Imaging study of maxillary sinus in normal adults using cone-beam CT / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo estimate different dimensions of maxillary sinus measured on cone-beam computerized tomography (cone-beam CT), and determine the differences in side and gender.METHODScone-beam CT image data from 200 normal adults was selected and analyzed by Invivo Dental software. The craniocaudal diameter, anteroposterior diameter, width and volume of maxillary sinus were measured as well as the thickness of the orbital floor. Statistical analysis was performed with SPSS 11.5.RESULTSThere were no statistically significant differences in the craniocaudal diameter, anteroposterior diameter, width and volume of maxillary sinus between sides (P>0.05, respectively). Significant differences were noted in the craniocaudal diameter and volume of bilateral maxillary sinus and the width of right maxillary sinus based on gender (P0.05, respectively).CONCLUSIONOur findings indicate that cone-beam CT can be used to measure different dimensions of maxillary sinus and provide imaging anatomical data for clinical treatment.

Effects of vacuum sealing drainage combined with irrigation of oxygen loaded fluid on wounds of pa- tients with chronic venous leg ulcers / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects of VSD combined with irrigation of oxygen loaded fluid on the growth of granulation tissue and macrophage polarization in chronic venous leg ulcers.</p><p><b>METHODS</b>Thiry-four patients with chronic venous leg ulcers hospitalized in our department from December 2010 to July 2014 were divided into VSD group ( A, n = 11) , VSD + irrigation group ( B, n = 11) , and VSD + oxygen loaded fluid irrigation group ( C, n = 12) according to the random number table. After admissian, debridement was performed, and granulation tissue in the center of the wound was harvested during the operation. After dehridement, the patients in group A were treated with VSD only (negative pressure from -30 to -25 kPa, the same below) ; the patients in group B were treated with VSD combining irrigation of normal saline; the patients in group C were treated with VSD combining normal saline loaded with oxygen irrigation (flow of 1 L/min) . On post treatment day (PTD) 7, the VSD devices were removed. Cross observation was conducted before debridement and on PTD 7. On PTD 7, the granulation tissue in the center of the wound was harvested for histopathological observation with HE staining and Masson staining, following calculation of granulation tissue coverage rate. After debridement but before the negative pressure therapy (hereinafter referred to as before treatment) and on PTD 7, partial pressure of oxygen of the skin around the wound was measured by transcutaneous tissue oxygen tension survey meter. On PTD 7, expression of vascular endothelial growth factor (VECF) was determined with immunohistochemistry. Before treatment and on PTD 7, cells with double positive expressions of induced nitric oxide synthase plus CD68 ( type I macro- phage) and arginase 1 plus CD68 ( type II macrophage) were observed with immunofluorescence staining and quantified. Data were processed with Fisher's exact test, one-way analysis of variance, covariance analysis, paired test, and LSD test.</p><p><b>RESULTS</b>(1) The gross observation showed that before debridement there was a certain amount of necrotic tissue and little granulation tissue in the wounds of patients in all the 3 groups. On PTD 7, new granulation tissue was found in the wounds of patients in all the 3 groups, and in group C its amount was the largest. (2) On PTD 7, the granulation tissue coverage rate of wounds in pa- tients of group C was higher than that of group A or B ( P <0.05 or P <0.01). (3) On PTD 7, HE staining showed that there appeared more abundant new born microvessels and fibroblasts in the wounds of patients in group C than those in groups A and B; Masson staining showed that there was more abundant fresh collagen distributed orderly in the wounds of patients in group C compared with group A or B. (4) On PTD 7, it was found that partial pressure of oxygen of the skin around the wounds in patients of group C [(40.7 +/- 4.1) mmHg, 1 mmHg = 0.133 kPa] was higher than that of group A [ (35.0 +/- 3.1) mmHg] or B [(35.4 +/- 2.7) mmHg, with P values below 0.01]; the partial pressure of oxygen of the skin around the wounds of patients in all the 3 groups was increased significantly compared with that before treatment (with values from 10.38 to 22.52, P values below 0.01). (5) On PTD 7, the expression of VECF in the wounds of patients in group C was higher than that in group A or B ( P <0.05 or P < 0.01). (6) On PTD 7, the number of type I macrophages in granulation tissue of patients was respectively 14.3 +/- 2.3, 11.5 +/- 3.0, and 10.7 +/- 2.3 per 400 times vision field in groups A , B, and C ( F = 25.14, P < 0.01), while the number in group C was less than that in group A or B ( P < 0.05 or P < 0.01). Compared with that before treatment, the number of type I macrophages was significantly decreased on PTD 7 in all the 3 groups (with values from 14.76 to 23. 73, P values below 0. 01). On PTD 7, the number of type II macrophages in granulation tissue of patients was respectively 32.7 +/- 3.2, 35.1 +/- 3.3 , and 41.3 +/- 3.2 per 400 times vision field in groups A, B, and C ( F = 81.10, P < 0.01), and the number in group C was lager than that in group A or B ( with P values below 0. 01). Compared with that before treatment, the number of type II macrophages in all the 3 groups was significantly increased (with t values from -69.34 to -47.95, P values below 0.01).</p><p><b>CONCLUSIONS</b>VSD combined with irrigation of oxygen loaded fluid can raise the partial pressure of oxygen of the skin around the wounds effectively, promoting the transition of macrophages from type I to type II, thus it may promote the growth of granulation tissue, resulting in a better recipient for skin grafting or epithelization.</p>

