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Objective To investigate changes in thickness of the skin and muscular layer during the treatment with botulinum toxin A injections in patients with glabellar lines.Methods Twenty-six subjects with moderate to severe glabellar lines were enrolled into this study,who received botulinum toxin A injections in Peking Union Medical College Hospital from August 2017 to February 2018.Before the injections,4 and 16 weeks after the injections,thickness of the dermis at the injection site was measured by using 50 MHz high-frequency ultrasound,and full thickness of the skin and thickness of the muscular layer were measured with 20 MHz high-frequency ultrasound.Repeated measures analysis of variance,paired ttest and Bonferroni method were used to compare the pretreatment and posttreatment tissue thicknesses measured by using high-frequency ultrasound.Results Before the injections,the thickness of the dermis,full thickness of the skin,thickness of the muscular layer were 2.01 ± 0.48,4.32 ± 0.73 and 4.51 ± 0.67 mm respectively.No significant difference was observed among the pretreatment,4-and 16-week posttreatment thickness of the dermis (F =1.94,P =0.199),while there were significant differences among the pretreatment,4-and 16-week posttreatment full thickness of the skin and thickness of the muscular layer (F =6.28,24.19,P =0.020,＜ 0.001 respectively).Four weeks after the injections,the full thickness of the skin significantly increased (4.88 ± 0.93 mm,t =3.72,P =0.004),while the thickness of the muscular layer significantly decreased (3.82 ± 0.79 mm,t =4.65,P =0.001)compared with the pretreatment thicknesses.Sixteen weeks after the injections,the full thickness of the skin (4.61 ± 0.73 mm) and thickness of the muscular layer (4.38 ± 0.90 mm) did not significantly differ from those before and 4 weeks after the injections (all P ＞ 0.016 7).Conclusions Botulinum toxin A injections can change the thickness of the subcutaneous tissue and muscular layer.High-frequency ultrasound can be applied to the evaluation of efficacy and to follow-up after the treatment of glabellar lines with botulinum toxin A injections.
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Objective To summarize the clinical characteristics of recurrent endometrial carcinoma.Methods A total of 22 cases of recurrent endometrial carcinoma from January 2006 to December 2015 were enrolled.Primary diagnosis of endometrial carcinoma were made in our hospital,with complete clinical data and standard NCCN staging operation.The recurrence of endometrial cancer was confirmed by pathological diagnosis after second surgery or biopsy.Clinical data were retrospectively analyzed.Results The median age of primary diagnosis was 52 years old (rang,44-63 years old).And the most common clinical symptom was postmenopausal vaginal bleeding (54.5％,12/22).There were 18 cases (81.8％) of endometrial adenocarcinoma,3 cases (13.6％) of serous adenocarcinoma,and 1 case (4.5％) of clear cell carcinoma.As to the muscular layer infiltration,there were 14 cases (63.6％) ＜ 1/2,7 cases (31.8％) ＞ 1/2 and 1 case (4.5％) involving the whole layer.There were 4 cases (18.2％) of positive pelvic lymph node and no para-aortic lymph nodes metastasis.As to the postoperative clinical pathologic stage,there were 12 cases (54.5％) of FIGO Ⅰ A,5 cases (22.7％) of FIGO Ⅰ B,1 case (4.5％) of FIGO Ⅱ,and4 cases (18.2％) of FIGO ⅢC1.The median recurrent time was 4 years (rang,1.5-7 years),without obvious self-conscious symptoms,including serum CA125 elevated in 12 cases (54.5％) and positive ultrasound,CT or X-ray examination findings in 10 cases (45.5％).As to the recurrence location,14 cases (63.6％) were in the pelvic cavity,6 cases (27.3％) of retroperitoneal lymph nodes,1 case (4.5％) of anterior abdominal wall accompaning lung metastasis,and 1 case (4.5％) of lung metastasis.Three patients accept Lynch syndrome screening,of which 2 cases were positive.Conclusions Muscular layer infiltration is common in recurrence of endometrial cancer,with no obvious clinical symptoms.Pelvic cavity is the most common location of recurrence.
