Advances in revision surgery after primary total hip arthroplasty for Crowe type Ⅳ developmental dysplasia of the hip / 中国修复重建外科杂志

OBJECTIVE@#To review research advances of revision surgery after primary total hip arthroplasty (THA) for patients with Crowe type Ⅳ developmental dysplasia of the hip (DDH).@*METHODS@#The recent literature on revision surgery after primary THA in patients with Crowe type Ⅳ DDH was reviewed. The reasons for revision surgery were analyzed and the difficulties of revision surgery, the management methods, and the related prosthesis choices were summarized.@*RESULTS@#Patients with Crowe type Ⅳ DDH have small anteroposterior diameter of the acetabulum, large variation in acetabular and femoral anteversion angles, severe soft tissue contractures, which make both THA and revision surgery more difficult. There are many reasons for patients undergoing revision surgery after primary THA, mainly due to aseptic loosening of the prosthesis. Therefore, it is necessary to restore anatomical structures in primary THA, as much as possible and reduce the generation of wear particles to avoid postoperative loosening of the prosthesis. Due to the anatomical characteristics of Crowe type Ⅳ DDH, the patients have acetabular and femoral bone defects, and the repair and reconstruction of bone defects become the key to revision surgery. The acetabular side is usually reconstructed with the appropriate acetabular cup or combined metal block, Cage, or custom component depending on the extent of the bone defect, while the femoral side is preferred to the S-ROM prosthesis. In addition, the prosthetic interface should be ceramic-ceramic or ceramic-highly cross-linked polyethylene wherever possible.@*CONCLUSION@#The reasons leading to revision surgery after primary THA in patients with Crowe type Ⅳ DDH and the surgical difficulties have been clarified, and a large number of clinical studies have proposed corresponding revision modalities based on which good early- and mid-term outcomes have been obtained, but further follow-up is needed to clarify the long-term outcomes. With technological advances and the development of new materials, personalized prostheses for these patients are expected to become a reality.

AF4/FMR2 and IL-10 gene single nucleotide polymorphisms are correlated with disease susceptibility and immune infiltration in ankylosing spondylitis / 南方医科大学学报

OBJECTIVE@#To explore the correlation of polymorphisms of AF4/FMR2 family genes and IL-10 gene with genetic susceptibility to ankylosing spondylitis (AS) and identify the high-risk factors of AS.@*METHODS@#This case-control study was conducted among 207 AS patients and 321 healthy individuals. The tag single nucleotide polymorphisms (SNPs) rs340630, rs241084, rs10865035, rs1698105, and rs1800896 of the AF4/FMR2 family gene and IL-10 gene of the AS patients were genotyped, and the distribution frequencies of the genotypes and alleles were analyzed to explore the relationship between different genetic models and AS and the gene-gene and gene-environment interactions.@*RESULTS@#Gender ratio, smoking history, drinking history, hypertension, erythrocyte sedimentation rate and C-reactive protein differed significantly between the case group and the control group (P < 0.05). The dominant model and recessive model of AFF1 rs340630, the recessive model of AFF3 rs10865035, and the recessive model of IL-10 rs1800896 were significantly different between the two groups (P=0.031, 0.010, 0.031, and 0.019, respectively). Gene-environment interaction analysis suggested that the interaction model incorporating AFF1 rs340630, AFF2 rs241084, AFF3 rs10865035, AFF4 rs1698105, IL-10 rs1800896, smoking history and drinking history was the best model. The genes related with AF4/FMR2 and IL-10 were enriched in the biological processes of AF4 super extension complex, interleukin family signal transduction, cytokine stimulation and apoptosis. The expression levels of AF4/FMR2 and IL-10 were positively correlated with immune infiltration (r > 0).@*CONCLUSION@#The SNPs of AF4/FMR2 and IL-10 genes are associated with the susceptibility to AS, and the interactions of AF4/FMR2 and IL-10 genes with the environmental factors contributes causes AS through immune infiltration.

