Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.
Humans ; Odontogenic Tumors ; Skin Neoplasms

Objective To study the quality standard of Folium Nelumbinis.Methods Flavonoids of Folium Nelumbinis were identified by TLC.The extraction conditions of flavonoids was studied and the content of total flavonoids was determined by ultraviolet spectrophotometry .Results Quercetin in Folium Nelumbinis was identified by TLC.The optimal extraction conditions were defined and the content of total flavonoids was about 13 %.Conclusion This method is simple and convenient, and is feasible for the quantitative determination of Folium Nelumbinis.

OBJECTIVEThe purpose of this study was to observe the roentgenographic characters of distraction osteogenesis (DO) correction of cleft palate (CP), to study the expression of BMP proportional to fixation period time intervals, and to explore the new bone formation mechanism in Cleft Palate bone shelf.

METHODS12 cats were used to establish the CP animal model surgically, and then were assigned randomly to (1) Experimental group (12 cats): CP defects were DO repaired at the rate and rhythm of 0.4 mm x 2/day. Specimen retrieval at 2, 4, 6, 8, 12 weeks after completion of distraction, roentgenography and Anti-BMP immunohistochemistry studies were performed; (2) Experimental control group (2 cats): CP defects without any treatment procedures, and (3) Empty control group of 2 cats.

RESULTSAnti-BMP immunohistochemistry study showed positive DAB dye in early 2 weeks and most extensively positive expression of BMP in 4 to 6 weeks. The expression of BMP wore off gradually through 8 to 12 weeks. The roentgenography showed that the newly mineralized bone was developed from the cut bone edges bilaterally to the central transparent zone, and the newly formed bone bridged the defect area completely at the end of the study. The CP bone defect was reconstructed and the distraction gap was filled with de nove osteogenesis. No new bone formation was observed in experimental control group.

CONCLUSIONThe process of new bone formation in the distraction area is dynamic. Being stimulated primarily, the process was kept highly active till quiescence phase finally. The X-ray examination shows that there is distinctively low roentgenopeque. Nevertheless, roentgenography is so far a very effective and convenient method to evaluate and monitor the DO correction efficiency.

Animals ; Bone Morphogenetic Proteins ; biosynthesis ; metabolism ; Bone Regeneration ; Cats ; Cleft Palate ; diagnostic imaging ; metabolism ; surgery ; Osteogenesis ; Osteogenesis, Distraction ; Palate, Hard ; diagnostic imaging ; metabolism ; surgery ; Radiography ; X-Ray Film

Objective To compare the clinical effect between retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation and transurethral resection of the prostate (TURP) for giant benign prostatic hyperplasia (BPH).MethodsThe clinical data and follow-up of 128 cases of giant BPH were analyzed retrospectively.Seventy-two cases underwent TURP (TURP group) and 56 cases underwent retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation ( laparoscopic group ).The operation time,blood loss,gland mass excision,bladder washing time,catheterization time,hospital stay,hospital cost,international prostate symptoms score (IPSS) and quality of life questionnaires (QOL),maximum flow rate (MFR),residual urine volume (RUV) were compared between two groups.ResultsThe bladder washing time,catheterization time,hospital stay in laparoscopic group were less than those in TURP group[0 d vs.(2.8 ± 1.2) d,(2.3 ± 0.6) d vs.(5.2 ± 1.5) d,(4.2 ± 0.5) d vs.(7.5 ±0.5) d],gland mass excision in laparoscopic group was more than that in TURP group [(100.2 ±25.4) g vs.(85.6 ± 15.5) g],there were significant differences between two groups(P＜ 0.05).There was no significant difference in the operation time,blood loss,hospital cost between two groups (P ＞ 0.05).There were significant differences in IPSS,QOL,RUV and MRF before and after 3,6 months treatment for two groups [ laparoscopic group:(9.1 ± 3.4),(7.5 ± 2.5 ) scores vs.(27.5 ± 5.8) scores,( 1.8 ± 1.1 ),( 1.6 ± 0.8)scores vs. (5.5 t0.5) scores,(26.5 ± 11.5),(22.4 ± 12.6) ml vs. (145.0 ±48.0) ml,(17.6 ±8.4),(20.2 ± 5.4) ml/s vs.(8.3 ± 3.5) ml/s;TURP group:(9.2 ± 3.8),(7.8 ± 2.2) scores vs.(28.5 ± 5.4) scores,( 1.9 ± 1.2),( 1.7 ± 0.6) scores vs.(5.0 ± 0.5 ) scores,(28.5 ± 12.9),(23.0 ± 11.7) ml vs. ( 155.0 ± 47.0) ml,( 17.8 ± 9.2),( 19.8 ± 4.5 ) ml/s vs.(7.2 ± 3.2 ) ml/s ] (P ＜ 0.01 ),but there was no significant difference between two groups (P ＞ 0.05).ConclusionsThe clinical effect of two microtrauma surgery are good.Laparoscopic technique is a feasible treatment option for patients suffered from giant BPH for which has the benefit of a quicker recovery,shorter hospital stay,less complications,no bladder washing.

