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Sepsis, a series of pathophysiological abnormalities caused by infection, is also one of the most important factors of death and disability in infected patients all over the world, so it has always been the focus of the medical community. Cytokines are small molecule proteins secreted by cells with biological activity, involved in the immune and inflammatory regulation of sepsis. Many studies using cytokine targeting to treat sepsis have achieved beneficial effects, and the level of cytokines is also believed to be related to the development, severity of sepsis, so they are reliable biomarkers of sepsis. Among them, pro-inflammatory cytokines such as interferon-β (IFN-β) and interleukins (IL-1β, IL-3, IL-6, and IL-7) are the focus of the discussion in this review. IFN-β and IL-1β are double-sided in the treatment of sepsis, namely early low-dose treatment can reduce sepsis by restoring the function of immune cells and play a protective effect, but they are also related to severe inflammatory response of sepsis and can aggravate the mortality of sepsis patients. IL-3 and IL-6 focus more on enhancing inflammatory factors and play a damage role. IL-7 mainly participates in immune regulation, promoting lymphocyte activation and protecting sepsis.
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Objective:To evaluate the clinical efficacy of metal braided stent deployed by fully protruding into the inferior vena cava for the treatment of iliac vein compression syndrome(IVCS).Methods:The clinical data of patients with IVCS treated with interwoven nitinol mesh stent protruding into the inferior vena cava and released from Jan 2018 to May 2021 in our center were retrospectively analyzed.Results:A total of 118 patients were included in this study. Among them, 7 cases were complicated with acute thrombosis, 3 cases were complicated with post thrombotic syndrome (PTS), and 108 cases were no more thrombotic iliac vein compression. The technical success rate was 100%, with an average of 2.03±0.77 stents implanted. Of the 23 ulcer patients, 18 ulcers healed after intervention, and the healing rate was 78.26%. The postoperative CEAP grade was significantly improved ( t=11.54, P<0.01), and the primary patency rate and second patency rate were 97.46% and 98.31% at 1 year after intervention. Conclusion:The fashion of fully protruding into inferior vena cava deployment in the treatment of iliac vein compressive disease has a high patency rate and satisfactory clinical efficacy.
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Objective:To evaluate the application value of three-dimension digital subtraction angiography (3D-DSA) in the diagnosis and treatment of iliac vein compression syndrome (IVCS).Methods:A retrospective analysis was made on 171 patients with a tentative diagnosis of IVCS based on signs, symptoms, and finding of CTV or MRV, and iliac vein angiography. The diagnostic efficacy of MRV, 2D-DSA and 3D-DSA were analyzed. The imaging advantages of 3D-DSA in the diagnosis and treatment of IVCS were evaluated.Results:Ninty-three patients underwent MRV and 3D-DSA simultaneously, 101 patients had 2D-DSA and 3D-DSA simultaneously. 3D-DSA was taken as gold standard, the diagonotic sensitivity, specificity, Youden index of MRV was 75.61%, 72.73% and 0.48 respectively. The sensitivity, specificity, Youden index of 2D-DSA was 90.22%, 100% and 0.90 respectively. There are significant differences in the diagonotic sensitivity between MRV and 3D-DSA, 2D-DSA and 3D-DSA ( P<0.05). There is no significant difference in the diagonotic specificity between MRV and 3D-DSA, 2D-DSA and 3D-DSA ( P=1.000). In this study, we found that 3D-DSA has greater imaging evaluation advantages in preoperative evaluation, intraoperative guidance and immediate postoperative reexamination in the diagnosis and treatment of iliac vein disease. Conclusions:3D-DSA can improve the detection rate of IVCS, and has its advantage in imaging evaluation.
