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Introduction: The morphological characteristics of the endometrium in patients with choriocarcinoma have not been well described. We described the endometrial morphology patterns in 46 choriocarcinomas and analyzed their relationship with the clinicopathological characteristics of these patients. Methods: Forty-six patients diagnosed with choriocarcinoma that had sufficient endometrial tissues for histopathological diagnosis were selected. Diagnoses of choriocarcinoma and secretory status of endometrium were reviewed. LHCGR expression of endometrium was evaluated by immunostaining. Results: Endometrial morphology was classified as secretory or nonsecretory. The 15 secretory specimens included 2 highly secretory and 13 common secretory specimens. The 31 nonsecretory patterns included 1 hyperplasia without atypia, 7 disordered proliferations, 13 typical proliferations, and 10 resting endometria. Among these, 11 specimens with overall nonsecretory patterns showed focally weak secretory changes surrounding the choriocarcinoma lesion. Secretory patterns were observed in classic choriocarcinomas (8/17) and monomorphic choriocarcinomas (7/21) but not in scanty-trophoblast choriocarcinomas (0/8). Secretory changes appeared significantly less frequently in patients who received multi-agent chemotherapy (4/25) than in those who did not (7/14) or received single-agent chemotherapy (4/7) (P = 0.030). The differences in age, months since the last pregnancy, pregnancy type, recurrence, specimen type, gross diameter, human chorionic gonadotropin (hCG) levels, and expression of hCG receptors were not statistically significant. Conclusions: The endometrial morphologies in choriocarcinoma were diverse, including various proliferative and secretory changes, but rarely hypersecretory changes, compared to the prevailing hypersecretory endometrium in hydatidiform moles. The variety in endometrial morphology was the consequence of ovarian hormonal disturbances of the hypothalamic-pituitary-gonadal axis by hCG from choriocarcinoma. Therefore, the endometrium may serve as a clue for histopathological diagnosis of choriocarcinoma. Our study presents the largest cohort reported to date to describe the diverse spectrum of endometrial changes in choriocarcinoma patients.
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Objective:To investigate the method and effect of anatomic reduction of orbital septum fat in blepharoplasty to correct the first and second degree of upper eyelid depression.Methods:From January 2019 to January 2021, the data of patients with first and second degree upper eyelid depression admitted to Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. Orbital septum was fully exposed and cut in blepharoplasty, the orbital fat of upper eyelid central group and the medial group were dissected and seperated to form the fat flap pedicled on the medial side. The fat flap was rotated 180° to the medial side and fixed with the orbital fat of the medial group to correct the upper eyelid depression. Complications such as infection, hematoma, fat liquefaction, nodules and orthers were observed after surgery. Questionnaire was used to investigate the satisfaction of patients, with 1-4 points indicating dissatisfaction, general satisfaction, satisfaction and very satisfaction, respectively.Results:A total of 62 patients were included, all patients were female, aged 18-44 years, wit mean 27 years. All patients were bilateral upper eyelid depression. After 6 months of follow-up, the curvature of the double eyelid line was smooth, the width and narrowness of double eyelid were natural, and the upper eyelid depression was significantly improved. Satisfaction survey showed that 60 cases were very satisfied and 2 cases were satisfied. Wound infection was occurred in 1 case, and was cured after dressing change. Scar hyperplasia was observed in 2 cases, which was obviously alleviated after external treatment with anti-scar hyperplasia drugs. No fat liquefaction, nodule and other complications occured.Conclusions:For the first and second degree of upper eyelid depression, it can be corrected by anatomic reduction of orbital septal fat in blepharoplasty. The operation is simple, with fewer complication and high satisfaction.
