Pathogenic mechanisms of congenital abnormalities of kidney and urinary tract / 中华围产医学杂志

Congenital abnormalities of the kidney and urinary tract (CAKUT) are common congenital malformations identified by prenatal ultrasound. This review summarizes the fetal renal development, the mechanism of CAKUT, and the influence of the fetal environment on CAKUT. CAKUT can manifest as different degrees of renal disease, from transient hydronephrosis to severe bilateral renal dysplasia, a major risk factor for chronic and end-stage renal disease in childhood. Genetic factors and abnormal fetal environment can both contribute to CAKUT. Ultrasound screening is conducive to detect CAKUT but may miss some defects. Monogenic mutations identified in CAKUT can help us gain more insight into the molecular mechanisms of renal development.

Implantation of inverted Y-type metal airway stent with modified guide wire insertion technique under local anesthesia for malignant carina stenosis: initial experience in 10 patients / 介入放射学杂志

Objective To assess the technical feasibility and effectiveness of X-ray-guided implantation of inverted Y-type metal airway stent under local anesthesia by using a modified technique of exchanging guide wire in order to shorten operation time.Methods The clinical data of a total of 16 patients,who received inverted Y-type metal airway stent implantation under local anesthesia,were retrospectively analyzed.Routine gradual guide wire exchange method with a harder one was used in 6 patients (routine group),while in 10 patients (modification group) a modified technique of exchanging guide wire,i.e.inserting two hard wires at one time,was employed.Technical success rate and operation time were used as the main observation indexes.Results Under local anesthesia,the implantation of inverted Y-type metal airway stent was successfully accomplished in all 16 patients.The mean operation time of the routine group and the modification group was 15.6 minutes and 11.1 minutes respectively,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the performance of implantation of inverted Ytype metal airway stent under local anesthesia to treat malignant carina stenosis,the use of modified technique of guide wire insertion,i.e.inserting two hard wires at one time,can effectively shorten the operation time.

Effects of hyaluronic acid on scar formation in the acellular nerve allograft / 中国组织工程研究

BACKGROUND:In terms of the histocompatibility, immune rejection and scar formation after repair, acel ular nerve al ograft is closer to autologous nerve cel s. At present, hyaluronic acid has been applied for autologous peripheral nerve repair;however, research on the nerve al ograft is rarely reported. OBJECTIVE:To explore the effect of hyaluronic acid on the anastomotic scar in acel ular nerve al ograft repair of rat sciatic nerve defect. METHODS:Thirty-six Sprague-Dawley rats were randomly divided into three groups (n=12 per group). The rat model of nerve defect of 10 mm was established by cutting the sciatic nerve of the left hind leg and then given nerve al ograft combined with the injection of hyaluronic acid at anastomosis (experimental group), only nerve al ograft (control group) and autologous nerve graft (nerve autograft group), respectively. Afterwards, the healing of the proximal anastomosis was observed and scar components were assessed. RESULTS AND CONCLUSION:Gross observations showed that the rat skin and muscle fascia had no significant differences in healing among groups, while the surrounding tissue adhesion in the experimental group was milder than that in the control group (P0.05). These findings indicate that in the peripheral nerve repair, hyaluronic acid abrogates the scar formation by increasing the deposition of col agen type III and reducing the deposition of col agen type I.

The effects of JNK1 on the responses of cytolytic T cells against viral infection / 中华微生物学和免疫学杂志

Objective To examine the role of c-Jun NH2-terminal kinase(JNK) 1 in cytolytic T lymphocyte (CTL) responses against virus infection.Methods Wild-type (WT) and JNK1-knockout (JNK1-/-) mice were infected with ectromelia virus(ECTV) through hind footpads.Survival and virus titers in the target organs (liver and spleen) were analyzed.Effector T cells in the spleen and popliteal lymph nodes were determined on day 3 and 7 post-infection.Proliferation and INF-γ production of CTL were also detected.Results JNK1 deficiency caused an increased susceptibility to ECTV infection in mice,indicated by higher case fatality and viral burden in target organs.The decrease in CTL response correlated with a defect in CTL proliferation and INF-γproduction.Conclusion The data suggest that JNK1 is involved in expansion of activated CTL during ECTV infection,and plays an important antiviral role in regulating the proliferation and effector function of CTL.