Objective To observe the changes of TNF-α and NF-κB after different doses of nalmefene hydrochloride (NAL) therapy for traumatic brain injury (TBI) in an effort to identify the effect of NAL on TBI-induced inflammatory response and the possible mechanism.Methods A model of TBI in the rat was produced using the improved Feeney' s free-fall impact method.The animals were randomly divided into sham group,TBI group,TBI + large dose of NAL (ip,0.2 mg/kg) group (TBI + NAL1group),TBI + medial dose of NAL (ip,0.14 mg/kg) group (TBI + NAL2 group),TBI + small dose of NAL (ip,0.07 mg/kg) group (TBI + NAL3 group).Form of brain tissues in each group was observed and mRNA levels of TNF-α and NF-κB were measured by real-time quantitative PCR assay.Results HE staining revealed severe injury and inflammatory infiltration of brain parenchyma in TBI group ;on the contrary,the situation ameliorated in TBI + NAL1 group,TBI + NAL2 group and TBI + NAL3group,with especially obvious improvement in TBI + NAL2 group.In PCR assay,significant expression of NF-κB and TNF-α was observed at post-TBI days 1,3,5 and 7 (P ＜ 0.05),followed by great reverse after NAL therapy (P ＜ 0.05),particularly in TBI + NAL2 group.Conclusions NAL can reduce the inflammation response to TBI and promote post-injury recovery.Moreover,there exists a NAL concentration window.

Objective To explore the expression of PD-1 and CTLA-4 in osteosarcoma and their clinical significance. Methods Fifty-eight cases of osteosarcoma encountered from 2007 to 2016 were enrolled. The expression levels of PD-1 and CTLA-4 were detected through immunohistochemistry (EnVision method). Results PD-1 was positively expressed in 31 (53.4%) cases and negatively expressed in 27 (46.6%) cases. CTLA-4 was positively expressed in 19 (32.8%) cases and negatively expressed in 39 (67.2%) cases. A total of 12 (20.7%) cases were PD-1 and CTLA-4 double positive, whereas 20 (34.5%) cases were double negative, and 26 (44.8%) cases were single positive. The positive expression of PD-1 was correlated with neoadjuvant chemotherapy, tumor metastasis and relapse, and shortened survival time (P < 0.05). The positive expression of CTLA-4 was partly related with late Ennecking stage (P=0.051). Double positive expression was related to the highest tumor metastasis and relapse rates and the worst prognosis (P < 0.05), compared with double negative and single positive expression. Conclusion Positive expression of PD-1 and CTLA-4 in osteosarcoma is associated with worse prognosis, whereas double positive expression is associated with the highest tumor relapse and metastasis rates and shortest survival time. These results are potential valuable references for osteosarcoma immunotherapy.