Clinical study of anti-Mullerian hormone in prediction of ovarian aging / 中华妇产科杂志

Objective To explore the serum anti-Mullerian hormone (AMH) level in women of childbearing age with normal menstrual cycles. Methods A total of 1 423 women with regular menstrual cycles were selected and divided into 5 groups according to their ages, i.e.≤25, 26-30, 31-35, 36-40,≥41 years. Their serum levels of AMH were measured, and the relationship between AMH and age was analyzed. Results The serum AMH levels of 5 groups according to ages (≤25, 26-30, 31-35, 36-40, ≥41 years) were 3.62, 3.10, 2.27, 1.07, 0.45μg/L, respectively. The comparison of serum AMH levels in different age groups had significant difference (P<0.01). Serum AMH level declined with increasing age,and dropped significantly after 36. The serum AMH level and age showed a negative correlation with significant difference (r=-0.374, P<0.01). Quadratic regression of logAMH proximally reflected the relationship between AMH and age. Conclusion AMH determination for women of childbearing age could provide reference for the evaluation of ovarian function.

Effects of vacuum sealing drainage combined with irrigation of oxygen loaded fluid on chronic wounds in diabetic patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects of VSD combined with irrigation of oxygen loaded fluid on chronic wounds in diabetic patients.</p><p><b>METHODS</b>Twenty-six diabetic patients hospitalized in Nanfang Hospital of Southern Medical University from September 2010 to June 2013, with chronic ulcers on lower extremities conforming to the inclusive criteria, were divided into group VSD (n = 8), VSD + irrigation control group (VSD + IC, n = 9), VSD + oxygen loaded fluid irrigation group (VSD OLI, n = 9) according to the random number table. After gross observation was conducted and wound secretion was sent for bacterial culturing right after admission, debridement was performed. During the debridement, granulation tissue of wound center was harvested for determination of the activity of lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH) with ELISA. After debridement, the patients in group VSD were treated with VSD (negative pressure from -30 to -25 kPa, the same below); the patients in group VSD + IC were treated with VSD combining irrigation of normal saline; the patients in group VSD + OLI were treated with VSD combining normal saline loaded with oxygen (flow of 1 L/min ) irrigation. Drainage tube blockage was recorded and its incidence rate was recorded during the treatment. On post treatment day (PTD) 7, tissue exudates were collected and analyzed with blood gas analyzer for determining the partial pressure of oxygen of the exudate. After the VSD was terminated, bacterial culture was conducted as before, and the bacterial clearance rate was calculated. After the calculation of granulation tissue coverage rate, the granulation tissue in the center of the wound was harvested for histopathological observation with HE staining; morphological characteristics and density of mitochondria were observed with transmission electron microscopy; the activity of LDH and SDH was estimated as before; microvascular density (MVD) was counted after CD31 antibody immunohistochemical staining. Then the second stage operation was performed. The method of second stage operation was recorded and survival rate of grafted skin or flap was calculated. Data were processed with one-way analysis of variance, LSD- t test, rank sum test, or Fisher's exact test.