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Objective:To compare the efficacy between drug-coated balloon (DCB) combined with bare metal stenting (BMS) and plain old balloon angioplasty (POBA) with BMS placement in the treatment of femoral-popliteal TASC D lesions.Methods:According to the Trans-Atlantic Inter-Society Consensus (TASC) D grade femoral-popliteal lesions as the standard, we enrolled 115 cases (120 limbs) receiving DCB combined with BMS (group DCB, 37 limbs in 36 cases) and POBA combined with BMS (group POBA, 83 limbs in 79 cases) from Jan 2017 to Mar 2020 to observe patency rate, freedom from clinical-drived target lesion reintervention rate (FCD-TLR) and complications.Results:The mean follow-up time was 18.1 months and the average occlusion length was (29.1±6.5)mm. In group DCB vs group POBA, the primary patency rates at 3-month, 9-month, 1-year and 2-year were 89.2% vs. 86.7%, 86.4% vs. 76.9%, 66.8% vs. 70.9% and 63.1% vs. 56.9%, respectively ( P=0.73); FCD-TLRs were 100.0% vs. 95.1%, 94.3% vs. 82.3% , 78.5% vs. 80.6% and 74.1% vs. 68.9% ( P=0.69), respectively. Conclusion:The benefit of DCB combined with BMS over POBA combined with BMS in improving the early primary patency rate and reducing FCD-TLR was not definite.
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Objective To investigate the mechanism of action of integrin α4 (ITGA4) in liver fibrosis based on the anti-liver fibrosis effect of sticky sugar amino acid (SSAA) in rats. Methods A rat model of liver fibrosis was induced by intraperitoneal injection of CCl 4 , and then colchicine and low-, middle-, and high-dose SSAA were used for intervention, with blank control group and SSAA group as control. After 12 weeks of experimental intervention, serum and liver samples were collected to measure the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and HE staining and Sirius Red staining were used to observe the pathological conditions of liver tissue; quantitative real-time PCR was used to measure the transcriptional level of ITGA4, integrin β1 (ITGB1), transforming growth factor-β1 (TGFβ1), alpha-smooth muscle actin (α-SMA), and TIMP2 in liver tissue; Western blot was used to measure the relative protein expression levels of ITGA4, ITGB1, TGFβ1, α-SMA, MMP2, TIMP1, and TIMP2; immunohistochemistry was used to observe the protein expression of TGFβ1 and α-SMA. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for comparison between two groups. Results There were significant increases in AST and ALT in the CCl 4 model group, and intervention with colchicine or low-, middle-, and high-dose SSAA reduced the levels of AST and ALT, with a significant difference between the CCl 4 model group and the other groups (all P < 0.05). HE staining and Sirius Red staining showed disordered structure of hepatic lobules and an increase in collagen fibers in the CCl 4 model group, and the structure of hepatic lobules was improved after intervention with colchicine or low-, middle-, and high-dose SSAA. The CCl 4 model group had significantly higher transcriptional levels of ITGA4, TGFβ1, α-SMA, and TIMP2 than the other groups, and there were significant reductions in the transcriptional levels of each factor after intervention with colchicine or SSAA, with a significant difference between the CCl 4 model group and the other groups (all P < 0.05). The CCl 4 model group had significantly higher protein expression levels of ITGA4, TGFβ1, α-SMA, TIMP2, and TIMP1 and a significantly lower protein expression level of MMP2 than the other groups, and intervention with colchicine or SSAA inhibited the expression of ITGA4, TGFβ1, α-SMA, TIMP2, and TIMP1 and promoted the expression of MMP2. Immunohistochemistry showed that the CCl 4 model group had significantly higher expression levels of TGFβ1 and α-SMA than the other groups, which was inhibited by intervention with colchicine or SSAA. The high-dose SSAA group had the most significant effect in reducing aminotransferases, improving lobular structure, and inhibiting the protein expression of liver fibrosis factors. Conclusion The high expression of ITGA4 in the liver is associated with the development of liver fibrosis, which is consistent with the increases in the expression of TGFβ1 and α-SMA. Inhibiting the expression of ITGA4 can provide more therapeutic targets for liver fibrosis and expand the anti-liver fibrosis mechanism of SSAA.