Value of predictive liver metastasis in pancreatic neuroendocrine neoplasms based on ultrasonographic radiomics / 中华超声影像学杂志

Objective:To explore the predictive value of ultrasound-based radiomics for liver metastasis in pancreatic neuroendocrine tumors (pNEN).Methods:A retrospective analysis was conducted on clinical, pathological, and ultrasound data of 269 pNEN patients confirmed by pathology at Tianjin Medical University Cancer Institute and Hospital from January 2012 to June 2022, including 94 patients with liver metastasis and 175 without liver metastasis. The regions of interest (ROI) were delineated on the maximum diameter section of the tumor using ITKSNAP software, and radiomics features were extracted using Pyradiomics. Radiomics features with an intra-group correlation coefficient greater than 0.90 were retained, and the optimal features were selected using the maximum relevance minimum redundancy (MRMR) algorithm. The dataset was randomly divided into a training set and a validation set in a ratio of 7∶3, and the random forest algorithm (Rfs) was used to predict pNEN liver metastasis. Three models were constructed, including the clinical ultrasound model, the radiomics model, and the comprehensive model that combined clinical ultrasound and radiomics features. The predictive performance of different models for pNEN liver metastasis was analyzed using the ROC curve, and the predictive performance of different models was compared using the Delong test.Results:A total of 874 features were extracted from the ROI, and 12 highly robust radiomics features were retained for model construction based on inter- and intra-observer correlation grading and feature selection. The area under curve(AUC), sensitivity, specificity, and accuracy of the radiomics model, the clinical ultrasound model, and the comprehensive model for predicting liver metastasis in pNEN patients were 0.800, 0.574, 0.789, 0.714; 0.780, 0.596, 0.874, 0.777; and 0.890, 0.694, 0.874, 0.810, respectively. The Delong test showed that the comprehensive model had the best predictive performance, with an AUC superior to that of radiomics model ( Z=3.845, P=0.000 12) and clinical ultrasound model ( Z=3.506, P=0.000 45). Conclusions:The radiomics model based on ultrasound has good performance in predicting liver metastasis in pNEN, and the comprehensive model that combines clinical ultrasound and radiomics features can further improve the predictive performance of the model.

Mechanism of action of lipotoxicity in nonalcoholic steatohepatitis / 临床肝胆病杂志

Nonalcoholic steatohepatitis (NASH) is an important part of the exacerbation of nonalcoholic fatty liver disease (NAFLD), and inflammation and liver damage are important pathological features of this stage. As one of the pathogenic mechanisms of NASH, lipotoxicity can regulate liver inflammation and hepatocyte apoptosis through multiple pathways. Therefore, this article elaborates on the specific regulatory mechanism of lipotoxicity on NASH from the two aspects of inflammation and hepatocyte apoptosis, which involves a variety of liver nonparenchymal cells and various signaling pathways such as JNK, NF-κB, and caspase-mediated cell apoptosis, so as to provide new ideas for the diagnosis and treatment of NASH in clinical practice.

Early diagnosis and prediction for lateral cervical lymph node metastases of medullary thyroid microcarcinoma / 中华普通外科杂志

Objective:To evaluate the clinical and ultrasonographic features for early diagnosis and prediction of lateral cervical lymph node metastasis of medullary thyroid microcarcinoma.Methods:From Jan 2010 to Jan 2020 233 patients undergoing primary surgery were categorized as "medullary thyroid microcarcinoma" and "medullary thyroid macrocarcinoma". The preoperative clinical and ultrasonographic characteristics, the diagnostic positive rate of preoperative serum calcitonin and fine needle aspiration (FNA) were investigated between two groups. All patients with medullary thyroid microcarcinoma were divided on the basis of wether there was lateral cervical lymph node metastasis.Results:There were statistically significant differences in initial diagnostic method(χ 2=32.290, P=0.000), TNM staging(χ 2=50.300, P=0.000) between medullary thyroid microcarcinoma and medullary thyroid macrocarcinoma. Medullary thyroid microcarcinoma showed more malignant ultrasonic features. The diagnostic accuracy of preoperative serum calcitonin was higher than FNA for medullary thyroid micro carcinoma(χ 2=47.933, P=0.000). Multivariate regression analysis demonstrated that the abutment/perimeter ≥1/4( OR=25.475, 95%CI: 2.320-279.771), preoperative serum calcitonin >65 ng/L( OR=32.663, 95%CI:2.433-438.409) were the independent factor for lateral cervical lymph node metastases of medullary thyroid microcarcinoma. Conclusions:The combination of ultrasonography and serum calcitonin helps establish early diagnosis of medullary thyroid microcarcinoma. Medullary thyroid microcarcinoma with the abutment/perimeter ≥1/4, serum calcitonin >65 ng/L predicts lateral cervical lymph node metastases.

