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OBJECTIVE@#To summarize the etiology mechanism and treatment of iatrogenic blepharoptosis after double eyelid surgery in Asia.@*METHODS@#To extensively review the literature related to iatrogenic blepharoptosis after double eyelid surgery, and to summarize and analyze the related anatomical mechanism, existing treatment options, and indications.@*RESULTS@#Iatrogenic blepharoptosis is a relatively common complication after double eyelid surgery, sometimes it is combined with other eyelid deformities such as sunken upper eyelid and wide double eyelid, which makes it difficult to repair. The etiology is mainly caused by improper adhesion of tissues and scars, improper removal of upper eyelid tissue, and injury of a link of levator muscle power system. Whether blepharoptosis occurs after double eyelid surgery by incision or suture, it should be repaired by incision. The principles of repair include surgical loosening of tissue adhesion, anatomical reduction, and repair of damaged tissues. The key is to use surrounding tissues or transplanted fat to prevent adhesion.@*CONCLUSION@#When repairing iatrogenic blepharoptosis clinically, appropriate surgical methods should be selected based on the causes and severity of the blepharoptosis, combined with treatment principles, in order to achieve better repair results.
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Humans , Blepharoptosis/surgery , Treatment Outcome , Retrospective Studies , Blepharoplasty/methods , Eyelids/surgery , Iatrogenic Disease , Oculomotor Muscles/surgeryABSTRACT
【Objective】 To determine molecular basis of a rare HLA-A typing results carrying triple A alleles in potential allo-HSCT donor and her family. 【Methods】 HLA-A, -B, -C, -DRB1, -DQB1, -E, -F, -G of 5 members in the family were genotyped at a high-resolution level using next-generation sequencing (NGS). HLA-A of probosita was re-checked using polymerase chain reaction-sequence-based typing (PCR-SBT), and SNP oligonucleotide probes (SNP-array)were scanned with genomic DNA of probosita. 【Results】 There was 162.9Kb duplication in 6p22.1(29, 803, 377-29, 966, 301)of probosita who carried triple A alleles A*02∶01∶01, A*11∶01∶01, A*24∶02∶01. Other two family members were found to carry this haplotype: A*02∶01∶01, A*24∶02∶01, B*54∶01∶01, C*01∶02∶01, DRB1*04∶05∶01, DQB1*04∶01∶01, E*01∶01∶01∶03, F*01∶01∶01, G*01∶01∶01∶01, which as a Mendelian gene was segregated and stably transmitted through two generations. 【Conclusion】 Tiny gene duplication induces one haplotype carries two HLA-A alleles in a potential healthy donor for allo-transplantaion and stably transmits through two generations.Routine HLA typing laboratories should pay more attention to this situation and accurately report.
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Objective:To determine lysophosphatidic acid receptor 6 (LPAR6) expression in patients with mycosis fungoides (MF) , a variant of cutaneous T-cell lymphoma (CTCL) , and to investigate its role and mechanism of action in the development and prognosis of CTCL.Methods:A total of 110 patients with confirmed MF were collected from Department of Dermatology, Peking University First Hospital from 2011 to 2020, including 24 with large-cell transformation (LCT) and 25 with non-large cell transformation (NLCT) in the discovery cohort, and 24 with LCT and 37 with NLCT in the validation cohort. RNA sequencing and RT-PCR were conducted to determine the LPAR6 expression in patients in the discovery cohort and validation cohort respectively. LPAR6 expression was compared between patients with LCT and those with NLCT, and its effect on the prognosis of patients was evaluated. Two LPAR6-overexpressing CTCL cell lines MyLa and Sz4 were constructed to evaluate the effect of LPAR6 overexpression on proliferative activity of MyLa and Sz4 cells, with the cells normally expressing LPAR6 as the control group; after the treatment with LPAR6-related ligand lysophosphatidic acid (LPA) , 2S-OMPT, adenosine triphosphate (ATP) or adenosine (ADO) , the effects of LPAR6 activation on the proliferative activity and apoptosis of LPAR6-overexpressing MyLa and Sz4 cells were evaluated by the MTS method and flow cytometry respectively. Log-rank test was used for prognostic analysis, and t test or Mann-Whitney U test was used for comparisons between two groups. Results:As RNA sequencing showed, LPAR6 was one of the significantly underexpressed genes in the LCT group in the discovery cohort; in the validation cohort, LPAR6 expression (median[ Q1, Q3]) was significantly lower in the LCT group (204.90[81.90, 512.70]) than in the NLCT group (809.40[417.50, 1 829.20], U= 242.00, P= 0.002) ; in the two cohorts, the underexpression of LPAR6 was significantly associated with increased risk of poor prognosis (both P < 0.01) . Cell proliferation