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Objective:To discuss the surgical strategies of atlantoaxial dislocation in children with mucopolysaccharidosis IVA.Methods:8 cases of atlantoaxial dislocation in children with mucopolysaccharidosis IVA treated with posterior atlantoaxial reduction, decompression, bone graft and internal fixation from April, 2019 to October, 2020 were retrospectively analyzed, including 6 males and 2 females, aged 6.2±3.1 years (range, 2-10 years). All the 8 children had lower limb weakness and walking instability, and some of them could not even stand and walk, and all of them had odontoid hypoplasia, atlantoaxial dislocation and systemic skeletal dysplasia. Measures, including American Spinal injury Association (ASIA) grade, modified atlanto-dental interval (mADI) and reduction rate, screw placement type and fusion of bone graft, were recorded and analyzed.Results:The follow-up time was 17.8±7.4 months (range, 8-27 months). The total operation time was 144.0±43.1 mins (range, 90-220 min) and the blood loss during the surgery was 89.1±55.1 ml (range, 15-180 ml). The ASIA grade were 3 cases of "C" level, 4 cases of "D" level and 1 case of "E" level before the operation, and 1 case of "C" level, 1 case of "D" level and 6 cases of "E" level at the latest follow-up. The mADI reduced from 7.38±2.62 mm pre-surgery to 2.50±1.60 mm ( t=5.71, P=0.001). The reduction rate of the latest follow-up mADI was 65.0%±26.3%. 31 pedicle screws were inserted, including 26 Type I screws (83.9%), 4 Type II screws (12.9%) and 1 Type III screw (3.2%), and no injury of spinal cord or blood vessels were observed associated with the Type III screw. One unilateral axial lamina screw was used in 1 case. 5 patients showed fusion (autogenous bone) 6 months after the surgery, 2 patients got fusion (allogeneic bone) 1 year after the surgery, and other patients showed bone graft resorption (allogeneic bone) at the latest follow-up. One patient developed type II respiratory failure on the night of operation and recovered after rescue. Other patients had no complications such as vascular and nerve injury, screw loosening and so on. Conclusion:The majority of children with type IVa mucopolysaccharidosis are accompanied by absence of odontoid process. If such children are complicated with atlantoaxial dislocation and cervical spinal canal stenosis resulting in cervical spinal cord injury, timely surgical intervention should be carried out. Posterior atlantoaxial fusion is a safe and effective surgical method. As children have the characteristics of multi-system involvement, multi-disciplinary cooperation may be needed to ensure perioperative safety.
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Objective: To explore the delay in the first diagnosis of tuberculosis patients in Macheng City from 2016 to 2018 and its influencing factors, so as to provide scientific basis for tuberculosis control. Methods A retrospective survey (face-to-face interview) was conducted on 372 new smear positive TB patients registered in the TB special report system of China's disease prevention and control information system from 2016 to 2018, Then the influencing factors of first visit delay were analyzed by single factor analysis and multi factor Logistic regression analysis. Results Among the 372 TB patients, 230 were delayed in the first diagnosis, the delay rate of the first diagnosis was 61.83%, the median delay time of the first diagnosis was 17.0d, and the average delay time was 37.74d.Multivariate logistic regression analysis showed that family financial difficulties (OR = 31.609, 95% CI: 7.240-138.010), no time (OR= 9.597, 95% CI: 2.014-45.729), not care (OR= 13.232, 95% CI: 2.978-58.804), Far away from the clinic (OR= 15.374, 95% CI: 2.896-81.616), non-agricultural occupational (OR = 31.4439, 95% CI: 4.398-224.8049), first visit in township (OR = 0.171, 95% CI: 0.037-0.785), the difference was statistically significant (P 0.05). Conclusion The first diagnosis delay rate of tuberculosis patients in Macheng City is high, some effective measures should be taken to minimize the first visit of TB patients.
