Hemostasis Using Prothrombin Complex Concentrate in Patients Undergoing Cardiac Surgery: Systematic Review with Meta-Analysis

ABSTRACT Objective: The purpose of present study was to comprehensively explore the efficacy and safety of prothrombin complex concentrate (PCC) to treat massive bleeding in patients undergoing cardiac surgery. Methods: PubMed®, Embase, and Cochrane Library databases were searched for studies investigating PCC administration during cardiac surgery published before September 10, 2022. Mean difference (MD) with 95% confidence interval (CI) was applied to analyze continuous data, and dichotomous data were analyzed as risk ratio (RR) with 95% CI. Results: Twelve studies were included in the meta-analysis. Compared with other non-PCC treatment regimens, PCC was not associated with elevated mortality (RR=1.18, 95% CI=0.86-1.60, P=0.30, I2=0%), shorter hospital stay (MD=-2.17 days; 95% CI=-5.62-1.28, P=0.22, I2=91%), reduced total thoracic drainage (MD=-67.94 ml, 95% CI=-239.52-103.65, P=0.44, I2=91%), thromboembolic events (RR=1.10, 95% CI=0.74-1.65, P=0.63, I2=39%), increase in atrial fibrillation events (RR=0.73, 95% CI=0.52-1.05, P=0.24, I2=29%), and myocardial infarction (RR=1.10, 95% CI=0.80-1.51, P=0.57, I2=81%). However, PCC use was associated with reduced intensive care unit length of stay (MD=-0.81 days, 95% CI=-1.48- -0.13, P=0.02, I2=0%), bleeding (MD=-248.67 ml, 95% CI=-465.36- -31.97, P=0.02, I2=84%), and intra-aortic balloon pump/extracorporeal membrane oxygenation (RR=0.65, 95% CI=0.42-0.996, P=0.05, I2=0%) when compared with non-PCC treatment regimens. Conclusion: The use of PCC in cardiac surgery did not correlate with mortality, length of hospital stay, thoracic drainage, atrial fibrillation, myocardial infarction, and thromboembolic events. However, PCC significantly improved postoperative intensive care unit length of stay, bleeding, and intra-aortic balloon pump/ extracorporeal membrane oxygenation outcomes in patients undergoing cardiac surgery.

Application of Sphenoid Sinus Morphological Characteristics in Sex Estimation Based on Magnetic Resonance Imaging Images / Aplicación de las Características Morfológicas del Seno Esfenoidal en la Estimación del Sexo Basada en Imágenes de Resonancia Magnética

SUMMARY: Sex determination of unknown persons plays an important role in forensic science. As most bones used for sex determination are recovered in incomplete state, it is often necessary to use bones that are recovered intact e.g., the sphenoid sinus. This study aimed to evaluate the diagnostic value of sphenoid sinuses dimensions for sex determination using Magnetic Resonance Imaging (MRI) images in Chinese adults. MRI images of 79 sphenoid sinuses (from 44 men and 35 women) were retrospectively selected. The height, anterior-posterior diameter, area, and perimeter were measured in the midsagittal view of the sphenoid sinuses. All data were subjected to descriptive and discriminative functional analysis with unpaired t-test and canonical discriminant. Comparison between male and female groups showed significant statistical differences regarding the height, anterior-posterior diameter, area, and perimeter of sphenoid sinuses. The predictive accuracy rate of the sphenoid sinus to identify sex was 63.6 % in males and 62.9 % in females with an overall accuracy of 63.3 %. This study proposed the importance of sexual dimorphism of sphenoid sinus dimensions, especially if other methods are not available. It suggested using MRI in forensics science thus obviating the complete dependence on the usage of conventional computed tomography (CT) and facilitating the study of forensic anatomy at the level of soft tissue.

La determinación del sexo de personas desconocidas juega un papel importante en la ciencia forense. Como la mayoría de los huesos utilizados para la determinación del sexo se recuperan en un estado incompleto, a menudo es necesario utilizar huesos recuperados intactos, por ejemplo, el seno esfenoidal. Este estudio tuvo como objetivo evaluar el valor diagnóstico de las dimensiones de los senos esfenoidales para la determinación del sexo utilizando imágenes de resonancia magnética en individuos adultos chinos. Se seleccionaron retrospectivamente imágenes de resonancia magnética de 79 senos esfenoidales (de 44 hombres y 35 mujeres). La altura, el diámetro anteroposterior, el área y el perímetro de los senos esfenoidales, se midieron en vista mediana sagital. Todos los datos se sometieron a análisis funcional descriptivo y discriminativo con prueba t no pareada y discriminante canónico. La comparación entre los grupos de hombres y mujeres mostró diferencias estadísticas significativas en cuanto a la altura, el diámetro anteroposterior, el área y el perímetro de los senos esfenoidales. La tasa de precisión predictiva del seno esfenoidal para identificar el sexo fue del 63,6 % en hombres y del 62,9 % en mujeres, con una precisión general del 63,3 %. Este estudio propuso la importancia del dimorfismo sexual de las dimensiones del seno esfenoidal, especialmente si no se dispone de otros métodos. Se sugiere utilizar la resonancia magnética en la ciencia forense, obviando así la dependencia total del uso de la tomografía computarizada convencional y facilitando con esto el estudio de la anatomía forense a nivel de los tejidos blandos.

