Combining extracorporeal shock wave treatment with proprioceptive neuromuscular facilitation can improve the lower limb motor function of stroke survivors with foot drop / 中华物理医学与康复杂志

Objective:To observe any effect of combining extracorporeal shock wave stimulation with proprioceptive neuromuscular facilitation (PNF) on the lower limb motor function of stroke survivors with foot drop.Methods:Thirty-six stroke survivors with foot drop were randomly divided into an extracorporeal shock wave group, a PNF group and a combination group, each of 12. The extracorporeal shock wave group and PNF group were given those therapies alone, while the combination group was provided with both. The extracorporeal shock wave therapy protocol was 2000 times on each muscle at an intensity of 2.5 bar and a frequency of 10Hz, twice a week for 4 weeks, while the PNF was provided at least 3 times per week for 4 weeks. Before and after the intervention, all of the participants were evaluated using the modified Ashworth scale (MAS), the 10-metre walk test (10 MWT) and the Fugl-Meyer lower limb motor function scale (FMA). Active range of the ankle joint and toe out angle were also observed.Results:After the intervention the lower limb muscle tone had decreased significantly in 8 of the PNF group members and in 9 of those in the extracorporeal shock wave group, but it has decreased significantly in all 12 members of the combination group. And the average magnitude of the improvement was also significantly greater in the combination group than in the other two groups. Moreover, significant differences were observed in the active range of the ankle joint after the treatment in the combination group, but not in the other two groups. After the intervention the average 10 MWT times and FMA scores of the PNF and combination groups had improved significantly, but not those of the extracorporeal shock wave group, but significant improvement in toe out angles was observed in all three groups, though the average improvement in the combination group was significantly greater than in the other 2 groups.Conclusion:Combining extracorporeal shock waves with PNF can effectively improve the lower limb motor function of stroke survivors with foot drop.

Change of brain structure imaging of long-term withdrawal of methamphetamine-dependent patients / 中南大学学报(医学版)

Objective:To explore the characteristics of brain structure in patients with long-term withdrawal of methamphetamine-dependence.Methods:A total of 44 patients with withdrawal of methamphetamine-dependent for more than 14 months were recruited,who met the diagnostic criteria for substance dependence in the fifth edition of the American Mental Disorders Diagnostic and Statistical Manual (DSM-Ⅴ),and 40 healthy subjects were used as the control.In addition to the general scale of drug-relevant survey,the subjects received the 3.0T magnetic resonance high-resolution scan.The voxel-based morphometric measurements for the subject's brain gray volume were conducted.Results:There was no significant difference in age,education,smoking and alcohol consumption between the methamphetamine-dependent withdrawal group and the control group (P＞0.05).The volumes for the bilateral cerebellum,the left side of temporal gyrus and the right side of the lingual gyrus in the methamphetamine-dependent withdrawal group were increased than those in the control group.The volumes for the bilateral lingual gyrus and bilateral cuneus in the methamphetamine-dependent withdrawal group were decreased than those in the control group.The volumes of left of cuneus and cerebellum were positively correlated with the duration of abstinence.Conclusion:After long-term abstinence,although the patients still show abnormal brain structure,their behavior and cognitive function is improved.The cerebral nerve structural is recovered from long-term abstinence.

Expression and clinical significance of costimulatory molecule B7-H4 and programmed death ligand 1 in bladder cancer / 中华泌尿外科杂志