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Objective: To observe the effect of interventional embolization in treatment of benign prostatic hyperplasia (BPH) patients with common trunk of prostatic artery (PA) and dorsal penile artery. Methods: Data of 29 BPH patients with common trunk of PA and dorsal penis artery treated with interventional embolization were retrospectively analyzed. Results: Among 29 patients, superselective embolization of PA with small PVA particles (diameter 150-300 μm) was successfully performed in 12 cases. Postembolization angiography showed that the prostatic parenchyma staining disappeared, while the dorsal penis artery existed. Clinical symptoms were significantly improved in these 12 patients, and no penis-related complications occurred. However, microcatheter could not enter into PA in the rest 17 cases, among them conventional embolization with small PVA particles was performed in 2 cases, the symptoms such as dysuria were significantly improved after operation, but penile ischemia and necrosis occurred. Embolization with large PVA particles (350-560 μm in diameter) was performed in 3 cases, no complication of penile occurred after operation, but the improvement of symptoms was limited. The other 12 cases were embolized with small PVA particles after temporary ligation on the root of penis with rubber strips, the symptoms were obviously improved after operation, and no complication of penis ischemia nor necrosis occurred. Conclusion: Interventional embolization is effective for BPH patients with common trunk of prostate artery and dorsal penis artery. The details of embolization should be individually adjusted according to vascular anatomy and the possibility of superselection.
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Objective:To explore the suitable mouse strains,and establish stable human-miceX-GVHD model.Methods:This study selected the Nude Mice and NOD/SCID, and gave them sublethal dose of γ-ray irradiation whole body , and then intraperitoneal transplanted human peripheral blood mononuclear cells ( PBMC) to establish xenogeneic acute graft-versus-host disease model.By detection of human T cells in the mice′s tail venous blood,tissues,organs of the infiltration and other indicators (By flow cy-tometry and immunohistochemistry ) ,we compared the human immune cell infiltration rates in the two mouse model and recorded the survival time.Finally,we determined the appropriate strains of mice to establish X-GVHD.Optimization means were transfer ways and the appropriate amount of human PBMC ,and the best time to observe the changes of T cell phenotype and function.Results:The NOD/SCID mouse was more suitable for inducing human-mouseX-GVHD model,and there were no significant differences between intrap-eritoneal injection and intravenous injection.Transfer human PBMC more than 5 ×107 can establish human-mouseX-GVHD model.Using the optimized experimental conditions to establish the human-mouseX-GVHD model,we found the 7-11 days was the best time to observe the changes of T cell phenotype and function ,and the average survival time was(14.16±1.77)days.Conclusion:Human-miceX-GVHD model can be successfully established by intraperitoneal injection of 5×107 human PBMC into NOD/SCID, and the best time to observe the changes of T cell phenotype and function is between 7-11 days.
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Objective To assess the different methods and their outcomes of interventional therapy for stenosis or occlusion in superior vena cava and its branches. Methods Sixty patients with stenosis or occlusion of SVC and its branches were retrospectively analyzed after interventional therapy. Among them, 38 were males and 22 were females, with age range from 15 to 72 years old(mean age 58). Seventeen patients were treated by thrombolysis, and the rest 43 patients accepted percutaneous angioplasty and stenting. Before and after that, the pressures within the vein were measured at the inflow side. The paired-t test was used for statistical analysis. Results After treatment, the pressure at the inflow side dropped from (24.8±2.3)mm Hg to (7.1±1.5)mm Hg(1 mm Hg=0.133 kPa), with a significant difference(t=3.232,P＜0.01). The clinical outcomes included complete relief in 27 patients, partial relief in 28 patients and non-relief in 5 patients. No major complications occurred. During 6 months follow up, restenosis occurred in 10 patients, among whom 6 received repeat intervention with good results. The other 4 patients turned to surgery .Conclusion Interventional therapy for stenosis or occlusion in SVC and its branches could recanalize the vessels, restore the blood flow and relief the clinical symptoms.