Serum lipoprotein-associated phospholipase A2 level is positively correlated with the recurrence risk of acute ischemic cerebral infarction in hypertensive patients / 南方医科大学学报

OBJECTIVE@#To explore the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level and the risk of acute ischemic stroke (AIS) recurrence in hypertensive patients.@*METHODS@#This retrospective case-control study was conducted among 211 hypertensive patients with AIS treated in Foshan First People's Hospital, including 35 patients with recurrence of AIS during the 1-year follow-up as confirmed by head CT/MR. In the overall patients, 60 had grade 1 hypertension (including 5 recurrent cases), 76 had grade 2 hypertension (with 11 recurrent cases), and 75 had grade 3 hypertension (with 19 recurrent cases). Univariate analysis, multivariate logistic regression analysis, trend analysis, and smooth curve fitting analysis were performed to explore the correlation between serum Lp-PLA2 level within 24 h after admission and the risk of AIS recurrence. The predictive efficacy of serum Lp-PLA2 level for AIS recurrence in different hypertension grades was evaluated using ROC curve analysis.@*RESULTS@#Serum Lp-PLA2 level, age, NIHSS score at admission, mRS scores at 7 days, homocysteine level and smoking status differed significantly between patients with and without AIS recurrence (P < 0.05). After adjustment for confounding factors, multivariate regression analysis showed that the highest tertile of Lp-PLA2 level was associated with a 4.13-fold increase of AIS recurrence risk compared with the lowest tertile (OR=5.13, 95% CI: 1.35-19.40), and each 1 ng/mL increase of Lp-PLA2 level was associated with a 1% increase of AIS recurrence risk (OR= 1.01, 95% CI: 1.01-1.02). Serum Lp-PLA2 level was shown to positively correlate with AIS recurrence risk, and in patients with grade 3 hypertension, its areas under the ROC curve for predicting AIS recurrence was 0.869 with a specificity of 0.893 and a sensitivity of 0.737.@*CONCLUSION@#Serum Lp-PLA2 concentration is an independent risk factor and potentially an effective predictor for AIS recurrence in patients with grade 3 hypertension.

Research progress of anti-fibrotic drugs that inhibit epithelial-mesenchymal transition in pulmonary fibrosis / 中华劳动卫生职业病杂志

Pulmonary fibrosis is the end-stage pathological change of lung diseases, which seriously affects the respiratory function of human body. A large number of studies at home and abroad have confirmed that epithelial-mesenchymal transition (EMT) is an important intermediate stage in the development of pulmonary fibrosis. Inhibition of multiple pathways upstream and downstream of EMT, such as the classical Smads pathway and non-Smads pathway of TGF-1 can effectively inhibit the process of EMT and alleviate pulmonary fibrosis. This article will review the main conclusions of the mechanism of action of EMT as a target to improve the pathology of pulmonary fibrosis so far, and provide a theoretical basis and research direction for further research and development of anti-pulmonary fibrosis drugs.

The mechanism of BRCC3/NLRP3 in promoting the transformation of endometriosis to endometriosis-associated ovarian carcinoma / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨NOD样受体蛋白3（NLRP3）炎症小体的活化在子宫内膜异位症（EMT）进展为EMT相关性卵巢癌（EAOC）过程中的作用及其机制。方法：选取2018年4月至2019年6月上海市长宁区幼保健院收治的EAOC、EMT、正常子宫内膜（CON组）组织标本各15例及患者的临床资料，利用免疫组织化学染色法、WB法检测EAOC、EMT和CON组织中NLRP3、caspase-1和IL-1β及含BRCA1/BRCA2的复杂亚基3（BRCC3）的表达水平。构建过表达BRCC3质粒和si-NLRP3质粒并转染EMT细胞CRL-7566，通过WB法检测转染后细胞中BRCC3蛋白的表达水平，利用MTT法、流式细胞术及Transwell实验分别检测转染后细胞增殖、凋亡、迁移与侵袭能力的变化。对过表达BRCC3组细胞进行干扰NLRP3实验，通过WB法检测干扰后BRCC3和NLRP3蛋白的表达水平，检测干扰后细胞增殖、凋亡、迁移与侵袭能力的变化。结果：EAOC和EMT组织中NLRP3、caspase-1、IL-1β和BRCC3的表达水平较CON组均呈明显升高（均P<0.01），且EAOC组织中NLRP3与BRCC3的表达呈正相关（r=0.65，P<0.01）。在CRL-7566细胞中过表达BRCC3显著促进细胞的增殖、迁移和侵袭并抑制细胞凋亡（均P<0.01），敲减NLRP3则抑制CRL-7566细胞的上述表型（均P<0.01），过表达BRCC3增强NLRP3的表达水平（P<0.01），而干扰BRCC3则抑制NLRP3表达（P<0.01）；干扰NLRP3可以部分逆转BRCC3对细胞凋亡的抑制作用（P<0.01）、对细胞迁移（P<0.05）和侵袭（P<0.01）的促进作用。结论：EAOC和EMT组织中NLRP3和BRCC3均呈高表达，过表达BRCC3可促进CRL-7566细胞的增殖、迁移和侵袭并抑制细胞凋亡，与EMT向EAOC转化有关，BRCC3/NLRP3是潜在的EAOC炎癌转化预测标志物及治疗靶点。