assay showed no significant difference in the proliferative activity of MyLa or Sz4 cells between the LPAR6 overexpression group and control group at 0, 24, 48 and 72 hours during the experiment (all P > 0.05) ; 48 hours after activation of LPAR6 by LPA, 2S-OMPT, ATP and ADO in MyLa cells, the LPAR6 overexpression group showed significantly decreased cellular proliferative activity (1.38 ± 0.01, 1.04 ± 0.01, 1.09 ± 0.03, 1.23 ± 0.01, respectively) compared the control group (1.73 ± 0.04, 1.23 ± 0.01, 1.24 ± 0.01, 1.42 ± 0.03, t= 30.33, 18.38, 4.78, 5.75, respectively, all P < 0.05) , but significantly increased cell apoptosis rate (17.93% ± 0.88%, 17.75% ± 0.35%, 23.97% ± 0.57%, 31.44% ± 0.34%, respectively) compared the control group (3.98% ± 0.03%, 7.81% ± 0.59%, 11.95% ± 0.85%, 12.02% ± 0.48%, t= 15.93, 14.49, 11.74, 33.01, respectively, all P < 0.05) ; 48 hours after activation of LPAR6 by 2S-OMPT and ADO in Sz4 cells, compared with the control group, the LPAR6 overexpression group also showed significantly decreased cellular proliferative activity (2S-OMPT: 1.29 ± 0.04 vs. 1.48 ± 0.01; ADO: 1.27 ± 0.01 vs. 1.51 ± 0.02; both P < 0.05) , but significantly increased cell apoptosis rate (2S-OMPT: 41.70% ± 0.70% vs. 29.35% ± 0.55%; ADO: 37.05% ± 0.15% vs. 24.60% ± 1.00%; both P < 0.05) . Conclusions:LPAR6 was underexpressed in the patients with LCT, and its underexpression was significantly associated with increased risk of poor prognosis. In vitro activation of LPAR6 could inhibit the proliferation of CTCL cells and promote their apoptosis, suggesting that the decrease of LPAR6 expression may be one of the important mechanisms underlying disease progression in patients with LCT.
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In order to solve the current problems in medical equipment maintenance, this study proposed an intelligent fault diagnosis method for medical equipment based on long short term memory network(LSTM). Firstly, in the case of no circuit drawings and unknown circuit board signal direction, the symptom phenomenon and port electrical signal of 7 different fault categories were collected, and the feature coding, normalization, fusion and screening were preprocessed. Then, the intelligent fault diagnosis model was built based on LSTM, and the fused and screened multi-modal features were used to carry out the fault diagnosis classification and identification experiment. The results were compared with those using port electrical signal, symptom phenomenon and the fusion of the two types. In addition, the fault diagnosis algorithm was compared with BP neural network (BPNN), recurrent neural network (RNN) and convolution neural network (CNN). The results show that based on the fused and screened multi-modal features, the average classification accuracy of LSTM algorithm model reaches 0.970 9, which is higher than that of using port electrical signal alone, symptom phenomenon alone or the fusion of the two types. It also has higher accuracy than BPNN, RNN and CNN, which provides a relatively feasible new idea for intelligent fault diagnosis of similar equipment.
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Algorithms , Electricity , Memory, Short-Term , Neural Networks, ComputerABSTRACT
Objective:To improve the diagnostic criteria of suspected cases through investigating the epidemiological and clinical manifestations of confirmed cases of novel coronavirus infection in children.Methods:We retrospectively analyzed the epidemiological and clinical manifestations of six children with novel coronavirus infection diagnosed in Chongqing Three Gorges Central Hospital from February 3, 2020 to February 15, 2020.Compared with the diagnostic criteria of suspected cases, we summarized the problems encountering in the application of this standard in clinic and try to put forward suggestions for improvement.Results:Among the six confirmed cases: five males and one female; three from Hubei Province and three from Wanzhou; six cases of clustered onset of the family.Visiting nature: six cases of suspected case, six cases from community or outpatient screening.Three fever cases with/without respiratory symptoms, one of which had diarrhea; all children′s blood routine and lymphocyte counts were within the normal range; chest CT imagings of No.1 and No.5 case showed typical novel coronavirus pneumonia signs, and the other three patients had abnormalities without the characteristics of novel coronavirus pneumonia, and one case was normal.Comparison results: Only No.1 case fully met the diagnostic criteria, and the remaining cases did not meet the diagnostic criteria for early suspected cases.Conclusion:In order to improve the accuracy and practicality of the diagnosis of suspected cases in children, it is recommended to refine and standardize the diagnostic criteria for some suspected cases.