miR-216b-5p Promotes the Migration and Invasion of LN-229 Glioma Cells by Targeting BTN3A2 / 中国生物化学与分子生物学报

Accumulating evidence indicated that microRNAs (miRNA) play an important role in tumor invasion and metastasis by regulating their target genes.However, whether the miRNA-216b-5p(miR-216b-5p ) and their target genes butyrophilin subfamily 3 member A2(BTN3A2) promote glioma invasion and metastasis is unclear.This study aims to study whether miR-216b-5p promoted migration and invasion in glioma cells by negatively regulating BTN3A2.The differential expression analysis of GSE15824 and GSE4290 was analyzed by GEO2R.We found that only BTN3A2 is up-regulated in both GSE15824 and GSE4290 (P<0.05).The gene set enrichment analysis (GSEA) analysis indicated BTN3A2 was related to many cancer-related pathways (P<0.05).The results of survival curves showed that the overall survival of patients with high expression of BTN3A2 decreased significantly (P <0.001).The expression of BTN3A2 was increased with the increase of WHO grade (P<0.05), while the expression of BTN3A2 was increased in 1p/19q uncombined deletion and IDH mutant patients (P<0.001).Western blotting results showed that BTN3A2 was up-regulated in seven glioma tissues and glioma cell lines U87, U251 and LN-229 and downregulated in the miR-216b-5p mimics group; Transwell results showed that transfection with BTN3A2 silencing plasmids(si-BTN3A2) or miR-216b-5p mimics plasmids could inhibit the ability of migration and invasion in LN-229 cells in vitro (P<0.05).The online websites predicted miR-216b-5p as a potential target gene of BTN3A2.The survival curve results show that compared with patients with low expression of miR-216b-5p , the survival rate of patients with high expression was significantly increased (P=0.025).The relative expression of miR-216b-5p was decreased in U87, U251 and LN229 cells was detected by real time quantitative PCR (P<0.05).The results of dual luciferase assay showed that BTN3A2 could bind to miR-216b-5p (P<0.05).Transwell experiment results showed that overexpression of miR-216b-5p can inhibit the migration and invasion ability of LN229 cells (P<0.05).In summary, miR-216b-5p promotes the migration and invasion by targeting BTN3A2 of LN-229 glioma cells.