Research on the Identification Model of Medical Damage / 法医学杂志

OBJECTIVES@#To understand the perceptions of doctors, patients and forensic examiners on the current situation of medical disputes and medical damage identification in China, and to explore the medical damage identification model that is more conducive for the resolution of medical disputes.@*METHODS@#A questionnaire was designed, and in-service clinicians, forensic examiners and inpatients in Sichuan Province and Chongqing City were randomly selected from April to November 2019. SPSS 22.0 software was used to analyze the data of various survey results.@*RESULTS@#Compared with patients (24.92%), doctors (61.72%) believed that the current doctor-patient relationship was more tense than before; both doctors and patients were more inclined to choose voluntary consultation and people's mediation to resolve medical disputes; forensic examiners have the highest level of cognition of medical and health-related laws and regulations, followed by doctors and patients; 66.72% of doctors and 78.41% of patients believed that medical damage identification was necessary, and they were more inclined to entrust forensic identification institutions; different groups all believed that forensic examiners and doctors should participate in the identification together, 80.94% of doctors believed that the appraisal institutions should be responsible for the forensic opinion, not the appraiser.@*CONCLUSIONS@#It is suggested that the Medical Association identification and forensic identification should learn from each other and formulate basic unified rules for the identification of medical damage. It is suggested to standardize the behavior of medical damage forensic identification institutions and appraisers, to improve their own appraisal level, actively invite clinical medical experts for consultation in identification, and promote the standardized, scientization of forensic identification.

The correlation between the classification of atrophic glossitis and changes of vitamin B12, folic acid and blood cell parameters / 口腔疾病防治

Objective@# To investigate the classification of atrophic glossitis and to study the correlation between the classification and changes of VitB12, folic acid (FOL) and blood cell parameters@*Methods@#A total of 70 patients with atrophic glossitis (AG) were divided into complex type and simple type according to whether they had ulcer or erosion on the tongue mucosa or not. Another 65 healthy subjects during the same period were collected as the control group. The levels of vitamin B12, FOL and blood cell parameters were statistically analyzed using SPSS 25.0 software package.@*Results@#The levels of vitamin B12, red blood cell count (RBC) (3.52 ± 0.69) × 1012·L-1, hemoglobin (HGB)(11.97 ± 1.70) g·dL-1, white blood cell count (WBC) (4.85 ± 1.16) × 109·L-1, neutrophil count (NEUT) (2.76 ± 0.99) × 109·L-1, lymphocyte count (LYMPH) (1.48 ± 0.44) × 109·L-1 in complex type AG group were lower than those in simple type AG group (P<0.05). The levels of mean red blood cell volume (MCV) (104.90 ± 11.13) fL, mean corpuscular hemoglobin (MCH) (34.83 ± 4.56) pg, mean corpuscular hemoglobin concentration (MCHC) (331.09 ± 13.60) g·L-1 were higher than those in the simple type AG group (P<0.05). There was no significant difference in FOL content between these two groups (P>0.05). The levels of VitB12, MCV, MCH, MCHC, WBC, lymph and neut were correlated with the classification of atrophic glossitis (P < 0.05). @*Conclusion@#VitB12 deficiency was more apparent in complex AG, especially in large cell anemia, which correlated with the levels of WBC, NEUT, and LYMPH.

Research Progress on Molecular Markers Related to Unexplained Sudden Cardiac Death and Its Forensic Application / 法医学杂志

Routine pathological examination of unexplained sudden cardiac death (USCD) lacks significant morphological characteristics. In the field of forensic medicine, molecular biology methods have been used to find the cause of death by detecting genes and research related to the mechanism of sudden cardiac death has been carried out. From the molecular pathology point of view, the application of multiple levels of biomarkers to resolve the causes of USCD has already shown potential and provides an important path for forensic identification of USCD. This article reviews the latest research progress on USCD-related genes, RNA, proteins and USCD, and summarizes forensic application.

Relationship between emotional intelligence trait anger and aggressive behavior of middle school students with childhood psychological abuse / 中国学校卫生

Objective@#To explore the intrinsic mechanism of emotional intelligence and trait anger in the association between childhood psychological abuse and aggressive behavior among middle school students,and to provide a theoretical basis for intervention of aggressive behaviors.@*Methods@#By using the multi-stage stratified random sampling method, 2 458 middle school students in Guizhou Province were selected, and group tests were carried out using psychological abuse scale, attack behavior scale,emotional intelligence scale and characteristic anger scale.@*Results@#Agressive behavior, trait anger and emotional intelligence differed significantly by gender(t=2.19，5.12，-2.34，P<0.05), and there were significant differences in aggressive behavior, psychological abuse, emotional intelligence and trait anger among middle school students of different student origins by residence(t=-18.77，-6.04，9.10，-9.94，P<0.05). Childhood psychological abuse (r=0.41), temperamental trait anger (r=0.52) and reactive trait anger (r=0.49) were significantly positively correlated with aggressive behavior（P<0.05）. Emotional intelligence was significantly negatively correlated with aggressive behavior (r=-0.33, P<0.05). The test of multiple mediation effects showed that emotional intelligence, temperamental trait anger and reactive trait anger played multiple mediation roles between psychological abuse and aggressive behavior in childhood.@*Conclusion@#Childhood psychological abuse could not only directly affect the aggressive behavior of middle school students, but also further affect the aggressive behavior through emotional intelligence and trait anger. Emotional intelligence and idiosyncratic anger are important internal mechanisms by which childhood psychological abuse affects aggressive behavior.

