Related factors of post-stroke depression in patients with cerebral infarction during hospitalization in rehabilitation department / 中国康复理论与实践

ObjectTo explore the risk factors related to the intensity of post-stroke depression in patients with cerebral infarction during hospitalization in the rehabilitation department. MethodsThe hospital consultation records of cerebral infarction patients in Beijing Bo'ai Hospital from December, 2019 to February, 2023 were reviewed from the hospital information system, and those who were diagnosed as depression visited the department of psychology were selected. It was collected including general information of sexes, ages, education levels, matrimony; medical features of course, location, affected side, sensory disorders, aphasia, agrypnia, dysphagia, hand-shoulder syndrome, constipation; functioning of muscle strength and Brunnstrom stages; and scores of Mini-Mental State Examination (MMSE), National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Fugl-Meyer Assessment-Balance (FMA-B), modified Barthel Index (MBI) and Hamilton Depression Scale (HAMD). Patients with HAMD scores ≤ 20 were as the low group, and those > 20 were as the high group. ResultA total of 2 403 hospitalized stroke patients were included, out of which 269 patients with cerebral infarction were diagnosed as depression and visited the department of psychology; while 103 cases were in the low group and 166 cases were in the high group. The incidence of constipation was less, and the incidence of dysphagia and shoulder-hand syndrome was higher in the high group (χ2 > 5.379, P < 0.05), with weaker strength of iliopsoas muscle and quadriceps muscle, earlier of Brunnstrom stage of lower extremities and hands, and worse scores of NIHSS, MMSE, FMA, FMA-B and MBI (|Z| > 2.020, t > 2.171, P < 0.05). Logistic regression showed that constipation (OR = 0.435), quadriceps muscle strength (OR = 0.782) and dysphagia (OR = 2.602) related to the intensity of post-stroke depression in convalescent patients (P < 0.05). ConclusionPost-stroke dysphagia and poor quadriceps muscle strength may exacerbate post-stroke depression; however, constipation may not.

Advanced Faster RCNN: a non-contrast CT-based algorithm for detecting pancreatic lesions in multiple disease stages / 南方医科大学学报

OBJECTIVE@#To propose a non-contrast CT-based algorithm for automated and accurate detection of pancreatic lesions at a low cost.@*METHODS@#With Faster RCNN as the benchmark model, an advanced Faster RCNN (aFaster RCNN) model for pancreatic lesions detection based on plain CT was constructed. The model uses the residual connection network Resnet50 as the feature extraction module to extract the deep image features of pancreatic lesions. According to the morphology of pancreatic lesions, 9 anchor frame sizes were redesigned to construct the RPN module. A new Bounding Box regression loss function was proposed to constrain the training process of RPN module regression subnetwork by comprehensively considering the constraints of the lesion shape and anatomical structure. Finally, a detection frame was generated using the detector in the second stage. The data from a total of 728 cases of pancreatic diseases from 4 clinical centers in China were used for training (518 cases, 71.15%) and testing (210 cases, 28.85%) of the model. The performance of aFaster RCNN was verified through ablation experiments and comparison experiments with 3 classical target detection models SSD, YOLO and CenterNet.@*RESULTS@#The aFaster RCNN model for pancreatic lesion detection achieved recall rates of 73.64% at the image level and 92.38% at the patient level, with an average precision of 45.29% and 53.80% at the image and patient levels, respectively, which were higher than those of the 3 models for comparison.@*CONCLUSION@#The proposed method can effectively extract the imaging features of pancreatic lesions from non-contrast CT images to detect the pancreatic lesions.

Research progress on the effect of iron oxide nanoparticles in macrophage polarization / 生物医学工程学杂志

Macrophages are important immune effector cells with significant plasticity and heterogeneity in the body immune system, and play an important role in normal physiological conditions and in the process of inflammation. It has been found that macrophage polarization involves a variety of cytokines and is a key link in immune regulation. Targeting macrophages by nanoparticles has a certain impact on the occurrence and development of a variety of diseases. Due to its characteristics, iron oxide nanoparticles have been used as the medium and carrier for cancer diagnosis and treatment, making full use of the special microenvironment of tumors to actively or passively aggregate drugs in tumor tissues, which has a good application prospect. However, the specific regulatory mechanism of reprogramming macrophages using iron oxide nanoparticles remains to be further explored. In this paper, the classification, polarization effect and metabolic mechanism of macrophages were firstly described. Secondly, the application of iron oxide nanoparticles and the induction of macrophage reprogramming were reviewed. Finally, the research prospect and difficulties and challenges of iron oxide nanoparticles were discussed to provide basic data and theoretical support for further research on the mechanism of the polarization effect of nanoparticles on macrophages.

