Spontaneous pneumorrhachis with pneumomediastinum, scrotal emphysema, and extensive subcutaneous emphysema in a patient with pneumonia: A case report and literature review.

BACKGROUND: Spontaneous pneumorrhachis with pneumomediastinum, scrotal emphysema, and extensive subcutaneous emphysema caused by acute pneumonia are rarely observed in clinical practice. CASE PRESENTATION: Herein, we report a case of a 12-year-old boy with spontaneous pneumorrhachis with pneumomediastinum, scrotal emphysema, and extensive subcutaneous emphysema caused by a severe cough due to mycoplasma pneumonia. This patient neither received invasive or noninvasive ventilator treatment nor surgical treatment before the onset of the disease. After treatment, the patient recovered smoothly and was discharged from the hospital. LITERATURE REVIEW: We reviewed all cases of spontaneous pneumorrhachis in children and adolescents between 1988 and 2022 in the PubMed database. Twenty-seven cases met our inclusion criteria, and the data on demographic information, triggers, comorbidities, symptoms, imaging findings, treatment, and prognosis were extracted and analyzed. CONCLUSION: Although spontaneous pneumorrhachis is a rare condition, it has been reported in children. Computed tomography scanning is the gold standard for its detection. Spontaneous pneumorrhachis is typically a benign disease. This condition usually does not require any special treatment and should be monitored as common types of air leaks, such as pneumothorax and pneumomediastinum.

Magnetic resonance spectroscopy on hepatocellular carcinoma after transcatheter arterial chemoembolization.

BACKGROUND AND OBJECTIVE: Proton magnetic resonance spectroscopy (MRS) of the liver in vivo is in experimental phase. MRS observation on liver cancer after transcatheter arterial chemoembolization (TACE) has seldom been reported. This study was to investigate the value of MRS in assessing the metabolic changes of hepatocellular carcinoma (HCC) after TACE. METHODS: Twenty-five consecutive patients with pathologically-confirmed HCC received 1H MRS of all hepatic lesions using 1.5T whole body MR scanner before TACE and at 3-10 days after TACE. Choline-to-lipid (Cho/Lip), glucogen/glucose-to-lipid (Glu/Lip), and glytamine/glutamate-to-lipid (Glx/Lip) ratios were measured and analyzed statistically. RESULTS: The Cho/Lip, Glu/Lip, and Glx/Lip ratios were 0.21 +/- 0.08, 0.11 +/- 0.05, 0.28 +/- 0.10 before TACE, respectively, and were 0.10 +/- 0.08, 0.07 +/- 0.07, 0.18 +/- 0.12 after TACE, respectively, with significant differences (P < 0.05). CONCLUSIONS: Using MRS can evaluate the early metabolic responses of HCC to TACE.

[Dicer efficiently converts large dsRNAs into siRNAs suitable for COX-2 gene].

OBJECTIVE: To report the use of Dicer to cleave double-stranded RNA (dsRNAs) into small interference RNAs (D-siRNAs) that can target multiple sites within an mRNA, and to acquire an new method to cure inflammation of the airway and tumor. METHODS: Using RiboMAX Large Scale RNA Production Systems-SP6 and T7 kit were used to transcribe A549 cell COX-2 DNA into RNA (dsRNAs). We mixed dsRNAs with Dicer in the reaction buffer. We recovered siRNAs using RNA Purification Column. RESULTS: Dicer efficiently converted double-stranded RNA of COX-2 into small interference RNAs of 21 approximately 23 bp. CONCLUSION: Dicer efficiently converts double-stranded RNA (dsRNA) into small interference RNAs (D-siRNAs of 21 approximately 23 bp).

Transfection of human VEGF165 gene into bone marrow mesenchymal stem cells in rats.

OBJECTIVE: To create a method for transfecting human vascular endothelial growth factor165 (hVEGF165) gene into bone marrow mesenchymal stem cells (MSCs) in rats. METHODS: MSCs of Wistar rats were isolated by density gradient centrifugation and purified based on their ability of adhesion to plastic. Detections of cell surface antigens, including CD34, CD45, CD44, and SH3, were performed using flow cytometry. MSCs' potential of differentiating into osteoblast and lipoblast in vitro was tested. The vector pcDNA(3.1)-hVEGF165 was transfected into MSCs with the liposome mediated method. The expression of hVEGF165 in the transfected cells was detected by enzyme linked immunosorbent assay (ELISA), reverse transcription-polymerase chain reaction (RT-PCR), and Western blot analysis. RESULTS: The cultured MSCs were CD34-, CD45-, CD44+ , and SH+, which were differentiated into osteoblasts and lipocytes successfully. The expressed hVEGF165 in the transfected rat MSCs was demonstrated. CONCLUSION: The vector pcDNA(3.1)-hVEGF165 is successfully expressed in MSCs.