Effects of dexmedetomidine pretreatment on expression of TFAM and SDHA during lung ischemia-reperfusion in mice / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine pretreatment on the expression of mitochondrial transcription factor A ( TFAM) and succinate dehydrogenase ( SDHA) during lung ischemia-reperfusion ( I∕R) in mice. Methods Twenty-four clean-grade healthy male C57BL∕6J mice, aged 8-10 weeks, weighing 18-22 g, were divided into 3 groups ( n=8 each) using a random number table method:sham operation group ( group S ) , lung I∕R group ( group I∕R ) and dexmedetomidine pretreatment group ( group D) . In I∕R and D groups, lung I∕R was induced by clamping the left pulmonary hilum for 60 min followed by 120-min reperfusion in anesthetized mice. The chest was only opened, but the left pulmonary hilum was not occluded in group S. Dexmedetomidine 25μg∕kg was intraperitoneally injected at 30 min be-fore ischemia in group D, while the equal volume of normal saline was given instead of dexmedetomidine in I∕R and S groups. The mice were sacrificed at 120 min of reperfusion, and lungs were removed for determi-nation of wet∕dry weight ratio ( W∕D ratio) , cell apoptosis ( by TUNEL) and expression of TFAM and SDHA mRNA in lung tissues ( by real-time polymerase chain reaction ) and for examination of the pathological changes of lung tissues. The apoptosis index was calculated. Results Compared with group S, the W∕D ratio, apoptosis index and lung injury scores were significantly increased, and the expression of TFAM and SDHA mRNA was down-regulated in I∕R and D groups ( P<0. 05) . Compared with group I∕R, the W∕D ra-tio, apoptosis index and lung injury scores were significantly decreased, and the expression of TFAM and SDHA mRNA was up-regulated in group D ( P<0. 05) . Conclusion The mechanism by which dexmedeto-midine pretreatment attenuates lung I∕R injury is related to up-regulating the expression of TFAM and SDHA in mice.

Comparative study of superb micro-vascular imaging and power Doppler imaging in the diagnosis of different size solid breast tumors / 中华超声影像学杂志

Objective To compare the diagnostic efficiency of superb micro-vascular imaging ( SMI) and power Doppler imaging ( PDI) in differentiating different size breast tumors . Methods Retrospective analysis were performent in a total of 170 cases of breast tumors of 144 patients screened with SMI and PDI in our hospital from August 2016 to July 2017 ,and pathological results were finally obtained . These tumors were divided into two groups according to the maximum diameter 2 .0 cm . SMI and PDI diagnostic efficiency were compared by showing blood flow distribution ,vascular morphology and Alder grade . Results There were 68 benign tumors and 102 malignant tumors .When the maximum diameter was no more than 2 .0 cm ,there were no significant difference in the blood flow distribution ,vascular morphology and Alder grade between PDI and SMI of benign tumors( all P > 0 .05) ;However ,there were significant differences in the vascular morphology and Alder grade of malignant tumors( all P < 0 .05) ,but no difference in blood flow distribution( P = 0 .174) ;The area under the curve of ROC by PDI and SMI were 0 .724 and 0 .844 ,thus , the difference was statistically significant( P = 0 .024) . When the maximum diameter was more than 2 .0 cm ,the between PDI and SMI differences in blood flow distribution ,vascular morphology and Alder grade were not statistically significant ( all P > 0 .05) in benign tumors ,but there was statistical difference in vascular morphology ( P = 0 .001) in malignant tumors ,and there was no significant difference in blood flow distribution ,Alder grade in malignant tumors between PDI and SMI ( all P > 0 .05) . The area under the curve of ROC by PDI and SMI were 0 .768 and 0 .802 ,the difference was not statistically significant ( P = 0 .447) . Conclusions SMI can show the blood flow characteristics more clearly in breast tumors . When the maximum diameter is no more than 2 .0 cm ,SMI diagnostic efficiency is better than PDI .

Submental island flap for repairing oral defect after radical resection of oral cancer / 天津医药