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AlM: To analyze the prescribing of different antiplatelet drugs and clinical conditions of patients with coronary heart disease in department of Geriatrics. METHODS: This study was a single center and cross-sectional study. Patients with coronary heart disease were recruited when hospitalized in the department of Geriatrics department, Xiangya Hospital, Central South University between December 2021 and June 2022. We investigated and analyzed the clinical conditions of patients including the prescribing of the antiplatelet drugs. RESULTS: A total of 347 coronary heart disease patients with a mean age of (65.2 ± 10.1) years were included. The antiplatelet drug clopidogrel was the most commonly prescribed. Among the different dual antiplatelet therapy (DAPT), aspirin combined with clopidogrel was the most widely used. With the increasing of the numbers of target coronary lesions, the prescribing rate of clopidogrel increased significantly (P < 0.05). In three groups with different degrees of target coronary lesions, the prescribing rate of aspirin was higher than that of indobufene (P < 0.05). Compared with patients taking aspirin, the patients taking indobufene were older with a higher blood creatinine level, a higher proportion of chronic gastropathy and the higher level of platelet aggregation rates (P < 0.05). CONCLUSlON: Clopidogrel is the most commonly prescribed antiplatelet drugs in patients with coronary heart disease. Aspirin combined with clopidogrel is the most widely used in DAPT. Compared with aspirin, indobufene is more commonly used in elderly patients with the chronic gastritis and a higher serum creatinine level.
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Objective:To compare the features and advantages of the standardized residency training of urology in America and China, and to provide a reference for the improvement of the Chinese standardized residency training system.Methods:By studying the latest standardized training documents in China and the America, referring to the specific training rules of standardized training pilots (Shanghai and other cities), and the latest related researches, this article compares the differences between the Chinese and American standardized residency training systems from such five aspects as the source of urology training students, training objectives, training content, quality control and external environment, and tries to figure out the reasons for their formation.Results:There are many places in American standardized residency training system that can be referred, such as unifying the period of training system, strengthening the assessment of clinical capabilities of residents, focusing on the combination of clinical and scientific research, and improving the remuneration and practice environment of residents. At present, the quality and effectiveness of Chinese urology standardized residency training needs to be improved, especially the ability of independent diagnosis and surgical skills.Conclusion:By analyzing the differences of standardized residency training system between China and the United States, this article puts forward the following suggestions: a) to unify the educational system and establish a unified admission standard for urologists; b) to formulate a clear training goal and establish a national standardized assessment system; c) to improve the income level of urology residents, willing to establish a standardized residency training system that truly suits China's national conditions.
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【Objective】 To investigate the effects of gallbladder cancer-associated fibroblasts (CAFs) on the migration of lymphatic endothelial cells (LECs) so as to elucidate the molecular mechanisms involved. 【Methods】 The CAFs and normal fibroblasts (NFs) were extracted by enzymatic digestion, and the supernatant (CM) of CAFs and NFs was collected. The levels of IL-6, IGFBP3 and other related cytokines were detected by semi-quantitative protein factor microarray and ELISA. The expressions of α-SMA (CAFs maker) and IGFBP3 in gallbladder cancer and para-cancer tissues were detected by immunohistochemistry, and the correlation of α-SMA and IGFBP3 expressions with clinicopathological characteristics were analyzed. LECs were cultured and divided into serum-free medium group (control group), CAF-CM co-culture group, NF-CM co-culture group, IGFBP3 group, and CAF-CM+IGFBP3 inhibitor (2-Deoxy-D-glucose, 2-DG) group according to different treatment. Transwell migration assays and wound healing assays were applied to analyze the migration ability of LECs under different treatment. The expressions of E-cadherin, N-cadherin and Vimentin were detected by Western blotting. 【Results】 Protein factor microarray and ELISA showed that the concentration of IGFBP3 in CAF-CM was significantly increased, and the expression of α-SMA was significantly related to lymph node metastasis, advanced TNM stage and expression of IGFBP3. IGFBP3 secreted from CAF-CM significantly promoted LECs migration, up-regulated the expression of N-cadherin and Vimentin, and down-regulated the expression of E-cadherin. Treatment with IGFBP3 inhibitor 2-DG could reverse the effect of CAF-CM on migration of LECs and related protein expressions. 【Conclusion】 Gallbladder CAFs promote the migration of LECs via releasing IGFBP3, which affects EMT transformation.