Objective To detect the expression of costimulatory molecules B7-H4 and programmed death ligand 1 (PD-L1) in bladder cancer,and to explore the correlation between them and clinicopathological features of bladder cancer.Methods Immunohistochemical staining was used to detect the expression of B7-H4 and PD-L1 in 98 cases of bladder urothelial carcinoma,which were confirmed by pathology from August 2014 to December 2015 in our hospital.There were 23 females,aged 45-82 years,with an average age of 67.8 years.Among them,42 cases of adjacent normal tissues were used as controls.The clinical stage,histological grade and recurrence of bladder cancer were collected,and the correlation between them was analyzed.Results The positive rates of B7-H4 and PD-L1 in bladder urothelial carcinoma were 54.1％ (53/98) and 59.2％ (58/98),respectively,and there was no expression in normal bladder tissues (P ＜ 0.05).The positive expression rate of B7-H4 in muscle invasive bladder cancer (MIBC) patients was higher than that in non-muscle invasive bladder cancer (NMIBC) [73.5％ (25/34) vs.43.8％ (28/64),P =0.005].The positive expression rate of B7-H4 in high-grade patients was higher than that of low-grade [70.0％ (21/30) vs.47.1％ (32/68),P =0.036].The expression rate of B7-H4 in high-risk group was higher than that of low-intermediate risk group [57.1％ (20/35) vs.27.6％ (8/29),P =0.018].The positive expression rate of PD-L1 in patients with MIBC was higher than that in NMIBC [79.4％ (27/34) vs.48.4％ (31/64),P =0.003].The PD-L1 expression rate of histological high-level group was higher than that of low-level group [73.3％ (22/30) vs.52.9％ (36/68)],but the difference was not statistically significant (P =0.058).The PD-L1 expression rate in high-risk group was 68.6％ (24/35),and also higher than low-middle group 24.1％ (7/29) (P ＜ 0.05).There was a positive correlation between the expression of B7-H4 and PD-L1 in bladder urothelial carcinoma (r =0.318,P=0.002).The combined recurrence rate of the two groups was significantly higher than that of the negative expression of the two groups [66.7％ (14/21) vs.30.8％ (8/26),P=0.014].Conclusions The expression of B7-H4 and PD-L1 is up-regulated in bladder urothelial carcinoma,which is closely related to the clinical stage,histological grade,risk classification and recurrence of NMIBC.

Langerhans cell histiocytosis in children with nasal congestion as chief complain: a case report / 临床耳鼻咽喉头颈外科杂志

Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder. Here, we report a rare case of multi-system LCH in a 20-month-old children presenting nasal congestion, fever, abnormal liver function, anemia, and skin damage. The radiograph computed tomography showed an osteolytic lesion in the lateral skull base with tumor extension. Pathological biopsy was performed, and the histopathologic diagnosis was LCH. A general review of LCH, including clinical manifestations, diagnosis, treatment, and prgognosis, is presented.

Real-time ultrasound guided placement of permanent internal jugular vein catheters in maintenance hemodialysis patients / 中南大学学报(医学版)

OBJECTIVE@#To investigate the value of real-time ultrasound guided placement of permanent internal jugular vein (IJV) catheterization in maintenance hemodialysis patients, and analyze its technical success and complication rate.@*METHODS@#We prospectively analyzed 63 patients (39 males, 24 females) who underwent permanent IJV cannulation with real-time ultrasound guidance from January to October in 2012. Under the real-time guidance of Logiq 5 color Doppler, we placed the tunneled cuffed catheters into the jugular vein by Seldinger technique. The number of needle punctures, technical success, the operation time, and complications were recorded. The patients were divided into a normal-risk group and a high-risk group: those who suffered multiple catheter insertions, previous difficulties during catheterization, poor compliance, obesity, impaired consciousness, skeletal deformity, disorder of haemostasis were regarded as high-risk patients.@*RESULTS@#Cannulation of IJV was done in all patients. Of the 63 catheters, 20 (31.7%) were placed in the high-risk patients; 60 (95.2%) were successfully placed at the first attempt, with the average number of punctures of (1.23±0.21) (range 1-3); Only 3 immediate complications (4.7%) developed; 3 (4.7%) catheter infections occurred in the course of using. Cannulation of IJV took longer time in the high-risk group than that in the normal-risk group [(30.6±0.11) min vs (19.1±0.09) min, P<0.05]. The number of needle punctures, percent of successful cannulation, and the frequency of immediate complications were similar in the high- and normal-risk groups. It was more likely to form catheter thrombosis during long-term use in the high-risk group (4/20, 20%) which might cause poor blood flow.@*CONCLUSION@#Permanent IJV cannulation under real-time ultrasound guidance is very safe with high success rates. Nephrologists can use this technique with ease and with minimal complications in both normal- and high-risk patients.