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Colorectal cancer is the fourth most malignant tumors in China, among which the left hemicolon cancer accounts for about 5%?6%. Due to the complex anatomy around the left hemicolon, being adjacent to the pancreas, spleen, kidney, ureter and other important organs, its vascular and nerve distribution is variably distributed, leading difficulties in laparoscopic radical surgery for left hemicolon cancer. In surgical practice, the 4K laparoscopic system has shown its features of high-definition amplification, good color reproduction, and clear anatomy, etc. However, there is still no clear consensus on its application in the radical resection for the left hemicolon cancer. The authors summarize clinical practice, explore the technique key points of 4K laparoscopic D 3 resection with complete mesocolic excision for the left hemicolon cancer.
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OBJECTIVE@#To provide appropriate treatment strategy and precise genetic counseling through studying the phenotype and genotype of a patient featuring learning difficulty and abnormal gait.@*METHODS@#Detailed history taking, physical examination and auxiliary examination (including neuropsychological evaluation, brain imaging and skeletal system X ray) were conducted. The patient was also analyzed by whole exome sequencing, G banding karyotyping and array-based comparative genomic hybridization (aCGH). Multiples ligation-dependent probe amplification (MLPA) was applied to his parents to determine the origin of genomic variation.@*RESULTS@#In addition to obvious dermatological manifestation (Cafe-au-Lait spots), the patient also had facial abnormalities, ocular disorders, skeletal malformations, neurological manifestations, psychiatric and behavioral abnormalities. Whole exome sequencing and G banding karyotyping were both negative. aCGH has identified a microdeletion at 17q11.2, which encompassed the NF1 and neighboring genes. Neither parents has carried the same microdeletion by MLPA analysis.@*CONCLUSION@#The patient had a de novo 17q11.2 microdeletion, which probably accounted for his neurofibromatosis type 1-microdeletion syndrome phenotype.
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Objective To observe the influences of uncoupling protein 2 (UCP-2) rs660339 variants transfection on cell proliferation and apoptosis of human umbilical vein endothelial cell (HUVEC). Methods Two UCP-2 green fluorescent protein (GFP) lentivirus constructs were created with the rs660339 locus carried C or T (UCP-2C or UCP-2T), respectively. HUVEC were cultured after lentiviral infection of UCP-2C or UCP-2T. The expression of UCP-2C or UCP-2T was detected with real time polymerase chain reaction. Cell proliferation and cell apoptosis were compared among negative control (NC) group, UCP-2T group and UCP-2C group using CCK-8 cell viability and flow cytometry. Western blot and immunostaining were employed to examine the expression of Bcl-2 gene. Results The lentivirus constructs were successfully created.>80%of the transfected cells were found to express GFP under fluorescent microscope. The mRNA levels of UCP-2 gene were significantly increased (F=29.183, P=0.001) in the UCP-2T group and UCP-2C group. The CCK-8 assay revealed that on day two (F=15.970, P=0.004), day three (F=16.738, P=0.004), day four (F=5.414, P=0.045) post-infection, UCP-2T and UCP-2C group showed significantly greater proliferation than the NC cells. The apoptotic rate in the UCP-2T and UCP-2C group was significantly lower than NC group (F=277.138, P=0.000), and the apoptotic rate of UCP-2T was significantly lower than that of UCP-2C (P=0.003). The protein levels of Bcl-2 in the UCP-2T and UCP-2C group were significantly greater than that in the NC group (F=425.679, P=0.000), and the Bcl-2 expression of UCP-2T was greater than that of UCP-2C (P=0.002). The Bcl-2 density in the UCP-2T and UCP-2C group were greater than that in the NC group (F=11.827, P=0.008), while there was no difference between UCP-2T and UCP-2C group (P=0.404). Conclusion The variants of UCP-2 rs660339 may influence HUVEC proliferation and apoptosis, and UCP-2T showed a stronger effect of inhibiting apoptosis than UCP-2C.