Sleep disturbance and association with social behavior in preschool children with autism spectrum disorder / 中国康复理论与实践

ObjectiveTo explore sleep disturbance in preschool children with autism spectrum disorder (ASD) and analyze the relationship between sleep disturbance and social behavior. MethodsFrom December, 2020 to December, 2022, 221 preschool children with ASD from Beijing Bo'ai Hospital and other two institutes, and 246 healthy preschool children socially recruited were investigated with Children's Sleep Habits Questionnaire (CSHQ). A total of 47 ASD children and 47 healthy children were selected from them to wear a sleep monitoring watch for seven days, while the ASD children were evaluated with Gesell Development Diagnosis Scale (GDDS), Psychoeducational Profile-Third Edition (PEP-3), Autism Diagnostic Observation Schedule-2 (ADOS), Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and Social Responsiveness Scale (SRS). ResultsAll the factor-scores were more in the ASD children than in the healthy children (t > 2.491, P < 0.05), except that of daytime sleepiness. The prevalence of sleep disturbance (CSHQ ≥ 41) was 89.6% in ASD children, which was more than that of the healthy children (76.8%) (χ2 = 13.360, P < 0.001). The sleep problems in ASD children included bedtime resistance, sleep anxiety, sleep duration, sleep onset delay, parasomnias and sleep disordered breathing. ASD children were shorter in total bedtime, shorter in total sleep time, longer in sleep latency, longer in awake time and lower in sleep efficiency (|t| > 2.001, P < 0.05), compared with those of healthy children. For ASD children, the total bedtime negatively correlated with GDDS-language, PEP-3-expressive language, PEP-3-communication and PEP-3-maladaptive behaviors (r < -0.300, P < 0.05); the sleep efficiency negatively correlated with total score of CARS (r = -0.365, P < 0.05); sleep latency correlated with GDDS-social, PEP-3-cognitive, PEP-3-expressive language, PEP-3-receptive language, PEP-3-visual-motor imitation, PEP-3-characteristic verbal behaviors, PEP-3-communication, original score of ADOS, ADOS-social affect, and total score of CARS (|r| > 2.90, P < 0.05); and total awake time positively correlated with total score of CARS (r = 0.406, P < 0.05). ConclusionSleep disturbance is prevalent and various in preschool ASD children, and influence their social behaviors.

Effect of motor imagery therapy on hand function and motor imagery ability of patients after stroke / 中国康复理论与实践

ObjectiveTo observe the effect of motor imagery therapy on hand function and motor imagery ability of stroke patients. MethodsFrom March, 2018 to March, 2020, 41 stroke patients in Beijing Bo'ai Hospital were selected and randomly divided into control group (n = 20) and observation group (n = 21). Both groups received conventional rehabilitation training, and the observation group received motor imagery therapy in addition, for four weeks. Before and after training, the scores of Fugl-Meyer Assessment-Hand (FMA-H) and Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10), and the accuracy of mental rotation task were compared between two groups. ResultsOne patient in the observation group dropped down. Before training, there was no significant difference in the scores of FMA-H and KVIQ, and the accuracy of mental rotation task between two groups (P > 0.05). After training, all the indexes improved in both groups (t > 6.611, P < 0.001), and the scores of FMA-H (t = 3.742, P < 0.001) and KVIQ (t = 4.122, P < 0.001), and the accuracy of mental rotation task (t = 2.075, P < 0.05) were higher in the observation group than in the control group. ConclusionMotor imagery therapy could facilliate the recovery of hand dysfunction and improve the motor imagery ability of stroke patients.