Danshen-Chuanxiongqin Injection attenuates cerebral ischemic stroke by inhibiting neuroinflammation via the TLR2/ TLR4-MyD88-NF-κB Pathway in tMCAO mice / 中国天然药物

Danshen-Chuanxiongqin Injection (DCI) is a commonly used traditional Chinese medicine for the treatment of cerebral ischemic stroke in China. However, its underlying mechanisms remain completely understood. The current study was designed to explore the protective mechanisms of DCI against cerebral ischemic stroke through integrating whole-transcriptome sequencing coupled with network pharmacology analysis. First, using a mouse model of cerebral ischemic stroke by transient middle cerebral artery occlusion (tMCAO), we found that DCI (4.10 mL·kg

Morphological changes in the midface of Beagle dogs treated by trans-sutural distraction / Cambios morfológicos en la cara media de perros Beagle tratados por distracción trans-sutural

Trans-sutural distraction is a biological process that induces the formation of new bone and changes the position of bone by pulling on growing suture under the action of external forces. Currently, therapy to midfacial hypoplasia treated by trans-sutural distraction has been applied. In this study, Beagle dogs were selected as experimental animals, and a traction device designed by ourselves was applied to Beagle dogs to simulate the treatment process of trans-sutural distraction in human face, so as to provide a basis for the subsequent research on the related mechanism of trans-sutural distraction. The objective is that the animal model can provide the basis for the follow-up study of transsutural distraction. 45 month beagle dogs were randomly divided into two groups 3 in experiment group and 3 in control group. Implant nails were implanted as the bone marker in the bilateral zygomatic temporal suture, zygomandibular maxillary suture and palatine transverse suture in experimental group. The traction of the maxilla was carried out by the external cranial traction frame with canine fossa as bearing point, 800g force each side, elastic traction for 15 days. The control group only implanted the implant nail as the bone marker on both sides of the bone suture. The distance between two implant nails was measured by vernier calipers and X-ray examination, compared with preoperative and postoperative changes. X-ray and cephalometric measurements were used to measure change in the cranial basal angle. HE staining was used to observe the width of the bone seams, the morphology and structure of the cells and the tissue of the new bone under the phase contrast microscope. Then descriptive statistical analysis and t-test between two independent samples are carried out for the measurement data. The experimental group had a good retention of the beagle traction frame. In the experimental group, the maxillaries of dogs were protrudent in the process of traction gradually and the occlusal relationship changed to type II malocclusion. When the traction is 15 days, the coverage distance is about 8~9 mm. Before and after the traction, the distance between landmark points indicated that the spacing between the transverse palatine suture was the largest (experimental group: 5.52±0.19 mm control group 1.31±0.06 mm P<0.05), and zygomaticotemporal suture was the second (experimental group: 3.12±0.15 mm, control group 0.73±0.04 mm, P<0.05), and zygomaticomaxillary suture was less (experimental group: 2.60±0.34 mm, control group 0.53±0.05 mm, P<0.05). The cranial basal angle was no change before and after operation (controlgroup: 32.3±1.3°, experimental group: 33.2±1.1° P>0.05. Histology showed that the collagenous fibers in the suture of the control group were denser and the osteoblasts were visible on the edge of the suture, showing osteogenic activity. The experimental group significantly widened suture (experimental group: 1209.388±42.714 µm, control group 248.276±22.864 µm, P<0.05), the number of fibroblasts increased significantly with loose collagen fiber. The direction of cell and fiber arrangement were parallel to the traction force. There were many small blood vessels and marrow cavities, and the bone trabecula around the bone suture was thin (experimental group: 23.684±3.774 mm, control group: 86.810±9.219 mm, P < 0.05), showing active osteogenic activity. The growing beagle dog can be used to establish a suture traction animal model for experimental study. In the experiment, Kirschner wire was used to penetrate the bottom plane of the piriform hole of the maxilla (about the position of the canine fossa at the back) and the traction direction was basically the same as the growth direction, and the maxilla was basically parallel and moved forward.