Construction of a three-channel stone clearance system for the treatment of complicated bladder stones in patients with benign prostatic hyperplasia / 国际外科学杂志

Objective To explore the construction of a new stone clearance model and evaluate its clinic effect in the treatment of complicated bladder stones in patients with benign prostatic hyperplasia.Methods Forty-two cases of complicated bladder stones in patients with benign prostatic hyperplasia were treated by pneumatic lithotripsy using a three-channel stone clearance system composed of a resectoscope sheath,nephroscope sheath and lateral bladder telescope.Comparisons of gravel effect and I-PSS score,QOL score,BOO grade and Qmax differences preoperatively and 3 months post-operatively were made.Results Forty-two cases were stone-free with the first treatment without complications (bladder perforation,obvious water extravasation,serious bleeding or urethral injury),and the average time for lithotripsy was (43.6 ± 11.2) minutes.Subsequent transurethral resection of the prostate surgery was performed successfully.When measured at 3 months post-operatively,I-PSS score(9.5 ± 3.6) points,QOL score(1.3 ± 1.2) points,Qmax(17.7 ± 5.9) mL and BOO classification were significantly different when compared to preoperative scores.Conclusion The three-channel stone clearance system consisting of resectoscope sheath,nephroscope sheath and lateral bladder telescope can continuously and efficiently handle complicated bladder stones in patients with benign prostatic hyperplasia,leading to good clinical results.

Protective effect of minocycline on hepatic ischemia-reperfusion injury in rats / 中南大学学报(医学版)

Objective: To explore the protective effect of minocycline on hepatic ischemia-reperfusion injury (IRI) in rats and the underlying mechanisms. Methods: A total of 54 male Sprague-Dawley rats were randomly divided into 3 groups: the sham-operated group (control group), the ischemic–reperfusion (IR group), and the minocycline preconditioning group (n=18 per group). The rats in the minocycline preconditioning group were given minocycline (45 mg/kg) by gastric irrigation at 36 h before operation and then were subsequently administered with minocycline (22.5 mg/kg) at every 12 h. hTe rats were sacriifcedat 2, 6, 24 h after reperfusion. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were measured. HE staining of liver tissues was performed to detect the histological changes, and the degree of liver IRI according to Suzuki score were calculated. hTe levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were determined by spectrophotometer; the mRNA expression of tumor necrosis factor-α (TNF-α) and interleukin-1 beta (IL-1β) in the liver were measured by real-time PCR; Dickkopf-1 (DKK-1) and beta-catenin (β-catenin) protein expression in the liver were detected by Western blot. Results: Atfer 2, 6, 24 h reperfusion, compared with the IR group, the liver function (ALT, AST and LDH) in the minocycline group was signiifcantly improved (allP<0.05); the Suzuki’s scores and the levels of hepatic TNF-α and IL-1β mRNA were signiifcantly decreased (allP<0. 05); the MDA and MPO levels the liver were decreased (bothP<0.05); the protein expression of hepatic DKK-1 was decreased (P<0.05), while the protein expression of β-catenin was increased (P<0.05). Conclusion: Minocycline can alleviate the ischemic-reperfusion injury mainly through reducing oxidative stress and inhibiting the release of pro-inlfammatory cytokines depends on the activation of the Wnt/β-catenin signaling pathway in the liver.