Objective To summarize the surgery skills and evaluate the clinical outcome of submental island flap for repairing oral defect after radical resection of oral cancer. Methods A total of 25 consecutive patients underwent submental island flap reconstruction after ablative surgery for oral cancer from January 2015 to May 2017 were enrolled in this study. The patterns of venous return, the technique notes and postoperative complications were summarized. The oncological safety of submental island flap in oral reconstruction was analyzed. Results The submental island flaps were harvested with the sizes ranging from(5 cm×3 cm)to(12 cm×5 cm).The mean operation time was(350.5±50.5)min.The vein of the flap was found to drain into the facial vein,and then returned to the internal jugular vein in 17 patients(68.0%), into the external jugular vein in 4 patients(16%),and into the anterior jugular vein in 4 patients(16%).Twenty-four flaps survived completely,and 1 flap failed due to the damage of the submental artery.Wound infection occurred in only 1 patient, and primary wound healing was observed in the other 24 patients. Eight patients (32.0%) with cervical lymph node metastases were verified by the postoperative pathological examination, 4 patients were submandibular lymph node metastases.The prevalence of occult lymph node metastasis involving level Ⅰwas 16.0%.The mean follow-up period was (14.3 ± 5.2) months. Local recurrence was found in 1 patient and cervical recurrence in 2 patients without postoperative radiotherapy during the follow-up. Conclusion There are three various drainage patterns for the venous return of submental island flap.Our data suggest that vein drainage of the flap into the external jugular vein and the anterior jugular vein,which are previously overlooked,should receive greater attention during the harvest of submental flap to avoid venous congestion and flap loss.Close follow-up or postoperative radiotherapy are recommended for patients without cervical lymph node metastases.

Comparison of the subjective satisfaction of free radial forearm flap and anterolateral thigh flap for the donor site after surgical reconstruction in tongue cancer patients / 天津医药

Objective To compare the subjective satisfaction of the free radial forearm flap (FRFF) and anterolateral thigh flap (ALTF) of the donor site after surgical reconstruction for tongue cancer. Methods A total of 121 consecutive patients underwent FRFF or ALTF reconstruction after ablative surgery for untreated, primary tongue squamous cell carcinoma at Tianjin Stomatological Hospital and Peking University School and Hospital of Stomatology from August 2011 to October 2014 were enrolled in this study. The subjective satisfaction of the donor site, including sensibility, movement disabilities, cosmetics, social activities and general impacts on the quality of life (QOL), was assessed by a self-established donor site morbidity questionnaire from October 2016 to January 2017. Results Of the 121 patients, 34 died because of cancer or other diseases, 2 were excluded because of recurrence after reconstruction surgery, 11 lost to contact, and 74 (61.2％) completed the questionnaires finally, which included 39 patients in FRFF group and 35 patients in ALTF group. The scores for sensibility, cosmetics, general impacts on the QOL and composite score were significantly higher in ALTF group than those of FRFF group (P<0.05). No significant differences were found in the movement disabilities and social activities between the two groups (P > 0.05). Conclusion ALTF has the advantage of better results of donor site morbidity, less adverse effect on the general QOL, and higher subjective satisfaction.

Comparative study of cholic acid compounds of bezoar on anti-cerebral infarction and regulating endoplasmic reticulum stress / 药物评价研究

Objective Using middle cerebral artery occlusion (MCAO) model to observe protective effect of effective components of bezoar on brain damage.To discuss the anti-cerebral ischemia mechanism and compare the efficacy of effective components of bezoar from the endoplasmic reticulum stress intervention angle.Methods Rats were stratified randomly divided into sham group,model group,Qingkailing group (positive drug,3 mL/kg),taurine group,ursodeoxycholic acid (UDCA,78 mg/kg) group,taurine-conjugated ursodeoxycholic acid (TUDCA,100 mg/kg) group.Through establish MCAO model in rats,observed the scores of the neurologic impairment,measured infarct volume by TTC.Immunohistochemistry and Western blotting were Used to detect the content of P-PERK,P-EIF2α,and ATF4.Results Compared with sham group,neurologic impairment scores of model group significantly reduced (P ＜ 0.01).Compared with model group,Qingkailing group,UDCA group,and TUDCA group significantly improved neurological function in rats (P ＜ 0.05,0.01).Compared model group,all the treatment groups could significantly reduce the volume of cerebral infarction (P ＜ 0.01).Compared with sham group,expression of P-PERK,P-EIF2α,and ATF4 was significantly increased (P ＜ 0.01).Compared with model group,all the treatment groups reduced the expression of P-PERK,P-EIF2α,and ATF4 in varying degrees,effect of Qingkailing and TUDCA were more obvious.Conclusion The effective components ofbezoar alleviate cerebral ischemia reperfusion injury in rats by inhibiting endoplasmic reticulum stress,the effect of TUDCA is better than that of taurine and UDCA.