La distracción trans-sutural es un proceso biológico que induce la formación de hueso nuevo y cambia la posición del éste al tirar de la sutura en crecimiento bajo la acción de fuerzas externas. Actualmente, se ha aplicado la terapia para la hipoplasia de la cara media tratada por distracción trans-sutural. En este estudio, fueron seleccionados perros Beagle como animales experimentales, y un dispositivo de tracción fue instalado a los perros para simular el proceso de tratamiento de la distracción trans-sutural en el rostro humano. El objetivo fue proporcionar una base para la investigación posterior sobre mecanismos relacionados con la distracción trans-sutural. El modelo animal puede proporcionar la base para este tipo de estudio de seguimiento de la distracción trans-sutural. Perros Beagle de 45 meses de edad se dividieron aleatoriamente en dos grupos: 3 en el grupo experimental y 3 en el grupo control. Los clavos de implante se usaron como marcadores óseos en la sutura temporal cigomática bilateral, la sutura maxilar cigomandibular y en la sutura transversal palatina en el grupo experimental. La tracción del maxilar se realizó mediante el marco de tracción craneal externo con fosa canina como punto de apoyo, 800 g de fuerza a cada lado, tracción elástica durante 15 días. En el grupo control solo se implantó el clavo del implante como marcador óseo en ambos lados de la sutura. La distancia entre dos clavos de implante se midió mediante calibradores de vernier y examen de rayos X, en comparación con los cambios preoperatorios y postoperatorios. Se utilizaron mediciones cefalométricas y de rayos X para medir el cambio en el ángulo basal craneal. La tinción con HE se usó para observar el ancho de las suturas óseas, la morfología y la estructura de las células y el tejido del hueso nuevo bajo el microscopio de contraste de fase. Luego se realizó un análisis estadístico descriptivo y una prueba t entre dos muestras independientes para los datos de medición. El grupo experimental tuvo una buena retención del cuadro de tracción del Beagle. En el grupo experimental, los maxilares de los perros sobresalieron gradualmente en el proceso de tracción y la relación oclusal cambió a maloclusión tipo II. Cuando la tracción era de 15 días, la distancia de cobertura fue de aproximadamente 8 ~ 9 mm. Antes y después de la tracción, la distancia entre los puntos de referencia indicaba que el espacio entre la sutura palatina transversal era más grande (grupo experimental: 5,52 ± 0,19 mm, grupo de control 1,31 ± 0,06 mm, P <0,05), y la sutura cigomáticotemporal fue la segunda. (Grupo experimental: 3,12 ± 0,15 mm, grupo control 0,73 ± 0,04 mm, P <0,05), y la sutura cigomaticomaxilar fue menor (grupo experimental, 2,60 ± 0,34 mm, grupo control 0,53 ± 0,05 mm, P <0,05). El ángulo basal craneal no cambió antes ni después de la operación (grupo control 32,3 ± 1,3, grupo experimental, 33,2 ± 1,1 ° , P> 0,05). La histología mostró que las fibras colágenas en la sutura del grupo control eran más densas y los osteoblastos se observaron en el margen de la sutura, mostrando actividad osteogénica. En el grupo experimental se amplió significativamente la sutura (1209,388 ± 42,714 µm, grupo control 248,276 ± 22,864 µm, P <0,05), el número de fibroblastos aumentó significativamente con fibras colágenas dispersas. La dirección de la disposición de la celda y las fibras era paralela a la fuerza de tracción. Se observó gran cantidad de vasos sanguíneos pequeños, cavidades medulares, y trabéculas óseas alrededor de la sutura ósea (grupo experimental: 23,684 ± 3,774 mm, grupo control: 86,810 ± 9,219 mm, P <0,05), que mostró actividad osteogénica activa. El perro Beagle en crecimiento se puede utilizar para estudios experimentales y así establecer un modelo animal de tracción de sutura. En el proceso, se usó alambre de Kirschner para penetrar en el plano inferior del foramen piriforme del maxilar (aproximadamente en la posición de la fosa canina en la parte posterior) y la dirección de tracción fue básicamente la misma que en el crecimiento.

Intrahepatic cholangiocarcinoma with aberrant hepatic artery presenting as hepatic abscess: a case report

Intrahepatic cholangiocarcinoma (ICC) is a primary hepatic malignancy that originates from epithelial cells of bile duct. Lack of diagnostic measures and therapies leads to an increasing number of deaths from ICC worldwide. Here we described a case of 61-year-old Chinese female, who initially presented with right upper quadrant pain, combined with the results that a low density mass accompanied by multiple nodules occupied the right liver lobe by CT-scan, which also showed an aberrant right hepatic artery that participated in the right liver lobe and origining from the superior mesenteric artery, this patient was clinically considered as hepatic abscess (HA). The patient’s right upper quadrant pain was alleviated after been treated with the infusion chemotherapy of the aberrant right hepatic artery (ARHA) via percutaneous femoral arterial catheterization by Seldinger technique (Meropenem 7 days) following the failure of the liver-puncture drainage.  However, the right upper quadrant pain occurred again 6 days later, serum CA19-9>1000.0 U/ml, which indicated the possibility of hepatic malignancy, so we performed laparotomy. The histopathological result of intraoperative frozen section demonstrated cholangiocarcinoma, unfortunately, it was unresectable. Finally, right lower lung pneumonia and pleural empyema happened to her and she succumbed to respiratory failure 22 days following surgery. In this report, we will discuss the case with reference to the literature.

Alveolar soft part sarcoma in children: a clinicopathological study of 13 cases / 中华病理学杂志

To investigate the clinicopathological manifestations, molecular genetic, diagnostic histology and differential diagnosis of alveolar soft part sarcoma (ASPS) in children. A total of 13 cases of ASPS diagnosed at Beijing Children's Hospital from August 2009 to November 2018 were collected. HE staining, histochemical staining for PAS and D-PAS, immunohistochemical (IHC) staining for TFE3, INI1 and CD68 and florescence in situ hybridization (FISH) for TFE3 gene translocation were performed. There were four males and nine females, age ranged from 1 year and 2 months to 13 years and 8 months (mean 7.8 years); and four patients were under 5 years old. Histologically, the tumors showed a distinctive and characteristic nested or organoid growth pattern (11 cases) or solid, diffuse growth (2 cases). The tumor cells possessed abundant eosinophilic, or glycogen-rich and clear to vacuolated cytoplasm. The chromatin was relatively dispersed, with prominent and pleomorphic nucleoli; mitotic figures were rare. Vascular invasion was frequently seen. IHC staining showed specific nuclear TFE3 staining. The tumor cells were also positive for INI1,CD68 and vimentin; but were negative for MyoD1, Myogenin, CK and S-100 protein. Seven cases showed PAS and D-PAS staining, with fuchsia acicular or rod-shaped crystals in tumor cytoplasm. Nine cases showed TFE3 break-apart signals by FISH. ASPS is a rare soft tissue sarcoma in children. Compared with ASPA in adults, it has both similarities and unique clinicopathologic characteristics. The diagnosis needs to be confirmed by combining clinical, pathologic, IHC and genetic testing.