Malnutrition in early life and metabolic diseases in adulthood / 中华内分泌代谢杂志

The prevalence of metabolic diseases, such as type 2 diabetes mellitus and obesity, is increasing all over the world. Metabolic diseases have become a major public health problem in China, and primary prevention is particularly important and urgent. According to the theory of DOHaD (Developmental Origin of Health and Diseases), negative environmental factors in early life, such as malnutrition, may increase the risk of some non-communicable diseases, especially metabolic diseases in adulthood. Due to regional economic development disparities in China, life cycle nutrition imbalance (such as malnutrition in early life and overnutrition in adults) is still a common problem. Recently, many scholars have made comprehensive and in-depth studies on the relationship between malnutrition in early life and the development of metabolic diseases in adulthood. This paper summarizes the recent results in this field and puts forward a metabolic model of undernutrition in early life and overnutrition in adulthood (double burden theory). These studies will provide related evidence for the prevention of metabolic diseases in rapidly developing countries such as China and India.

Evaluation of arteriovenous fistula by CT angiography / 中国医师进修杂志

Objective To examine arteriovenous fistula (AVF) for hemodialysis by CT angiography(CTA).Methods Sixty-nine patients with chronic renal failure were enrolled in this study. CTA was undertaken by 256-slice scanner. A total of 100 ml of iohexol was administered at a rate of 3 ml/s into a vein of contralateral limb or external jugular vein.Imaging commenced after a delay of 25-30 s and 86 times imaging were performed. Results The AVF were clearly displayed on CTA. Eight CTA were normal. Twenty-five CTA showed stoma stenosis. Forty-two CTA showed venous stenosis. Ten CTA showed stoma stenosis combined with venous stenosis. Only one CTA showed artery stenosis. Conclusions CTA can reveal the AVF safely and correctly,which might help to find abnormality of AVF and direct treatment .

Diagnostic value of Fuji intelligent color enhancement on vocal leukoplakia and esophageal diseases / 中华消化内镜杂志

Objective To study the clinical application of Fuji intelligent color enhancement ( FICE) on the diagnosis of vocal leukoplakia and esophageal diseases. Methods A total of 50 patients suspected with vocal leukoplakia by electronic laryngoscopy were enrolled for undergoing meticulous examination of vocal cords and esophagus using FICE from January 2014 to January 2016. The diagnostic value of FICE for vocal leukoplakia were analyzed. Results Among the 50 patients, 50 lesions were found using laryngoscopy and 52 lesions were found using FICE. There were significant differences between FICE mode and white light mode on the capillary pattern score and lesion boundary resolution score ( all P<0. 05) . The diagnostic coincidence rate of FICE mode with pathology was higher than that of white light mode [ 89. 4％ ( 42/47 ) VS 68. 1％ ( 32/47 ) , P = 0. 01 ] . Among the 50 patients suspected with vocal leukoplakia, 31 combined with gastroesophageal reflux disease, and were given proton-pump inhibitor treatment. In the follow-up after three months, lesions of 16 cases alleviated, 13 cases disappeared, and 2 cases had no significant changes. Conclusion FICE has a higher clinical value than conventional laryngoscopy and white light endoscopy on the diagnosis of vocal leukoplakia.

Clinical significance of neutrophil gelatinase-associated lipocalin in evaluating residual renal function after living donor kidney resection / 中华老年医学杂志

Objective To investigate the clinical significance of serum and urinary levels of neutrophil gelatinase-associated lipocalin (NGAL ) for evaluating changes of residual renal function after living donor kidney resection under different operation model in young versus elderly patients. Methods The clinical data of renal transplants were retrospectively analyzed by successfully using 66 living-related donors at the First Affiliated Hospital of Zhengzhou University from September 2016 to October 2017. According to the operation model and age ,renal donors were divided into 4 groups :group A (young/open) ,group B (young/laparoscopic) ,group C (aged/open) ,and group D (aged/laparoscopic).Blood and urinary NGAL and serum levels of creatinine ,cystatin C ,and other indices of renal function were assayed and collected before and at 1 ,3 ,7 days after operation. Results Both blood NGAL levels and urinary NGAL levels showed no statistically significant difference (all P>0.05) among four groups both before and after operation ,except that urinary NGAL was higher in group C (aged/open) than other groups ,at 1 day after operation ,(P = 0.03).The post-vs.pre-operation level dynamic changes of renal function were four or three times higher in urine or serum NGAL level than in serum creatinine or cystatin C level at 1 day after operation ,which showed an important role for predicting an early residual renal damage and relative treatment. Conclusions NGAL can be used as indices in evaluating changes of residual renal function after living donor kidney resection ,especially in the elderly receiving open kidney resection.