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Objective To observe the apoptosis of interstitial cells of Cajal in deep muscular layer ( ICC-DMP ) of small intestine in rats with multiple organ dysfunction syndrome ( MODS ) as a result of bacterial peritonitis, and the expression of c-kit ( an ICC phenotype marker ) and Bax/Bcl-2, in order to investigate the mechanism of gastrointestinal motility dysfunction in MODS. Methods According to the random number table, 40 Wistar rats were randomly divided into two groups:control group ( n=20 ) and MODS group ( n=20 ). The MODS model in rats was reproduced by intraperitoneal injection of 8×108 cfu/mL Escherichia coli suspension 1 mL, and the control group was given the same amount of normal saline. After 24 hours, the upper small intestine was harvested for examination. Ultrastructure of ICC-DMP was observed using electron microscope. The network structure of ICC-DMP and the expression of c-kit and Bax/Bcl-2 were observed and determined with immunofluorescence and laser scanning confocal microscope. Results Macroscopic observation revealed that the gastrointestinal motility of rats was normal in the control group. Compared with the control group, gastro intestine was significantly expanded with parulytic ileus in MODS group. It was shown by transmission electron microscopy that intermediate filament structure of ICC-DMP was clear without swelling of mitochondria; chromatin distributed uniformly with small amounts of heterochromatin aggregated in perinuclear. Compared with the control group, intermediate filament structure of ICC-DMP was fuzzy, and mitochondria were swollen obviously in MODS group;chromatin was assembled in nucleus centre. It was shown by laser scanning confocal microscope that the network structure of ICC-DMP was clear, the expression of c-kit and Bcl-2 was strongly and overlapping;the expression of Bax was weak and scatter distributed. Compared with control group, ICC-DMP quantity in MODS group was significantly reduced ( cells/HP: 15.80±2.30 vs. 25.70±3.97, t = 6.819, P = 0.000 ), and ICC network was incomplete. The expression of c-kit and Bcl-2 was significantly decreased as compared with control group [ c-kit ( fluorescence intensity ):129.56±36.90 vs. 307.23±40.07, t=10.314, P=0.000;Bcl-2 ( fluorescence intensity ):103.23±25.19 vs. 378.92±43.79, t=17.259, P=0.000 ], whereas, the expression of Bax was significantly increased ( fluorescence intensity:270.94±36.98 vs. 92.57±20.92, t=-13.277, P=0.000 ). Conclusion The mechanism of gastrointestinal motility dysfunction in MODS maybe closely related to ultrastructural damage of ICC-DMP, changes of c-kit phenotypic and activation of mitochondrial apoptosis pathway.
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Objective To explore the therapeutic value of modified endoscopic submucosal dissection with ligation (ESD-L) for small tumors originated from gastric muscularis propria.Methods Total of 60 patients with tumors originated from gastric muscularis propria,which was confirmed by endoscopic ultrasonography and smaller than 12 mm and were recruited to the present study.The conventional ESD technique was used to dissect the tumor to the depth of muscularis propria.Then the bottom of the tumor and the beneath muscularis propria were ligated fully with a nylon loop.Further dissection was applied till the whole tumor was isolated.Results All 60 lesions were dissected completely with perforation occurred in 10 cases,which were managed successfully with metal hemoclip.Pathologic diagnosis was obtained in all lesions,and no recurrence was found during the follow-up.Conclusion Modified technique of ESD-L is effective for complete resection of small tumors originated from gastric muscularis propria,which can also decrease the risk of stomach perforation.
