Real-World Experience of the Efficacy and Safety of Upadacitinib 15 mg in Patients with Atopic Dermatitis in Korea / 대한피부과학회지

Background@#Upadacitinib is an oral Janus kinase1 (JAK1)-selective inhibitor, which showed a quick and significant effect on patients with atopic dermatitis in several phase 3 clinical studies. Although, an increasing number of studies have reported data on the real-world efficacy and safety of upadacitinib for the treatment of atopic dermatitis, no studies have yet been published in Korea. @*Objective@#We assessed the real-world efficacy and safety of upadacitinib for the treatment of atopic dermatitis in Korean patients. @*Methods@#A total of 17 patients with atopic dermatitis who received 15 mg of oral upadacitinib everyday for 16 weeks, were included in this retrospective single-center study. Based on electronic medical records, the clinical characteristics, Eczema Area and Severity Index (EASI) score, and adverse events were investigated. @*Results@#The mean EASI score was significantly reduced at 4 weeks of upadacitinib treatment (8.81±9.00) and gradually reduced at week 8 (5.70±7.38), week 12 (4.55±6.23), and week 16 (4.58±6.74) (p＜0.001). At week 16, 61.54%, 30.77%, and 15.38% of patients achieved EASI 75, EASI 90, and EASI 100 responses, respectively. There was no statistically significant difference between EASI 75 and EASI 90 by age or gender at week 16 (p＞0.05). A total of 13 people (76.5%) had adverse events, of which acne was the most common. In all patients, the symptoms were mild and self-limited, and no patient discontinued treatment. @*Conclusion@#Upadacitinib was effective and safe for Korean patients with atopic dermatitis in real-world clinical practice.

Differences of Structural Plasticity between Hemispheres during Rehabilitation for Subacute Stroke / 中国康复理论与实践

Objective:To explore the differences in plasticity mechanism of cortical structure between hemispheres during rehabilitation for stroke patients at subacute stage. Methods:From October 20, 2018 to February 1, 2020, 22 patients with first-onset subcortical ischemic stroke completed the assessments of MRI and clinical evaluation at admission, and after one and two months of rehabilitation. Cortical surface area, thickness, and volume were measured to evaluate cortical structure plasticity. Two-way repeated measures analyses of variance were implemented to estimate dynamic cortical morphology changes and differences between hemispheres. Results:A significant time effect occurred between admission and after one month of rehabilitation for both hemispheres. Cortical surface area, thickness and volume for most regions in both hemispheres gradually decreased, while parahippocampal gyrus thickness and volume increased. The surface area and volume of postcentral gyrus was significant between both hemispheres (F > 4.305, P < 0.05), in which ipsilesional hemisphere was lower than contralesional hemisphere. The reduction of the thickness (r = -0.474, P = 0.026) and volume (r = -0.432, P = 0.044) of postcentral gyrus in ipsilesional hemisphere was negatively correlated with the recovery rate of motor function. Conclusion:There are differences in cortical structure plasticity during stroke rehabilitation between hemispheres. Cortical morphology markedly changes in the first two months poststroke. The greater the reduction in thickness and volume of postcentral gyrus in ipsilesional hemisphere is, the worse the recovery of motor function may be.

Gray matter abnormalities in obsessive-compulsive disorder by voxel-based morphometry research / 解剖学报

Objective To investigate the abnormalities of gray matter volume in obsessive-compulsive disorder (OCD) patients relative to controls using the method of voxel-based morphometry (VBM), and to analyze the extent of change relative to clinical symptom. Methods Using VBM to compare the MRI images of 31 adult OCD patients with 31 healthy controls. Correlation analyses were conducted between the structural abnormalities of gray matter volume in each brain area among patients relative to their clinical scores. Results Compared with the healthy controls, the OCD patients showed reductions of gray matter volume in left putamen, insula, premotor area, superior parietal and right angular gyrus (P<0.01, Alphasim corrected). The gray matter volumes of left putamen and insular in the OCD patients showed a negative correlation with the Beck anxiety inventory (BAI) scores. Conclusion The changes in gray matter volumes of left putamen, insula, premotor area, superior parietal lobule and right angular gyrus may be related to the pathogenesis of OCD. The declines of left putamen and insula are related to the abnormal anxiety in the OCD patients.