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Objective To investigate the clinical effects and prognostic factors of radical surgery for primary gallbladder cancer (GBC).Methods The retrospective case-control study was conducted.The clinicopathological data of 305 patients with primary GBC who underwent radical Ro resection in the First Affiliated Hospital of Xi'an Jiaotong University from 2013 to 2017 were collected,including 108 males and 197 females,aged from 30 to 88 years,with a median age of 62 years.According to the different tumor staging,patients underwent corresponding operation and adjuvant treatment based on the postoperative indication of chemotherapy.Observation indicators:(1) results of imaging and laboratory examinations;(2) treatment situations:① surgical situations,② postoperative adjuvant treatment;(3) results of postoperative pathological examination;(4) followup;(5) prognostic factors analysis.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to December 5,2018,and death was used as the end point.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were described as M (range).Count data were represented as percentage.The survival curve and survival rate were respectively drawn and calculated using the Kaplan-Meier method.The univariate analysis and multivariate analysis were respectively done using the Log-rank test and COX regression model.Results (1) Results of imaging and laboratory examinations:results of imaging examination showed that diagnostic rates of ultrasound,CT and MRI examination were respectively 84.06% (174/207),85.71% (168/196) and 63.11% (65/103).Results of laboratory examination showed that the positive rates of CA19-9,CA125 and carcinoembryonic antigen (CEA) were respectively 55.34% (145/262),48.06% (124/258) and 46.15% (126/273).(2) Treatment situations:① surgical situations:305 patients underwent radical R0 resection for primary GBC,including 145 undergoing liver wedge resection + D2 lymph node dissection,61 undergoing liver wedge resection + D1 lymph node dissection,55 undergoing liver Ⅳ B and Ⅴ segmentectomy + D2 lymph node dissection,11 undergoing liver Ⅳ B and Ⅴ segrnentectomy + D1 lymph node dissection,9 undergoing right hepatectomy + D2 lymph node dissection,5 undergoing liver wedge resection + D2 lymph node dissection + partial colectomy,4 undergoing pancreaticoduodenectomy,3 undergoing simple cholecystectomy in Tis stage,3 undergoing right hepatectomy + D1 lymph node dissection,2 undergoing liver ⅣB and Ⅴ segmentectomy + D2 lymph node dissection + partial colectomy,1 undergoing liver Ⅳ B and Ⅴ segmentectomy + resection and reconstruction of portal vein + D2 lymph node dissection,1 undergoing liver ⅣB and Ⅴ segmentectomy + D2 lymph node dissection + partial resection of the stomach or duodenum,1 undergoing pancreaticoduodenectomy + resection and reconstruction of portal vein,1 undergoing right hepatectomy + pancreaticoduodenectomy,1 undergoing right hepatic lobectomy + partial gastrectomy + D2 lymph node dissection,1 undergoing right hepatic lobectomy + D1 lymph node dissection and 1 undergoing right hepatic trilobectomy + D2 lymph node dissection.Of 94 patients with unsuspected GBC,78 who were diagnosed in the other hospitals received salvage surgery in the authors' center.Twenty-one patients had postoperative surgery-related complications,including 11 with bile leakage,8 with pulmonary infection and 2 with abdominal bleeding.Two patients died in the perioperative period.② Postoperative adjuvant treatment:26 patients underwent postoperative adjuvant chemotherapy.Chemotherapy regimen:gemcitabine + oxaliplatin were used in 12 patients,gemcitabine + tegafur in 7 patients,gemcitabine + cisplatin in 6 patients,oxaliplatin + tegafur in 1 patient.(3) Results of postoperative pathological examination.The postoperative pathological type of 305 patients:257,23,6,5,4,3,3,2,1 and 1 patients were respectively confirmed as pure adenocarcinoma,adenocarcinoma combined with squamous cell carcinoma,adenocarcinoma combined with neuroendocrine carcinoma,mucinous adenocarcinoma,neuroendocrine carcinoma,adenocarcinoma combined with mucinous carcinoma,squamous cell carcinoma,sarcomatoid carcinoma,adenocarcinoma combined with sarcomatoid carcinoma,adenocarcinoma combined with signet-ring cell carcinoma.Degree of tumor differentiation:highdifferentiated,moderate-differentiated and low-differentiated tumors were detected in 37,130 and 121 patients,respectively,17 with unknown differentiated degree.Of 305 patients,16 and 32 patients had respectively vascular invasion and nerve invasion.The number of lymph node dissected of 305 patients was 8±5,with positive lymph node of 0 (range,0-9),including 121 with lymphatic metastasis (26 with jumping lymphatic metastasis).TNM staging of 305 patients:stage 0,Ⅰ,Ⅱ,ⅢA,ⅢB,ⅣA and ⅣB were detected in 7,18,13,137,57,11 and 62 patients,respectively.