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Objective:To study the safety and efficacy of using the ultrasonic lithotripsy system (ULS) in assisting percutaneous nephroscopic retroperitoneal pancreatic necrosectomy in patients with acute necrotizing pancreatitis (ANP) extending to both sides of the retroperitoneal regions.Methods:The clinical data of 47 patients with extensive ANP who underwent video-assisted retroperitoneal debridement (VARD) from January 2017 to October 2022 at the Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, were analyzed retrospectively. There were 32 males and 15 females, aged [ M( Q1, Q3)] 60(43, 75) years old. The patients were divided into two groups based on the debridement methods: patients treated by nephroscopic pancreatic necrosectomy (NPN) were included in the NPN group ( n=22), while patients treated by the ULS-assisted treatment were included in the ULS group ( n=25). The surgical debridement time, operation time and complications of the two groups were compared. Follow up on recurrence and death of patients was done by telephone, outpatient and/or re-hospitalization records. Results:All patients underwent the VARD operation successfully, without any need for conversion to laparotomy, transfer to intensive care unit and death related to the operations. The pancreatic exocrine function was not damaged in both groups. When compared with the ULS group, the NPN group required significantly more debridement time [3(2, 4) times/person vs. 2(1, 2) times/person], longer operation time [65(40, 85) min vs. 35(30, 50) min] and longer hospitalization time [91(76, 130) d vs. 72(62, 102) d, all P<0.05]. No complications occurred in the ULS group. In the NPN group, postoperative hemorrhage occurred in 3 patients, colon fistula in 1 patient, and delayed viral encephalitis in 1 patient. The incidence of postoperative complications in the NPN group was significantly higher than that in the ULS group [22.7%(5/22) vs. 0(0/25), P=0.032]. All the 47 patients with extensive ANP were followed up for a median of 28 months (range 3 to 60 months), and there were no patients who developed residual recurrence and death. Conclusion:For patients with extensive ANP, ULS-assisted nephroscopic pancreatic necrosectomy was safe and feasible. When compared with NPN, the ULS-assisted procedure showed more advantages in debridement efficiency, operation time and hospital stay.
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In the past century, the diagnosis and treatment of severe acute pancreatitis has repeatedly fluctuated between surgery and internal medicine. Through the joint efforts of many disciplines, a great breakthrough has been made. Initial fluid resuscitation, nutritional support, and prevention of pancreatitis related complications are currently the best treatment methods. Local complications may occur in patients with severe acute pancreatitis, including pancreatic pseudocysts and walled-off necrosis. Infected pancreatic necrosis is a fearful complication of severe acute pancreatitis. There has been a consensus on the " step-up" approach for the treatment of infected pancreatic necrosis, that is, percutaneous catheter drainage should be used first, and further surgical or endoscopic minimally invasive treatment should be taken for patients with poor drainage. And open surgery is no longer the preferred means of intervention. This article summarizes the progress of diagnosis and treatment of severe acute pancreatitis at home and abroad and shares the experience of the author's team in the diagnosis and treatment of severe acute pancreatitis.
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Objective@#To investigate the features of alveolar bone morphology of mandibular central incisors in high-angle adult females using cone-beam computed tomography (CBCT) and evaluate the influence of aging in these patients.@*Methods@# CBCT and lateral cephalometric images of 142 untreated adult female patients were selected and grouped by facial growth pattern. The number of high-angle cases was increased to 164 to further explore the difference within high-angle adult females who were divided into two groups according to age. The indexes of alveolar bone height and thickness in the lower incisor region and inclination of the lower incisors were measured by Dolphin software. The data was statistically analyzed.@*Results@#Compared with the average-angle group, the high-angle group had a lower alveolar bone attachment level (P < 0.05) and less bone thickness at the root apex level (P < 0.05). The thickness of lingual alveolar bone decreased with labial inclination of the lower incisors in both the high-angle and average-angle groups (r = -0.251, P = 0.025; r = -0.428, P = 0.001, respectively). In hyperdivergent female patients, the middle-aged group had a lower attachment level of alveolar bone than the young group (P < 0.05), but no significant difference in bone thickness at the root apex level (P > 0.05) was found between the two groups@*Conclusion @# High-angle adult females had thinner mandibular anterior alveolar bone with significantly lower attachment levels. Aging and inclination of lower incisors influenced bone morphology and should be taken into careful consideration.