Effects of bone marrow mesenchymal stem cell transplantation on retinal neovascularization in neonatal rats with oxygen-induced retinopathy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the effects of rat bone mesenchymal stem cell (BMSC) transplantation on retinal neovascularization, and to observe the changes of hypoxia-inducible factor-1 alpha (HIF-1α) and vascular endothelial growth factors (VEGF) in rats with oxygen-induced retinopathy (OIR).</p><p><b>METHODS</b>Seventy-two seven-day-old Sprague-Dawley rats were randomly divided into three groups: normal control (CON), model (OIR) and BMSC transplantation. In the BMSC transplantation group, BMSCs were transplanted 5 days after oxygen conditioning. The phosphate buffered saline of the same volume was injected in the CON and OIR groups. The OIR model was prerpared according to the classic hyperoxygen method. At seven days after transplantation, retinal neovascularization was examined by retinal flat-mount staining and hematoxylin eosin (HE) staining. The expression of HIF-1α and VEGF proteins was examined by immunohistochemistry staining and Western blot analysis.</p><p><b>RESULTS</b>The retinal flat-mount staining results showed that the vessels were well organized in the CON group, but the vessels were irregularly organized, and lots of nonperfusion areas were observed in the OIR group. The large vessels were a bit circuitous, the retinal vessels were relatively organized, and less nonperfusion areas were noted in the BMSC transplantation group. The HE staining results showed that many neovessels and preretinal neovascular (pre-RNC) cells were observed on the internal limiting membrane in the OIR group. There were less pre-RNC cells in the BMSC transplantation group compared with the OIR group (P<0.01). The immunohistochemistry analysis showed that more HIF-1αand VEGFcells were observed in the OIR group compared with the CON group, and less HIF-1αand VEGFcells were observed in the BMSC transplantation group compared with OIR group (P<0.05). The Western blot analysis showed the expression of HIF-1α and VEGF proteins in the OIR group was significantly higher than that in the CON group. The expression of HIF-1α and VEGF proteins in the BMSC transplantation group was lower than that in the OIR group (P<0.01).</p><p><b>CONCLUSIONS</b>BMSC transplantation therapy could alleviate retinal neovascularization in OIR rats, and its mechanisms might be associated with the inhibition of the expression of HIF-1α and VEGF proteins.</p>

Application of superb microvascular imaging in renal cystic masses / 中华超声影像学杂志

Objective To compare the difference of colour Doppler flow imaging(CDFI)and superb-microvascular imaging(SMI)for detecting blood flow in cystic renal mass,and explore the consistency of conventional ultrasound combined with SMI and Contrast-enhanced ultrasonography(CEUS) in the diagnosis of renal cystic masses based on the Bosniak classification system,so as to evaluate the diagnosis value of SMI in renal cystic masses.Methods Fifty-five patients with renal cystic mass were enrolled in this study and underwent conventional ultrasound,CDFI and SMI.Patients with renal cystic mass at category Ⅱ for higher received contrast-enhanced ultrasonography additionally.The diagnostic performance of SMI and CEUS were evaluated based on final diagnosis obtained by follow-up or pathology diagnosis after surgery.Results In 55 cases,44 cases got the pathological diagnosis afer surgical resection including 38 cases of malignant masses,and 6 cases of benign masses.CDFI and SMI showed significant difference in tumor flow imaging(P <0.05).Kappa Value of SMI and CEUS was 0.866.The sensitivity,specificity, accuracy,positive predictive value and negative predictive value of SMI were 94.8%,75.0%,89.1%,90.2% and 85.7% respectively.Conclusions SMI is superior to CDFI in displaying micro-vascular of separated and solid structure in renal cystic masses.SMI has a better consistency with CEUS in Bosniak classification.SMI can improve the accuracy of non-invasive ultrasound in the diagnosis of renal cystic lesions.