Preliminary evaluation and analysis of standardized training effect of traditional Chinese medicine residents in the First Affiliated Hospital of Hunan University of Chinese Medicine / 国际中医中药杂志

Objective To evaluate the implementation effect of the standardized training system for the residents in the First Affiliated Hospital of Hunan University of Chinese Medicine. Methods The First Affiliated Hospital of Hunan University of Chinese Medicine 2015 Chinese medicine (including Chinese Medicine) clinical medical postgraduates of TCM standardized resident training mode, make a comprehensive evaluation on the analysis and comparison of the training mode of the traditional 2015 stage. Results The outstanding students in grade 2014 were 15 (10.1％), and the 2015 were 33 people (23.1％), where the difference was significant. There 134 residents in grade 2014 completed the training (90.5％), and the 2015 were 140 (97.9％), where the difference was significant between two groups (P<0.05). Conclusions One year of residents training in Hunan province has achieved certain results that the Chinese medicine standardized resident training mode is superior to the traditional training mode in the clinical skills, but the detail specification needs to be improved.

Application of transversus abdominis plane block combined with rectus sheath block for peritoneal dialysis catheter placement / 中华肾脏病杂志

Objective To discuss the efficacy and safety of transversus abdominis plane block (TAPB) combined with rectus sheath block (RSB) for peritoneal dialysis catheter placement.Methods Thirty patients,ASA Ⅰ or Ⅱ,body mass index (BMI) 18-30 kg/m2,were scheduled for elective peritoneal dialysis catheter placement.They were randomly divided into three groups:local anesthesia group (group L),ultrasound-guided TAPB group (group T),ultrasound-guided TAPB combined with RSB group (group TR).Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before (T0) and after (T1) anaesthesia,the beginning of operation (T2) and abdomen-closing (T3),6 h (T4),12 h (T5),24 h (T6) after surgery.The consumption of local anesthetic during the surgery,dezocine after the surgery,the score of visual analogue scale (VAS) during rest and movement at T2-T6 and the adverse reactions were recorded.Results At T3,MAP and HR in group L and group T were higher than those in group TR (P ＜ 0.05).At T4 and T5,MAP and HR in group L were higher than those in group T and group TR (P ＜ 0.05);the consumption of local anesthetic ropivacaine in group L and group T were more than that in group TR (P ＜ 0.05);the consumption of local anesthetic ropivacaine and dezocine in group L were more than that in group T (P ＜ 0.05).The VAS score was significantly lower in group T and group TR at T3,T4,T5 compared with that in group L (P ＜ 0.05).There were no adverse reactions.Conclusion Ultrasound-guided TAPB combined with RSB is safe and efficacious in patients undergoing peritoneal dialysis catheter placement.

Application of transversus abdominis plane block combined with rectus sheath block for peritoneal dialysis catheter placement / 中华肾脏病杂志

Objective To discuss the efficacy and safety of transversus abdominis plane block (TAPB) combined with rectus sheath block (RSB) for peritoneal dialysis catheter placement.Methods Thirty patients,ASA Ⅰ or Ⅱ,body mass index (BMI) 18-30 kg/m2,were scheduled for elective peritoneal dialysis catheter placement.They were randomly divided into three groups:local anesthesia group (group L),ultrasound-guided TAPB group (group T),ultrasound-guided TAPB combined with RSB group (group TR).Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before (T0) and after (T1) anaesthesia,the beginning of operation (T2) and abdomen-closing (T3),6 h (T4),12 h (T5),24 h (T6) after surgery.The consumption of local anesthetic during the surgery,dezocine after the surgery,the score of visual analogue scale (VAS) during rest and movement at T2-T6 and the adverse reactions were recorded.Results At T3,MAP and HR in group L and group T were higher than those in group TR (P ＜ 0.05).At T4 and T5,MAP and HR in group L were higher than those in group T and group TR (P ＜ 0.05);the consumption of local anesthetic ropivacaine in group L and group T were more than that in group TR (P ＜ 0.05);the consumption of local anesthetic ropivacaine and dezocine in group L were more than that in group T (P ＜ 0.05).The VAS score was significantly lower in group T and group TR at T3,T4,T5 compared with that in group L (P ＜ 0.05).There were no adverse reactions.Conclusion Ultrasound-guided TAPB combined with RSB is safe and efficacious in patients undergoing peritoneal dialysis catheter placement.