Role of Kelch-like ECH-associated Protein-1-Nuclear Factor Erythroid 2-related Factor-2/Antioxidant Responsive Element Signal Pathway for Multiple Sclerosis (review) / 中国康复理论与实践

Multiple sclerosis (MS) is a chronic inflammatory disease, mainly due to the activation of the T cells, which makes oxidative stress reaction in brain and leads to demyelination finally. Kelch-like ECH-associated protein-1 (Keap1)-nuclear factor erythroid 2-related factor-2 (Nrf2)/antioxidant responsive element (ARE) signal pathway is one of the most important endogenous antioxidant pathways, which promotes the expression of detoxification enzymes and antioxidant protein to eliminate oxygen free radicals and balance intracellular redox system. Activation of the Keap1-Nrf2/ARE may delay the progression of MS by drugs or rehabilitation.

Effects of Isokinetic Flexion and Extension Training at Different Angular Velocities on Core Muscles of Patients with Low Back Pain / 中国康复理论与实践

Objective:To explore the effect of isokinetic muscle strength training at different angular velocities on the core muscles of patients with low back pain, and to find out the better angular velocity. Methods:From January, 2016 to June, 2018, 60 patients with chronic low back pain were randomly divided into three groups, with 20 cases in each group. Group A (control group) only received routine rehabilitation therapy. Additionally, groups B and C received isokinetic muscle strength training at 30°/s and 90°/s, respectively, three times a week for four weeks. They were measured peak torque and average power before and after training. Results:After training, the peak torques and powers of both flexor and extensor were higher in groups B and C than in group A (P < 0.05), the peak torques of both flexor and extensor were lower in group C than in group B (P < 0.05), however, no significant difference was found in powers of both flexor and extensor between groups B and C (P > 0.05). After training, the score of VAS decreased in groups B and C (t > 4.098, P < 0.01), and was lower in groups B and C than in group A (P < 0.05), however, no significant difference was found between groups B and C (P > 0.05). Conclusion:Isokinetic muscle strength training could increase the peak torque and power of trunk flexor and extensor in patients with low back pain, in which lower angular velocity (30°/s) has a better effect.

Characteristics of Trunk Muscles in Isokinetic Training at Different Velocities / 中国康复理论与实践

Objective:To study the presentation and changes of trunk flexors and extensors in isokinetic training at different velocities. Methods:From March to September, 2018, 27 health volunteers were enrolled. Their peak torques of trunk flexors and extensors at 30°/s, 60°/s, and 90°/s were collected. Results:The peak torques of trunk flexors and extensors slightly decreased with the increasing of velocities, but no significant difference was found (F < 2.070, P > 0.05). At 30°/s and 60°/s, the peak torque of extensors was higher than that of flexors (t > 3.138, P < 0.01); at 90°/s, no significant difference was found in the peak torque between flexors and extensors (t = -0.946, P > 0.05). The ratios of the peak torque of flexors to extensors were 0.79∶1 both at 30°/s and 60°/s. The peak torque of flexors decreased in the tenth contraction compared with the second contraction at all the angular velocities, however, it was significantly different only at 30°/s (t = 5.159, P < 0.01); meanwhile, the peak torque of extensors increased with significance only at 60°/s (t = -2.142, P < 0.05). Conclusion:At 30°/s and 60°/s, there might be a linear relation between trunk flexors and extensors, and the peak torque ratios of trunk flexors to extensors were approximately the same.