</p><p><b>RESULTS</b>(1) The gross observation showed that before debridement there was only necrotic tissue without granulation tissue in the wounds of patients in all the 3 groups. On PTD 7, granulation tissue was found in the wounds of patients in all the 3 groups. HE staining showed that there were more abundant newborn microvessels and regularly arranged fibroblasts in the wounds of group VSD + OLI; less newborn microvessels and relatively sparsely fibroblasts were observed in the wounds of group VSD + IC. There were only sparse newborn microvessels and fibroblasts in the wounds of group VSD. (2) Rates of drainage tube blockage, granulation tissue coverage, and bacterial clearance showed significant differences among the 3 groups (with F values from 10.98 to 770.24, P values below 0.01). The drainage tube blockage rate was significantly lower in groups VSD + IC and VSD + OLI [(2.0 ± 0.4)% and (1.9 ± 0.6)%] than in group VSD [(16.0 ± 1.3)%, with t values respectively 28.77 and 29.20, P values below 0.01]. (3) On PTD 7, the partial pressure values of oxygen of the exudate in groups VSD + IC, VSD + OLI, and VSD were respectively (111 ± 4), (43 ± 4), and (40 ± 4) mmHg (1 mmHg = 0.133 kPa, F = 882.76, P < 0.01). (4) The density of mitochondria in group VSD + OLI was obviously higher than that of the other 2 groups, full in shape, with complete outer membrane and no vacuolization. (5) During debridement, the activity of LDH and SDH in 3 groups showed no significant differences (with F values respectively 0.08 and 1.03, P values above 0.05). On PTD 7, the activity of LDH was lower in group VSD + OLI [(103 ± 15) U/L] than in group VSD + IC [(136 ± 16) U/L, t = 4.49, P < 0.01], while it was higher in group VSD [(155 ± 16) U/L] than in group VSD + IC (t = 2.47, P < 0.05). The activity of SDH was higher in group VSD + OLI [(2.93 ± 0.27) U/L] than that in group VSD + IC [(1.77 ± 0.22) U/L] or group VSD [(1.61 ± 0.19) U/L, with t values respectively 10.21 and 11.65, P values below 0.01]. (6) On PTD 7, there was more positive expression of CD31 in group VSD + OLI than in the other 2 groups. The MVD of groups VSD, VSD + IC, and VSD + OLI were respectively (109 ± 5), (124 ± 5), (141 ± 6) per 400 times visual field (F = 68.78, P < 0.01). (7) The patients in 3 groups mainly received skin or flap grafting as the second stage operation. The survival rates of skin and flap in group VSD + OLI were higher than those of groups VSD + IC and VSD (with t values from 3.32 to 8.26, P < 0.05 or P < 0.01), and the rates were higher in group VSD + IC than in group VSD (with t values respectively 2.67 and 3.18, P values below 0.05).</p><p><b>CONCLUSIONS</b>VSD + OLI is effective in reducing drainage tube blockage, removing necrotic tissue and bacteria, ameliorating ischemia and hypoxia of wound tissue, providing fresh wound bed for wound healing, and improving skin or flap graft survival rates.</p>

Construction and identification of prokaryotic expression system of staphylococcal enterotoxin A gene and expressed product / 中国病理生理杂志

AIM:To construct a prokaryotic expression system of staphylococcal enterotoxin A(SEA)gene and determine the effects of the recombinant expression product rSEA in promoting lymphocyte proliferation and inhibiting tumor cell growth.METHODS:PCR was used to amplify entire SEA gene of S.aureus strain ATCC13565.The cloned SEA gene was sequenced after T-A cloning.SDS-PAGE was applied to measure the output of rSEA expressed by pET32a-SEA-E.coli BL21DE3.Ni-NTA affinity chromatography was performed to extract rSEA.Cytotoxicity of rSEA to Vero cells was detected using TCID_ 50 titration method and then the value of TCIC_ 50 was determined.MTT colorimetry was established to examine the effects of rSEA at different dosages on proliferation of mouse splenocytes and human peripheral blood mononuclear cells(PBMC)as well as on growth of HepG2 cells and HeLa cells in vitro.RESULTS:In comparison with the published corresponding sequences,similarities of the nucleotide and putative amino acid sequences of the cloned SEA gene were 100%.The output of rSEA was approximate 25% of the total bacterial proteins.rSEA had a cytotoxicity with TCIC_ 50 of 3.14 ?g to Vero cells.1.0-20.0 mg/L rSEA showed the significant effects of promoting proliferation of mouse splenocytes and human PBMC(P