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Objective To study the method and effectiveness of interventional therapy for the stenotic or obstructive inferior vena cava(IVC) caused by hepatic cancer. Methods All together 6 patients were enroled, 4 males and 2 females, with age of 45 to 58 years, average 53 years. The main symptoms including abdominal distention, varices on abdominal walls and edema in lower extremities were caused by compression or involvement of IVC with right hepatic lobe lesion. We performed thrombolysis first and follower by balloon dilation and stent placement. Results IVC were recanalized in all 6 patients with free patent blood flow. The postal venous pressure dropped from 4.4 kPa to 2.1 kPa without major complications. Conclusions Treating the IVC stenosis and obstruction caused by primary liver cancer with interventional method is safe and effective together with improvement of life quality and prolongation of survival time. (J Intervent Radiol, 2006, 15: 537-538)
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Summary: The expression of inducible co-stimulator (ICOS) in peripheral blood T lymphocytes from the patients with systemic lupus erythematosus (SLE) and the role in the pathogenesis of SLE was investigated. By using two-color immunofluorescent staining and flow cytometric assay, the expression levels of ICOS in peripheal blood T lymphocytes from 33 patients with SLE and 16 healthy volunteers were detected. SLE diseases activity index (SLEDAI) of the patients with SLE was used to evaluate the disease activity. The correlation between the ICOS expression and SLEDAI was analyzed among the groups. The results showed that the expression levels of ICOS in T lymphocytes in active SLE group was markedly higher than those in the control and inactive SLE groups (both P<0.01). There was no significant difference in the expression levels of ICOS between the inactive SLE and the control groups (P>0.05). In active SLE and inactive SLE groups, positive linear correlation was found between the levels of the ICOS expression in T lymphocytes and SLEDAI (r=0.711, P＝0.001; r=0.561, P＝0.03). It was suggested that the expression of ICOS in peripheral blood T lymphocytes from the patients with active SLE was up-regulated and and ICOS might be related to the pathogenesis of SLE.
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Objective To evaluate the efficacy and safety of interventional therapy for left iliac vein compression syndrome (LICS). Methods A total of 27 patients with LICS that were diagnosed by colour Doppler or venography,were included in this study. Among the cases,the disease course was shorter than 3 weeks in 13 patients,who presented with acute iliac-femoral vein thrombosis; in the other 14 patients,the disease course was longer than 3 weeks,showing the symptoms of chronic venous thrombosis. Venous puncture was performed via the contralateral femoral vein in 13 cases,and through the ipsilateral popliteal vein in 14. Venous filter was placed in 11 cases before thrombolysis,while in the other 16 cases,no filter was used. All of the patients received catheter-directed thrombolysis,afterwards,7 of them underwent percutaneous transluminal angioplasty,and the other 20 received angioplasty plus stent placement. Results In the 13 patients,who received venous puncture via the contralateral femoral approach,the guide wire could advance through the stenosis successfully in 8 patients but failed in 5. Ipsilateral popliteal vein puncture were then employed and succeeded in all the patients. Ipsilateral popliteal puncture were performed successfully in 14 patients. In 11 patients,inferior vena cava filter was placed before the procedure. In this series,the thrombolysis time was (85?16) h with a dose of (3000?320) thousand units urokinase. The thrombosis was dissolved completely in 13 acute patients and partial dissolution was attained in 14 patients in whom blood flow signal were detected color Doppler. After the operation,venogram showed complete patent iliac veins in all of the 27 cases. The patients were followed up for 6 to 26 months (mean,11 months). During the period,19 patients obtained patent iliac-femoral vein with the symptoms disappeared; 8 patients met the standard of improvement. Conclusions Interventional technique can be the first-line treatment for left iliac vein compression syndrome because of its favorable result and minimal invasion.
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The expression of inducible co-stimulator (ICOS) in peripheral blood T lymphocytes from the patients with systemic lupus erythematosus (SLE) and the role in the pathogenesis of SLE was investigated. By using two-color immunofluorescent staining and flow cytometric assay, the expression levels of ICOS in peripheal blood T lymphocytes from 33 patients with SLE and 16 healthy volunteers were detected. SLE diseases activity index (SLEDAI) of the patients with SLE was used to evaluate the disease activity. The correlation between the ICOS expression and SLEDAI was analyzed among the groups. The results showed that the expression levels of ICOS in T lymphocytes in active SLE group was markedly higher than those in the control and inactive SLE groups (both P0.05). In active SLE and inactive SLE groups, positive linear correlation was found between the levels of the ICOS expression in T lymphocytes and SLEDAI (r=0. 711, P=0.001; r=0.561, P=0.03). It was suggested that the expression of ICOS in peripheral blood T lymphocytes from the patients with active SLE was up-regulated and and ICOS might be related to the pathogenesis of SLE.