Application Progress of Isokinetic Muscle Strength Test in Trunk Core Muscles (review) / 中国康复理论与实践

Isokinetic muscle strength test has been applied to athletes, healthy people and patients with muscular dystrophy, and some results have been achieved. However, due to the different parts, purposes, intensity and methods of training, the information integration are unclear, lacking a complete overview of clinical application of isokinetic muscle test and training. This paper mainly reviewed the current research status of isokinetic muscle strength test and training in various fields of trunk muscle group, including low back pain, stroke, and sports medicine, etc. In addition, the indexes and influencing factors of trunk muscle group and core muscle group were briefly constructed, and some common research methods were integrated.

Screening and identification of apolipoprotein A-I as a potential marker for hepatoblastoma in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To screen and identify serum biomarkers for childhood hepatoblastoma (HB).</p><p><b>METHODS</b>The serum samples from 30 children with hepatoblastoma (HB), 20 children with systemic inflammatory response syndrome, and 20 normal children were treated with magnetic bead-based weak cation exchange chromatography. The platform of surface-enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS) was used to eliminate the interference of inflammatory factors and to screen out the differentially expressed proteins in serum between tumor group and normal group. After the purification and separation of target proteins were performed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, matrix-assisted laser desorption/ionization-time of flight-mass spectrometry was used to determine their amino acid sequences. The SwissProt database was searched for matched proteins. Finally, real-time PCR and ELISA were used to verify and measure the expression of target proteins.</p><p><b>RESULTS</b>After SELDI-TOF-MS was used for screening and elimination of the interference of inflammatory factors, a differentially expression protein with a mass-to-charge ratio of 9 348 Da was found in serum between HB group and normal group, and the HB group had significantly lower expression of this protein than the normal group (p<0.05). This protein was identified as apolipoprotein A-1 (Apo A-I). Real-time PCR and ELISA verified the low mRNA and protein expression of Apo A-I in serum in the HB group and high expression in serum in the normal group.</p><p><b>CONCLUSIONS</b>Apo A-I can be used as a non-inflammatory protein marker for HB and has a certain value in the early diagnosis of HB.</p>

Expression of Innate Immunity Genes in Epithelial Cells of Hypertrophic Adenoids with and without Pediatric Chronic Rhinosinusitis: A Preliminary Report / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Adenoid hypertrophy (AH) is associated with pediatric chronic rhinosinusitis (pCRS), but its role in the inflammatory process of pCRS is unclear. It is thought that innate immunity gene expression is disrupted in the epithelium of patients with chronic rhinosinusitis (CRS), including antimicrobial peptides and pattern recognition receptors (PRRs). The aim of this preliminary study was to detect the expression of innate immunity genes in epithelial cells of hypertrophic adenoids with and without pCRS to better understand their role in pCRS.</p><p><b>METHODS</b>Nine pCRS patients and nine simple AH patients undergoing adenoidectomy were recruited for the study. Adenoidal epithelium was isolated, and real-time quantitative polymerase chain reaction (RT-qPCR) was employed to measure relative expression levels of the following messenger RNAs in hypertrophic adenoid epithelial cells of pediatric patients with and without CRS: Human β-defensin (HBD) 2 and 3, surfactant protein (SP)-A and D, toll-like receptors 1-10, nucleotide-binding oligomerization domain (NOD)-like receptors NOD 1, NOD 2, and NACHT, LRR and PYD domains-containing protein 3, retinoic acid-induced gene 1, melanoma differentiation-associated gene 5, and nuclear factor-κB (NF-κB). RT-qPCR data from two groups were analyzed by independent sample t-tests and Mann-Whitney U-tests.</p><p><b>RESULTS</b>The relative expression of SP-D in adenoidal epithelium of pCRS group was significantly lower than that in AH group (pCRS 0.73 ± 0.10 vs. AH 1.21 ± 0.15; P = 0.0173, t = 2.654). The relative expression levels of all tested PRRs and NF-κB, as well as HBD-2, HBD-3, and SP-A, showed no statistically significant differences in isolated adenoidal epithelium between pCRS group and AH group.</p><p><b>CONCLUSIONS</b>Down-regulated SP-D levels in adenoidal epithelium may contribute to the development of pCRS. PRRs, however, are unlikely to play a significant role in the inflammatory process of pCRS.</p>