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Objective:To study the effect of peroxisome proliferator activated receptor- γ (PPAR-γ) agonists rosiglitazone on the hepatocytes of Sprague Dawley (SD) rats with severe acute pancreatitis (SAP) and the regulatory mechanism.Methods:Seventy two healthy male SD rats, weighing 255-315 g, aged 49-56 days, were randomly divided into SAP model group ( n=24, SAP model preparation), rosiglitazone group ( n=24, rosiglitazone intravenous injection after SAP model preparation) and sham operation group ( n=24, normal saline injection only). After 6 h, 12h and 24 hours of injection, 8 rats were treated at each time point. HE staining was used to study the liver tissue structure and detect the levels of serum tumor necrosis factor-α(TNF-α), interleukin (IL) -1β, IL-6, AST, ALT and lactate dehydrogenase (LDH) in the rats. Western blot was used to detect the expression of high mobility group box-1 protein (HMGB1), Janus activated kinase (JAK)2 and signal transducer and activator of transcription (STAT)3. Results:The levels of serum TNF-α , IL-1β, IL-6, AST, ALT, LDH in SAP model group and rosiglitazone group were significantly higher than those in the sham operation group (all P<0.05). IL-1β at 6, 12h and 24 h in rosiglitazone group was (226.5±52.1)ng/L, (458.2±82.3)ng/L, (556.4±83.4) ng/L, ALT was (158. 3±39.2) U/L, (235.0±44.6)U/L, (298.4±56.6) U/L, which was lower than that in SAP model group (443. 5±62.3) ng/L, (622.6±78.3) ng/L, (789.1±105.7) ng/L and (198.4±42.5)U/L, (253.8±47.0)U/L, (337.2±60.1) U/L, the differences were statistically significant (all P<0.05). AST and LDH in rosiglitazone group were also lower than those in SAP model group at each time point, and the differences were statistically significant (all P<0.05). HE staining showed that there were less inflammation, hemorrhage and necrosis in rosiglitazone group than those in SAP model group. Expression of STAT3 in liver of rosiglitazone group at 6 h, 12 h and 24 h was (0.22±0.03), (0.30±0.04), (0.31±0.06), lower than SAP model group (0. 28±0.04), (0.38±0.05), (0.40±0.06), the differences were statistically significant (all P<0.05). Expression of JAK2 and HMGB1 in rosiglitazone group at 12 h and 24 h was also lower than that in SAP model group (all P<0.05). Conclusion:PPAR-γ agonists rosiglitazone can protect the SAP rats suffering from hepatocyte injury and inflammation, through JAK2/STAT3 pathway.
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Objective:To summarize the relationship between the clinicopathological features and prognosis of immunoglobulin A nephropathy (IgAN) after renal transplantation.Methods:A total of 34 patients with IgAN after renal transplantation confirmed by renal biopsy were enrolled. And another 34 patients with primary IgAN confirmed by initial renal biopsy were adopted as controls. Clinical and pathological features of two groups were compared to explore the relationship between clinicopathological features and prognosis of allograft IgAN.Results:As compared with primary IgAN group, renal function in allograft IgAN group included serum creatinine [(158.5±75.9) vs (84.8±26.8) umol/L], urea nitrogen [(9.7±6.1) vs (5.2±1.4) mmol/L], uric acid [(406.7±87.8) vs (359.0±92.6) umol/L], estimated glomerular filtration rate {(57.4±25.4) vs (91.2±28.6) [ml/(min·1.73m 2)]}. All were statistically significantly higher ( P<0.05) while other parameters showed no differences. Pathologically, the proportion of T1 type (50.0% vs 17.6%) of renal tubular atrophy/interstitial fibrosis was significantly higher in allograft IgAN group than control group ( P<0.05). Furthermore, univariate and multivariate Logistic regression analyses were performed between various pathological parameters and prognosis in allograft IgAN patients. It indicated that the degree of mesangial hyperplasia of patients with transplanted IgAN had a significantly negative impact on the prognosis. Conclusions:The clinicopathological features of patients with allograft IgAN show no difference from those of patients with primary IgAN. And among patients with allograft IgAN, those with severe mesangial hyperplasia often have a worse prognosis.