C-phycocyanin inhibits epithelial-mesenchymal transformation ofTGF-β1-induced cervical cancer Caski cells / 中国肿瘤生物治疗杂志

@# Objective: To investigate the effect of C-phycocyanin (C-PC) on the epithelial-mesenchymal transition (EMT) of cervical cancer Caski cells induced by transforming growth factor beta1 (TGF-β1). Methods: According to different treatment methods, Caski cells were divided into three groups: 10 ng/ml TGF-β1 treatment group, 10 ng/ml TGF-β1+300 μg/ml C-PC co-treatment group and control group (untreated). After 24 h of treatment, the morphological changes of Caski cells were observed, and the effects of TGF-β1 and C-PC on the migration and invasion of Caski cells were detected by Scratch test and Transwell test, respectively. Western blotting was used to detect the effect of C-PC on the expression of epithelial phenotypic marker protein E-cadherin and stromal phenotypic marker protein N-cadherin in TGF-β1-induced Caski cells, and qPCR was used to detect the mRNA expressions of EMT related factors Snail, Zeb1 and Twist. Results: Caski cells in the TGF-β1 treatment group lost the characteristics of the original epithelial phenotype, while the cells in the TGF-β1+C-PC co-treatment group maintained the characteristics of normal epithelial phenotype; the migration rate ([60.0±1.4]% vs [33.5±2.2]%, [40.0±2.8]%, both P<0.05) and the number of invasive transmembrane cells ([108.2±6.2] vs [25.2±3.1], [39.8±5.4], both P<0.01]) of Caski cells in the TGF- β1 treatment group were significantly higher than those in the co-treatment group and the control group. Compared with the control group, the expression of E-cadherin in Caski cells treated with TGF-β1 decreased significantly (P<0.05), while the mRNA expressions of Twist, Snail and Zeb1 increased significantly (all P<0.05); However, co-treatment with C-PC reversed above changes (P<0.05 or P<0.01), and significantly decreased the protein expression level of N-cadherin (P< 0.05). Conclusion: C-PC treatment can inhibit the invasion and metastasis ability of Caski cells induced by TGF-β1 and further affects the EMT process. The mechanism may be related to the decrease of mRNAexpressions of Twist, Snail and Zeb1 by C-PC treatment. ·

Effect of Curcumin in Reversing Resistance of Human Colon Carcinoma Against Oxaliplatin Cell Line HCT-116/L-OHP / 中国实验方剂学杂志

Objective:To construct oxaliplatin (L-OHP) drug-resistant cell line HCT-116/L-OHP in human colon cancer, in order to observe the reversal effect of curcumin (cur) on its drug resistance, and preliminarily explore the possible drug resistance mechanism. Method:The concentration gradient increasing method was used to gradually increase the L-OHP concentration of HCT-116 in parental colon cancer cells, and the cell line HCT-116/L-OHP resistant to L-OHP was established. The cytotoxicity of L-OHP and curcumin to HCT-116 and HCT-116/L-OHP cells was detected by cell counting kit-8(CCK-8) method to observe whether curative resistance could be reversed. Western blot was used to detect the expressions of drug-resistance-related proteins. Real-time PCR was used to detect changes in related genes. Result:Human colon cancer cell line resistant to L-OHP were successfully established and named as HCT-116/L-OHP, with a drug resistance index of 12.6.Compared with HCT-116 cell lines, the expression levels of resected and repaired cross complementation gene 1 (ERCC1) protein and gene in HCT-116/L-OHP cell lines were significantly increased (PP-1), the expression of ERCC1 decreased (PPConclusion:HCT-116/L-OHP cell lines have a stable drug resistance, and its drug resistance mechanism may be up-regulated with the expression of ERCC1, which leads to the up-regulation of Bcl-2,GST-π,MRP,P-gp,Survivin and other related proteins, and enables tumor cells to acquire drug resistance. Curcumin can reverse the drug resistance of HCT-116/L-OHP, and its mechanism may be to reduce the expression of ERCC1, thereby down-regulating the expressions of Bcl-2,GST-π,MRP,P-gp,Survivin and other drug-resistant related genes and proteins, and increase the sensitivity of tumor to L-OHP, so as to reverse the drug resistance of tumor cells.