Establishment of predictive model of testicular torsion in pediatric patients with acute scrotum / 中华实用儿科临床杂志

Objective To establish a predictive model of testicular torsion according to the clinical data of pediatric patients with acute scrotum.Methods Retrospective study was performed to analyze medical records of 118 pediatric patients with acute scrotum.A case-control study was conducted,the case group included the patients with testicular torsion and the control group included the patients without testicular torsion.Data of patients including physical signs and laboratory tests related to testicular torsion were assessed by univariate analysis through Chi-square test or t test.All factors which had statistical significance in the univariate analysis were used as independent variables for multivariate Logistic analysis to establish a predictive model of pediatric testicular torsion.Results There were 54 patients in the case group and 64 patients in the control group.Vanishment of cremaster reflex,duration of pain,fever,urine positive and fading away of color Doppler flow imaging (CDFI) were independent predictors of pediatric testicular torsion (all P ＜ 0.05),and the OR values were 4.330,0.888,0.229,0.107 and 4.408,respectively.The predictive model of testicular torsion in pediatric patients was as follows:In [P / (1-P)] =2.307 + 1.466 × vanishment of cremaster reflex-0.119 × duration of pain-1.476 × fever-2.235 × urine positive + 1.484 × CDFI.Conclusions The Logistic regression model,which takes into account vanishment of cremaster reflex,duration of pain,fever,urine positive and CDFI,can be used to predict the risk factors of pediatric testicular torsion to provide a basis of surgical exploration.

Antagonism between gene therapy and epigenetic therapy on human laryngeal carcinoma tumor-bearing mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gene therapy and epigenetic therapy have gained more attention in cancer treatment. However, the effect of a combined treatment of gene therapy and epigenetic therapy on head and neck squamous cell carcinoma have not been studied yet. To study the mechanism and clinical application, human laryngeal carcinoma cell (Hep-2) tumor-bearing mice were used.</p><p><b>METHODS</b>A xenograft tumor model was established by the subcutaneous inoculation of Hep-2 cells in the right armpit of BALB/c nu/nu mice. The mice with well-formed tumor were randomly divided into six groups. Multisite injections of rAd-p53 and/or 5-aza-dC were used to treat tumor. Tumor growth was monitored by measuring tumor volume and growth rate. p53 and E-cadherin protein levels in tumor tissues were detected by immunohistochemical staining. The mRNA levels were monitored with FQ-PCR.</p><p><b>RESULTS</b>Gene therapy was much more effective than single epigenetic therapy and combined therapy. The gene therapy group has the lowest tumor growth rate and the highest expression levels of p53 and E-cadherin.</p><p><b>CONCLUSIONS</b>The combined treatment of gene and epigenetic therapy is not suggested for treating head and neck carcinoma, because gene therapy shows an antagonistic effect to epigenetic therapy. However, the mechanisms of action are still unclear.</p>

Clinical analysis of 41 children's urinary calculus and acute renal failure / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the treatment of acute renal failure caused by irrational drug use.</p><p><b>METHOD</b>Data of 41 cases of acute renal failure seen from July 2008 to June 2012 in our hospital were reviewed. Bilateral renal parenchymas diffuse echo was found enhanced by ultrasound in all cases. Calculus image was not found by X-ray. All children had medical history of using cephalosporins or others. Alkalinization of urine and antispasmodic treatment were given to all children immediately, 17 children were treated with hemodialysis and 4 children accepted intraureteral cannula placement.</p><p><b>RESULT</b>In 24 children who accepted alkalinization of urine and antispasmodic treatment micturition could be restored within 24 hours, in 11 children micturition recovered after only one hemodialysis treatment and 2 children gradually restored micturition after hemodialysis twice, 4 children who accepted intraureteral cannula immediately restored micturition. In all children micturition recovered gradually after a week of treatment. Ultrasound examination showed that 39 children's calculus disappeared totally and renal parenchymas echo recovered to normal. The residual calculi with diameter less than 5 mm were found in 2 children, but they had no symptoms. The children received potassium sodium hydrogen citrate granules per os and were discharged from hospital. Ultrasound showed calculus disappeared totally one month later.</p><p><b>CONCLUSION</b>Irrational drug use can cause children urolithiasis combined with acute renal failure, while renal dysfunction can reverse by drug withdrawal and early alkalinization of urine, antispasmodic treatment, intraureteral cannula or hemodialysis when necessary, most calculus can be expelled after micturition recovered to normal.</p>