OBJECTIVETo study the changes in the expression of large-conductance calcium-activated potassium (BKCa) channels in dorsal root ganglion (DRG) neurons after electrical injury in rats' sciatic nerves and its influence on sensory conduction function.

METHODSOne-hundred and thirty-six adult SD rats were divided into normal control group, sham electrical injury group, and 75, 100, 125 V electrical injury groups according to the random number table, with 8 rats in normal control group and 32 rats in each of the rest 4 groups. Rats in normal control group were routinely fed without any treatment. Blunt dissection of the sciatic nerves of left hind leg of rats was performed in sham electrical injury group, while sciatic nerves of left hind leg of rats in electrical injury groups were electrically injured with corresponding voltage. Eight rats of normal control group fed for one week, and 8 rats from each of the rest four groups on post injury day (PID) 3 and in post injury week (PIW) 1, 2, 3 respectively were collected to detect the paw withdrawal mechanical threshold (PWMT). In addition, rats of 100 V electrical injury group in PIW 1 were collected and intrathecally injected with NS1619 after former PWMT detection, and PWMT was detected per 30 minutes within three hours post injection. The rats in each group at each time point were sacrificed after PWMT detection. The DRG of L4 to L6 segments of spinal cord was sampled to observe the BKCa channels distribution with immunohistochemical staining and to detect the protein and mRNA expressions of BKCa channels with Western blotting and reverse transcription-polymerase chain reaction respectively. Data were processed with one-way analysis of variance, analysis of variance of factorial design, and SNK test.

RESULTS(1) The PWMT values of rats in 75 and 100 V electrical injury groups on PID 3 and in PIW 1, 2, 3 were (5.8±0.6), (5.0±0.8), (4.2±0.3), (5.9±1.1) g; (5.3±1.3), (5.9±2.0), (4.5±2.7), (4.3±1.3) g, respectively, which were significantly lower than the value (s) in normal control group [(11.2±2.0) g] and sham electrical injury group [respectively (11.3±2.1), (12.0±2.0), (11.1±1.6), (10.3±2.1) g, with P values below 0.05]. The PWMT values of rats in 125 V electrical injury group decreased obviously on PID 3 and in PIW 1 [(6.1±1.6) and (5.7±1.7) g] as compared with the value (s) in normal control group and sham electrical injury group, and they were obviously increased in PIW 2 and 3 [(26.7±3.3) and (21.7±3.4) g] as compared with the value (s) of the rest 4 groups (with P values below 0.05). The PWMT of 100 V electrical injury group in PIW 1 firstly increased and then decreased within three hours post injection, which increased significantly at post injection minutes 30, 60, 90, 120 as compared with that before intervention [respectively (8.5±0.8), (9.7±1.2), (11.0±1.5), (8.6±0.8) g, with P values below 0.05]. (2) The positive expression of BKCa channels in large amount was observed in the cytoplasm and cytomembrane of neurons on the DRG of rats in normal control group and sham electrical injury group at each time point. The positive expression of BKCa channels in the cytoplasm and cytomembrane of neurons on the DRG of rats decreased over time in electrical injury groups, which was most obvious in 125 V electrical injury group. (3) There were no statistically significant differences in the protein expression of BKCa channels in DRG of rats among the five groups on PID 3 (with P values above 0.05). Compared with those in normal control group (0.477±0.027, 0.521±0.034, 0.475±0.022) and sham electrical injury group (0.511±0.025, 0.489±0.025, 0.483±0.032) in PIW 1, 2, 3, the protein expressions of BKCa channels in DRG of rats in 75, 100, 125 V electrical injury groups were decreased significantly (0.274±0.026, 0.202±0.019, 0.285±0.033; 0.253±0.022, 0.233±0.024, 0.203±0.017; 0.092±0.017, 0.095±0.021, 0.087±0.016, with P values below 0.05). The protein expressions of BKCa channels in DRG of rats in 125 V electrical injury group in PIW 1, 2, 3 were obviously lower than those in 75 and 100 V electrical injury groups (with P values below 0.05). (4) The mRNA expression levels of BKCa channels in DRG of rats in 75, 100, 125 V electrical injury groups on PID 3 and in PIW 1, 2, 3 were 0.326±0.021, 0.238±0.019, 0.291±0.022, 0.364±0.018; 0.264±0.020, 0.293±0.017, 0.243±0.023, 0.295±0.021; 0.134±0.023, 0.089±0.017, 0.074±0.018, 0.087±0.020, respectively, significantly decreased as compared with the level (s) in normal control group (0.581±0.051) and sham electrical injury group (0.603±0.045, 0.586±0.032, 0.614±0.045, 0.572±0.038), with P values below 0.05. The mRNA expression levels of BKCa channels in DRG of rats in 125 V electrical injury group at each time point were lower than those in 75 and 100 V electrical injury groups (with P values below 0.05).