Value of three scoring systems in evaluating the prognosis of children with severe sepsis / 中国当代儿科杂志

OBJECTIVE@#To study the predictive value of Pediatric Age-adapted Sequential Organ Failure Assessment Score (pSOFA), Pediatric Risk of Mortality Score III (PRISM III), and Pediatric Critical Illness Score (PCIS) in children with severe sepsis.@*METHODS@#A retrospective analysis was performed for the clinical data of 193 hospitalized children with severe sepsis. According to the final outcome, these children were divided into a survival group with 151 children and a death group with 42 children. The scores of pSOFA, PRISM III, and PCIS were determined according to the worst values of each index within 24 hours after admission. The receiver operating characteristic (ROC) curve was used to analyze the efficiency of each scoring system in predicting the risk of death due to sepsis. Smooth curve fitting was used to analyze the correlation between the three scoring systems and the threshold effect of each scoring system. Decision curve analysis (DCA) was used to evaluate the application value of each scoring system.@*RESULTS@#The ROC analysis showed that PCIS and pSOFA had a similar predictive value (P=0.182) and that PRISM III and pSOFA had a similar predictive value (P=0.210), while PRISM III had a better predictive value than PCIS (P=0.045). PRISM III had the highest degree of fitting with prognosis, followed by pSOFA and PCIS. The DCA analysis showed that when the risk of death was 0.4 and 0.6 in children with severe sepsis and the three scoring systems were used as the basis for emergency intervention decision-making, pSOFA achieved the highest standardized net benefit, followed by PRISM III and PCIS.@*CONCLUSIONS@#All three scoring systems have a certain value in predicting the prognosis of children with severe sepsis, and pSOFA has a better value than PRISM III and PCIS.

Research on correction method of palatal rugae morphology in forensic digital identification system / Investigación sobre el método de corrección de la morfología de las rugas palatinas en sistema digital de identificación forense

SUMMARY: Palatal rugae is an irregular soft tissue, which is located in the front third of the hard palate, and is asymmetrically distributed from the middle suture to the sides. The difference, stability and extensive characteristics of palatal rugae morphology have gradually make it a characteristic indicator of forensic identification. However, a mature digital palatal rugae identification system has not yet been established at present. Feature extraction is the premise of palatal rugae image recognition. In order to obtain palatal rugae feature information in all directions and improve the reliability of forensic identification, it is necessary to collect palatal rugae images from a plurality of different angles. When the collected images are sent to the recognition system, the diversity of angles will often cause problems such as error recognition. If the tilted images are not rotated properly, it will make the forensic identification face many difficulties. To solve the problem of image skew caused by the diversity of acquisition angle, an algorithm based on orientation vector to correct the tilted palatal rugae images was proposed in this paper. Firstly, the criteria for standard palatal rugae image and the selection rules for feature points were set; Secondly, characterizing feature points according to the rules, and fitting two lines and find their direction vector; Finally, to obtain the corrected images, the tilted images were rotated by the angle determined by the two direction vectors. Simulation results show that the proposed algorithm can correct the tilted palatal rugae images collected from different angles and has strong robustness.

RESUMEN: Las rugas palatinas son tejidos blandos irregulares, que se ubican en el tercio frontal del paladar duro y se distribuyen asimétricamente desde la sutura mediana hacia los lados. La diferencia, la estabilidad y las características extensivas de la morfología de las rugas palatinas la han convertido gradualmente en un indicador característico de la identificación forense. Sin embargo, un sistema de identificación de rugas palatinas digitales maduras todavía no se ha establecido en la actualidad. La extracción de características es la premisa del reconocimiento de imágenes de las rugas palatinas. Para obtener información sobre las características de las rugas palatinas en todas las direcciones, y mejorar la confiabilidad de la identificación forense, es necesario recopilar imágenes de las rugas palatinas desde una pluralidad de ángulos diferentes. Cuando las imágenes recogidas se envían al sistema de reconocimiento, la diversidad de ángulos a menudo causará problemas como el reconocimiento de errores. Si las imágenes inclinadas no se giran correctamente, la identificación forense se enfrentará a muchas dificultades. Para resolver el problema del sesgo de la imagen causado por la diversidad del ángulo de adquisición, en este documento se propuso un algoritmo basado en el vector de orientación para corregir las imágenes de las arrugas palatinas inclinadas. En primer lugar, se establecieron los criterios para la imagen de las rugas palatinas estándar, y las reglas de selección para los puntos de características. En segundo lugar, se determinaron puntos de características según las reglas, y se ajustaron dos líneas y encontrar la dirección del vector. Finalmente, para obtener las imágenes corregidas, las imágenes inclinadas se giraron según el ángulo determinado por la dirección de dos vectores. Los resultados de la simulación muestran que el algoritmo propuesto puede corregir las imágenes de rugas palatinas inclinadas recopiladas desde diferentes ángulos y tiene una gran robustez.

Evaluation of resin inlay restoration after root canal therapy for deciduous molars / 口腔疾病防治

Objective @#To explore the clinical effect of composite resin inlays in repairing large areas of primary molar defects after root canal treatment to provide a reference for the restoration of carious primary molars.@*Methods@#Thirty-eight primary molars of 32 children were selected as the research objects. Indirect restoration with composite resin inlays was performed after root canal therapy. The clinical efficacy was evaluated in terms of five indices, including restoration retention, marginal integrity, gingival status, anatomical morphology and secondary caries, according to the modified USHPS evaluation criteria, at 6, 12 and 18 months after restoration.@*Results @#During the 18-month follow-up period, 36 of the 38 teeth were successfully restored, and all the evaluated items reached grade A or B. Six months after the repair, one prosthesis had fallen off, resulting in a success rate of 97.37% (37/38). The success rate remained 97.37% (37/38) 12 months after the repair; 18 months after the repair, another prosthesis had failed(Marginal integrity and anatomical morphology were grade C), reducing the success rate to 94.74% (36/38). There was no significant difference in the success rate of resin inlay repair at 6, 12 or 18 months (χ2=0.518, p=0.772).@*Conclusion@#Composite resin inlay restoration is an alternative method for repairing primary molars with large defects after root canal treatment.