(4) Follow-up:245 of 305 patients were followed up for 18.0 months (range,6.0-70.0 months).The survival time,1-and 3-year survival rates were respectively 29.5 months (range,0.5-69.9 months),71.6% and 45.8%.One hundred and twenty-two patients died during the follow-up.(5) Prognostic factors analysis:the results of univariate analysis showed that preoperative level of bilirubin,pathological type,degree of tumor differentiation,liver invasion,vascular invasion,nerve invasion,T staging,N staging and postoperative chemotherapy were factors affecting prognosis of patients with primary GBC (x2 =10.26,3.96,45.89,34.64,12.75,27.05,35.09,39.44,4.40,P<0.05).The results of multivariate analysis showed that low-differentiated tumor,liver invasion and N2 staging were independent risk factors affecting prognosis of patients with primary GBC [odds ratio (OR)=1.90,1.71,1.46,95% confidence interval (CI):1.34-2.70,1.15-2.52,1.17-1.82,P<0.05],and postoperative chemotherapy was a protective factor affecting prognosis of patients with primary GBC (OR=0.35,95% CI:0.15-0.82,P<0.05).Conclusions For patients with primary GBC undergoing radical resection,D2 lymph node dissection should be performed routinely.The low-differentiated tumor,liver invasion and N2 staging are independent risk factors affecting prognosis of patients,and postoperative chemotherapy is a protective factor.
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Objective@#This paper describes a technique of facelift that utilizes bidirectional barbed sutures for superficial musculoaponeurotic system (SMAS) double plication. It corrects the facial aging of middle and lower part.@*Methods@#An extensive skin flap was undermined subcutaneously, and the sagging tissue of SMAS was lifted latero-superiorly by a secured barbed suture in two oval-shaped areas, with double plication, and without the need for knots, in order to correct the nasolabial groove and descended jowls, repositioning the midfacial volumes.@*Results@#A very high patient satisfaction was obtained in 76 patients. One patient had a small hematoma, and one patient had a temporary contour irregularity in the cheek. All resolved without any treatment.@*Conclusions@#The double plication facelift utilizing barbed sutures, mainly affects the middle and lower third of the face. Its advantages are: quick procedure, pleasant results, low complication rate, and short recovery period. It also eliminates the possibility of knot visibility, palpability, or extrusion.
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Objective@#To investigate the feasibility and therapeutic effect of frontal and scalp expanded skin flap combined with laser hair removal for children congenital facial giant nevi.@*Methods@#From January 2013 to December 2015, 6 cases with congenital facial giant nevi were treated with expanded frontal and scalp skin flap combined with laser hair removal in the department of plastic surgery, An Zhen Hospital, Capital Medical University. The process of treatment could be divided into three stages. Stage 1: The expander capacity was determined according to the size of lesion. Expander was implanted under the galea aponeurotica in front and scalp, and expanded regularly postoperatively. Stage 2: The expander was removed and facial giant nevi was excised. The expanded skin flap was designed according to the shape and size of nevi. Stage 3: After the expanded skin flap healed completely, laser hair removal was performed for 4-6 times with 6 weeks of interval time.@*Results@#300 ml to 350 ml expanders were selected with expanding frequency of 2 times a week. The expansion time lasted for 16 to 20 weeks(average, 18.7 weeks). The complications such as leakage, angle and skin flap blood supply obstacle didn't occurr in the process of expansion. The size of frontal and scalp skin flap ranged from 12 cm×11 cm to 20 cm×17 cm. Venous drainage disorder happened in one flap and was treated by partial suture removal and acupuncture bleeding treatment. Skin flap necrosis didn't occurred. The defects at donor sites were sutured directly with inconspicious scar. The effect of semiconductor laser hair removal was good without recurrence during one-year follow-up period. All expanded skin flaps had no obvious contraction with good match of color and texture.@*Conclusions@#This method provides a new selection of donor site for larger facial defect with reliable effet. The facial giant nevi could be excised completely and repaired in one operation with short operation time. The scar in middle face and secondary deformities can be avoided.
