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Objective:To investigate the clinical features and treatment status of immune-related myositis (IRM) caused by immune checkpoint inhibitors (ICIs) in order to improve the diagnosis and treatment rate of the disease.Methods:Two cases of IRM combined with the diagnosis and treatment were described and the literature about IRM in the past 10 years was reviewed, and the clinical data of 59 patients were analyzed.Results:IRM was more common in males, with a total of 47 (79.7%). IRM usually occurred after 45 days of medication or after two doses. The clinical manifestations were mainly myalgia and muscle weakness, which were more common in the limbs. The initial symptoms were ptosis and diplopia. Fifty patients (84.7%) had serum creatine kinase (CK) levels higher than twice the upper limit of normal (UNL). In immunological examinations, 18 patients were found to be positive for anti-rhabdoid muscle antibody (AsM-Ab), while most of the myositisspecific antibodies (MSAs) and myositis-associated antibodies (MAAs) were negative. Thirty-four patients (75.6%) had abnormal EMG, and most patients showed myogenic injury. Muscle magnetic resonance imaging (MRI) showed muscle edema and inflammation in 8 patients. Muscle biopsies from 18 (45.0%) patients showed varying degrees of necrotic myofibers. Fifty-seven patients (96.6%) discontinued ICIs after developing IRM, 54(91.5%) received cortico-steroids, and 20(33.9%) received other treatments including intravenous immuno-globulin (IVIG), plasma exchange.Conclusion:IRM can occur in the early stage of ICIs treatment. Electro-myography, muscle MRI and muscle biopsy in suspicious cases can improve the diagnosis rate of the disease. Early use of corticoteroid, IVIG and other immunotherapy can effectively alleviate the disease.
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Objective:To investigate the clinical effect of lateral rectus abdominis approach combined with presacral decompression for surgical treatment of old Denis type II sacral fractures complicated with upper sacral plexus injury.Methods:A retrospective case series study was performed on the clinical data of 9 patients with old Denis type II sacral fractures complicated with upper sacral plexus injury (L 4-S 1) admitted to Zhongnan Hospital of Wuhan University from June 2010 to December 2016. There were 6 males and 3 females, aged (33.1±7.5)years (range, 15-58 years). Embolization of internal iliac artery and preimplantation of abdominal aortic balloon were performed 2 hours before operation under the guidance of digital subtraction angiography (DSA). Surgery was performed using a single lateral rectus abdominis approach combined with presacral decompression. The operation time, intraoperative blood loss and full weight-bearing time were recorded. The visual analogue scale (VAS) and European QOL Five Dimensional health scale (EQ-5D) were compared before and after operation. The Gibbons' impairment scale was used to assess neurological function. X-ray and CT scan were used to observe internal fixation and fracture healing. The complications during and after operation were recorded. Results:The patients were followed up for 24-52 months [(35.2±5.2)months]. The operation time was (2.9±0.6)hours. The intraoperative bleeding was (573±138)ml, and the full weight-bearing time was (11.6±1.2)weeks. X-ray and CT scan showed bone healing in all patients at the latest follow-up. The VAS and EQ-5D scale improved from preoperative (7.8±0.6)points and (0.34±0.07)points to the final follow-up of (0.8±0.3)points and (0.81±0.05)points ( P<0.05). According to Gibbons classification, 8 patients were grade I and 1 patient was grade II one year after operation ( P<0.01). Namely, the radiation pain of lower extremities was significantly improved in all patients, among which 8 patients showed pain disappeared and completely returned to normal and 1 patient showed residual numbness and hypoesthesia of the affected limbs. No major complications (eg, iatrogenic lumbosacral plexus injury, vital blood vessels or pelvic organs injury) occurred during the operation. During the follow-up period, only one patient developed traumatic hip arthritis and underwent total hip arthroplasty 6 months after operation. Fractures of the remaining patients were healed well without complications like infection, pressure ulcer or implant failure. Conclusions:For old Denis type II sacral fractures complicated with upper sacral plexus injury, lateral rectus abdominis approach combined with presacral decompression can fully decompress the upper sacral plexus nerve, relieve pain, and promote functional rehabilitation, with low incidence of complications. It is an alternative surgical method for the treatment of old Denis type II sacral fractures complicated with upper sacral plexus injury.