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Objective@#To improve the diagnostic criteria of suspected cases through investigating the epidemiological and clinical manifestations of confirmed cases of new-type coronavirus infection in children.@*Methods@#We retrospective analyzed the epidemiological and clinical manifestations of 6 children with new coronavirus infection diagnosed in Chongqing Three Gorges Central Hospital from February 3, 2020 to February 15, 2020 . Compared with the diagnostic criteria of suspected cases,we summarized the problems encountered in the application of this standard in clinical work and try to put forward Suggestions for improvement.@*Results@#Among the 6 children with confirmed cases: 5 males and 1 female; 3 from Hubei Province and 3 from Wanzhou ; 6 cases of clustered onset of the family; Visiting nature: 3 cases of suspected case income, 3 cases of community or outpatient screening . Three cases with fever and / or respiratory symptoms, one of which had symptoms of diarrhea; all children's blood routine and lymphocyte counts were within the normal range; chest CT imaging except for cases No. 1 and No. 5 were in line with typical new coronavirus pneumonia signs. In addition, the remaining 3 patients had abnormal imaging but did not have the characteristics of new coronavirus pneumonia, and 1 case was normal. Comparison results:Only case 1 of all cases fully met the diagnostic criteria, and the remaining cases did not meet the diagnostic criteria of early suspected cases.@*Conclusion@#In order to improve the accuracy and practicality of the diagnosis of suspected cases in children, it is recommended to refine and standardize the diagnostic criteria of some suspected cases.
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Colistin has been revalued as the last resort for multi-drug resistant gram-negative bacte-ria infections and attracted considerable attention. The plasmid-mediated colistin resistance gene mcr-1 was first reported in 2005,which not only altered our understanding of the mechanisms of colistin resistance,but also posed a significant threat to public health. Until now,mcr-1 has been reported in more than 30 countries and regions spreading over five continents. The whole world has paid high attention to mcr-1 and taken meas-ures to control the administration of colistin in order to contain the spread and dissemination of mcr-1. This review focused on the structure,epidemiology and molecular biological characteristics of mcr-1 and measures for the prevention of mcr-1 spreading,aiming at enhancing the recognition,prevention and control of mcr-1.
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Objective To study the diagnosis accuracy and features of echocardiography on aortic coarctation combined with hypoplastic aortic arch. Methods The echocardiographic characteristics of seven patients who were diagnosed as aortic coarctation combined with hypoplastic aortic arch were analyzed and compared with results of cardiac catheterization, CT scan and operation. The diagnostic features of echocardiography were summarized. Results Besides the echocardiographic characteristics of aortic coarctation,other specific echocardiographic characteristics of hypoplastic aortic arch were:distinct stenoses of transverse and decsending part of aortic arch were visualized in supra-sternal long-axis view; the range of hypoplastic part started from innominate artery beginning or left common carotid artery beginning; the ratio of diameter of hypoplastic aortic arch over that of descending aorta at diaphragm was less than 0. 5; the blood flow speed detected by Doppler at the site of aortic coarctation was in the normal range. The echocardiographic characteristics of the aortic coarctation combined with hypoplastic aortic arch were correspondent to the results of cardiac catheterization, CT scan and operation results. Conclusions There is high accuracy of echocardiography in diagnosis of aortic coarctation combined with hypoplastic aortic arch. Hypoplastic aortic arch should be paid more attention in diagnosis of aortic coarctation.