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BACKGROUND:Human umbilical cord mesenchymal stem cel s belong to a special class of stem cel s with a limited number, which are difficult to isolate and purify. Importantly, there is a lack of clinical understanding of biological characteristics of human umbilical cord mesenchymal stem cel s. OBJECTIVE:To study the bioactive properties and cardiomyocyte-like differentiation of human umbilical cord mesenchymal stem cel s. METHODS:Under a sterile col ection, umbilical cord blood of newborn from cesarean section was col ected to isolate human mesenchymal stem cel s by digestion using col agenase II. Immunohistochemical staining was used to detect cel surface markers and observe morphological characteristics, and MTT assay used to detect cel proliferation and draw cel growth curve. Cel s grown to 70%-80%confluence were treated with 10μmol/L 5-azacytidine for 24 hours. RESULTS AND CONCLUSION:One week after adherent tissue culture, human umbilical cord mesenchymal stem cel s were seen, and then the cel s cultured in culture medium showed colony growth. Within 24 hours of cel seeding, cel s at passages 3 and 10 were at latency period and then grew logarithmical y with a doubling time of 30 hours. Immunocytochemical staining showed that passage 3 cel s at over 90%confluence expressed CD44 and CD29, rather than CD28 and CD31.Three weeks after induced culture, the cel s with the absence of processes grew irregularly;after 4 weeks, the cel s were round in shape and expressed cardiac-specific immune markers. Taken together, isolated human umbilical cord mesenchymal stem cel s with strong proliferative ability have the basic biological characteristics of mesenchymal stem cel s, which are capable of differentiating into cardiomyocyte-like cel s induced by 5-azacytidine.
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BACKGROUND:Dental implantation in maxilary esthetic zone is difficult to achieve desired outcomes. OBJECTIVE:To observe the feasibility of digital rapid prototyping implant template for anterior implantation. METHODS: Eighty patients scheduled to receive anterior implant treatment were enroled. According to the wishes of patients, they were divided into two groups, with 40 cases in each group, and were given routine implant treatment (control group) and digital rapid prototyping template-aided dental restoration (observation group). After implantation, the X-axis, Y-axis and Z-axis errors of the two groups were measured, and the patients were folowed up for 12 months. RESULTS AND CONCLUSION:After implantation, the errors of X, Y and Z axes in the observation group was significantly lower than those in the control group (P< 0.05); at 24 hours after implantation, patients in the two groups showed good appearance of the anterior tooth with no dental prosthesis loosing. Imaging examinations in the two groups showed no obvious bone resorption. These findings indicate that the aid therapy using digital rapid prototyping can obtain satisfactory therapeutic effect on anterior tooth restoration in the maxilary esthetic zone and precisely localize the dental implantation site.
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BACKGROUND:Hepatic fibrosis in chronic liver disease can be reversed. Studies have shown that Periplaneta americana extract has anti-fibrosis effect, and has protective effect on the experimental hepatic fibrosis rats. OBJECTIVE:To observe the effect of Periplaneta americana extract sticky sugar amino acid on hepatic fibrosis, and to primarily explore the mechanism of sticky sugar amino acid against hepatic fibrosis. METHODS:Rat models of immune hepatic fibrosis were induced by pig serum and intragastricaly administered 0.5, 0.25, 0.10 g/kg sticky sugar amino acid. Four indexes of hepatic fibrosis were detected by radioimmunoassay. Immunohistochemical staining wasused to measure transforming growth factor beta 1, tissue inhibitor of metaloproteinase protein expression intensity and positive cel rate, to determine the correlation of different concentrations of sticky sugar amino acid, transformation growth factorbeta 1 and tissue inhibitor of metaloproteinase. RESULTS AND CONCLUSION:(1) The Periplaneta americana extract sticky sugar amino acid reduced the levels of laminin, type III procolagen, type IV colagen and hyaluronidase (P 0.9). (3) Results confirmed that the Periplaneta americana extract sticky sugar amino acid can change the reversal of hepatic fibrosis. Its mechanism of action is associated with expression of transforming growth factor beta 1 and tissue inhibitor of metaloproteinase 1 inhibited by sticky sugar amino acids.