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OBJECTIVE@#To investigate the effects of autophagy on osteogenic differentiation of stem cells from the apical papilla (SCAPs) in the presence of tumor necrosis factor- (TNF-) stimulation .@*METHODS@#SCAPs treated with TNF- (0, 5, and 10 ng/mL) with or without 5 mmol/L 3-MA were examined for the expression of autophagy marker LC3-Ⅱ using Western blotting. The cells were transfected with GFP-LC3 plasmid and fluorescence microscopy was used for quantitative analysis of intracellular GFP-LC3; AO staining was used to detect the acidic vesicles in the cells. The cell viability was assessed with CCK-8 assays and the cell apoptosis rate was analyzed using flow cytometry. The cells treated with TNF- or with TNF- and 3-MA were cultured in osteogenic differentiation medium for 3 to 14 days, and real- time PCR was used to detect the mRNA expressions of osteogenesis-related genes (ALP, BSP, and OCN) for evaluating the cell differentiation.@*RESULTS@#TNF- induced activation of autophagy in cultured SCAPs. Pharmacological inhibition of TNF--induced autophagy by 3-MA significantly decreased the cell viability and increased the apoptosis rate of SCAPs ( < 0.05). Compared with the cells treated with TNF- alone, the cells treated with both TNF- and 3-MA exhibited decreased expressions of the ALP and BSP mRNA on days 3, 7 and 14 during osteogenic induction ( < 0.05) and decreased expression of OCN mRNA on days 3 and 7 during the induction ( < 0.05).@*CONCLUSIONS@#Autophagy may play an important role during the osteogenic differentiation of SCAPs in the presence of TNF- stimulation.
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Humans , Autophagy , Physiology , Cell Differentiation , Physiology , Cell Survival , Cells, Cultured , Dental Papilla , Cell Biology , Green Fluorescent Proteins , Osteogenesis , Physiology , Stem Cells , Physiology , Transfection , Tumor Necrosis Factor-alpha , PharmacologyABSTRACT
Objective To compile a questionnaire about tobacco control for the nursing students and to provide evidence of research and evaluation for nursing students' knowledge,attitude,belief and practice related with tobacco control.Methods Based on the conceptual framework of predisposing factors,contributing factors and reinforcing factors of action,develop the questionnaire about tobacco control through literature review and expert consultation.The questionnaire includes 8 dimensions and 24 items in all.Those are the recognition of the harm of smoking,attitudes towards tobacco control,knowledge about laws and regulations of tobacco control and harms of cigarettes,future smoking tendency,future participation intention in social tobacco control,perception of information of tobacco control in media and participation of school tobacco control activities.By cluster sampling method,5 210 nursing students in two medical universities in the main district of Chongqing were investigated.Reliability and validity of the questionnaire were tested through SPSS 19.0 and Lisrel 8.8 215 students were retested.Results Cronbach's α for the whole questionnaire was 0.720 and for eight dimensions,it ranged from 0.529 to 0.748.Split-half coefficient was 0.806 and for eight dimensions,it ranged from 0.526 to 0.818.Test-retest reliability coefficient was 0.858.Spearman coefficient for each dimension was greater than 0.7.The principal component analysis was used to extract 8 common factors and the accumulative variance contribution rate was 57.209％.The factor loading of all items was 0.43-0.83.NFI,NNFI,CFI and IFI were 0.92,0.91,0.93 and 0.93.The construction of the questionnaire was consistent with the theory.Conclusion The reliability and validity of questionnaire about tobacco control for nursing students were good.It can be used in researches about the nursing students' tobacco control.
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Objective:To compare the maxillary sinus mucosa's stress distribution when elevated by three lift materials.Methods:Three Finite element models of maxillary sinus mucosa with 0.3 mm thickness elevated by implant,grafting autogenous cancellous bone and hydroxyapatite respectively were established in the specific units.ANSYS finite element analysis software was used to evaluate maxillary sinus mucosa deformation by the simulated closed sinus lift surgery.Differences of Von Mises stress values of mucosa surface were calculated when maxillary sinus mucosa lift height was increased from 1 mm to 5 mm according to the a large deformation theory. Results:The Von Mises stress values on membrane surface elevated by implant,grafting autogenous cancellous bone and hydroxyapa-tite bone substitute materials showed no difference within 5 mm elevation.Conclusion:Closed maxillary sinus floor lifting operation with implant elevating the maxillary sinus membrane directly is a simple and minimally invasive way for sinus floor elevation.