Inhibition of human laryngeal carcinoma growth by gene therapy and epigenetic therapy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the effects of gene therapy and epigenetic therapy on the tumor growth of laryngeal carcinoma and the underlying mechanisms.</p><p><b>METHODS</b>The animal model of human laryngeal carcinoma was established by the subcutaneous inoculation of Hep-2 cells at the right armpit of BALB/c nu/nu mice. The tumor-bearing mice were randomized into 4 groups, p53 therapy group(rAd-p53), epigenetic therapy group(5-aza-dC), combination therapy group (rAd-p53+5-aza-dC) and control group. The gene and protein expressions of molecular markers p53 and E-cadherin were detected by FQ-PCR and immunohistochemistry.</p><p><b>RESULTS</b>By the day 20 of the treatments, the mean tumor volumes were(106.09 ± 24.40)mm(3) in p53 therapy group, (166.55 ± 40.11) mm(3) in epigenetic therapy group, (126.11 ± 22.49) mm(3) in combination therapy group,and (252.83 ± 54.09) mm(3) in control group. Both gene therapy (F = 37.30, P < 0.05) and epigenetic therapy (F = 4.79, P < 0.05) inhibited the growth of xenografted tumors, with an interaction effect (F = 22.01, P < 0.05) between the two groups. The integral optical density value of p53 protein expression of p53 therapy group (628.07 ± 95.16) was significantly higher than that of combination therapy group (494.76 ± 100.22), (t = 8.72, P < 0.05). The integral optical density values of E-cadherin protein expression were 558.89 ± 97.58 in p53 therapy group, 380.41 ± 90.60 in epigenetic therapy group, 494.76 ± 102.88 in combination therapy group,and 162.60 ± 40.38 in control group respectively, indicating the enhancements of E-cadherin protein expression by gene therapy (F = 45.24, P < 0.05) or epigenetic therapy(F = 5.73, P < 0.05)and the existence of interaction effect (F = 21.82, P < 0.05) between gene therapy and epigenetic therapy. The expression levels of p53 gene were 4.43 ± 0.12 in p53 therapy group, 1.06 ± 0.11 in epigenetic therapy group, 3.51 ± 0.10 in combination therapy group,and 1.09 ± 0.11 in control group, respectively, showing an interaction effect between gene therapy and epigenetic therapy (F = 298.11, P < 0.05). The expression levels of E-cadherin gene were 4.50 ± 0.34 in p53 therapy group, 2.02 ± 0.16 in epigenetic therapy group, 2.99 ± 0.12 in combination therapy group, and 1.00 ± 0.11 in control group, respectively. The expression of E-cadherin gene was enhanced by gene therapy (F = 329.12, P < 0.05)or epigenetic therapy(F = 88.57, P < 0.05), with an interaction effect between the two therapies (F = 122.17, P < 0.05).</p><p><b>CONCLUSIONS</b>Xenografted tumors of human laryngeal carcinoma cells are inhibited by gene therapy, the epigenetic therapy and the combination therapy. The gene therapy was significantly better than the epigenetic therapy or the combination therapy. There might be antagonistic effect between p53 and 5-aza-dC.</p>