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Antígenos de Diferenciación de Linfocitos T/biosíntesis , Antígenos de Diferenciación de Linfocitos T/genética , Lupus Eritematoso Sistémico/sangre , Lupus Eritematoso Sistémico/etiología , Lupus Eritematoso Sistémico/inmunología , Linfocitos T/inmunologíaRESUMEN
Objective To investigate the expression of inducible co-stimulator (ICOS) on T lymphocytes in peripheral blood from the patients with systemic lupus erythematosus (SLE). Methods Two-color immunofluorescent staining and flow cytometric assay were used to analyze the level of ICOS expression on T lymphocytes in peripheral blood from 33 SLE patients and 16 healthy volunteers. The data of systemic lupus erythematosus diseases activity index (SLEDAI) in SLE patients were also collected. Results The level of ICOS expression on T cells from active SLE group was markedly higher than that in the control group and the inactive SLE group (P 0.05). However, a positive correlation between the expression level of ICOS and the SLEDAI score was found in both active SLE group and inactive SLE group(r = 0.711,P = 0.001?r = 0.561,P = 0.03). Conclusions The expression of ICOS on T cell in peripheral blood from active SLE is increased, which might play a role in the pathogenesis of SLE.
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Objective To evaluate the effect of transarterial chemoembolization (TACE) before operation, including side effects and the improvment for the suceesfult resection rate.Methods 56 patients with cardiac cancer were divided into two groups: TACE group and resection group. The former included 25 patients (male 14, female 11) undertaken TACE 7-15 days before surgery. The image manifestations, histological changes and side effects together with the time of operation, volume of blood lose during operation and the succesful resection rate were compared with those of the latter. Results 1. TACE induced the necrosis of tumor tissue to some extent and possessed the power to localize the lesion with little side effects. 2. TACE before resection did not only minimize the injury of operation but also improved the resection rate. Conclusion TACE is a safe, effective modality before operation and is worthy for recommendation
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Male mice of Kunmlng strain were infected with 10 000 tachyzoites intraperitoneally. 2 hours after infection the mice were divided into 2 groups and administered 5 % of amylurn and 200 mg/kg of artemether by gavage for 8 consecutive days. The ultrastructural enzyme cytochemical studles on cytidine monophosphatase (CMP ase) and glucose-6-phosphatase (G-6-P-ase) of the parasites were carried out. CMP-ase was found scattered in the lysosomes of the parasites as well as in the macrophages. No differences were observed in the localization and intensity of CMP-ase activity between the nontreated and treated with drug parasites. G6-P-ase was found surrounding the parasite membrane and scattered in the parasitophorous vacuole in the nontreated parasites. After treatment with artemether, the intensity of G-6-P-ase activity was decreased compared with nontreated control parasites. It is suggested that artemether may exert some action on the G-6-Patase of T. gondii and thus influence the energy metabolism of the parasite.
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Objective:To develop a new model of evaluating histocompatibility between donor and recipient.Methods:①We harvested 15 couples of blood samples of donor and recipient in human BMT and detected histocompatibility between donor and recipient using the aboved model.The time when GVHR began was recorded.②Skin grafts of KunMing hybride mice were respectively placed on inbred mice,BALB/c and C57BL/6.And then histocompatibility between donor and recipient was detected using the model.Survival time of skin allografts was recorded.Results:The smaller differences of histocompatibility evaluated by means of the model were,the later GVHR in human BMT would happen and the longer survival time of skin allografts in mice would become.Conclusion:The model could be used to detect correctly histocompatibility between donor and recipient.