Prospect of bone morphogenetic protein 13 in liver diseases / 中南大学学报(医学版)

Bone morphogenetic proteins (BMPs) belong to TGF-β superfamily and are a group of important cytokines involved in cell differentiation, proliferation and embryonic development. Multiple BMPs play important roles in several functions of vertebrates. Signaling pathway of BMPs is known to be mediated by Smad proteins, which include 8 members while Smad1, Smad5 and Smad8 are involved in BMPs signal transduction while Smad2 and Smad3 are mediated TGF-β signal transduction. Although several BMPs such as BMP4 and BMP9 have been documented in the liver, BMP13 has not been examined in the liver. BMP13 also known as growth differentiation factor (GDF)-6 or cartilage-derived morphogenetic protein (CDMP)-2 is one of the BMPs family members. Function of BMP13 has been investigated in bone and tendon repair. It can stimulate tendon-like cell proliferation. However, our recent findings revealed that there was expression of BMP13 in the liver and its expression was modulated during metabolic disorders. The current article is to understand biological function of BMP13 especially in the liver.

IL-17 in the early diagnosis of acute renal allograft rejection in mice / 中南大学学报(医学版)

ObjectiveTo investigate the expression of T helper (Th) 17 cells and the related interleukin 17 (IL-17) in acute renal allograft rejection in mice and its significance.Methods We established a mouse renal allograft model,in which mice were randomly divided into a renal isograft group and an acute renal allograft rejection group.Three and 7 d after the transplantation,the serum interferon (IFN)-γand IL-17 levels in the mice were determined by enzyme-linked immunosorbent assay,the percentage of Th1 and Th17 cells in the total kidney-infiltrating lymphocytes was investigated by flow cytometry,and the transplanted kidney species were given routine pathological examination after fixation with 10％ formalin.ResultsCompared with the isograft group,the allograft mice showed a significantly higher content of IL-17 (P ＜0.05 ) but not IFN-γ in the serum 3 d after transplantation,and showed significantly higher serum IL-17 and IFN-γcontents 7 d after transplantation (P ＜ 0.05 ).Also,compared with the isograft group,the allograft mice exhibited significantly higher percentage of Th1 and Th17 cells on both day 3 and day 7 ( P ＜ 0.05 ).In the allograft group,the contents of serum IFN-γand IL-17 and the percentage of Th1 and Th17 cells were significantly higher on day 7 than on day 3 (P ＜ 0.05 ).Routine pathological examination indicated that,as time passed,the allograft mice showed gradually stronger rejection responses.ConclusionTh17 cells might play an important role in the development of acute renal allograft rejection,and IL-17 can be used as an early indicator of acute rejection.

Mouse model of orthotopic small bowel transplantation / 中南大学学报(医学版)

ObjectiveTo investigate the surgical procedures of orthotopic small bowel transplantation (SBT) model in mice to study the function and rejection of SBT.MethodsWe established a mouse SBT allograft model as follows: the donor portal vein was anastomosed end by side with the recipient inferior vena cava; the donor superior mesenteric artery with aorta patch was anastomosed end by side with recipient abdominal aorta.After an appropriate length of the recipient's small bowel was removed,the donor's small bowel and the recipient's small bowel were end-to-end anastomosed discontinuously.The mice were fasted for 4 d after the operation,free access to water and subcutaneously injection of 2 mL of 5％ glucose saline twice daily.Operation success was regarded as survival for more than 5 d.There is no antibiotic and immunosuppressor.ResultsA total of 30 transplantations were done,the 5 d survival rate was 60％ ( 18/30),and 12 died within 5 d.Among the dead recipients,5 died of arterial anastomotic stenosis and anastomotic thrombosis,2 of hemorrhagic shock caused by anastomotic bleeding,and the other 5 of intra-abdominal infection caused by postoperative intestinal fistula.The donors' operative time was (40 ± 4.5 ) min,warm ischemia time was about 0.5 min,donor preparation time was about 3 min,and cold preservation time was (30 ±7.5) min.The recipients' operative time was (95 ±8.0) min,among which,the abdominal aorta and inferior vena cava clamping time was ( 38 ± 3.5 ) min,the venous anastomotic time was (10 ±2.0) min and the arterial anastomotic time was (15 ± 3.0) min.The mean intraoperative blood loss of the surviving recipient mice was about 0.2 mL.ConclusionHigh quality vascular anastomosis,and rehydration of donors and recipients are crucial factors for improving the success rate of SBT.