Correlation between symptoms of pollen allergic rhinitis and pollen grain spreading in summer and autumn / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between airborne pollen concentrations and symptoms in patients with pollen allergic rhinitis.</p><p><b>METHODS</b>Durhum sampler was used to collect the pollen concentration and species from June to September in 2011. The clinical skin prick test (SPT) data were analyzed. The patients with pollen allergic rhinitis were divided into pure pollen allergic rhinitis group (pollen group) and pollen combined perennial allergens allergic rhinitis group (combined group). Symptom scores of patients were assessed, and correlation between pollen concentration and onset of symptoms of patients were analyzed. SPSS 16.0 software was used to analyse the data.</p><p><b>RESULTS</b>While the peak of Summer-Autumn pollen concentration appeared from August 20 to September 15, the major pollen included Artemisia L, Chenopodium album and Humulus scandens. The peak of pollen concentration in one day reached 638/1000 mm(2). The patients taken SPT from June to September accounted for 51.9% of the patients in whole year, among which SPT pollen positive patients were 1509, 60.7% of all SPT positive patients. The amount and rate of SPT positive patients showed significant correlation with pollen concentration(r value were 0.90 and 0.99, both P < 0.05). Onset of symptoms in two groups was correlated with pollen concentration in Summer-Autumn. Symptoms of cough in combined group showed more severe compared with patients with pollen group (t = 2.36, P < 0.05).</p><p><b>CONCLUSIONS</b>Pollen concentration has a major effect on onset of symptoms of allergic rhinitis. Airborne pollen monitoring has important preventive and therapeutic significance on patients with allergic rhinitis.</p>

Clinical and histopathologic features of biofilm-associated chronic rhinosinusitis with nasal polyps in Chinese patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Biofilms have given new insights to the understanding of pathogenesis of chronic rhinosinusitis (CRS). However, the link between biofilms formation and local inflammatory response remains poorly defined in CRS with nasal polys. The aim of this study was to determine the potential association of the presence of biofilms in the nasal mucosal tissues with clinical features in Chinese patients, which had CRS with nasal polyps (CRSwNP).</p><p><b>METHODS</b>A total of 19 patients with CRSwNP and 12 patients with non-CRS were subjected to endoscopic surgery and their nasal mucosal tissue specimens were examined histologically and by scanning electron microscopy (SEM). Their demographic and clinical features were recorded.</p><p><b>RESULTS</b>Thirteen (68.4%) out of the 19 specimens from patients with CRSwNP, but none from control patients, were positive for biofilms that displayed typical characteristics of bacterial and fugal structures. The presence of biofilms in the nasal mucosal tissues was associated with significantly greater values of purulent nasal discharge and preoperative Lund-Kennedy scores, higher levels of serum total IgE and percentages of subjects with endoscopic surgery (ESS) history in patients with CRSwNP, and more severe inflammation in the nasal mucosal tissues of patients with CRSwNP.</p><p><b>CONCLUSION</b>Our study demonstrated the presence of biofilms in the nasal mucosal tissues of many patients, contributing to the understanding of the pathogenic process of CRSwNP in Chinese patients.</p>

The initial observation of adenovirus vector-mediated herpes simplex virus-thymidine kinase gene/ganciclovir system and photodynamic therapy for oral malignant tumor treatments / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the method of adenovirus vector-mediated herpes simplex virus-thymidine kinase gene (ADV-TK)/ganciclovir(GCV) system and photodynamic therapy(PDT) for treating the oral malignant tumor.</p><p><b>METHODS</b>Ten patients who were suffering from oral malignant tumor of the different positions were selected, and injected with the hematoporphyrin derivative (HPD), irradiated by picking the corresponding laser frequency, and injected the ADV-TK gene into the tumor body and periphery. By the imaging and the hemodynamics analysis, the clinical efficacy after infusing vein with GCV was assessed.</p><p><b>RESULTS</b>After the combination method treatments, patients' tumors appeared clear shrinkage or complete extinction. There was obvious fall of the blood flow volume in the tumor body. Imaging results showed significantly differences. So it was a perfect and effective treatment.</p><p><b>CONCLUSION</b>There are many advantages to apply the ADV-TK/GCV system and PDT treatment on the oral malignant tumor, minimal side effects and greater clinical security. It is a safe and credible therapy which can be offered for curing the oral malignant tumor systematically.</p>

