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Objective@#To summarize the clinical characteristics and nerve conduction damage in patients with early POEMS syndrome, and to explore the value of segment nerve conduction velocity in the diagnosis of POEMS syndrome. @*Methods@#A total of 73 patients with POEMS syndrome and 27 healthy controls in Peking Union Medical College Hospital from September 2009 to June 2019 were recruited in this study. The motor and sensory nerve conduction characteristics of median, ulnar, tibial, and peroneal nerves and the clinical features of the participants were analyzed. The analysis parameters included: (1) distal motor latency (DML), compound muscle action potential (CMAP); (2) the median velocity from elbow to wrist, the median velocity from axillary to elbow, the ulnar velocity from the site below elbow to wrist, the ulnar velocity from the site above elbow to below elbow, the ulnar velocity from axillary to the site above elbow, the tibial velocity from ankle to knee, the peroneal velocity from ankle to fibulae capitulum; (3) sensory nerve conduction velocity and amplitude of these nerves; (4) terminal latency indices (TLI) of median; (5) motor nerve conduction blocks. @*Results@#Peripheral nerve damages were the initial symptoms in thirty-two patients in this group, accounting for 43.8% (32/73), and 81.3% (26/32) of these patients only showed numbness in lower extremities. All POEMS syndrome patients with numbness had abnormal sensory nerve conduction, and 9.5% (7/73) of patients without sensory symptoms also had abnormal sensory nerve conduction. On the other hand, the decrease of CMAP amplitude corresponded to clinical muscle strength decline and motor dysfunction. In the patients with POEMS syndrome, motor nerve conduction in the lower limbs were more likely to be affected and the damages were more severe than in the upper limbs: the proportion of CMAP disappearance in the lower limbs and upper limbs was 47.6% (112/235) vs 2.8% (7/252; χ2=133.698, P<0.01). Sensory nerve conduction damage was more severe than motor nerve conduction: the proportion of amplitude disappearance in sensory and motor conduction was 43.0% (141/328) vs 24.4% (119/487; χ2=133.698, P<0.01). The slowing of motor nerve conduction velocity was more common than the decrease of CMAP amplitude: the rate of slowing down of motor nerve conduction was 88.7% (432/487), and the rate of decrease of amplitude was 52.8% (257/487; χ2=151.905, P<0.01). The DML of median and ulnar nerve in the POEMS syndrome group was longer than that in the control group (median nerve: 4.4 (3.7, 5.0) ms vs 3.2 (3.0, 3.5) ms, U=854.000, P<0.01; ulnar nerve: 3.1 (2.7, 3.8) ms vs 2.5 (2.2, 2.7) ms, U=1 077.500, P<0.01). The TLI of median nerve in patients with POEMS syndrome was significantly higher than that of healthy controls (0.40±0.11 vs 0.35±0.06, t=3.466, P=0.001). There was no statistically significant difference in nerve conduction velocity between the forearm segment and the upper arm segment in the POEMS group. @*Conclusions@#Neurological damages were common in patients with POEMS syndrome with sensory nerve damage often being the initial clinical manifestation. In patients with POEMS syndrome, the nerve damage in the lower limbs was more severe than in the upper limbs, and sensory nerve damage was more severe than motor nerve damage. Segmental motor nerve conduction results suggested that demyelination damage occurred earlier than axonal damage, and proximal lesions were slightly heavier than distal lesions. No conduction block was detected in these patients. These characteristics of segmental nerve conduction can provide more evidence for clinical diagnosis of POEMS syndrome.
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Micro-invasive thoracic surgery has become new trends of thoracic surgery,and video-assisted thoracic surgery (VATS),which has the advantage of less trauma,rapid recovery and fewer postoperative complications,has become the mainstream of lung cancer resection.With the development of technology and surgical instruments,VATS has taken the place of open procedure,and the postoperatively follow-up also showed that both the two procedures have similar results in long-term survival rate and so on.With years of rapid develop,now the traditional VATS has nearly been perfect,the thoracic doctors eagerly try to find a new kind of micro-invasive surgery.It is in this background that Uniportal video-assisted thoracic surgery is born and it has been received by more and more operators.Uniportal VATS is not only inferior than multiportal VATS in Postoperative survival,but also has the advantage in reliving post thoracotomy chest pain as it only has one incision.In this paper,the author would like to summarize up the newest development of uniportal VATS in recently years.
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BACKGROUND:Mechano growth factor has the potential to activate muscle satelite cels and promote myogenic cel growth, and has dual roles in maintaining bone mass and repairing bone defects. OBJECTIVE: To explore the mechanism underlying osteogenic differentiation of rabbit bone marrow mesenchymal stem cels promoted by the mechano growth factor. METHODS:The best concentration and time of mechano growth factor to promote osteogenic differentiation of rabbit bone marrow mesenchymal stem cels were detected by MTT. The mRNA and protein expressions of alkaline phosphatase and osteocalcin were detected by qPCR and western blot, respectively. The phosphorylation level of AKT and mTOR were detected by western blot assay. RESULTS AND CONCLUSION:The best concentration and time of mechano growth factor was 45 μg/L and 5 days for promoting the osteogenic differentiation of rabbit bone marrow mesenchymal stem cels. The expressions of alkaline phosphatase and osteocalcin at mRNA and protein levels were highest after 4-hour intervention with 45 μg/L mechano growth factor, and meanwhile, the phosphorylation levels of mTOR and AKT were also highest. These findings indicate that the mechano growth factor can promote the differentiation of rabbit bone marrow mesenchymal stem cels into osteoblastsvia PI3K/AKT pathway, and its best concentration and time are 45 μg/L and 4 hours, respectively.