CONCLUSIONSThe electrical injury in sciatic nerves results in reduction of the BKCa channels expression in rat's DRG of corresponding spinal segments, which plays a role in the pathological process of sensory conduction dysfunction.

Animals ; Blotting, Western ; Electricity ; adverse effects ; Ganglia, Spinal ; metabolism ; Large-Conductance Calcium-Activated Potassium Channels ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries

Objective:To explore the tricuspid annular plane systolic excusion(TAPSE) in children with left-to-right shunt after congenital heart disease surgery and to understand the early systolic function of right heart in thesepatient.Methods:From June 2018 to December 2018, a prospective study was conducted in 20 infants after repair of left-to-right shunt congenital heart disease, including 10 males(50%) and 10 females(50%) , aged from 1 to 12 months, with a median of 4.5(2.0, 6.8) months, a body mass of 3.0-9.0 kg with median of 6.0(3.7, 7.7) kg.On the first postoperative day, blood was taken from central venous for N-terminal pro-B-type natriuretic peptide(NT pro-BNP) test, TAPSE and left ventricular ejective fraction(LVEF) was measured by echocardiography.The effects of aortic occlusion time, cardiopulmonary bypass time, preoperative pneumonia and preoperative heart failure on TAPSE were compared. The relationship between TAPSE and heart rate, systolic pressure, central venous pressure, vasoactive drug score, endotracheal intubation time, detention time in intensive care unit, NT pro-BNP and LVEF after operation was analysed.Results:The aortic cross-clamping time was 15-87 minutes, with median 31(28, 50) minutes. The cardiopulmonary bypass time was 35-117 minutes, with an average of(68±22)minutes. The time of tracheal intubation was 4-117 hours, with an average of(50±35) hours. The stay time in CICU was 1-14 days, with a median of 5(2, 7) days.The LVEF was 0.18-0.66, with median 0.53(0.42, 0.57). The TAPSE was 2.0-10.0 mm, with an average of(5.2±2.0) mm. On the first day after operation, NT pro-BNP was 1 548-35 000 pg/ml, with an average of(9 446±8 130) pg/ml.TAPSE was negatively correlated with postoperative intubation time( r=-0.576, P= 0.007) and detention time in ICU( r=-0.765, P=0.000), and positively correlated with postoperative LVEF( r=0.461, P=0.041)( P<0.05). TAPSE was negatively correlated with heart rate( r=-0.303, P=0.193), central venous pressure( r=-0.425, P=0.062), vasoactive drug score( r=-0.418, P=0.067) and NT Pro BNP( r=-0.348, P=0.132), and positively correlated with systolic pressure( r=0.146, P=0.54), but there was no statistical significance in each item.Compared with patients with TAPSE≥5mm, the detention time and tracheal intubation time were longer than those TAPSE<5 mm, the central venous pressure and NT-pro BNP was higher than those TAPSE<5 mm( P<0.05), the difference was statistically significant, other indicators had no significant difference. Conclusion:It is simple and feasible to measure TAPSE by echocardiography in children after operation with left-to-right shunt congenital heart disease.TAPSE decreased postoperatively suggested that the function of right ventricle decreased at the early stage after surgery, and with left ventricle systolic function decreased, which eventually led to the increase of NT pro-BNP, the need for higher doses of vasoactive drug support, longer tracheal intubation time and the stay time in CICU.Attention should be paid to the right heart function of children after congenital heart surgery.