Fluoroscopically Guided Three-Tube Insertion for the Treatment of Postoperative Gastroesophageal Anastomotic Leakage

OBJECTIVE: To retrospectively evaluate the feasibility and effectiveness of three-tube insertion for the treatment of postoperative gastroesophageal anastomotic leakage (GEAL). MATERIALS AND METHODS: From January 2007 to January 2011, 28 cases of postoperative GEAL after an esophagectomy with intrathoracic esophagogastric anastomotic procedures for esophageal and cardiac carcinoma were treated by the insertion of three tubes under fluoroscopic guidance. The three tubes consisted of a drainage tube through the leak, a nasogastric decompression tube, and a nasojejunum feeding tube. The study population consisted of 28 patients (18 males, 10 females) ranging in their ages from 36 to 72 years (mean: 59 years). We evaluated the feasibility of three-tube insertion to facilitate leakage site closure, and the patients' nutritional benefit by checking their serum albumin levels between pre- and post-enteral feeding via the feeding tube. RESULTS: The three tubes were successfully placed under fluoroscopic guidance in all twenty-eight patients (100%). The procedure times for the three tube insertion ranged from 30 to 70 minutes (mean time: 45 minutes). In 27 of 28 patients (96%), leakage site closure after three-tube insertion was achieved, while it was not attained in one patient who received stent implantation as a substitute. All patients showed good tolerance of the three-tube insertion in the nasal cavity. The mean time needed for leakage treatment was 21 +/- 3.5 days. The serum albumin level change was significant, increasing from pre-enteral feeding (2.5 +/- 0.40 g/dL) to post-enteral feeding (3.7 +/- 0.51 g/dL) via the feeding tube (p < 0.001). The duration of follow-up ranged from 7 to 60 months (mean: 28 months). CONCLUSION: Based on the results of this study, the insertion of three tubes under fluoroscopic guidance is safe, and also provides effective relief from postesophagectomy GEAL. Moreover, our findings suggest that three-tube insertion may be used as the primary procedure to treat postoperative GEAL.

USPIO enhanced 7.0T MRI research of inflammation in rat ischemic stroke / 中国医学影像技术

Objective To observe signal changes induced by USPIO accords with iron swallowed by macrophages in brain tissue sections in rats. Methods Thirty-eight SD rats were divided into two groups randomly. Three of them were involved in sham operation group, other thirty-five rats were divided into five subgroups averagely according to 7.0T MR scanning time (6 h, 12 h, 24 h, 48 h and 72 h). After establishment of MCAO models, USPIO was injected to tail intravenous and monitored with high resolution MRI at different time point, while rats in control group were injected with the same dose of sodium chloride. Brain tissue wax section was acquired after MR scanning. Cell necrosis, iron particle and activated macrophages were observed with HE dying, Prussian Blue dying and CD68 immunochemistry staining respectively. Results The ischemic lesion was detected as hyperintense area on T2WI after occlusion and perfusion of MCA. The accumulation of USPIO appeared as hypointense on T2WI but hyperintense on T1WI. The maximum signal change was observed at 48-72 h in both T1WI and T2WI (P>0.05). The iron particle accumulation was found in the boundary of ischemic lesion and necrotic area with Prussian Blue dying. Activated microglia was manifested with CD68 immunochemistry staining, the number of microglia at 72 h was more than those of the other time points. Conclusion USPIO can be used as a contrast agent to monitor rat ischemic stroke in vivo, and the signal changes induced by USPIO approximately accord with iron swallowed by macrophages in brain tissue sections. The cells which swallow USPIO are mainly activated macrophages.