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Objective:To analyse the use of nephroscopic peripancreatic necrotic tissue removal through drainage tube sinus tracts without the use of anesthesia.Methods:The data of 17 patients with severe acute pancreatitis (SAP) were treated from August 2016 to December 2019 at the Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine were studied. There were 5 males and 12 females, age ranged from 24 to 80 years (mean 49.3 years). These 17 patients underwent nephroscopic pancreatic necrosis tissue removal through drainage tube sinus tracts of drains using a dual-scope necrosectomy approach without the use of any anesthesia. The surgical related and follow-up data were analysed.Results:Of 17 patients who underwent pancreatic necrosis removal as the first operation, one underwent a further postoperative nephroscopic resection without anesthesia, while 10 patients underwent three nephroscopic resections without anesthesia, and 6 patients underwent four nephroscopic resections without anesthesia. The operative durations of nephroscopic resection without anesthesia was 26 to 37 min. All patients had smooth surgical procedures and they were fed on the same day after surgery. There were no postoperative complications on follow-up after discharge from hospital for 1 to 40 months.Conclusion:Transcatheter sinusoidal nephroscopic pancreatic necrotic tissue removal without anesthesia was safe. There was no need for fasting. The procedure is minimally invasive and it can be repeated, especially for those patients who cannot tolerate any form of anesthesia. This is the least invasive procedure for treatment of SAP.
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Objective@#To investigate the effects of exogenous interleukin (IL)-35 on the balance of helper T cell 17 (Th17) and regulatory T cell (Treg) in peripheral blood of patients with oral lichen planus (OLP).@*Methods@#Totally 12 peripheral blood samples of OLP patients (OLP group, one male and 11 female, 26-68 years old; four cases of reticular OLP and eight cases of erosive OLP) were collected from patients of Department of Oral Mucosal Specialist of the Affiliated Hospital of Guizhou Medical University from October to December 2016. During the same period, thirteen normal peripheral blood samples were collected from the Physical Examination Center of the Affiliated Hospital of Guizhou Medical University (normal control group, one male and 12 female, 20-68 years old). The peripheral blood mononuclear cells (PBMC) were extracted in sterile condition and CD4+ T cells were sorted by flow cytometry (FCM). Quantitative real-time PCR (qPCR) technique was used to detect the mRNA expression levels of retinoid-related orphan nuclear γt (RORγt) and forkhead box3 (Foxp3). The CD4+ T cells were divided into experimental group and control group. The CD4+ T cells of experimental group were cultured in vitro by adding rhIL-35, and the CD4+ T cells of control group were cultured with the same volume of phosphate buffered saline (PBS). After the completion of the culture, the cells were collected. The expression levels of the same factors were detected by qPCR.@*Results@#The expression [M(Q25, Q75)] of Foxp3 [0.15 (0.09, 0.30)] and RORγt mRNA [1.04 (0.45, 2.15)] in the CD4+ T cells of OLP were significantly higher than those in normal control group [0.04 (0.02, 0.06), 0.10 (0.05, 0.11)] (Z=-4.134, P<0.01; Z=-3.699, P<0.01). The ratio of ROR γt/Foxp3 mRNA in OLP group [6.22(3.67, 15.34)] was higher than that in normal control group [2.50 (1.24, 5.23)] (Z=-2.665, P=0.007). In the CD4+ T cells of OLP patients, the expression of Foxp3 mRNA in the experiment group [0.40 (0.21, 1.22)] was higher than that in the control group [0.15 (0.11, 0.26)](Z=-2.510, P=0.012), and the expression of ROR γt mRNA between two groups showed no significant difference (P>0.05). The ROR γt/Foxp3 mRNA ratio [3.44 (1.55, 8.16)] of the experiment group was lower than that in the control group [6.22 (4.43, 12.21)] (Z=-2.746, P=0.006).@*Conclusions@#There was a Th17/Treg imbalance with predominated by Th17 cells in the peripheral blood of patients with OLP. Exogenous rhIL-35 had an immunomodulatory effect on the balance of Th17/Treg.