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Objective To retrospectively evaluate and analyze the clinical effect of posterior pedicle subtraction osteotomy in treating chronic, posttraumatic thoracolumbar kyphosis. Methods Nineteen patients (11 males and 8 females) with chronic, posttraumatic thoracolumbar kyphosis were corrected surgically. The patients were at age range of 29-61 years (mean 42 years). Preoperative kyphosis Cobb angle ranged from 31° to 63° (mean 47°) and trauma history ranged from 8 months to 63 months (mean 29 months). All patients were treated with pedicle subtraction osteotomy according to the size of Cobb angle, extent of spinal stenosis and source of compression. Results Sagittal alignment was improved to average 40.2°, with a correction rate of 85.8%. Two patients developed postoperative leakage of cerebrospinal fluid. Among them, one was combined with encephalic infection and cured with active treatment, and the other developed postoperative wound infection, which were treated conservatively with antibiotics and local wound care. There were no other severe complications. The average follow-up period was 15 months (range 6-41 months). At the last follow-up, clinical symptoms and neurological function were improved significantly. Neither loss of correction nor failure of internal fixators was observed. X-ray and dynamic X-ray films showed a 100% fusion in all patients. Conclusions The single-stage posterior pedicle subtraction osteotomy is a safe and effective procedure for correction of posttraumatic thoracolumbar kyphosis. It is possible and safe to obtain a correction within 55° on single segment by this technique.
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malities should be alerted in TOF.
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Human tumor suppressor gene beclin 1 regulates cell growth through autophagy. The mRNA expression of beclin 1 was reported to be down-regulated in breast cancer with high frequency of loss of heterozygosity (LOH). However, there was no report about the expression levels or the regulatory mechanisms of beclin 1 in gastric and colorectal cancer. Both the mRNA and protein expression levels of beclin 1 was detected in the tissues of gastric and coiorectai cancers, as well as the aberrant DNA methylation and LOH related to the expression of beclin 1. By comparing with normal tissues adjacent to the tissue of these tumors, it was found that beclin 1 mRNA expression levels were significantly decreased in gastric tumor tissue. Furtherly by explorating the 5' region of beclin 1 gene sequence, a large and dense CpG island was discovered and meanwhile methylations in the promoter and the intron 2 regions of beclin 1 were found in both gastric and colorectal tumors. And LOH was found in gastric tumors. These findings suggested that aberrant DNA methylation, as well as LOH, were involved in the regulation of beclin 1 expression in gastric and colorectal cancer.
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BACKGROUND: Previous studies have indicated that hyperhomocysteinemia can induce atherosclerosis by enhancing oxidative stress, whereas Ginkgo biloba extract (GbE) can scavenge oxygen-derived free radicals.OBJECTIVE: To observe the role of reactive oxygen species (ROS) and nuclear factor-kappa B (NF-κB) in the expression of cell adhesion molecules (CAMs) induced by homocysteine (Hcy), and investigate the effect of GbE.DESIGN: A randomized controlled animal trial.SETTING: Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERrALS: Twenty-four healthy male rabbits of 6 months old. Dl-methionine (Sigma Chemical, Co.,Ltd.); GbE (Guizhou Yibai Pharmaceutical Company; powder).METHODS: The experiment was accomplished in the Laboratory of Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2003 to April 2004. ① After adaptive feeding for 2 weeks, the rabbits were randomly divided into three groups: Model group (n =12): The rabbits were treated with subcutaneous injection of dl-methionine (80 mg/kg per day); GbE group (n =8): The rabbits were administrated with GbE (mixed with feed, 50 m/kg per day) at 1 hour before the subcutaneous injection of dl-methionine; Control group (n=4): The rabbits were injected with equivalent sodium chloride. They were administrated for 7 weeks continuously. ②Histological changes were observed under light and electron microscopes: ROS level was determined with colorimetries (721 visible spectrophotometer); The expressions of CAMs and NF-κB in endothelial cells were detected with immunohistochemical methods; The concentration of plasma Hcy was measured with high-performance liquid chromatography.MAIN OUTCOME MEASURES: Histological changes, ROS level and expressions of CAMs and NF-κB in endothelial cells.RESULTS: All the 24 rabbits were involved in the analysis of results. ① ROS level: After administration, the ROS level in the model group was obviously increased (2.92±0.20,2.48±0.26, P ＜ 0.05), whereas those in the GbE group and control group (2.41±0.23, 2.43±0.20) had no obvious differences as compared with those before administration (2.31±0.27,2.47±0.32, P ＞ 0.05). ② Histological changes: Aortas of rabbits in the model group presented initial changes of atherosclerosis, including shedding or necrosis of endothelial cells and nuclear pyknosis or standing in a clutter of smooth muscle cells. There were scarcely any changes in the GbE group and control group. ③ Expressions of CAMs and NF-κB in endothelial cells: After treatments, the expressions of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and NF-κB in the model group were obviously higher than those in the control group (P ＜0.05), and there were no significant differences between the GbE group and control group (P ＞ 0.05). ④ Concentration of plasma Hcy: After 7 weeks, the concentration of plasma Hcy was higher in the model group and GbE group than in the control group [(25.01±6.80), (26.71±2.36), (16.85± 1.64) μmol/L, P ＜ 0.05].CONCLUSION: Hcy-induced oxidative stress plays an important role in NF-κB activation. GbE might suppress the activation of NF-κB and expression of CAMs by reducing ROS.