Effect of FPZ, a total flavonoids ointment topical application from Pouzolzia zeylanica var. microphylla, on mice skin infections

ABSTRACT The present study was designed to investigate the effect of FPZ, a total flavonoids ointment topical application from Pouzolzia zeylanica var. microphylla (Wedd.) Masam, Urticaceae, on skin infections in mice. FPZ ointment anti-infective effect was investigated on Staphylococcus aureus-induced skin abscess and skin ulcers in mice by evaluating the variation in abscess volume, histopathology of skin tissue and healing rate. Secondary, it is topical anti-inflammatory activities on carrageenan-induced hind paw edema in mice was estimated. Besides, FPZ ointment fingerprint was performed by using ultra-performance liquid chromatography and FPZ ointment chemical constituents were isolated and identified by repeated column chromatograph and spectroscopic methods. The results revealed that FPZ ointment topical application at the concentration of 2.5-10% could attenuate skin abscess and ulcers and accelerate wound healing, as compared with control group treated with vehicle (p < 0.05). The histological analysis indicated that FPZ ointment acted via inflammation inhibition, granulation promotion and epidermis formation. Moreover, FPZ ointment effectively inhibited carrageenan-induced paw edema in a dose-dependent manner, especially 10% FPZ which showed superior activities in comparison with dexamethasone used as reference drug. FPZ ointment topical application showed a significant anti-infective effect against pyogenic bacterial skin infection in mice.

Study on the morphology of micro-implant-bone interface cells and bone histomorphology under different implantation / Estudio sobre la morfología de las células de la interfaz microscópica implante-hueso y la histomorfología ósea bajo diferentes implantaciones

SUMMARY: Micro-implant stability has always been the focus of orthodontic clinical research.In the experiment, the morphological changes of bone tissue around the micro-implants in self-tapping and assisting implantation were investigated to explore the effect of different implantation on the osseointegration of micro-implants in order to provide some theoretical basis for clinical practice. Six adult male Beagle dogs were selected,three implants were implanted into the left and right maxillary bone of Beagle dogs at the 0th, 4th and 6th week, respectively. One side to self-tapping implantation, the opposite side to assisting implantation. At the 8th week of the experiment, the animals were sacrificed and the micro-implant-bone tissue specimens with the healing time of 8w, 4w and 2w were obtained.The specimens were stained with Toluidine Blue (TB) and photographed under 100X, 200X microscope. Morphology of microimplant- bone interface cells was observed under light microscope. In self-tapping group, there were some fibrous tissues surrounding the micro-implants at the 2th week, the formation of osteoblasts and osteoid was observed at the 4th week, the wavy and lamellar bone tissues were seen at the 8th week.In assisting group,more collagen fibers were deposited around the micro-implant at the 2th week, there were a large number of osteoid-like cells, and the collagen was gradually replaced by the bone tissue at the 4th week, the osteoblasts were active and the osteoblasts were linear arrange and form a laminate bone at the 8th week.Whether implanted self-tapping or assisted implantation, micro-implant-bone interface reconstruction can occur. If the clinical need for early loading force, micro-implant try to choose selftapping implantation. By appropriately prolonging the healing time, the initial stability of the micro-implant under assistive implantation can be improved.

RESUMEN: La estabilidad del microimplante siempre ha sido el foco de la investigación clínica en ortodoncia. En este trabajo se investigaron los cambios morfológicos del tejido óseo alrededor de los microimplantes autorroscantes y se ayudó a la implantación para explorar el efecto de diferentes implantes en la osteointegración de microimplantes con el fin de proporcionar alguna base teórica para la práctica clínica. Se seleccionaron seis perros Beagle machos adultos, y se colocaron tres implantes en los huesos maxilares izquierdo y derecho en la 0ª, 4ª y 6ª semana, respectivamente. De un lado se colocó el implante autorroscante, y del otro lado el implante asistido. En la octava semana, se sacrificaron los animales y se obtuvieron las muestras de microimplante-hueso con el tiempo de cicatrización de 8, 4 y 2 semanas. Las muestras fueron teñidas con azul de toluidina (TB) y fotografiadas bajo aumento de 100X, y microscopio de 200X. La morfología de las células de la interfaz microimplante-hueso se observó bajo microscopio óptico. En el grupo autorroscante, había tejido fibroso que rodeaba los microimplantes a la 2ª semana, se observó la formación de osteoblastos y osteoide a la 4ª semana y de tejido óseo ondulado y lamelar a la 8ª semana. En el grupo asistido, se depositaron más fibras de colágeno alrededor del microimplante en la 2ª semana, hubo un gran número de células similares a osteoide, y el colágeno fue reemplazado gradualmente por el tejido óseo en la 4ª semana; los osteoblastos estaban activos y se ubicaron linealmente formando un hueso laminado en la 8ª semana. Ya sea que el implante sea con autoasistencia o con implantación asistida, puede ocurrir la reconstrucción de la interfaz microimplante-hueso. Si existe la necesidad clínica de una fuerza de carga temprana, el microimplante de elección sería la implantación autorroscante. Al prolongar apropiadamente el tiempo de curación, se puede mejorar la estabilidad inicial del microimplante bajo implantación asistida.