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Objective:To observe the clinical efficacy of modified Shenling Baizhu San combined with thyroxine tablets in the treatment of Hashimoto's thyroiditis (HT). Method:The 68 patients with HT were randomly divided into treatment group and control group, with 34 patients in each group. Control group was treated with thyroxine tablets alone, while treatment group was treated with modified Shenling Baizhu San in addition to the therapy of control group. Free triiodothyronine (FT3), free Thyroxine (FT4), thyroid stimulating hormone (TSH), serum thyroid peroxidase antibody (TPOAb) and thyroglobulin were observed before and after treatment in the two groups of HT patients. The changes of thyroglobulin antibody (TgAb) and traditional Chinese medicine (TCM) syndrome score, and the safety of TCM prescription were observed. Result:After 3 months of treatment, the effective rate of treatment group was 91.2%, which was significantly higher than 70.6% of control group, with statistically significant difference (PPP3 and FT4 in treatment group and control group increased significantly after 3 months of treatment (PPPPConclusion:Modified Shenling Baizhu San combined with thyroxine tablets in the treatment of HT is more effective than simple thyroxine tablets, which is worthy of further clinical and experimental study.
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Objective: To evaluate the effect of meticillin-resistant Staphylococcus aureus(MRSA)on the pyroptosis of bone-marrow derived macrophages(BMDM)and investigate the mechanism of MRSA-induced pyroptosis in macrophages. Methods: The BMDM were triggered by the combination of lipopolysaccharide(LPS, 100 ng/ml)with adenosine-triphosphate(ATP, 3 mmol/L)or nigericin(Ng, 10 mmol/L)or treated with MRSA(multiplicity of infection 200, MOI 200)alone to induce pyroptosis in vitro. The cell morphology examination and lactate dehydrogenase(LDH)assay were applied to evaluate the cytotoxicity. The expression of pro- inflammatory cytokines, the interleukin(IL)- 1β, IL- 6 and tumor-necrosis factor(TNF)-α was detected by ELISA. The cleaved caspase-1 and mature IL-1β in the cells and released into the supernatant were detected by Western blotting. The signal pathway for the induction of pyroptosis by MRSA was investigated via the transfection of lentivirus- mediated short- hairpin RNA(shRNA)into the BMDM. Results: The treatment of BMDM with LPS/ATP, LPS/nigericin or MRSA alone caused cytotoxicity and up-regulated the expression of pro-inflammatory cytokines, IL-1β, IL-6 and TNF-α, as well as the caspase-1 activation and mature Zl-1β (P<0.01). After silencing NLRP3 or NLRC4, the expression of IL-1β induced by MRSA was significantly lessened(P< 0.01). Conclusion: MRSA could induce BMDM pyroptosis probably via activating NLRP3 inflammasome or NLRC4 inflammasome.
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<p><b>OBJECTIVE</b>To study the clinical and laboratory characteristics of juvenile myelomonocytic leukemia (JMML).</p><p><b>METHODS</b>The clinical characteristics and laboratory results were retrospectively analyzed in 10 children with newly diagnosed JMML. They were compared with those of 28 children with myelodysplastic syndrome (MDS) and 44 children with chronic myeloid leukemia (CML).</p><p><b>RESULTS</b>Compared with the children with CML or MDS, the children with JMML had significantly higher rates of skin rashes, ecchymosis, and lymphadenectasis, a significantly lower serum cholinesterase (ChE) level, and a significantly higher fetal hemoglobin level (P<0.05). The white blood cell count of children with JMML was significantly higher than that of children with MDS, but significantly lower than that of children with CML (P<0.05). In addition, the myeloid/erythroid ratio and rate of dyshaematopoiesis were significantly lower in children with JMML than those in children with CML or MDS. The children with JMML had a significantly higher expression of mature monocyte marker CD14 than those with CML or MDS (P<0.05). The levels of myeloid markers CD33, CD11b, CD13, and CD15 in children with JMML were significantly higher than those in children with MDS, but significantly lower than those in children with CML (P<0.05). The levels of CD2 and CD7 in children with JMML were higher than those in children with CML, but lower than those in children with MDS (P<0.05).</p><p><b>CONCLUSIONS</b>Skin rashes, ecchymosis, lymphadenectasis, and ChE reduction are more common in children with JMML than in those with CML or MDS, while dyshaematopoiesis is less common. In addition, CD14 level increases significantly in children with JMML.</p>
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Child , Child, Preschool , Female , Humans , Infant , Male , Leukemia, Myelomonocytic, Juvenile , Genetics , Allergy and Immunology , Lipopolysaccharide ReceptorsABSTRACT
