Descending necrotizing mediastinitis: a clinical analysis based on 10 years of published data in China / 口腔疾病防治

Objective@#To investigate the clinical characteristics, diagnosis, treatment, and prognosis of descending necrotizing mediastinitis (DNM) to provide a reference for the early diagnosis and timely treatment of DNM.@*Methods@#Data on DNM in China was electronically retrieved from the core databases and comprehensively reviewed from June 2012 to June 2023. The infection, pathogenic microorganisms, main symptoms, comorbidities and treatment methods of DNM were analyzed.@*Results@#The data of a total of 781 DNM patients, with an average age of (52.97 ± 5.64) years, were retrieved, including 554 males and 227 females. Odontogenic source, tonsillitis, pharyngeal abscess, sialoadenitis, upper respiratory tract infection, foreign body injury, or iatrogenic traumatic procedures are common causes. Among these, odontogenic infection is the most common source. Streptococcus sp. (n = 217) and Staphylococcus sp. (n = 82) were most isolated, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa (equally n = 59). A total of 69.4% (542/781) of DNM patients recruited in this study were discovered to have various comorbidities, and more than one-third of these patients (n = 185) had diabetes. Of the broad antibiotics, carbapenem was most frequently used as treatment, and vancomycin was the most frequently coadministered. The mediastinal drainage approach varies widely, and the optimal regimen is still unknown. Seventy-two patients were treated with video-assisted thoracoscopic/mediastinoscopic surgical drainage, 22 patients were treated with percutaneous catheter drainage, 30 underwent the transcervical approach, and 40 underwent thoracotomy. A total of 617 patients who were selected underwent the appropriate combined operation for surgical drainage according to the specific location of the infected focus. The overall mortality rate of all 781 DNM patients included was 11.2%.@*Conclusion@#The most effective diagnosis and treatment of DNM is a high degree of clinical vigilance followed by prompt and adequate drainage with intensive care, including hemodynamic monitoring, nutritional support, computer tomographic scanning repeated as necessary, and combined use of systemic antibiotics.

Combination of GI-RADS and 3D-CEUS for differential diagnosis of ovarian masses

SUMMARY OBJECTIVE The purpose of this study is to evaluate the efficacy of the combination of gynecologic imaging reporting and data system (GI-RADS) ultrasonographic stratification and three-dimensional contrast-enhanced ultrasonography (3D-CEUS) in order to distinguish malignant from benign ovarian masses. METHODS In this study, 102 patients with ovarian masses were examined by both two-dimensional ultrasound(2D-US) and 3D-CEUS. Sonographic features of ovarian masses obtained from 3D-CEUS were analyzed and compared with 2D-US. All patients with ovarian masses were confirmed by operational pathology or long-term follow-up results. RESULTS (1)The Chi-square test and multiple Logistic regression analysis confirmed that there were only eight independent predictors of malignant masses, including thick septa (≥3mm), thick papillary projections(≥7mm), solid areas, presence of ascites, central vascularization, contrast enhancement, distribution of contrast agent, and vascular characteristics of the solid part and their odds ratios which were 5.52, 5.39, 4.94, 4.34, 5.92, 7.44, 6.09, and 7.67, respectively (P<0.05). (2)These eight signs were used to combine the GI-RADS with 3D-CEUS scoring system in which the corresponding value of the area under the curve (AUC) was 0.969, which was superior to using GI-RADS lonely (Z-value=1.64, P<0.025). Using 4 points as the cut-off, the scoring system showed the performance was clearly better than using GI-RADS alone (P<0.05). (3) The Kappa value was 0.872 for two different clinicians with equal experience. CONCLUSIONS The combination of GI-RADS and 3D-CEUS scoring system would be a more effective method to distinguish malignant from benign ovarian masses.