Objective:To explore the safety and feasibility of the simultaneous combined operation in children with congenital heart disease complicated with non-cardiac malformation.Methods:A total of 72 children undergoing combined surgery or simple heart surgery in the Department of Cardiac Surgery, Children′s Hospital, Capital Institute of Pediatrics from January 2017 to January 2019 were enrolled.According to the severity of the disease, patients in the combined operation group (group A) and the simple heart surgery group (group B) were separately subdivided into the low risk group (group L) and the high risk group (group H). There were 36 children in group A, with the age ranging from 1.5 to 168.0 months old (median: 18.0 months). There were 36 cases in group B, with the age ranging from 1.0 to 170.0 months old (median: 19.0 months). Patients in groups A and B were sent to the cardiac intensive care unit(ICU) after operation.The cardiopulmonary bypass (CPB) time, aortic clamping (ACC) time, tracheal intubation time, intensive care unit (ICU) retention time, brain natriuretic peptide (BNP), alanine aminotransferase (ALT) and creatinine (Cr) were recorded.Besides, the cardiac output index (CI), cardiac circulation efficiency (CCE), maximum pressure gradient (dp/dt), lactic acid (Lac), blood glucose (Glu), inotropic score (IS) were also recorded at the time of returning to ICU (T0), 4 hours after operation (T1), 8 hours after operation (T2), 12 hours after operation (T3), 24 hours after operation (T4) and 48 hours after operation (T5), respectively.Results:(1) Intra-group comparison in group A: the age [(39.9±37.0) months], height [(94.1±20.1) cm] and weight [(14.4±6.7) kg] of children at low risk (group L-A) were significantly higher than those at high risk (group H-A) [(7.5±3.7) months, (68.1±6.4) cm, (7.8±2.2) kg] (all P<0.01). The CPB time [(37.0±23.6) min], ACC time [(19.1±13.4) min], endotracheal intubation time [(7.1±4.7) h], ICU retention time [(1.1±0.3) d] and BNP 24 hours after operation [(2 257.3±952.0) ng/L] in group L-A were significantly lower than those in group H-A [(84.7±28.4) min, (41.9±30.7) min, (71.0±67.6) h, (8.7±5.7) d and (5 327.2±992.9) ng/L] (all P<0.01). Glu, IS, CI, CCE were significantly different between patients at low risk and patients at high risk ( P<0.05). At the time of T0-T5, the Glu( F=4.43, P<0.05) and IS ( F=26.99, P<0.01)of group L-A were lower than those of group H-A, and the CI ( F=18.39, P<0.01)and CCE ( F=5.28, P<0.05) of group L-A were higher than those of group H-A.(2) Comparison between groups A and B: there was no significant difference in age, height, weight, CPB time, ACC time, hemodynamic parameters, arterial blood gas parameters and postoperative clinical indexes between patients at high risk or patients at low risk in group A and group B (all P>0.05). Conclusions:(1) For the patients at low risk, hemodynamics remains stable after the combined operation.The combined operation does not increase the endotracheal intubation time and ICU retention time, so it is safe and feasible.(2) For the patients at high risk, hemodynamics is also stable after the combined operation.However, their IS is higher than that of patients at low risk at any time point, and the incidence of postoperative adverse events is higher than that of patients at low risk.It is necessary to evaluate the condition and operation plan of the children before operation.