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Coordination of cell division and cell fate is crucial for the successful development of mammalian early embryos. Aurora kinases are evolutionarily conserved serine/threonine kinases and key regulators of mitosis. Aurora kinase B (AurkB) is ubiquitously expressed while Aurora kinase C (AurkC) is specifically expressed in gametes and preimplantation embryos. We found that increasing AurkC level in one blastomere of the 2-cell embryo accelerated cell division and decreasing AurkC level slowed down mitosis. Changing AurkB level had the opposite effect. The kinase domains of AurkB and AurkC were responsible for their different ability to phosphorylate Histone H3 Serine 10 (H3S10P) and regulate metaphase timing. Using an Oct4-photoactivatable GFP fusion protein (Oct4-paGFP) and fluorescence decay after photoactivation assay, we found that AurkB overexpression reduced Oct4 retention in the nucleus. Finally, we show that blastomeres with higher AurkC level elevated pluripotency gene expression, which were inclined to enter the inner cell mass lineage and subsequently contributed to the embryo proper. Collectively, our results are the first demonstration that the activity of mitotic kinases can influence cell fate decisions in mammalian preimplantation embryos and have important implications to assisted reproduction.
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Animals , Mice , Aurora Kinase B , Metabolism , Aurora Kinase C , Metabolism , Blastocyst , Metabolism , Gene Expression Regulation, Developmental , Physiology , Histones , Metabolism , Phosphorylation , PhysiologyABSTRACT
Objective To investigate the effect of hypercapnia on hypoxic-ischemic brain injury in rats.Methods Forty-eight adult male SD rats were randomly divided into three groups: sham group (group S), hypoxic ischemic group (group HI) and hypercapnia group (group HP), n=16 in each group.Levine`s model was used to cause hypoxic-ischemic brain injury.In group S, the left common carotid artery was separated without ligation for 1 h, then ventilation with air maintaining the normal levels of PaO2 and PaCO2 for 3 h.In group HI, the left common carotid artery was separated and ligated for 1 h, PaO2 was maintained at 30-49 mm Hg by ventilating with low concentration (11%-13%) O2 for 3 hours.Based on group HI, PaCO2 in group HP was maintain at 60-80 mm Hg by inhalation of mixture gas containing (11%-13%) O2-8%CO2-N2 for 3 hours.FITC-dextran was used to measure the permeability of blood-brain barrier, TUNEL staining were used to observe the changes in the structure of the cerebral cortex.The expressions of aquaporin AQP4 and RECA-1 in cerebral cortex were detected by immunofluorescence and western blot.Results The level of brain water content, permeability of blood brain barrier and AQP4 expression were significantly increased in group HP as compared with group S and group HI (P<0.05).The histopathologic damage,as well as neuronal apoptotic index were aggravated in group HP as compared with group HI (P<0.05).Conclusion Hypercapnia may aggravate the brain damage during severe hypoxic-ischemic brain injury.This may associate with the increased expression AQP4 and the damage of blood-brain barrier.