Objective To study the effect of combined laparoscopic and percutaneous nephroscopic necrosectomy in the treatment of peripancreatic abscesses.Methods The clinical data of 8 patients with peripancreatic abscesses treated by combined laparoscopic and percutaneous nephroscopic necrosectomy in our hospital from June 2015 to June 2017 were retrospectively analyzed.Results 8 patients were treated with percutaneous puncture and drainage under Ultrasonic / Computed Tomography guidance.Combined laparoscopic and percutaneous nephroscopic necrosectomy was then carried out.Two patients underwent percutaneous nephroscopic surgery twice and laparoscopic surgery once,and 3 patients underwent percutaneous nephroscopic surgery thrice,and 3 patients underwent percutaneous nephroscopic surgery 4 times and laparoscopic surgery once.One patient after percutaneous nephroscopic necrosectomy was complicated with sinus tract hemorrhage,which was treated by haemostasis through a small incision.Two patients who developed postoperative colonic fistula were treated successfully by conservative treatment.The average length of hospital stay was 80 d (60 ～ 153 d),and there was no death.Conclusion Combined laparoscopic and percutaneous nephroscopic necrosectomy was a minimally invasive and efficacious method to treat peripancreatic abscesses.
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Professor WU Liang-cun is good at the treatment of primary hepatic carcinoma. He views that the main pathogenesis of primary hepatic carcinoma is liver and kidney deficiency. Therefore, treatment should be based on enriching water to nourish wood, with soothing the liver and regulating qi, clearing the gallbladder and removing dampness, promoting blood circulation for removing blood stasis, detoxicating and resolving masses.
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Different diseases may have the same pathogenesis in the development process of the disease. Accurately grasping the main symptoms of the disease to analyze pathogenesis is a prerequisite for prescription and medication, and the guarantee to enhance the clinical efficacy as well. Diet injuries are common pathogenic factors of pediatric diseases, which can cause respiratory, digestive and nervous and others system diseases. Diet injures should be paid attention in clinical syndrome differentiation. This article analyzed the application of food guide sluggish method in pediatric diseases through medical cases, with a purpose to give more inspiration to clinical doctors.
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Objective@#To investigate the expression of Epstein-Barr virus-induced gene 3 (EBi3) and interleukin-12p35 (IL-12p35) in two subunits of interleukin-35 (IL-35) in oral lichen planus (OLP) lesions, and to explore the role of IL-35 played in the formation and development of OLP lesions.@*Methods@#Totally 41 samples of OLP lesions and 15 samples of normal tissues were collected from patients of the Department of Periodontology and Oral Medicine, Affiliated Stomatological Hospital of Guizhou Medical University from October 2010 to December 2016. The expression levels of EBi3 mRNA and IL-12p35 mRNA in the samples were detected by quantitative real-time PCR (qPCR) and the distribution and expression of protein EBi3 and IL-12p35 were detected by immunohistochemistry. The potential relationship between IL-35 and clinicopathological features of OLP was analyzed.@*Results@#The expression [M(Q25, Q75)] of EBi3 [3.38 (1.63, 11.25)] and IL-12p35 mRNA [6.39 (2.55, 14.30)] in OLP lesion tissues were significantly higher than those in normal control group [1.41 (0.33, 3.16), 2.47 (1.10, 5.14)] (Z=-2.806, P=0.005; Z=-2.276, P=0.023), respectively. The positive expression rates of EBi3 and IL-12p35 were 66% (27/41) and 39% (16/41), respectively, were significantly higher in OLP lesion tissues comparing with that in normal oral mucosa tissues [0%(0/15)] (P<0.05). The relative expressions of EBi3 and IL-12p35 were positively correlated (r=0.404, P=0.009). A significant correlation was found between EBi3 protein over expression and the degeneration of base cells in OLP lesions (χ2=9.172, P=0.010). The positive expression rate of IL-12p35 protein in erosive type lesions was higher than that in non-erosive type lesions (χ2=7.220, P=0.007). The positive expression rate of IL-35 protein in OLP lesions [34% (14/41)] was higher than that in normal control group (χ2=6.829, P=0.009). The expression rate of IL-35 in erosive type lesions (10/20) was significantly higher than that in eruption type lesions (4/21) (χ2=4.364, P=0.037).@*Conclusions@#The expression of IL-35 in OLP localized lesions was up-regulated, suggesting that IL-35 might play an important role in OLP lesion formation.