Emergency orthotopic liver transplantation for acute hepatic failure:a report of 8 cases / 中国普通外科杂志

Objective To study the efficacy of emergency orthotopic liver transplantation(EOLT) for acute(hepatic) failure(ALT).Methods A retrospective review was undertaken on the clinical data of 8 patients undergoing emergency liver transplantation for ALT.Results The 8 patients completely regained consciousness in 12 to 72 hours after operation.No case developed central nervous complications.One case of severe(hepatitis) complicated by acute renal failure died of respiratory infection and ARDS on postoperative day 7.One case who refused to take medication died from chronic rejection 12 months after operation.One case was(complicated) by bile duct stricture and biliary sludge at 14 months postoperatively and survived for 18 months.Four of the other 5 cases were followed up for 17 months and 1 cases for 14 months,and thir quality of life was excellent.3 of them have returned to work.Conclusions Emergency orthotopic liver thansplantation is an effective means to treat ALF.Intensive care and effective treatment preoperatively are pre-requisite(conditions) to ensure the success of EOLT.

The Clinical Analysis of Parathyroid Tumor / 中国医师杂志

Objective To evaluate the clinical parameter, diagnosis and operative mode of parathyroid tumor. Methods The clinical symptoms, examination methods and the mode of operation in 15 operated patients with parathyroid tumor from May 1979 to October 2001 were retrospectively analyzed. Results 15 patients with parathyroid tumors, including 10 adenomas, 3 carcinoma and 2 cysts, all revealed the symptom of hyperparathyroidism except 2 cases of cyst. The accuracy of B-US and CT in preoperative diagnosis on location was 86 7% and 91 7% respectively, and their accuracy in preoperative diagnosis on quality was 26 7% and 75 0% respectively. All patients were treated by surgery. Among them, 12 patients were cured, 1 died, and 2 relapsed. Conclusion If a patient has the symptoms of bone pain, nephrolith and the mass in neck, we should consider whether he suffers from parathyroid tumor. B-US is the first choice in preoperative diagnosis on tumor location, and CT was the good examination method for tumor location also. The diagnosis on tumor quality dependeds on pathological examination mostly. Surgery remains to be the most important. The only unilateral exploration for the benign parathyroid tumor is performed and the operative range of parathyroid carcinoma should include both the mass and thyroid.

A randomized controlled study on the application of the biofragmentable anastomosis ring and manual suture in intestinal anastomosis / 中国普通外科杂志

0.05).Anastomotic inflammatory reaction occurred in 2 patients(3.2%) in BAR group and 13 patients(20.0%) in manual group.The difference was statistically significant(P

Study of the arterial blood supply of the pancreas head and the gastroduodenal artery reconstruction of pancreatic graft / 中国普通外科杂志

Objective To investigate the arterial blood supply of the pancreas head and provide a theoretical basis for the gastroduodenal artery reconstruction in pancreatic transplantation(PT).Methods Photograms of digital subtraction artery(DSA)which performing on 300 patients were analyzed to recognize the aberrations of arterial blood supply of pancreatic head.Results In 300 DSA photograms,the gastroduodenal artery(GD.a)was identified in 131 cases,and the anterior superior pancreaicduodenal artery(ASPD.a)and posterior superior pancreaicduodenal artery(PSPD.a)in 79 cases.The rate of aberrant origin of pancreatic transverse artery(PT.a)from GD.a was 12.98℅.There are some minor sources of blood supply to the pancreas head from GD.a.The rate of absence of an ASPD.a-AIPD.a anastomosis and PSPD.a-PIPD.a anastomosis was 15.19℅and 24.05℅,respectively.Conclusions The reconstruction of gastroduodenal artery can ensure a complete blood supply to the pancreatic head and duodenum in PT.