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Ph.D candidate education is the highest level of higher education. Training model of Ph.D candidate in Medical College of Georgia and University of Manitoba)has vivid characters compared with that in China,which is reflected by the training objective,qualification of students and tutors,culti-vating procedures and admission requirements for graduation. This kind of cultivating model performs stringent selection and can gradually pick out persons who are really fit for the scientific research. Ph.D candidate quality in the two universities is guaranteed by systemic and deep courses learning,immediate update of knowledge and strict evaluation system. The goal of this article is to provide experience and ref-erence for improving the education quality of medical Ph.D candidates in China.
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In order to search for bioactive natural products from marine algae, the chemical constituents of red alga Laurencia saitoi was separated by the combination of normal phase silica gel, Sephadex LH-20 column chromatography and recrystallization. Seven compounds: aplysistatin (1), 5-acetoxypalisadin B (2), palisadin B (3), palisadin A (4), pacifigorgiol (5), stigmast4-en-3alpha, 6beta-diol (6), 2, 3, 5, 6-Tetrabromoindole (7), were isolated and their structures were elucidated by spectroscopic methods including 1H-NMR, 13C-NMR and MS techniques. All compounds were isolated from L. saitoi for the first time. Cytotoxicities of purified compounds were evaluated by MTT method, however, all of them were found inactive (IC50 >10 mg x L(-1).
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Humans , Cell Line, Tumor , Inhibitory Concentration 50 , Laurencia , Chemistry , Organic Chemicals , Chemistry , PharmacologyABSTRACT
Human Y chromosome contains sex determining region and the genes associated with spermatogenesis.Genomics of the human Y-chromosome association with male infertility appeared and new exploration for male infertility was formed.Though the genes of Y chromosome lack of meiotic recombination,Y chromosome did not disappear,but also it is being in evolution.It includes several families of satellite sequences and the alphoid repeats,Alu repeats associated with male infertility.A total of 107 genes were listed in the database in Y chromosome.The male specific region on Y(MSY) harbours 156 transcription units of which half(78) are suspected to encode proteins,27 protein or protein families identified,11 protein only expressed in the testis associated with spermatogenesis.It is likely that the genes on Y chromosome play an important role not only on spermatogenesis,but also on prostate,brain or other organs.
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Objective: To build a relationship model of perceived academic self-efficacy, learning stress, and learning burnout of high school students. Methods: 674 high school students were surveyed with Learning Stress Scale of High School Students, The Perceived Academic Self -efficacy Scale, Scale of Learning Burnout of High School Students. Results: Learning stress had a direct effect on a low level of learning efficacy, perceived alienation to teacher and physical exhaustion (The direct effect value were -0.22,0.12,0.27). At the same time, perceived basic ability and perceived control partially mediated the impact of learning stress on the low level of learning efficacy, perceived alienation to teacher and physical exhaustion (the mediated effect value were -0.155 and-0.264, 0.066 and 0.299, 0.089 and 0.233). Perceived basic ability and perceived control fully mediated the relationship between learning stress and emotional exhaustion (the mediated effect value were 0.033 and 0.387). Conclusion: The students with a higher level of stress reported suffering more learning burnout than those with a lower level of stress, and vice versa.
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Objective:To evaluate the effect of surgical c ro wn-lengthening and restoration procedure in the treatment of short clinical cro wn in anterior tooth. Methods: 28 short clinical crowns of 5 pat ients were lengthened through operation. 6 weeks after operation metal-fused ce ramic prosthesis was individually prepared.Results: Post-operat ion follow-up was performed 6 weeks after treatment,the average length of the c rown of the anterior tooth increased by (2.9?0.6) mm. No complication was obs erved. All the patients were satisfied with the esthetic effects one year after restoration.Conclusion: Surgical crown-lenthening and prosthesi s procedure may be used in the treatment of the short clinical crown.
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OBJECTIVE: To study the effects of occlusal trauma on the ultra-structure of synovial membrane and articular cartilage in rabbit's temporomandibular joints (TMJ). METHODS: TMJs from six rabbits with occlusal trauma and three control rabbits were studied by transmission electron microscopy. RESULTS: Degenerative changes in synovial membrane and articular cartilage of TMJ were induced following occlusal trauma. The structure of the articular surface was damaged, and chondrocytes in cartilage showed signs of degeneration. The synovial lining cells contained dense accumulations of vimentin intermediate filaments (IFs), which were especially prevalent in the cellular processes as well as paranuclearly. Microvilli on the synovial cell membrane were commonly seen. The "vermiform bodies" in the deeper interstitium of the synovial tissue were also found. Our findings of the punctate adherens between synovial lining cells were described in detail. CONCLUSIONS: The occlusal trauma is really a factor inducing degenerative changes of the TMJ.