Effects of pulsed magnetic field on insulin-like growth factor-1 (IGF-1) in cerebrospinal fluid and effects of IGF-1 on functional recovery / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effects of pulsed magnetic field on insulin-like growth factor-1 (IGF-1) level in the cerebrospinal fluid (CSF) and the association of IGF-1 alterations with the activities of daily living (ADL) of patients with brain injury.</p><p><b>METHODS</b>Sixty-five patients with brain injury were divided randomly into the control group (n=30) and magnetic therapy group (n=35), both receiving conventional therapy and in the latter group, daily pulsed magnetic field treatment (20-40 mT, 50 Hz, 20 min per time, 1 time per day) for 14 consecutive days were administered. On the first and 14th days of the treatment, 2 ml CSF was collected from the cases patients for IGF-1 measurement by radioimmunoassay, and Barthel index (BI) was used to assess the ADL of the patients.</p><p><b>RESULTS</b>After a 14-day treatment, IGF-1 level in the CSF were significantly increased in the magnetic group in comparison with the level before the treatment and with those in the control group (P<0.05). IGF-1 in the CSF underwent no significant changes in the control group (P>0.05). The scores of BI increased significantly in both groups after the treatment (P<0.01), but the increment was more obvious in the magnetic therapy group (P<0.05). A significant positive correlation was found between IGF-1 level in the CSF and BI in these patients (r=0.283, P=0.022).</p><p><b>CONCLUSION</b>Pulsed magnetic field might increase IGF-1 level in the CSF of patients with brain injury to promote the recovery of the patients ADL, suggesting its potential clinical value in the treatment of brain injury.</p>

Analysis of the diagnosis and treatment of recurrent vulvovaginal candidiasis in 80 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the appropriate therapy for treating recurrent vulvovaginal candidiasis (RVVC).</p><p><b>METHODS</b>Individual consolidated and maintenance therapy were chosen according to fungal culture of vaginal secretion and antifungal drug sensitivity per month as one therapy duration. Drugs were used orally and vaginally together to consolidate the therapy. Oral drugs were fluconazole (0.15 qw after 0.15 q3d for 2 times) or ketoconazole (0.2, bid for 3 days ) or itraconazole (0.2 bid for 3 days ). After Nystain (400 000 unit qn for 7 days ) or clotrimazole(0.1 qn for 7 days) or amphotericin B (0.01 qn for 6 days ) being vaginally used, Living preparation of lactobacillus (0.25 qn for 5 days) was vaginally used. The therapy was continued for 2 to 5 therapy durations after the symptoms disappeared with negative fungal culture.</p><p><b>RESULTS</b>Among 80 cases of RVVC, C. albicans was mostly detected (74%), C. glabrata was 20%. The susceptivity to candidas of oral agents revealed that the sensitive rare of ketoconazole, fluconazole and itraconazole were (91.3%), (81.3%) and (62.5%), respectively. As for vaginal agents, nystain and amphotericin B were 100% sensitive, clotrimazole was 92.5%sensitive, miconazole was 55.0% sensitive. The remote cure of 3 and 6 therapy durations after discontinuing for 12 months was 78.9% and 90.4%</p><p><b>CONCLUSION</b>The predominant pathogen in RVVC is C. albicans. The effective measures to cure RVVC are to choose sensitive drugs for individual consolidated, maintenance therapy and restore vaginal acidic environment.</p>