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Objective:To observe the clinical efficacy of point application with Da Huang (Rhizoma Rhei Cruda) powder at Shenque (CV 8) plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions after chemotherapy for non-Hodgkin lymphoma (NHL).Methods:A total of 60 cases with NHL under chemotherapy were divided into two groups by hospitalization order,with 30 cases in each group.The control group was treated with routine nursing and the observation group was additionally given point application with Da Huang (Rhizoma Rhei Cruda) powder plus moxa-salt hot compress on the umbilicus,to compare the effect in preventing gastrointestinal adverse reactions after chemotherapy between the two groups.Results:The occurrence rates of constipation,nausea,vomiting and poor appetite on the second day and fifth day after chemotherapy were obviously lower in the observation group than those in the control group,with statistically significant differences between the two groups (all P＜0.05).Conclusion:The point application with Da Huang (Rhizoma Rhei Cruda) powder at Shenque (CV 8) plus maxa-salt hot compress on the umbilicus can produce more significant efficacy in preventing the gastrointestinal adverse reactions after chemotherapy for NHL than routine nursing.Moreover,it is simple and easy to be used and popularized.
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Objective To explore the predictor of invalid conservative treatment of acute calculous cholecystitis (ACC) in pregnant women.Methods A total of 107 pregnant patients with ACC in a tertiary hospital from Jan.2010 to Jun.2017 were studied retrospectively.Results Univariate analysis revealed that body temperature ＞ 37.3 ℃ (x2 =4.721,P ＜ 0.05),gallbladder dilation (x2 =4.764,P ＜ 0.05),TBiL (t=-2.518,P＜0.05),ALT (t=-2.860,P＜0.05),AST (t=-3.014,P＜0.05),hospital stay (x2 =9.769,P ＜ 0.05),rate of pregnancy termination (x2 =7.349,P ＜ 0.05) were all significantly higher in conservative therapy failure group than those in the conservative therapy success group.Multivariate analysis showed that gallbladder dilation,TBiL,body temperature ＞ 37.3 ℃,AST were the independent risk factors predicting invalid conservative management.Conclusion Gallbladder dilation,body temperature ＞ 37.3 ℃,high level of TBiL and AST are the early predictors for the invalid conservative management for ACC in pregnant women.
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<p><b>OBJECTIVE</b>This study aimed to investigate the ratio of T helper cell 17 (Th17) and regulatory T cells (Treg) in peripheral blood of oral lichen planus (OLP) and explore the pathogenesis of its possible role and significance.</p><p><b>METHODS</b>The peripheral blood samples were obtained from 33 patients with OLP (15 cases of reticular OLP and 18 cases of erosive OLP) and 17 healthy controls. The percentages of Th17 and Treg cells were detected by flow cytometry (FCM). Real-time fluorescence quantitative polymerase chain reaction (qPCR) technique was used to detect the expression levels of retinoid-related orphan nuclear receptor γt (RORγt) and forkhead box 3 (Foxp3).</p><p><b>RESULTS</b>The proportions of Th17, Treg cells, and their transcription factors (RORγt and Foxp3) in OLP were higher than those in the control groups (P<0.05). By contrast, in Treg cells and Foxp3, no significance was observed between erosive OLP and reticular OLP. Th17/Treg ratio increased in OLP. This ratio was significantly increased in erosive OLP compared with those in the control groups and reticular OLP (P<0.01). Nevertheless, no significance was noted between reticular OLP and control groups. Statistical analysis demonstrated positive correlations among Th17 cells, Th17/Treg, and clinical characteristics (r=0.66, P=0.00; r=0.66, P=0.00; r=0.52, P=0.00; r=0.50, P=0.00). Positive correlations also existed between Th17 and Treg cells (r=0.39, P=0.03).</p><p><b>CONCLUSIONS</b>Th17 cells, Treg cells, and their ratios all increased in the peripheral blood of OLP. Moreover, the imbalance inTh17/Treg may play a role in the pathogenesis of erosive OLP.</p>
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Madelung deformity is a rare deformity of forearm and wrist caused by growth disorders of distal radius ulnar and palmar epiphyseal. Current studies showed that its incidence mainly associated with trauma, epiphyseal developmental abnormalities, nutritional disorders and genetic deletion or mutation. The early clinical presentation is not typical, in middle and late time, wrist deformity and weak can appear. Plain film considered as the main means of diagnosis is often lack of early diagnosis significance. Although wrist joint magnetic resonance imaging showing early soft tissue and skeletal abnormalities were used for the early diagnosis of the disease, current domestic study in magnetic resonance imaging of this deformity is less. According to the size of the distal ulnar inclination angle and palm angle, this deformity can be divided into different types. The patients with severe deformity and symptoms usually need surgical intervention including ulna revision and osteotomy of the distal radius at present. Although the two operation can achieve good clinical results, the surgical trauma, infection and postoperative risk of joint activities are more.