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Objective To investigate the effect of exogenous hydrogen sulfide (H2S) on neuronal apoptosis during focal cerebral ischemia-reperfusion (I/R) in rats.Methods One hundred eight male Sprague-Dawley rats,aged 6-8 weeks,weighing 250-270 g,were randomly divided into 3 groups (n =36 each) using a random number table:control group (group C),I/R group and H2S group.Focal cerebral ischemia was induced by middle cerebral artery occlusion in anesthetized rats.A nylon thread with a rounded tip was inserted into the left internal carotid artery and advanced intracranially to block blood flow into the middle cerebral artery.Middle cerebral artery occlusion was maintained for 90 min followed by reperfusion.In group H2S,0.25% NaSH (a donor of exogenous H2S) 10 mg/kg was injected intraperitoneally at the onset of reperfusion.The equal volume of normal saline was given in C and I/R groups.At 1,3 and 7 days of reperfusion,neurological deficit was scored,and corner test was performed.Brains were removed for determination of myocardial infarct size,Bax-,Bcl-2-and caspase-3-positive cells,and cell apoptosis.The percentage of myocardial infarct size,rate of Bax-,Bcl-2-and caspase-3-positive cells and apoptosis rate were calculated.Results Compared with group C,the neurological deficit score was significantly decreased,and the corner score,percentage of myocardial infarct size,rate of Bax-,Bcl-2-and caspase-3-positive cells and apoptosis rate were increased at each time point of reperfusion in I/R and H2S groups (P<0.05).Compared with group I/R,the neurological deficit score and Bcl-2-positive cells were significantly increased,and the corner score,percentage of myocardial infarct size,rate of Bax-and caspase-3-positive cells and apoptosis rate were decreased at each time point of reperfusion in group H2S (P<0.05).Conclusion The mechanism by which exogenous H2S attenuates focal cerebral I/R is related to inhibition of neuronal apoptosis in rats.
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OBJECTIVE@#There are many scaffold materials of repairing nasal alar cartilage defects. Auricuiar cartilage was used extensively in terms of its abundant tissues, good elasticity, little donor-site malformation, good plasticity etc. The authors dissected auricular cartilage and nasal alar cartilage, measured cartilage's morphous data and found some similar territories with nasal alar cartilage in the structure of auricular cartilage.@*METHOD@#An anatomical study was performed using 10 adult cadavers acquired through Plastic Surgery Hospital, Peking Union Medical College, Beijing, China. Seven male and three female cadav-ers were included in the study. Harvest 20 auricular cartilage specimens and 20 nasal alar cartilage specimens. Then, Computed Tomography Scan on the auricular cartilage and nasal alar cartilage were performed. The datas were imported into mimics and three-dimensional reconstructions of the auricular cartilage and nasal alar cartilage were carried on.@*RESULT@#Parts of the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are ana-tomically similar to nasal alar cartilage.@*CONCLUSION@#This study reports the anatomy of auricular cartilage and nasal alar cartilage, found some territories in the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are anatomically similar to nasal alar cartilage. This research provides the anatomical basis that auricular cartilage was used to repair the nasal cartilage defect.
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Adult , Female , Humans , Male , Cadaver , Ear Auricle , Ear Cartilage , Nasal Cartilages , Plastic Surgery Procedures , Tomography, X-Ray ComputedABSTRACT
Objective To study the relationship between the inflammatory cytokine levels and the expression of hepatic alpha-7 nicotinic acetylcholine receptor (α7 nAChR) in hyperlipidemia rats and to investigate the intervention effect of Yirui Capsules ( mainly composed of Radix Salviae Miltiorrhizae, Fructus Crataegi, Rhizoma Alismatis, etc). Methods Fifty male SD rats were randomly divided into blank control group ( fed with conventional diet, N=10) and high-fat diet group (fed with high-fat diet, N=40). After feeding for 14 d, the forty rats in high-fat diet group were further randomly divided into model control group, and low-, middle-, and high-dose Yirui Capsules groups (140, 280, 560 mg/kg, respectively), 10 rats in each group and the treatment lasting 30 days. And then, the serum levels of lipids were detected, C-reactive protein (CRP) and tumor necrosis factor (TNF) -α in the serum were detected by enzyme-linked immunosorbent assay ( ELISA) , and the expression of hepatic α7 nAChR was analyzed by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR) . Results Yirui Capsules in different dosages could improve serum lipid levels in hyperlipidemia rats to various degrees. The contents of serum inflammatory cytokines CRP and TNF-α and the mRNA expression of hepatic α7nAChR were increased in the model control group as compared with those in the blank control group ( P<0.01). The contents of inflammatory cytokines CRP, TNF-αand the mRNA expression of hepatic α7nAChR were decreased in the three Yirui Capsules groups as compared with those in the model control group ( P<0.01). The results of immunohistochemical staining for α7nAChR expression were consistent with RT-PCR results. Conclusion The expression of hepatic α7nAChR is increased in hyperlipidemia rats. Yirui capsules are effective on decreasing inflammatory cytokine levels, improving lipid metabolism, and down-regulating α7nAChR expression.