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BACKGROUND:Targis/composite fiber is a new type of non-metalic repair material that has good hardness and strength, but it is rarely reported on its application in the repair of young permanent tooth defects. OBJECTIVE:To investigate the clinical effect of Targis/composite fiber in repairing young permanent tooth defects. METHODS:Sixty cases of young permanent teeth defects 10-17 years of age were enroled, including 27 males and 33 females. Al cases were subjected to Targis/composite fiber repairing. After 36 months of folow-up, alkaline phosphatase level, probing depth, gingival sulcus bleeding index, tooth mobility, plaque index, gingival crevicular fluid volume and aspartate aminotransferase level in patients were detected; the integrity and edge of dental prosthesis and the color matching. RESULTS AND CONCLUSION:After 36 months, the alkaline phosphatase level in the patients had no significant changes (P> 0.05), but the probing depth, gingival sulcus bleeding index, tooth mobility, plaque index, gingival crevicular fluid volume and aspartate aminot ransferase level were decreased significantly compared with those before repair (P< 0.05). Additionaly, there were two cases of incomplete dental prosthesis, six of color mismatching, andtwo of unsealed prosthesis edge. These findings indicate that the Targis/composite fiber for repairing young permanent tooth defects has good histocom patibility maintains periodontal health in good condition, is a kind of ideal repair materials.
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BACKGROUND:Maxilary posterior tooth defects can be repaired using the dental implant. However, implantation accuracy is not ensured by traditional plaster models used as implant template, which leads to the incidence of complications,andaffectsthe repair effects. OBJECTIVE:To study application effects of surgical guide plates designed using the computer aided design (CAD)/computer aided manufacturing (CAM) technology for the repair of maxilary posterior tooth defects. METHODS:Implant treatment was performed in 30 patients with maxilary posterior tooth defects. Surgical guide plate was made using the CAD/CAM technology after CT scan of the jaw bone. The repair was conducted with guideplateassistant. The deviation between the virtual and actual implant position was measured after implantation. The clinical repair effects and periodontal tissues were observed during the 12-month folow-up. RESULTS AND CONCLUSION:Thirty-sixCAD/CAM surgical guide plates in 30 patients werestabilized after implantation. Thirty-six implants were emplaced precisely with the assist of the surgical guide plates. There was no any problem during the process of implantation. The deviation of the head between the virtual and actual implant position was very smal, which did not affect the accuracy of implant placement. Before and 6 and 12 months after the repair, gingival crevicular fluid, tumor necrosis factor-α, and sulcus bleeding index were not obviously changed in the patients. Our results suggest that the implant head deviation and angle deviation appearduring the repair process of maxilary posterior tooth defects using CAD/CAM surgical guide for dental implants;however, the implantation accuracy is not affected. The repair effect is ideal and periodontal tissue is in good status after implantation.