Multi-modality imaging in the diagnosis and differential diagnosis of small renal mass / 天津医药

Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.

Effect of ethyl acetate extract of Shenbing No. 1 Decoction on renal interstitial fibrosis caused by unilateral ureteral obstruction in rats / 中草药

Objective: To investigate the effect of ethyl acetate extract of Shenbing No. 1 Decoction (EASD) on the expression of TGF-β1 and a-SMA in rats with renal fibrosis. Methods: Totally 50 SD rats were randomly divided into Sham operation group, unilateral ureteral obstruction (UUO) model group, Lotensin treated group (1.67 mg/kg), Shenbing No. 1 Decoction group (18.75 g/kg) and EASD group (300 mg/kg). A rat model of renal fibrosis was induced by unilateral ureteral ligation. The rats were executed after 14 d. The contents of 24 h urinary protein (24hUP), serum blood urea nitrogen (BUN), and serum creatitine (Scr) were tested. Renal tubular interstitial fibrosis was evaluated by HE staining and Masson staining. The protein expression levels of TGF-β1 and a-SMA were observed by immunohistochemical method. Quantitative real-time PCR was adopted to inspect the mRNA expression of a-SMA and TGF-β1. Results: Compared with Sham-operation group, in rats of other groups, the serum levels of BUN and SCr increased (P 0.05). Conclusion: Shenbing No. 1 Decoction and EASD may ameliorate renal interstitial fibrosis by down-regulating the expression levels of TGF-β1 and a-SMA.

Surgical treatment of adult mandibular condylar fractures:a clinical analysis of 32 cases / 天津医药

Objective To investigate the effect of surgical treatment of adult mandibular condylar fractures (including intracapsular fracture). Methods Thirty-two patients (33 sides) with condylar fractures underwent open reduction and rigid fixation. Six patients with intracapsular condylar fractures were treated with two 18-mm positional screws through a preauricular approach. Six patients (7 sides) with condylar neck fractures were rigidly fixed by 1 mini-plate via a retromandibular transparotid approach. Twenty patients with subcondylar fractures were operated and fixed by two titanium plates using an angular approach. Results The mean follow-up period was 13.5 months, and the mean maximum mouth opening was 37.5 mm by the last visit. All patients acquired good occlusal relationship and mandibular symmetry. Seven patients (21.9%) experienced transient palsy of the branches of the facial nerve, and recovered completely after three months. One patient developed a salivary fistula, and healed after two weeks of gauze compression. No permanent deficit of any facial nerve branch was observed. No patient showed condylar head resorption. Conclusion Appropriate surgical approaches and fixation methods for different types of condylar fractures are the key factors to achieve reliable clinical results.

Comparative Study of Conventional Vascular Ultrasound and Superb Micro Vascular Imaging for Diagnosing Carotid Artery Stenosis in Relevant Patients / 中国循环杂志

Objective: To assess the values of conventional vascular ultrasound (US) and superb micro vascular imaging (SMI) for diagnosing carotid artery stenosis in relevant patients. Methods: A total of 37 patients of extra cranial carotid stenosis (with 70 blood vessels) treated in our hospital from 2014-08 to 2015-03 were retrospectively studied. Digital subtraction angiography (DAS) examination was used as golden standard, the diagnostic efifcacies for carotid artery stenosis by US and by SMI were compared. Results: The accuracy, sensitivity and specificity for diagnosing carotid stenosis by US were 81.42%, 83.33% and 80.95%; by SMI were 91.43%, 92.16% and 89.47% respectively. Conclusion: US and SMI showed good agreement for diagnosing carotid artery stenosis, while SMI was superior to US for accurately assess the degree of carotid stenosis, it might be used as a more reliable method for evaluating carotid plaque and stenosis in relevant patients.