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Acomplacência da bexiga depende de músculos lisos, fibras colágenas, fibras elásticas e suas relações. O objetivo deste trabalho é determinar a composição da matriz extracelular em amostras de bexigas normais através de análise bioquímica de colágeno e glicosaminoglicanos em amostras obtidas de mulheres em diferentes grupos de idade, analisando separadamente as camadas urotelial e muscular. Avaliamos 17 amostras de bexiga divididas em três grupos: infância (N=5), menacme (N=6) e pós-menopausa (N=6). As bexigas foram analisadas para concentração de GAG total e colágeno e para análise qualitativa de GAG por eletroforese em gel de agarose. Na camada muscular, não houve diferença entre os grupos tanto para GAG quanto para colágeno. Na camada urotelial, a análise da concentração de colágeno não mostrou diferença entre os grupos, mas a concentração de GAG no grupo da pós-menopausa (0.21 +- 0.12 ug de ácido hexurônico/mg de tecido seco) apresentou diferença em relação aos grupos do menacme (1.78 +- 1.62 ug de ácido hexurônico/mg de tecido seco) e da infância (2.29 +- 1.32 ug de ácido hexurônico/mg de tecido seco). Nosso trabalho concluiu que a concentração de GAG está substancialmente diminuída na cadama urotelial da bexiga de mulheres na pós-menopausa.
Bladder compliance is dependent on smooth muscle, collagen fibers, elastic fiber and their ratios. The luminal surface of the urothelium is covered by an adhering glycosaminoglycan (GAG) layer. The aim of this study was to determine the composition of the extracellular matrix (ECM) in normal samples of women bladders through biochemistry analysis of collagen and GAG on samples obtained from individuals from different age groups, analyzing separately the urothelial and muscular layers. We studied samples taken from bladders of 17 patients divided in three different groups: childhood (N=5), menacme (N=6) and menopause (N=6). Bladders were analyzed for total GAG and collagen concentration per mg dry tissue and for the contents of GAG species, as determined by agarose electrophoresis and reported as the percent of total sulfated GAG. In muscular layer, collagen and GAG concentration showed no difference between groups. In urothelial layer, collagen concentration showed no difference between groups but GAG concentration in menopause (0.21 +- 0.12 ug hexuronic acid/mg dry tissue) was different from menacme (1.78 +- 1.62 ug hexuronic acid/mg dry tissue) and childhood (2.29 +- 1.32 ug hexuronic acid/mg dry tissue). There was no difference between sulfated GAG in three groups. In conclusion, GAG concentration in urothelial layer was substantially lower in menopause women.
Subject(s)
Humans , Female , Urinary Bladder/physiology , Fibrillar Collagens/analysis , Elastic Tissue , Extracellular Matrix , Electrophoresis, Agar Gel/methods , Electrophoresis, Agar Gel , Glycosaminoglycans/analysis , Muscle, Smooth , Urothelium , Age FactorsABSTRACT
Objective To find the X-ray characteristic and diadynamic method in congenital defect of muscular layer in stomach wall. Methods Six cases confirmed by operation and pathology were collected,underwent eight standing abdomen plain films,underwent 5 decubitus abdomen plain films in 6 cases. Results The appearances in standing plain film of freeing gas under diaphragm, eventration of diaphragm, passing through the whole abdomen of gas and liquid plane, vanished gastriole were found in 6 cases. Superior border of liver was found in 4 cases.The appearances in decubitus abdomen plain films of abdominal distension, increasing gas gathered in umbilical region, vanshed fat line in abdominal wall were found in 4 cases. Conclusion Large part of typical cases could be diagnosis by x-ray and clinical appearance.
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PURPOSE: To determine if intestinal valves through seromuscular ablation can retard intestinal transit time, improve absorption and nutrition in short-bowel syndromes with very short small-bowel remnant METHODS: Six domestic cats were assigned for the experimental and control groups. Pre-operative and post-operative determination of weight, character of stools, transmit time, and TPAG were done. All the cats underwent 80 percent resection of the small bowel. An intestinal valve through seromuscular ablation was made proximal to the anastomosis for the experimental group. Comparison of weight, character of stools, transmit time, and TPAG between the two groups were done post-operatively. T-test was used for statistical analysis with alpha 0.05 for level of significance RESULTS: All the cats in the experimental group survived, however, there were 4 mortalities noted in the control group. The average preoperative transit times were 209 minutes and 216 minutes for the control and experimental groups respectively. There was a significant decrease in TPAG post-operatively for the control CONCLUSION: Intestinal valves through seromuscular ablation can retard intestinal transmit time, improve absorption and nutrition in very short small-bowel remnant. (Author)