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Objective To identify the common clinical symptoms and signs of pectoral qi insufficiency syndrome;To provide evidence for its clinical treatment.Methods By retrieving 129 medical cases related to pectoral qi insufficiency syndrome in CNKI from January 1954 to October 2013 and Wanfang Database from January 1985 to October 2013, the authors made a statistical analysis of the symptoms and signs in medical cases related to pectoral qi insufficiency syndrome and elementarily generalized the common clinical characterization on pectoral qi insufficiency syndrome under the guidance of the TCM specialists.Results The cardinal syndromes of common clinical manifestation on pectoral qi insufficiency syndrome were shortness of breath and panting on exertion. The concomitant syndromes were pale or dim complexion, lassitude of spirit, lack of strength, shortage of qi and disinclination to talk, inability to sleep, dizziness, dizzy vision, etc. And it commonly superimposed failing to circulation qi-blood of cardiopulmonary as oppression in the chest, chest pain, palpitations, cyanosis, cough, etc, dysfunction of the spleen in transportation and transformation as torpid intake, sloppy stool, abdominal distension, and impairment of qi transformation due to Yang deficiency as cold limbs, fear of cold, edema, inhibited urination, and dry mouth.Conclusion The authors summarized cardinal syndrome, concomitant syndromes and superimposed symptoms on pectoral qi insufficiency syndrome from reported medical cases, which can provide scientific basis for normalizing the clinical diagnosis and treatment and interpreting the scientific connotation of pectoral qi insufficiency syndrome.
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In this paper, through a systematic review of literatures on pectoral qi theory, we summarized the defini-tion of pectoral qi, physiological function, deficiency-excess changes, clinical manifestations of pectoral qi deficiency and modern research progress of pectoral qi theory, in order to deepen the understanding of pectoral qi connotation. The connotations of pectoral qi have four major kinds of views. The pectoral qi is a combination of the natural fresh air inhaled by the lungs and the foodstuff essence-qi transformed by the spleen-stomach accumulated in the thorax. The substance of pectoral qi is heart-lung yang qi. Pectoral qi is the special title of acquired essences in the thorax. Pectoral qi accumulated in the thorax is the beating-qi beneath the left breast. Its physiological function includes flowing through the respiratory tract to promote the respiration movement of the lungs, permeating the heart and ves-sels to promote circulation of qi and blood, comprehensively regulating of the heart and lungs, controlling all qi and zang-fu, accumulating body fluids, resisting external evils, controlling mental activities, maintaining mental state healthy and vigorousness, controlling vision, hearing, sound, color, smell and movement, converging primordial qi to maintain the vigor and vitality. Disorders of pectoral qi are mainly manifested as deficiency or excess. Deficiency is mainly manifested in pectoral qi insufficiency, or pectoral qi sinking. Excess is mainly manifested in pectoral qi ob-struction, or pectoral qi counterflow. The common clinical manifestations of pectoral qi insufficiency include short-ness of breath and panting on exertion. The concomitant symptoms are pale or dim complexion, lassitude, lack of strength, shortage of breath and disinclination to talk, insomnia, dizziness, spontaneous sweating, emaciation, darkish tongue with thin and white fur, sunken thin or weak pulse. And it commonly superimposed with failing to circulation qi-blood of heart and lungs as chest distress, chest pain, palpitations, cyanosis, cough, expectoration, and hard stool. Spleen transportation and transformation dysfunction were manifested as poor appetite, loose stool, and abdominal dis-tension. Impairment of qi transformation due to yang deficiency is manifested as cold limbs, aversion to cold, edema, urination difficulty, and dry mouth. In addition, diseases which are treated with pectoral qi are give priority to the heart-lung diseases, and then gradually extend to diseases of other systems. At the same time, there are many reports on using pectoral qi theory in disease treatment. The essence of pectoral qi is also discussed from the perspective of modern medicine. Generally speaking, pectoral qi theory has been put forward early; however, the systematic study is difficult to meet the needs of clinical diagnosis and treatment. There are many problems which remain to be further studied and solved.
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Nasal supernumerary teeth and additional dental cyst is a common disease in Department of ENT and Department of Stomatology. In reported diseases, patients with a variety of additional teeth appeared in differ ent parts have varied clinical manifestations. Because of no obvious early symptoms, it is more difficult to diagnose, but CT examination in corresponding site can make it easy to diagnose the maxillary sinus and dentigerous cyst diagnosis. Operation is an effective method to cure the disease. Operation is simple, but the defect and tooth cavity after operation is one unavoidable problem for ENT doctor. In relevant literature it can be seen that the disease has a genetic tendency.