The value of contrast-enhanced ultrasound in the diagnosis of small renal cell carcinoma and renal angiomyolipoma with minimal fat / 中华泌尿外科杂志

Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of small renal cell carcinoma (SRCC) and renal angiomyolipoma (AML) with minimal fat.Methods The images and data of conventional ultrasound (US) and CEUS were retrospectively reviewed in 47 cases of small renal cell carcinoma and 8 cases of AML with minimal fat (d ＜ 30mm),which were confirmed by operation and pathologicall study,including 39 males and 16 females.The mean age of the patients was (54.8 ± 9.8) years old,ranged from 31 to 73 years old.The size,echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were observed,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results On contrast-enhanced sonography,fast wash-in and wash-off were observed in most of SRCC,while slow wash-off were observed in most of RAML with minimal fat.The statistically significant differences were found between SRCC and RAML with minimal fat in the values of TFP (time a to peak) and PI (peak-intensity).The occurrence of round pseudo-capsule and contrast-enhancement characteristics in SRCC was far more often than RAML with minimal fat.Conclusions Contrast-enhanced sonography combined with time-intensity analysis provides more useful information for the diagnosis of SRCC and AML with minimal fat.

Clinical experience of repairing large maxillofacial defects with pectoralis major myocutaneous flap / 天津医药

Objective To summarize the clinical outcomes of pectoralis major myocutaneous flap for repairing large defects in oral and maxillofacial area after resection of malignant tumor. Methods The clinical data of 27 patients underwent resection of malignant tumor in oral and maxillofacial area and reconstructed with pectoralis major myocutaneous flap were collected in our hospital from August 1998 to January 2015. The pectoralis major myocutaneous flaps were harvested with sizes ranging from 6 cm × 4 cm to 11 cm × 9 cm. The major myocutaneous flaps were used to reconstruct the defects of oral mucosa in 26 cases, and flap was used to reconstruct the defect of facial skin in 1 case. Seventeen major myocutaneous flaps reached the neck via the subclavicular tunnel, the other 10 were transferred over the clavicle. Results After surgery, 20 flaps (74.1%) were survived completely, 6 were partial necrosis (22.2%) and one was total necrosis (3.7%). Thirteen cases showed postoperative complications (48.1%), in which 10 cases were wound infection (37.0%), including 8 patients with infection at the recipient site and 2 patients with infection at the donor site. The wound infection was found in all of 7 patients with flap necrosis. The other complications included wound dehiscence in 1 patient (3.7%), neck hematoma in 1 patient (3.7%), and lung infection in 1 patient (3.7%). Conclusion In order to avoid the flap necrosis and reduce wound infection at the recipient site, the major myocutaneous flap should be designed based on the characteristics of blood supply, and the vascular pedicle should be protected carefully in the operation.

Study on preparation of ligustrazine ocular implant and correlation between in vivo and in vitro drug release / 中国中药杂志

<p><b>OBJECTIVE</b>To prepare ligustrazine (TMPZ) ocular sustained-release implant, and investigate its in vitro drug release, pharmacokinetics in rabbit vitreum and in vitro correlation.</p><p><b>METHOD</b>Ligustrazine ocular sustained-release implants were prepared by micro-twin conical screw mixers with hot-melting extrusion method, with polyactic-co-glycolic acid (PLGA) as the matrix. HPLC was adopted to determine the concentration in vitreum after ligustrazine was implanted in rabbit eyes, in order to examine its in vivo sustained-release behavior, and study the correlation between in vitro and in vivo.</p><p><b>RESULT</b>Ligustrazine implants were prepared with a drug-loading rate between 10% and 30%, which was in conformity to the pharmacopoeia in terms of the content uniformity. Its in vitro release was in conformity to the zero-order release model. With PLGA 5050, 2. 5A as a vector, ligustrazine implants with a drug-loading rate of 30% could slowly release drug for more than 3 weeks, indicating a good correlation between in vitro and in vivo release.</p><p><b>CONCLUSION</b>Ligustrazine ocular implants prepared with hot-melting extrusion method is practicable. Ligustrazine ocular implants release drug smoothly in rabbit vitreous vitreums, suggesting good sustained-release effect.</p>