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Circular excision by secondary intention healing is useful for small skin defects. The study compared the effect of the neighboring undermining on wound healing. Patients undergoing circular excision (diameters less than 20 mm) were divided into four groups in sequence by the range of neighboring subcutaneous undermining. Key outcome measures were complication rate, healing time, mature scar width, and quality. Statistical differences between different undermining types were assessed. Six hundred twenty-eight patients were randomized. No complication rates differed among undermining types. Groups 4 (range 15 mm) and 3 (range 10 mm) did not differ in healing time but healed faster than Group 2 (range 5 mm); the slowest was Group 1 (range 0 mm). Scar width measured declined from Group 1 to Group 4. The visual assessment of mature scars rating increased gradually, including Groups 1, 2, 3, and 4, but there was no difference between Groups 3 and 4. The undermining of the surrounding tissue is useful to promote secondary intention healing of small skin defects and to improve the cosmetic results of the final scar. The study compared the effect of neighboring undermining on wound secondary healing of circular excision. Key outcome measures were complication rate, healing time, mature scar width, and quality. Statistical differences between different undermining types were used.
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Cicatrix/prevention & control , Dermatologic Surgical Procedures/methods , Skin Diseases/surgery , Skin/pathology , Wound Healing , Adult , Biopsy , Cicatrix/epidemiology , Cicatrix/pathology , Female , Humans , Incidence , Male , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Reoperation , Retrospective Studies , Skin Diseases/pathology , Surveys and Questionnaires , Time Factors , Treatment OutcomeABSTRACT
Neoplasms of perivascular epithelioid cells (PEComas) are characterized by epithelioid to spindle cells with eosinophilic to clear cytoplasm, an intimate relationship with blood vessels, and coexpression of myoid and melanocytic immunohistochemical markers. While most reported hepatic PEComas, such as angiomyolipoma (AML), behave in a benign fashion, emerging PEComas cases without typical characteristics require further clarification. We report a case of primary hepatic perivascular epithelioid cell tumors-not otherwise specified (HPEComas-NOS) with untypical pathological and immunohistochemical features compared to those of the benign hepatic AML cases. HPEComas-NOS may represent a special type of PEComas classified as having "malignant potential" or at "high risk of aggressive behavior", suggesting the need for further clarification of hepatic PEComas and long-term follow-up of patients with HPEComas-NOS.
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Female , Humans , Middle Aged , Liver Neoplasms , Perivascular Epithelioid Cell NeoplasmsABSTRACT
Objective To evaluate the effects of hypothermic cardiopulmonary bypass (CPB) on rocuronium-induced neuromuscular blockade in the patients undergoing open heart surgery.Methods Twenty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective open heart surgery,aged 18-45 yr,with body mass index of 18-25 kg/m2,were randomly assigned into 2 groups (n =10 each) using a random number table:room temperature group (group R) and hypothermia group (group H).The nasopharyngeal temperature was maintained at 30-31 ℃ during CPB in group H or at 36-37 ℃ during CPB in group R,and it was maintained at 36-37 ℃ before and after CPB in both groups.Anesthesia was induced with iv etomidate 0.3 mg/kg,fentanyl 2-4 μg/kg and rocuronium 0.3 mg/kg.The patients were tracheally intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of sufentanil and intermittent iv boluses of midazolam and fentanyl.BIS value was maintained at 40-60.Neuromuscular block was monitored using TOF-WATCH SX accelerometer.Train-of-four stimulation (intensity 40 mA,frequency 2 Hz,wave length 0.2 ms,interval 12 s) of ulnar nerve was used.Rocuronium was infused intravenously using an automatic feedback control system to maintain T1 at 8%-12%.At 10 min after start of operation (T0),10 min after onset of CPB (T1),and 10 min after termination of CPB,blood samples were collected for determination of the plasma concentration of rocuronium (by HPLC).The infusion rate and consumption of rocuronium were recorded before,during and after CPB.Results Compared with group R,the plasma concentration of rocuronium was significantly decreased at T1,2,and the infusion rate and consumption of rocuronium were decreased before and after CPB in group H.Conclusion Hypothermic CPB enhances rocuroniuminduced neuromuscular blockade in the patients undergoing open heart surgery.