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<p><b>OBJECTIVE</b>To investigate mechanism of di-(2-ethylhcxyl)phthalate (DEHP) exposure in causing blood-testis barrier (BTB) impairment in rats.</p><p><b>METHODS</b>Two-months-old male SD rats were randomly divided into corn oil control group and DEHP (750 mg/kg) exposure group for daily intragastic treatment for 30 consecutive days. After the treatments the rats were examined for histomorphological changes of the testicle using HE staining and the expressions of the junction proteins N-cadherin β-catenin, occludin and connexin43 of the BTB using Western blot. In the in vitro study, the vitality and ROS generation level in Sertoli cells exposed to different concentrations of DEHP were examined with MTT and ROS assay kits, respectively, and Nrf2 and p-p38 expressions were detected with Western blot.</p><p><b>RESULTS</b>Compared with the control group, the rats with DEHP exposure showed structural damage of the seminiferous tubule and polarity loss of the spermatids. DEHP exposure caused significantly decreased expressions of occludin and connexin43 but increased expressions of N-cadherin and β-catenin in the testicle tissues of the rats (P<0.05). The vitality of Sertoli cells was obviously decreased and ROS level increased significantly after exposure of the cells to increasing concentrations of DEHP, which also resulted in significantly up-regulated Nrf2 and p-p38 expressions (P<0.05).</p><p><b>CONCLUSIONS</b>DEHP exposure causes increased oxidative stress in the Sertoli cells of the testis, activates p38 MAPK signaling pathway, and results eventually in impaired spermatogenesis in rats.</p>
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Objective To investigate the effect of the type of neighborhoods on the population structure and dynamics of mos-quitoes. Methods The adult population dynamics and larvae breeding of mosquitoes in four different types of neighborhoods were investigated in Yangzhou City. Results The number of trapped mosquitoes was the largest in the urban villages,and more than 800 adult mosquitoes were trapped in each urban village,which was significantly higher than that of ordinary and high qual-ity residences. Aedes albopictus and Culex pipiens pallens were dominant species(D>10％)in the four types of residential ar-eas,and Ae. albopictus was the most dominant species(D>57％). The peak occurrence of Ae. albopictus in different areas oc-curred in early June,and it occurred again in the urban village in the middle of September. The occurrence quantity of Cx. pipi-ens pallens was stable in the ordinary residence and high quality residence,while in the urban village and resettlement residen-tial area,the peak occurred in mid-October. The orders of positive rates,densities and the numbers of mosquitoes in the differ-ent types of residential areas were:the urban villages>the resettlement residence>the ordinary residence>the high quality resi-dence. The water vat had the highest positive rate in all kinds of larval habitats,followed by tires and green belt with garbage wa-ter. Conclusions The main mosquito species in the four different types of residential areas are all Ae. albopictus and Cx. pipiens pallens,but the positive rate,density and the number of mosquitoes in the different types significantly change,especially in the urban villages,the number and the occurrence peak are significant different from those in the other types of residential areas.