Drug resistance mediated by outer membrane porin F (OmpF) and its regulatory gene of micF in Shigella strains / 中华微生物学和免疫学杂志

Objective To investigate the mechanism of drug resistance mediated by micF gene and outer membrane porin F ( OmpF) in Shigella strains. Methods Shigella strains were isolated from stool samples of patients who presented to the Second Hospital of Tianjin Medical University with acute diar-rhea in 2015. Antibiotic susceptibility test was performed to screen out the multidrug-resistant and non-multi-drug-resistant strains. The ompF gene was amplified by PCR. The micF and ompF genes at transcriptional levels in the two groups of strains were detected by quantitative real-time RT-PCR. Intracellular concentra-tions of ciprofloxacin in the two groups of Shigella strains were measured by automatic microplate reader. Re-sults According to the result of antibiotic susceptibility test, 13 strains that were resistant to 3 or more than 3 antibiotics were classified into the multidrug-resistant group, while the other 8 strains that were sensitive to all antibiotics used in this study or only resistant to 1 or 2 antibiotic were classified into the non-multidrug-re-sistant group. All of the 21 Shigella strains carried the ompF gene. Compared with the non-multidrug-resist-ant strains, the multidrug-resistant strains showed higher expression of micF gene, but lower expression of ompF gene. The differences in micF and ompF genes between the two groups were statistically significant. The result of correlation analysis suggested that there was a negative correlation between micF and ompF genes (r=-0. 244). The intracellular concentrations of ciprofloxacin in multidrug-resistant strains were low-er than those in the non-multidrug-resistant strains (P<0. 001). Conclusion The decreased expression of OmpF was one of the possible mechanisms of multidrug-resistance in Shigella strains. The micF gene was negatively related to the expression of OmpF. Moreover, the decreased intracellular concentrations of cipro-floxacin in multidrug-resistant strains might be related to the decreased expression of OmpF.

Detection of virulence gene and molecular typing of Shigella boydii isolated from clinical sources / 天津医药

Objective To understand genetic distribution, drug resistance, molecular typing and the epidemiological relativeness between strains of the Shigella boydii virulence. Methods Nine Shigella boydii strains were isolated form stool samples of patients with diarrhea from the Enteric Disease Clinic of the Second Hospital of Tianjin Medical University in June-October 2015. The strains were identified by biochemical test and serum agglutination test. Antibiotics susceptibility test was carried out using the Kirby-Bauer method. Polymerase chain reaction was used for detecting virulence genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) technique were used to determine the epidemiological relationship between nine Shigella boydii strains. Results There were three subtypes in nine isolated Shigella boydii samples, including one, three and five isolates inⅠ,Ⅱ,Ⅳsubtypes respectively. All of the 9 isolates were multi-drug resistant. The resistant rate of these strains for ampicillin was 100%(9/9), and then the resistant rates of these strains for ceftazidime, streptomycin, gentamicin, trimethoprim/sulfamethoxazole, cefotaxime, ceftriaxone, norfloxacin and levofloxacin were 1/9, 4/9, 4/9, 4/9, 5/9, 5/9, 6/9, 6/9 and 6/9, respectively. All of these strains were sensitive to amikacin, cefperazone-sulbactam and imipenem. The ipaH was carried by all the testing strains, and none of the strains carried the sen, set1A, set1B, ial, virA, icsA and SigA. The detective rates of pic, sepA and sat were 4/9, 5/9 and 7/9 strains, respectively. Nine shigella boydii strains were divided into 8 PFGE types. The similarity between the spectrums of PFGE was 63.21%-100%. Multilocus sequence typing showed that six isolates were belonged to ST648, two isolates were ST131 and one isolate was ST10. Conclusion Nine isolates of Shigella boydii (divided into three subtyping) isolated from our hospital are multi-drug resistant and they have distant relationships, belonging to the dissemination of case.