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Objective To evaluate the effects of nicotine or electric vagal stimulation on injury to transplanted lungs in rats.Methods Twenty-four male Wistar rats with transplanted lung,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),nicotine group (group NI) and electric vagal stimulation group (group VS).Nicotine 2 mg/kgwas injected intraperitoneally at 15 min after lung transplantation in group NI.Right cervical vagus nerve trank was stimulated for 20 min with continuous electric rectangular pulses (5 V,2 ms,1 Hz) at 10 min interval twice in total starting from 15 min after lung transplantation in group VS.Arterial blood samples were then collected for blood gas analysis at 15,30,45,75,105 and 135 min after lung transplantation.Arterial blood samples were then collected at 135 min after lung transplantation for determination of the plasma concentration of interleukin-6 (IL-6),IL-8 and tumor necrosis factor-α (TNF-α) by ELISA.The rats were sacrificed at 135 min after lung transplantation and the tissue of transplanted lung was removed for determination of lung injury score (LIS) according to the pathological changes obtained with light microscope,and of wet/dry lung weight ratio (W/D ratio).Results Compared with group C,PaO2 and pH value were significantly increased,and LIS,W/D ratio,and the concentrations of plasma IL-6,IL-8 and TNF-α were decreased in NI and VS groups.Conclusion Nicotine or electric vagal stimulation can attenuate injury to transplanted lungs in rats.
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Objective To explore the diagnostic value of CT for the vegetable stone disease in the stomach,esophagus and small intestine.Methods The clinical data and CT findings of 27 cases confirmed by endoscopy or surgery were analyzed retrospectively. Among 27 cases,6 cases performed contrast-enhanced scan.Results Among 27 cases,18 cases were the gastrolithiasis,6 cases were the intestinal stone disease,1 case was the esophagus stone disease,and 2 cases were the multiple stones of stomach and small intestine.CT missed 7 cases and misdiagnosed 1 case with the rate of missed diagnosis was 25.93%.The lesions were cylindrical or oval shape with mixed density in 27 cases,distinct boundary in 26 cases,sclerotic margin in 22 cases,ethmoid or honeycomb bub-bles in the lesion in 25 cases,no enhancement in 6 cases,and complicated small bowel obstruction in 8 cases on CT images.Conclu-sion The phytobezoars in the stomach,esophagus and small intestine have typical CT findings.Careful analyses can improve its di-agnostic accuracy.
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As a novel Golgi protein,GOLPH2 expression is associated with maintaining the structural integrity of the Golgi apparatus.As an oncoprotein,GOLPH2 expression is associated with malignant biological behavior of cancer cells.Important roles of GOLPH2 in the tumorigenesis and metastasis make it become a new target for tumor diagnosis and treatment.
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Training anesthesiology postgraduates should be started with clinical skill and scien-tific thinking. This article advocated setting up a multi-level and multi-mode training strategy based on theoretical study ,clinical skill training and scientific ability development according to the features of anesthesiology. Meanwhile,the training should have focus and orientation for postgraduates at different grades. This study solved the problems of training for postgraduates of anesthesiology and made a feasible training strategy to develop the clinical and scientific ability of postgraduates.