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Apoptosis action is primarily exerted at the level of mitochondira, in which Bcl-2 family of proteins play an important role in its regulation. Bcl-2 family consists of anti-apoptotic and pro-apoptotic members. The anti-apoptotic members usually exist in the outer mitochondrial membrane and inhibit cell death via interaction with pro-apoptotic counterparts BH3 domain. Pro-apoptotic members are commonly localize in the cytoplasm. A series of events occured, such as typical Bax conformational change, BAD and Bik phosphorylation as well as Bid and Bim proteolysis in response to several death stimuli. As a result, these pro-apoptotic proteins directly integrate to the outer mitochondrial membranes. Finally, mitochondrial permeability transition pore is opened, by followed the release of apoptogenic factors from the mitochondrial intermembrane space, including cytochrome c, apoptosis inducing factor(AIF) and Smac, then the activation of downstream caspases and execution of cell death.
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To investigate the protection effect of DNA vaccine in mammalian and avian systems, the DNA vaccine was inoculated in both BALB/c mice and SPF chickens immunized with DNA vaccines encoding hemagglutinin (HA) from A/Goose/GuangDong/1/96 (H5N1) virus. The mice and chickens were immunized twice, 3 weeks apart, by electroporation into muscles or intramuscular injection. Two weeks after the second immunization, the mice and chickens were challenged with a lethal dose of homologous virus. The mice and chickens immunized by electroporation obtained completely protection against the virus, and could effectively inhibited viruses to replicating in mouse lung and chicken cloaca. At the same time, these protections were companied by high levels specific antibody to H5N1 AIV, while the blank plasmid controls experience 100 percent mortality following challenge. Furthermore, in the experiment of mice by eletroporation,stronger obviously CTL activity were observed after challenge. Thus, the cellular immune responses of the mice immunized by electroporation were exhibited. These results strongly demonstrate that HA DNA vaccines provide effective protection against influenza virus infection in mammalian and avian, and suggest that electroporation is one of the efficient gene delivery systems for the transfer of influenza DNA vaccine in both humoral immunity and cellular immunity.
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Objective Study the value of clinical application of BaiJi and absorbable Gelatin in embolizing uterine myoma together with its effecty, side effect and complication.Methods 21 women with uterine myoma undergoing selective uterine arterial embolization by Seldinger's technique were studied. After retrograde transfemoral introduction of a 5 french catheter, the uterine arteries were successively catheterized. Bai Ji and absorbable Gelatin sponge particles were injected through free flow until devasculariztion. Results Uterine myoma's blood supply came from bilaterial uterine arteries demonstrated by angiography. All the supplying artering images disappeared after the embolization. 3～6 months follow up study showed: a marked reduction in the size of myomata by 38%～90%. Clinical symptoms were improved. There was one failure cas and then underwent uterotomy due to infection. Conclusions The short term effect of using Bai Ji and absorbable Gelatin for embolizing uterine myoma is clinically significant, while long term effects is still wating for research.
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Objective To summarize the experience of perioperative management of coronary artery bypass graft(CABG) in high-risk patients with coronary heart disease.Methods The clinical data of 164 patients underwent CABG from March 2004 to November 2005 were analyzed.Of 164 patients,151(92.05%) cases had severe coronary heart disease.Results Totally 144 artery-vessels and 353 venous-vessels were transplanted to patients.Combined operative procedures included 11 cases of ventricular aneurysm resect,5 cases of valve replacement,5 cases of valve repair,and 1 case of surgical repair of perforation of ventricular septum.Post-operative complications included 2 cases of low cardiac output,1 case of respiratory failure,1 case of renal failure,and 1 case of cerbral infarction.Two patients died and the operative mortality was 1.22%.Conclusion CABG procedure is safe in the treatment of high-risk patients with coronary heart disease.Proper preoperative and perioperative treatment can improve the curative effects significantly.