RESUMO OBJETIVO O objetivo deste estudo é avaliar a eficácia da combinação da estratificação por ultrassonografia usando o Sistema de Relatórios e Dados de Imagem Ginecológica (GI-RADS) e ultrassonografia 3D com contraste (3D-CEUS) para diferenciar massas ovarianas benignas de malignas. METODOLOGIA Neste estudo, 102 pacientes com massas ovarianas foram examinadas usando ultrassonografia bidimensional (2D-US) e 3D-CEUS. As características ultrassonográficas das massas ovarianas obtidas com 3D-CEUS foram analisadas e comparadas com de 2D-US. Todos os pacientes com massas ovarianas tiveram o diagnóstico confirmado pelos resultados de patologia cirúrgica ou acompanhamento de longo prazo. RESULTADOS (1) O teste qui-quadrado e a regressão logística múltipla confirmaram a existência de apenas oito preditores independentes de massas malignas, incluindo septos espessos (≥3mm), projeções papilares espessas (≥7mm), áreas sólidas, presença de ascite, vascularização central, aumento de contraste, distribuição do agente de contraste e características vasculares da parte sólida e suas razões de possibilidades (OR), que foram 5,52, 5,39, 4,94, 4,34, 5,92, 7,44, 6,09 e 7.67, respectivamente (P< 0,05). (2) Esses oito preditores foram utilizados para combinar o GI-RADS com o sistema de escores da 3D-CEUS, para o qual o valor correspondente da área sob a curva (AUC) foi de 0,969, superior ao uso exclusivo do GI-RADS (valor de Z = 1,64, P < 0,025). Usando 4 pontos como corte, o sistema de escores mostrou que o desempenho foi muito melhor do que com o uso exclusivo do GI-RADS (P < 0,05). (3) O valor de Kappa foi 0,872, obtido por dois médicos diferentes com igual experiência. CONCLUSÃO A combinação do GI-RADS e do sistema de pontuação da 3D-CEUS é um método mais eficaz para distinguir massas ovarianas benignas de malignas.

Expression of Notch signaling pathway in temporomandibular osteoarthritis / 口腔疾病防治

Objective@# To investigate the expression of Notch signaling molecules in temporomandibular joint arthritis (TMJOA), and to explore the role and mechanism of Notch signaling pathway in the development and progression of TMJOA. @*Methods @#72 Kunming mice were randomly divided into experimental group, sham-surgery group and normal group. In experimental group, discs on the right TMJ were subjected to total discectomy, sham-operation group underwent the same procedure without disc removal, while normal group serve as blank control. All the left temporomandibular joint discs were not treated. 8 mice in each group were sacrificed respectively at 1 week, 2 week, 4 week after surgery. Histological examinations were performed to assess success of TMJOA model, according to the pathological standard of osteoarthritis diagnosis. Immunochemistry techniques were performed in the successful TMJOA cartilages to evaluate the expression levels of Notch1 (NICD1), Jagged1, Hes1 and Hes5. The scores were evaluated by semi-quantitative method. @*Results @#Notch1 (NICD1), Jagged1 and Hes5 were activated in the experimental group with the expression levels increased dramatically over time. While Hes1 expression was suppressed at the beginning of osteoarthritis but was up-regulated afterwards.@*Conclusion @# Notch pathway-related molecular expression changed greatly in TMJOA model, indicating that the pathway in the occurrence and development of TMJOA plays an important role.

Study on the possible factors leading to complications of hydroxyapatite orbital implantation / 国际眼科杂志(Guoji Yanke Zazhi)

·Hydroxyapatite ( HA ) orbital implant has been widely used since it was developed due to its many advantages. It is one of the ideal materials to fill the orbital volume after enucleation or evicseration. However, it still causes complications, and some complications such as severe eye exposure may require reimplant surgery. The paper reviews the clinical application of HA orbital implant, the possible factors leading to complications of HA orbital implantation and the treatments for several common complications. The review aims to provide some help to readers.