Characterization of vocal fold regeneration after adipose-derived mesenchymal stem cells implanting / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the treatment for injured vocal folds by implanting autologous adipose-derived mesenchymal stem cells (ADSC), and to observe the characteristics of lamina propria of the vocal folds and its major extracellular matrix (ECM), as well as the growth features of ADSC.</p><p><b>METHODS</b>The lamina propria was injured by localized resection in fifty-three vocal folds of thirty-four rabbits. Isolation, culture and identification of ADSC were performed in twenty rabbits. Three to five days after vocal folds injury, autogeneic ADSC were implanted into the injured vocal folds. As control, scaffolds (collagen or hyaluronic acid) and none were injected into eighteen and fifteen vocal folds respectively. Larynges were harvested at 15 days, 40 days and 3, 6, 12 months after operation. The growth and distribution of ADSC were detected by DAPI stain. Meanwhile, HE staining was performed for histopathologic research, Masson trichrome staining, Alcian Blue staining and immunohistochemical staining were used for collagen, hyaluronic acid and fibronectin respectively.</p><p><b>RESULTS</b>ADSC showed a spindle-shaped adherent growth, with multi-differentiation potential. After implanting into the injured vocal fold, ADSC can survive in vocal fold lamina propria. In ADSC implanting group, the morphology and histologic structure of vocal folds were similar to normal in six and twelve months after ADSC implanting respectively. collagen had an increasing trend in three months, with the disorderly distribution in the vocal fold lamina propria, then it became decreasing until the twelveth month, when concentration closed to normal, however, distribution of collagen was a little irregular. The content of hyaluronic acid increased within forty days and distributed in the lamina propria, then gradually reduced to normal levels in the following twelve months, and limited in the superficial and middle layers of lamina propria, which closed to normal. Fibronectin in the lamina propria continued to scattered at the peak levels at fortieth day, then decreased in the later twelve months when the content became near normal. In the untreated group, vocal fold showed a local scar contracture at third month after injury, histology showed large number of fibrous tissue (mainly collagen fibers) hyperplasia with a tendency of increasing, disorders was also found in vocal fold lamina propria. In the scaffold implanting group, the changes were between the two groups above.</p><p><b>CONCLUSIONS</b>ADSC are good source of seed cells for vocal fold tissue engineering, which have the ability for promoting injured rabbit vocal folds ECM secretion, rational distribution and part ordering arrangement. ADSC also play an important role in vocal folds reparation and regeneration.</p>

Histopathological change of cricoarytenoid joint after laryngeal recurrent nerve paralysis in dogs / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the histopathological changes in cricoarytenoid joints in 32 animal models. The characteristic histopathological changes of arytenoid cartilages after recurrent nerve paralysis were evaluated.</p><p><b>METHODS</b>Sixteen dogs (32 vocal folds, 8 as normal control) were divided into different animal models of recurrent nerve paralysis as transection, half-section, ligation, or crush. The histopathological finds of arytenoid cartilages were analysed.</p><p><b>RESULTS</b>Arytenoid cartilages showed fibrin (12/24), disruption of the fibrous membrane (9/24), fibrillation (7/24) and degenerative changes in their joint surface structure (3/24) at various levels of intensity. The fibrin and disruption of the fibrous membrane were found 1 month after injury, and all changes appeared in 6 months. The fibrillation and arytenoid cartilages degenerative changes revealed in transaction group and ligation group, and became stronger in time of 6 months. The correlation among the fibrillation ratio and the normal control was positive (t were 6.23 and 3.65, P < 0.01). The correlation among the number of cellular of arytenoid cartilages and the normal control was positive (t = 2.78, P < 0.05). The fibrillation (7) and arytenoid cartilages degenerative changes (3) revealed in vocal fold fixation to influence the recovery of laryngeal function.</p><p><b>CONCLUSIONS</b>The histopathological change of cricoarytenoid joint after recurrent nerve paralysis was related to the severity of neural injury. Influence the recovery of laryngeal function more often from 6 months.</p>