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BACKGROUND:Alogeneic bone marrow stromal stem cel transplantation for treatment of bone diseases is a hot topic. To seek effective methods for prevention of post-transplantation immune rejection is urgent to be solved. OBJECTIVE:To explore the expression of MHC antigen on the surface of bone marrow stromal stem cels after osteogenic inductionin vitro. METHODS:Bone marrow samples were extracted from rabbits to in vitro isolate and culture bone marrow stromal stem cels. Then, the cels were cultured in IMDM medium containing bone morphogenetic protein-2. Flow cytometry was used to analyze the expression of MHC antigen on the osteoblasts differentiated from bone marrow stromal stem cels. RESULTS AND CONCLUSION:There was highly expressed MHC I antigen but no MHCII antigen on the osteoblasts differentiated from bone marrow stromal stem cels. After osteogenic induction, no immune rejection was found. These findings indicate that alogeneic or xenogeneic bone marrow stromal cel transplantation can be used in the treatment of bone defects.
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BACKGROUND:A series of pathological changes were found in atlas, including atlas dislocation, atlanto-occipital junction instability and vertebral fractures. Atlantoaxial pedicle screw, nail and rod fixation or nail plate fixation is a novel repair method recently proposed, and has certain advantages. OBJECTIVE:To compare the repair effects of atlas pedicle screw on different types of atlas lesions. METHODS:A total of 42 fresh vertebrae were obtained from Department of Human Anatomy, Basic Medical School, Inner Mongolia Medical University. In accordance with bone thickness of sagittal vertebral artery groove bottom, vertebrae were divided into three types:type I (common type), type II (light variation), and type III (severe variation). Al samples were subjected to atlas pedicle screw fixation. RESULTS AND CONCLUSION:The screw pul out force in different bone densities of vertebrae was not the same. Vertebrae with great thickness and great bone density had big screw pul out force (P<0.05). However, the screw in different cortical bone of vertebrae had the same function. No compression on blood vessels or phenomenon affecting vertebral activity was visible. These results indicated that atlas pedicle screw implantation showed good safety, no side effects, did not affect the normal work and life of patients.
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To identify the prevalence and the distribution of ticks infected with spotted fever group rickettsiae (SFGR) in Xunke Area of Heilongjiang Province ,China ,partial outer membrane protein A gene (ompA) and citrate synthase gene (gltA) specific fragments were assessed using the PCR method .The positive products were sequenced .Result showed that the pres-ence of SFGR was 14 of 60 in detection Dermacentor silvarum cases ,while the overall positive rate was 23 .33% .Its nucleotide sequence of ompA showed 99 .3% and 99 .18% similarity with nucleotide sequence of Rickettsia sp .JL-02 and Rickettsia rao-ultii respectively .And the evolutionary positions of SFGR species were similar with Rickettsiamontana and Rickettsiamassili-ae .It's concluded that the nature focus of tick-borne spotted fever did exist in the area of Xunke Area of Heilongjiang Province , China .
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OBJECTIVE: To discuss the positive effect of the revolutionary step in drug circulation(Trusteeship of Hospital Drugstore) on the reduction of drug costs and patients' medical expenses as well as on hospital management and development.METHODS: Based on the practice of "Trusteeship of Hospital Drugstore" in our hospital,this article analyzed and expounded the nine "possible" biased view points put forward in research paper entitled "Thoughts on 'Trusteeship of Hospital Drugstore'" published in the magazine "China Pharmacy"(Issue 13 of Vol.18,2007 May).RESULTS & CONCLUSIONS: The innovative practice of "Trusteeship of Hospital Drugstore" carried out currently in Nanjing is an attempt beneficial for drug circulation,which plays a positive and effective role in controlling the drug price over a reasonable range and alleviating patients' burden on medical expenses.
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[Objective]To study the biocompatibility of nacre on cultured human osteoblasts in vitro.[Method]The iliac bone of human were added with collagenase-trypsin,a lot of osteoblasts were released out.Then the osteoblasts were purified and cultured.Subsequently,the 3rd generation cultured human osteoblasts were inoculated with the extract of three materials:nacre,hydroxyapatite,and rubber.The appearance of osteoblast was observed under the phase contrast microscope.Microstructure of the osteoblast was observed under transmission electron microscope.Additionally,to determine whether these three materials affect cell proliferation,the numbers of BrdU-labeled cells were examined at three groups.MTT assay was tested to observe the viability of human osteoblasts.[Result]Under the phase contrast microscope,the appearance of the osteoblasts in two groups were spindle or triangle like,and black nodes were seen in confluent cell layer 19 days after cultured.The observation of electron microscopy showed that the nucleus of the osteoblasts in two groups were big and round,and there were a large number of mitochondrion and rough endoplasmic reticulum in two groups.Stereological analyses of the numbers of BrdU-labeled cells revealed that females produced more cells than males in the dentate gyrus but not in the subventricular zone.[Conclusion]The nacre have no harmful effect to character of biology of human osteoblasts in vitro.
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Objective To study the expression of WWOX gene in non-small cell lung cancer and its significance. Methods WWOX protein expression was evaluated by immunohistochemistry in 81 NSCLC patients(50 squamous cell carcinomas,31 adenocarcinomas and 20 adjacent normal lung tissues),and correlation with histopathologic(histotype,grade,tumor-node-metastasis,stage) and clinical characteristics was studied. Results WWOX expression was absent/reduced in 72.8% of NSCLC,whereas it was normal in 80.0% of adjacent normal lung tissues.WWOX expression was strongly associated with tumor histology and histologic grade(P