating various types of parotid gland tumors.