Insulin effects on fracture healing and cytokines in the osteotylus in experimental diabetic rats / 中国组织工程研究

BACKGROUND:Fracture healing in diabetic patients is usual y unsatisfactory because of hormones and metabolic disorder, and an eventual multiple organ dysfunction resulting from high blood glucose. OBJECTIVE:To dynamical y observe the changes of cytokines during the fracture healing process in diabetic rats before and after insulin treatment. METHODS:A total of 120 Sprague-Dawley rats were included in this study. Of them, 90 rats intravenously injected with 5%tetraoxypyrimidine to induce rat models of diabetes were randomized into insulin treatment and diabetes groups, respectively. The remaining 30 rats were intravenously injected with equal volume of saline and selected as control group. The next day, blood glucose was determined. Healing at 1, 4, and 8 weeks after fracture were observed by the X-ray film. Biomechanical strength of the injured right tibia was measured at 4, 6, and 8 weeks after modeling. Cytokines in the osteotylus were determined by immunohistochemical staining and in situ hybridization technique. RESULTS AND CONCLUSION:The X-ray films showed that the speed of fracture healing in the diabetes group was slower than insulin treatment and control groups. Biomechanical strength of the osteotylus in the diabetes group was significantly decreased compared with the insulin treatment and control groups. However, there were no significant differences in above-mentioned parameters between the control and insulin treatment groups. Bone morphogenetic protein 2, basic fibroblast growth factor, transforming growth factor-beta, and vascular endothelial growth factor were widely expressed in the osteotylus and their expressions in diabetes group were significantly lower and slower than those in the control and insulin treatment groups. There was no statistical difference between control and insulin treatment groups. These results indicate that osteotylus formation speed, biomechanical strength, and growth factor expressions at the fracture site in diabetes rats were decreased compared with normal rats. Insulin treatment can enhance cytokine levels at the fracture site, thereby promoting the osteoblast proliferation and fracture healing.

Effect of curcumin on autophagy and inflammatory response in mice subject to renal ischemia reperfusion injury / 中华器官移植杂志

Objective To investigate the effect of curcumin on autophagy and inflammatory response in mice subject to renal ischemia reperfusion.Method Forty male C57BL/6 mice were randomly divided into four groups (n =10 each):sham-operated (SO) group (Abdominal incision was made to expose the kidneys,bilateral renal pedicle dissociated and the abdomen sewed),ischemia reperfusion (IR) group,curcumin (CM) group (given CM 10 mg/kg) and 3-methyladenine (3-MA) group (given 3-MA 15 mg/kg).Six and 24 h after reperfusion,renal function was tested by determining the serum creatinine (Scr) and blood urea nitrogen (BUN) levels,and the morphological changes in the kidney tissue were observed.The expression of LC3,Beclin 1,Rab7 and LAMP2 in kidney tissue was detected by fluorescence quantitative RT-PCR and Western blotting.Fluorescence quantitative reverse transcription PCR and enzyme-linked immunosorbent assay were used to examine the expression of IL-6,IL-10,IL-17 and TNF-α in kidney tissue and serum.Result As compared with IR group and 3-MA group,the Scr and BUN levels in the CM group were significantly decreased (P＜0.01),and the renal morphological changes were improved significantly (P＜0.01).The mRNA and protein expression of LC3,Beclin 1,Rab7 and LAMP2 was significantly increased in kidney tissue,and the expression of IL-6,IL-17 and TNF-α was reduced,while IL-10 was increased (P＜ 0.01) in the CM group as compared with IR group and 3-MA group.Conclusion Curcumin possesses a protective effect against renal ischemia reperfusion injury in mice,which is probably mediated by promoting autophagy and subsequently inhibiting inflammatory response.

