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Objective:To investigate the changes of proopiomelanocortin(POMC) expression in hypothalamus and corresponding metabolism in miR-21 knockout mice.Methods:miR-21 knockout or wild-type C57BL/6J mice were divided into diabetic group and control group, respectively. Diabetic mice model were forged with high-fat diet and low-dose streptozotocin. The changes of body weight and blood glucose in each group were monitored. By the end of the experiment, mice were sacrificed, and POMC protein expression and STAT3 mRNA expression in hypothalamus were detected.Results:There were no significant differences in body weight and blood glucose levels among all groups at baseline( P>0.05). The differences of body weight and blood glucose levels among various groups were compared at 3, 6, 9 and 12 weeks after the model was established. The results showed that body weight of mice in the diabetes group or miR-21 knockout+ diabetes group was higher than that in the control group at each time point( P<0.05). Moreover, there were significant difference in body weight between diabetes group and miR-21 knockout+ diabetes group at 3 and 12 weeks( P<0.05). The blood glucose levels in diabetes group were significantly higher than those in other groups at each time point( P<0.05). The blood glucose level in miR-21 knockout+ diabetes group was lower than that in diabetes group and higher than control group( P<0.05). POMC protein and STAT3 mRNA levels in diabetes group were significantly lower than those in control group, while those in the miR-21 knockout+ diabetes group were higher than those in the diabetes group. Conclusions:The expression of POMC in hypothalamus of miR-21 knockout mice is higher than that of wild-type diabetic mice. miR-21 knockout can decrease blood glucose level and body weight, and improve energy metabolism of diabetic mice.
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Objective:To analyze the risk factors of modified midline catheter-related thrombosis and propose countermeasures.Methods:Retrospective analysis was used to divide patients admitted to the neurology department of Nanjing Drum Tower Hospital from February 2018 to July 2020 into thrombotic group (9 cases) and nonthrombotic group (117 cases). Univariate analysis and binary Logistic regression were used to analyze the risk factors for catheter-related thrombosis.Results:The incidence of thrombosis was 7.14% (9/126) in patients with modified midline catheters. Univariate analysis showed that the occurrence of catheter-related thrombosis in patients was related to the primary type ( χ2 value was 6.331, P<0.05) and catheter pretreatment ( χ2 value was 4.016, P<0.05). Multivariate analysis showed that there was no significant difference between the primary disease type and the catheter pretreatment method ( P>0.05). Conclusions:The incidence of thrombus in patients with encephalitis and pretreated catheter with normal saline is high, preventive care should be taken before the occurrence of thrombus, and thrombolytic therapy should be taken as soon as possible after the occurrence of thrombus.
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Objective: To explore the effectiveness of one-stage metacarpal osteotomy, thumb opponensplasty and polygonal flap reconstruction in the treatment of congenital spade hand deformity. Methods: Eight cases of congenital spade hand were treated between January 2013 and March 2017. There were 5 males and 3 females, with an average age of 17.5 months (range, 13-35 months). The clinical manifestations of all the children were congenital spade hand and the affected hand was shorter than the healthy side. The contralateral hand was normal and there was no chest, skull, or facial deformity. The operation was performed with metacarpal osteotomy and thumb opponensplasty, and through the dorsal metacarpal rectangular flap to reconstruct the first web and through rotation of polygonal skin flap to reconstruct thumb web and lateral fold of thumb index nail. The dorsal ulnar and proximal radial segment of thumb were repaired by skin grafting. A vernier caliper was used to measure the first web space and the thumb function was evaluated by modified Tada score. Results: The reconstruction of palmar function and the formation of first web were completed in one stage in 8 children. Skin grafting on the dorsal ulnar side of thumb and radial side of index finger survived after operation. All the children were followed up 13-29 months, with an average of 16.1 months. There was no infection, skin flap necrosis, lateral deviation of thumb, scar contracture, or other complications. At last follow-up, there was no significant difference in skin color between the healthy side and the first web of the affected hand. The opening distance of first web space was 3.5-5.0 cm, with an average of 4.2 cm. According to the modified Tada scoring system, the results were excellent in 7 cases and good in 1 case, with an excellent and good rate of 100%. The thumb could grasp and pinch actively, and the palm opposition function was good. Conclusion: One-stage thumb opponensplasty combined with polygonal flap for reconstruction of congenital spade hand deformity can improve hand function very well. The reasonable designing of skin flap can effectively cover important areas, and the operation is safe and reliable.
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Objective: To investigate the diagnosis and treatment of thumb polydactyly with symphalangism in children. Methods: Seven cases of thumb polydactyly with symphalangism were treated between January 2013 and May 2017. There were 5 males and 2 females, aged from 10 months to 11 years, with an average age of 3.1 years. The children were diagnosed with MRI and it was seen that the base of radial multi-finger and the proximal phalangeal joint were connected by cartilage. All patients were treated with resection, lateral collateral ligament reconstruction, bone osteotomy and internal fixation. Results: The operation was successfully completed, and there was no early complications such as infection and flap necrosis. All patients were followed up 6-23 months (mean, 14.1 months). At last follow-up, there was no deformity finger, scar contracture, and other complications. The extension of the interphalangeal joint was no limited, and the range of flexion of the interphalangeal joint was 20-75°(mean, 56.7°). The appearance and function of the thumb was rated as excellent in 3 cases and good in 4 cases by Japanese Society for Surgery of the Hand Scoring (JSSH), with the excellent and good rate of 100%. Conclusion: The thumb polydactyly with symphalangism in children can be combined with clinical manifestations, X-ray film, and MRI examination to diagnose, and can obtain satisfactory results through the reconstruction of lateral collateral ligament, bone osteotomy and internal fixation.