A susceptibility locus at chromosome 3p21 linked to familial nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) poses one of the serious health problems in southern Chinese, with an incidence rate ranging from 15 to 50/100,000. Chromosome translocation t(1;3) and frequent loss of heterogeneity on short arms of chromosome 3 and 9 have been reported to be associated with NPC, and a genome-wide scan identified an NPC susceptibility locus on chromosome 4p15.1-q12 recently. In our study, we collected samples from 18 families at high risk of NPC from the Hunan province in southern China, genotyped with a panel of polymorphic markers on short arms of chromosomes 3, 9, and 4p15.1-q12. A locus on 3p21 was identified to link to NPC with a maximum logarithm of odds for linkage score of 4.18. Fine mapping located the locus to a 13.6-cM region on 3p21.31-21.2, where a tumor suppressor gene cluster resided. Our findings identified a novel locus for NPC and provided a map location for susceptibility genes candidates. In contrast to a recent study, no significant evidence for NPC linkage to chromosomes 4 and 9 was observed.

[Expression of PTEN, p16, p21, and p53 proteins in lung cancer using tissue microarray and their clinical significance].

BACKGROUND & OBJECTIVE: The genesis of lung cancer was associated with mutation or abnormal expression of PTEN, p16, p21, and p53. Tissue microarray provides a high throughout tool for genes expression. But little is reported about expression of PTEN, p16, p21, and p53 in lung cancers with tissue microarray. The aim of this study was to investigate the expression of PTEN, p16, p21, and p53 proteins and to analyze their relationship with the pathogenesis, invasion, and metastasis in lung cancer. METHODS: The expression of the antioncogene proteins in 100 cases of lung cancer and corresponding adjacent tissues were determined by tissue microarray combined with immunohistochemistry. RESULTS: The positive expression rates of PTEN, p16, p21, and p53 proteins were 31% (31/100), 38% (38/100), 42% (42/100), 53% (53/100) in lung cancer tissues, and were 85% (85/100), 72% (72/100), 80% (80/100), and 23% (23/100) in the adjacent cancer tissues, respectively, showing a low expression of PTEN, p16, p21 in cancer tissues, and high expression of p53 outside of them (P< 0.05, P< 0.01). Furthermore, the expression of PTEN, P16, and p53 proteins showed positive correlation with the clinical degrees and pathological stages of lung squamous carcinomas and adenocarcinomas (P< 0.05,P< 0.01). In lung cancer with lymph node metastasis, the expression of PTEN, p16, and p21 were low, but the expression of p53 increased significantly (P< 0.05, P< 0.01). CONCLUSION: Tissue microarray provided a useful high-throughout tool for multigene expression in large-scale investigations. There existed low expression of PTEN, p16, p21 proteins and over-expression of mutated p53 protein. Coexpression of these antioncogenes played an important role in invasion and metastasis in lung cancer.

[Anticoagulation in chinese patients with carbomedics mechanical prosthetic heart valves].

OBJECTIVE: To provide some references for defining the Chinese optimal intensity of anticoagulation after mechanical heart valve prostheses replacement. METHODS: For the 178 patients with carbomedics mechanical prosthetic heart valves, the means of INR were compared between the patients with complications and those without complications at the standard of INR1. 4 - 2.0. Also, the variations of INR were compared among different follow-ups. RESULTS: During the follow-up, 22 hemorrhagic and 1 thromboembolic complication occurred. The total linearized rate of anticoagulation-related hemorrhage was 5.83% pty. The total linearized rate thromboembolism was 0.26% pty. The late mortality was 0.79% pty (3 cases ). The final mean INR was 1.68 +/- 0.38. The final mean oral warfarin dose was 2.34 +/- 0.80 mg. The differences of variations of INR in five periods were significant (F = 5.072, P < 0.05). The mean INR in the first month of follow-up was 1.75 +/- 0.27. CONCLUSION: For Chinese patients with mechanical prosthetic heart valve, hemorrhage is the principal complication, the ratio of which is much higher than that of thromboembolism. The low-dose anticoagulation (INR1. 4-2.0) could remarkably decrease hemorrhagic events as effectively as prevent the thrombolic events. Moreover the INR is the most unstable in the first month of follow-up, so re-examination for the patients in the first month after the operation is vitally important.