Quantitative Analysis of Cell Tracing by in vivo Imaging System / 华中科技大学学报（医学）（英德文版）

In vivo imaging system(IVIS)is a new and rapidly expanding technology,which has a wide range of applications in life science such as cell tracing.By counting the number of photons emitted from a specimen,IVIS can quantify biological events such as tumor growth.We used B16F10-luc-G5 tumor cells and 20 Babl/C mice injected subcutaneously with B16F10-luc-G5 tumor cells(1×106 in 100 μL)to develop a method to quantitatively analyze cells traced by IVIS in vitro and in vivo,respectively.The results showed a strong correlation between the number of tumor cells and the intensity of bioluminescence signal(R2=0.99)under different exposure conditions in in vitro assay.The results derived from the in vivo experiments showed that tumor luminescence was observed in all mice by IVIS at all days,and there was significant difference(P<0.01)between every two days from day 3 to day 14.Moreover,tumor dynamic morphology could be monitored by IVIS when it was invisible.There was a strong correlation between tumor volume and bioluminescence signal(R2=0.97)by IVIS.In summary,we demonstrated a way to accurately carry out the quantitative analysis of cells using IVIS both in vitro and in vivo.The data indicate that IVIS can be used as an effective and quantitative method for cell tracing both in vitro and in vivo.

Expression of Interleukin-15 and Its Receptor on the Surface of Stimulated Human Umbilical Vein Endothelial Cells / 华中科技大学学报（医学）（英德文版）

Human interleukin-15 (hlL-15) is an important cytokine to activate endothelial cells and can be regulated by many other cytokines. The aim of this study is to examine the ability of interferon-γ,(IFN-γ), and tumor necrosis factor-ct (TNF-α) to induce the production of human interleukin-15 (hlL-15)and IL-15 receptor (IL-15Rα) by human umbilical vein endothelial cells (HUVECs). The data are summarized as follows: 1. Northern blot revealed that IL-15 mRNA was up-regulated by IFN-γ and TNF-α. 2. lntracellular IL-15 protein was visualized by fluorescence microscopy, whereas the expres-sion of IL-15 on the surface of HUVECs was detected by fluorescence activated cell sorting (FACS),and no detectable IL-15 in the medium was verified by ELISA. 3. IL-15Rα was detected on the surface of HUVECs by FACS after IFN-γ and TNF-α stimulation, whereas Western blotting revealed that the elevated expression on surface IL-15Rα was not due to the increased protein expression. The conclusion demonstrated from our results is that IFN-γ and TNF-α play an important role in regulating the expres-sion of IL-15 and IL-15Rα on the surface of HUVECs.

Characterization of Acute Renal Allograft Rejection by Human Serum Proteomic Analysis / 华中科技大学学报（医学）（英德文版）

To identify acute renal allograft rejection biomarkers in human serum, two-dimensional differential in-gel electrophoresis (2-D DIGE) and reversed phase high-performance liquid chromatog-raphy (RP-HPLC) followed by electrospray ionization mass spectrometry (ESI-MS) were used. Serum samples from renal allograft patients and normal volunteers were divided into three groups: acute rejec-tion (AR), stable renal function (SRF) and normal volunteer (N). Serum samples were firstly processed using Multiple Affinity Removal Column to selectively remove the highest abundance proteins. Differ-entially expressed proteins were analyzed using 2-D DIGE. These differential protein spots were ex-cised, digested by trypsin, and identified by RP-HPLC-ESI/MS. Twenty-two differentially expressed proteins were identified in serum from AR group. These proteins included complement C9 precursor,apolipoprotein A-Ⅳ precursor, vitamin D-binding protein precursor, beta-2-glycoprotein 1 precursor,etc. Vitamin D-binding protein, one of these proteins, was confirmed by ELISA in the independent set of serum samples. In conclusion, the differentially expressed proteins as serum biomarker candidates may provide the basis of acute rejection noninvasive diagnosis. Confirmed vitamin D-binding protein may be one of serum biomarkers of acute rejection. Furthermore, it may provide great insights into un-derstanding the mechanisms and potential treatment strategy of acute rejection.