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Objective To summarize the clinical manifestations,pathological character,diagnosis and treatment of aggressive angiomyxoma (AAM).Methods A computer-based online search of PubMed database and CHKD database was undertaken for literature about AAM published from all the relevant documents with the key words of aggressive angiomyxon.According to the condition 210 articles were analyzed.All the articles were analyzed about natural history,clinical manifestation,diagnosis,pathological character,treatment and prognosis of AAM.Results A total of 282 cases in well-documented articles had been reported,among which 64 were male and 218 were female,with male to female ratio of 1:3.4.The age of the patients from 1 to 83 years(mean 40.38 years).The most common sites were the perineum,genital tract and soft tissue in pelvic cavity in females and the scrotum,spermatic cord and groin in males.None of the cases could be accurately diagnosed as AAM preoperatively.The minimum diameter of the tumors was 1 cm,and the maximum was 60 cm.All the specimens showed typical pathological features of AAM as reported previously.Immunohistochemistry indicated that AAM tended to be strongly positive for vimentin,CD34,Desmin,estrogen receptor,progesterone receptor but mostly negative for S-100 and Ki-67 and Actin.The medical history was from 1 month to 20 years.The recurrence of the postoperative follow-up was 2 months to 20 years.The diagnosis depended on pathological examination.Conclusions AAM is a sort of unusual soft connective tissue tumor.It is a kind of unknown cause,slow progression,locally invasive,easy to recur after tumor resection.Long-term follow-up is quite necessary because of the high rate of local recurrence.
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Objective To investigate the effect of active silver ions liquids on incontinence of patients with cerebrovascular diseases.Methods Forty-eight patients with incontinence from cerebrovascular diseases were randomly divided into the treatment group and control one in equal number:the control group was managed with washing and cleaning the perineum with warm water in the morning and evening and the treatment group with active antibacterial liquid silver ion liquids in the afternoon once a day.The two groups were compared in terms of red swelling,itching,papula,blister,local shallow ulcer and abscess in the skin around the perineum as well as the incidence of urinary system infections.Results The treatment group had significantly lower incidences of red swelling,itching,papula,blister,local shallow ulcer and abscess in the skin around the perineum as well as the incidence of urinary system infections,as compared to the control group(all P<0.05).Conclusion Cleaning perineum with active silver ions liquids is effective for the prevention of infections in the skin around the perineum and urinary system infections.
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Objective To explore the clinical outcome of using modified great toe wrap-around flap to reconstruct degloved thumb and fingers.Methods Eighteen patients were involved.Based on different types of injury,four procedures were carried on for reconstructing degloved thumb and fingers:①Unilateral modified great toe wrap-around flap to reconstruct 9 degloved thumbs of distal proximal level and 3 degloved fingers of proximal interphalangeal joint level.②Unilateral modified great toe wrap-around flap with second toe medial flap to reconstruct 2 total degloved fingers.③Bilateral modified great toe wrap-around flap to reconstruct 2 thumbs.④Bilateral modified great toe wrap-around flap and second toe medial flap with neurolized super thin anterolateral thigh flap to reconstruct 12 degloved fingers.This wrap-around flap carried with entire nail.A triangle flap was reserved at medial plantar of great toe.Results All free flaps were survived in one stage.Fifteen patients were followed up for 8 to 25 months.The contour of reconstructed digit was as same as contralateral digit with satisfactory motion arc and sensation.There was no extensive scar in donor toe.The width of medial plantar triangle flap increased significantly.All patients could walking,running,jumping without restricted.Conclusions With reconstructed by modified great toe wrap-around flap,degloved thumb or finger can be promised with excellent contour and function outcome.In the meantime,the loss of donor foot can be expected to minimal.This procedure is one of the best ways for reconstructing degloved thumb and finger.
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To investigate the expression of CD151 in human atherosclerosed artery and explore its clinical implications, Western blot and immunohistochemical techniques were used to determine the protein expression of CD151 in arterial tissues with atherosclerosis taken from 36 patients, including 26 cases who received bypass operation for peripheral artery atherosclerosis and 6 cases who died from coronary heart disease. The expression of CD151 in normal artery tissues from 15 healthy organ donators were also measured to serve as control. The results showed that expression of CD151 protein in atherosclerotic arteries was significantly higher than that in normal artery. In ath erosclerotic arteries, CD151 expression was localized in vascular smooth muscle cells (VSMCs) in all tunica media and in partial subintima, while in normal artery, sparse expression was found in tunica media near adventitia. It is concluded that high CD151 protein expression in artery is associated with atherosclerosis and CD151 plays an important role in the atherosclerosis related to VSMC. The expression of CD151 in human atherosclerotic artery depends on the extent of atherosclerotic dam age, it's independent of risk factors.