[Effect of ischemic preconditioning on myocardial bcl-2, bax, p53 gene expression during ischemia/reperfusion period in rabbits].

OBJECTIVE: To investigate the effects of ischemic preconditioning on myocardial bcl-2, bax, p53 gene expression during ischemia/reperfusion period in rabbits. METHODS: Twenty four rabbits were randomly allocated to three groups (n = 8), pseudo-operation group(Group P), ischemia/reperfusion group (Group IR) and ischemic preconditioning group(Group IP). Group IR and Group IP were subjected to three hours of left anterior descending coronary artery occlusion followed for three hours of reperfusion. Ischemic preconditioning was achieved by three 5-minute cycles of ischemia, each followed by 5 minutes of reperfusion. Apoptosis index(AI) and protein expression of Bcl-2, Bax, and p53 in the border zone of myocardium of ischemic area at risk were obtained with a flow cytometry. RESULTS: Compared with Group IR, AI was significantly reduced in Group IP(P < 0.01). Bcl-2 expressions was higher in Group IP than in Group IR, while bax and p53 expressions were lower in Group IP than in Group IR. CONCLUSION: The rabbit myocardial apoptosis induced by ischemic preconditioning inhibited ischemia-reperfusion in vivo partly related to the modulating of bcl-2, bax and p53 expression.

[Fibrillin-1 gene mutation in Chinese patients with Marfan syndrome and its gene diagnosis by haplotype analysis].

OBJECTIVE: To analyze fibrillin-1 (FBN(1)) gene mutation in Chinese patients with Marfan syndrome(MFS) and to make a gene diagnosis by haplotype analysis for MFS. METHODS: Nine MFS families were analysed with single strand conformation polymorphism(SSCP) and DNA sequencing. With the use of four primers designed in the flanking sequences of each short-sequence tandem-repeat region in FBN(1) gene, the haplotype-segregation analysis for MFS(B) was performed. RESULTS: In MFS(A)II(1), PCR-SSCP detected SSCP band alterations in exon 25 of FBN(1) gene; direct sequencing showed a small 13bp deletion, the deleted sequence being gcctctgcaccca at base 3243-3456 of cDNA. This mutation caused a frame-shift which was never seen in any unaffected members of the family, and it was a heterozygous mutation; neither of them was identified in 100 chromosomes from 50 normal control individuals. Haplotype-segregation analysis suggested that the disease was passed from Subject I(2) to Subject II(2), Subject II(3), Subject II(5) with the same allele in MFS B family, the proband's daughter also inherited the allele. These data indicated that MFS(B) family was linked to FBN(1) gene, the proband's daughter was an asymptomatic patient. CONCLUSION: The combination of mutation analysis and haplotype analysis can provide more evidence for gene diagnosis.

[Surgical treatment of infective endocarditis: a report of 41 cases].

OBJECTIVE: To study the characteristics and surgical treatment of infective endocarditis. METHODS: In all patients, surgical treatment was performed including aortic valve replacement in 22, mitral valve replacement in 9, combined aortic and mitral valve replacements in 4, tricuspid valve reconstruction in 3, and pulmonary valve repair in 3. Meanwhile, complicated deformities such as ventricular septal defect (VSD), atrial septal defect (ASD), patient ductus arterisus (PDA), ruptared aneuryem of the aortic sinus and right centricular outflow tract obstruction were corrected. RESULTS: There were 2 early postoperative deaths (an overall hospital mortality of 5%). A follow-up of 3 months to 5 years, with a mean of 3.2 years, documented no recurrent endocarditis and late death. CONCLUSION: Low mortality occurs in the surgical therapy for infective endocarditis. In order to avoid irreversible injury on cardiomyocyte, the operation, which is beneficial to the recovery of heart function, should be performed as early as possible.