Clinical application of little finger ulnar palmar artery perforator flaps / 中华创伤杂志

Objective To investigate the feasibility of repairing soft-tissue defects of the fifth phalange and the back of hand with ulnar palmar artery perforator flaps from the little finger.Methods Based on anatomic dissection,the fifth phalange ulnar palmar artery perforator flaps were created and transferred to repair soft-tissue defects at the little finger and the back of hand in 15 cases.Types of injury were stamping injury in 5 cases,planer injury in 4 cases,mechanical crash injury in 3 cases,blast injury in 2 cases,and cicatrical contracture following electric burn in 1 case.Injury involved in the palmar aspect near the middle segment of fifth phalange in 4 cases,dorsal aspect near the middle segment of fifth phalange in 6 cases,ulnar mesiodistal of the back of hand in 3 cases,and distal ulnar palmar aspect of hands in 2 cases.There were 6 patients wounded in left hands and 9 patients wounded in right hands.Results All flaps survived and all wounds healed by first intention.At the follow-up of 2-18 months,the flaps resurfaced the soft-tissue defects with good color and texture match and the maintenance of contour and function of donor and recipient sites were satisfactory.Conclusion The fifth phalange ulnar palmar artery perforator flap,as it has advantages of constant perforator vessels,rich blood supply and good texture and can be operated safely and easily,is considered an ideal treatment choice in repairing softtissue defects of the fifth phalange and the back of hand.

The effect of curcumin on the differentiation and functions of Th17 cells / 中华风湿病学杂志

Objective To establish a culture protocol for Th17 cells in vitro and evaluate the effect of curcumin on the differentiation and functions of Th17 cells and explore the related mechanisms. Methods Splenic CD4+CD25- T cells of C57BL/6 mice were isolated and purified with magnetic bead methods, and were co-cultured with plate-bound anti-CD3 and anti-CD28 antibodies and with transforming growth factor (TGF)-β, interleukin (IL)-6, IL-23, anti-interferon-γ antibody and anti-IL-2 antibody for Th17-polarization. The cultured Th17 cells were allocated into four groups: the control group, in which T cells were cultured on the basis of the above protocol; the low-concentration curcumin (CM-L, 5 μmol/L) and high-concentration (CM-H, 25 μmol/L) curcumin groups, and sirolimus (SRL, 100 ng/ml) group. The proportion of Th17 cells was detected with flow cytometry, and the mRNA expression of retinoic acid-related orphan receptor (ROR)γt, IL-17A, IL-21 was examined with real-time quantitative polymerase chain reaction. Finally, the protein expression of RORγt and the phosphorylation levels of signal transducer and activator of transcription (STAT) 3 were measured using western blotting analysis. Results The proportion of Th17 cells in the freshly isolated CD4+CD25- T cells was (3.1 ±0.4)%, whereas the proportion of the cells cultured with the protocol could get [(54.1±3.4)%, P0.05). Moreover, the mRNA levels of RORγt, IL-17A and IL-21, the protein expression of RORγt and the phosphorylation levels of STAT 3 in CM-L, CM-H and SRL groups were also lower than those in the control group (IL-17A mRNA: CM-L 0.81±0.05, CM-H 0.61±0.05, SRL 0.58±0.05, Control 1.01 ±0.11, t=4.81, 8.52, 8.89; IL-21 mRNA: CM-L 0.73±0.06, CM-H 0.49±0.03,SRL 0.59±0.03, Control 1.12±0.11, t=5.98, 9.22, 7.95, P<0.01). The mRNA level of IL-21 in the CM-H group was lower than that in the SRL group (P<0.05). Conclusion In vitro, curcumin can inhibit the differentiaton of splenic CD4+CD25- T cells into Th17 cells in the setting of Th 17-polarization and inhibit the expression of IL-17A and IL-21 mRNA, which is associated with the inhibitive effect of curcumin on RORγt expression and STAT 3 phosphorylation.

Endoscopy nasal microsurgery and multiple techniques in treatment of nasopharyngeal angiofibromas / 肿瘤研究与临床

Objective To explore the methods for endoscopy nasal microsurgery and multiple techniques in treatment of nasopharyngeal angiofibromas. Methods CT, MRI and digial substraction angiography (DSA) and endoscopic examination had been used. ALL 12 patients accepted preoperative feeding artery embolum, hypotention anesthesia and injected adrenaline-lidocaine. Microelectrotomy-electrocoagulation had been used to remove tumor. Results All patients were treated by endoscopic nasal surgery. No complications had occurred. No recurrence were found in follow-up period. Conclusion The important factors to reduce amount of introperative bleeding are to select proper operative patients and use multiple techniques. Endoscopy nasal surgery has dominance in reducing complications, wound, tumor recurrence, operative time and nasal function.