Objective To observe the difference of vascular endothelial growth factor (VEGF) and myeloperoxidase (MPO) between diabetic and non-diabetic patients with maintenance hemodialysis (MHD),and to explore whether it was associated with duration of hemodialysis.Methods A total of 120 patients with MHD were divided into diabetic group (40 cases) and non-diabetic group (80 cases) according to the primary disease.The blood samples from the patients before dialysis were selected to test the serum VEGF and plasma MPO and other indicators.The blood samples from April 2012 to March 2013 were labeled diabetic group 1(40 cases) and non-diabetic group 1 (80 cases).The blood samples from April 2013 to March 2014 were labeled diabetic group 2 (40 cases) and non-diabetic group 2 (80 cases).Results The serum VEGF and plasma MPO levels were (74.63 ± 47.43) ng/L,(300.63 ± 235.37) μ g/L in diabetic group 1,and (63.69 ± 43.23) ng/L,(275.35 ± 216.32) μ g/L in non-diabetic group 1,and there were significant differences between two groups (P ＜ 0.05).The serum VEGF and plasma MPO levels were (83.32 ± 40.38) ng/L,(414.12 ±265.52) μg/L in diabetic group 2,and (70.89 ±39.74) rig/L,(289.45 ±202.85) μg/L in non-diabetic group 2,and there were significant differences between two groups (P ＜ 0.05).The correlation analysis showed that VEGF was positively correlated with MPO in diabetic group 1 and diabetic group 2 (r =0.632 and 0.763,P ＜ 0.05),and VEGF was positively correlated with MPO in non-diabetic group 1 and non-diabetic group 2 (r =0.610 and 0.713,P ＜ 0.05).Conclusions Compared with those in non-diabetic MHD patients,VEGF and MPO levels are significandy higher in diabetic MHD patients.In non-diabetic MHD patients and diabetic MHD patients,VEGF and MPO levels will rise gradually with duration of hemodialysis.The expressions of VEGF and MPO are associated with each other.

BACKGROUND: Facial nerve injury causes facial nerve paralysis (or facial palsy) and even results in psychosocial disturbances of the patients. Repair the injured facial nerve and reconstruction of the nerve function as early as possible have been the primary concern in clinical studies.OBJECTIVE: To investigate the timing and surgical approaches for repairing facial paralysis in order to provides evidences for its therapeutic and prognostic evaluation.DESIGN: Case analysis based on patients.SETTING: Hospital of Plastic Surgery of Chinese Academy of Medical Sciences.PARTICIPANTS: Nine patients with traumatic facial paralysis hospitalized in the Hospital of Plastic Surgery of Chinese Academy of Medical Sciences from December 1993 to November 2001.METHODS: Facial nerve anastomosis was performed microsurgically along with the implantation of the sural nerve graft into orbicular muscle of the eye 3 or 4 months after nerve injury in the 9 patients. The clinical data of the patients were retrospectively reviewed.MAIN OUTCOME MEASURES: The facial nerve function was evaluated with House-Brackmann scale and photographs of the patients' faces before and after surgical treatment were taken.RESULTS: In the follow-up of these patients lasting 6 months to 2 years,all the patients attained satisfactory outcome.CONCLUSION: Early operation is crucial for the treatment of traumatic facial paralysis,with facial nerve anastomosis as the primary choice. The implantation of the nerve graft into muscle is also indicated for repairing traumatic facial paralysis in some cases. The importance of individualized treatment choice is reiterated on the basis of cicatrectomy and the extent and specific features of the injury.

Objectiv e To investigate the correlation between ( CAG) n repeat polymorphism of androgen receptor(AR)geneandmalebreastcancer.Methods 40casesofmalebreastcancerand40controlswerecol-lected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplifica -tion,sequencing and calculated the number of CAG repeats frquency .χ2 test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk .Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared (CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk .Longer CAG repeats can increase the risk of male breast cancer .

OBJECTIVEOn the basis of the concept of adhesive deformity from upper eyelid fold formation, the clinical results after using various methods to correct the adhesive deformities are summarized.

METHODSA total of 33 cases of adhesive deformity from upper eyelid fold formation have been treated using various corrective methods including taking off the sutures, shifting of the septal fat or the pre-septal orbicularis muscle, transferring of pretarsal orbicularis muscle, grafting of autogenous fat tissue, and repairing or/and shortening of the palpebral levator. Postoperative follow-up ranged from 3 months to 2 years.

RESULTSThe effective results have been got with the used methods except shifting of the pre-septal orbicularis muscle or transferring of pretarsal orbicularis muscle.

CONCLUSIONSThe suitable methods to correct the adhesive deformity from upper eyelid fold formation must be chosen according to the causes and the local situations.

Objective:To evaluate the clinical efficacy of Sini-Jia-Huanglian Decoction on chronic heart failure (CHF) with qi deficiency and blood stasis syndrome. Methods:A total of 100 patients with CHF and qi deficiency and blood stasis syndrome in Handan Mingren hospital from January 2018 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method, 50 cases in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with Sini-Jia-Huanglian Decoction on the basis of the control group. Both groups were treated for 30 days. TCM syndrome score was performed before and after treatment. The level of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) was detected by radioimmunoassay. The levels of peptide and galectin 3 (Gal-3) were detected by ELISA. The exercise tolerance was measured by 6-minute walking test, the clinical efficacy was tevaluated. Results:The total effective rate of the treatment group was 92.0% (46/50), and the control group was 76.0% (38/50), there was significant difference between the two groups ( χ2=4.762, P=0.029). After treatment, the scores of shortness of breath, palpitation, dyspnea, dizziness, chest pain and total scores in the treatment group were significantly lower than those in the control group ( t values were 4.257, 8.493, 8.211, 4.481, 5.500, 6.977, respectively, all Ps<0.01). After treatment, the levels of NT-proBNP (2 349.61 ± 683.50 ng/L vs. 3 026.27 ± 714.35 ng/L, t=4.840), and peptide (12.16 ± 3.43 ng/L vs. 17.52 ± 3.98 ng/L, t=7.214) and Gal-3 (3.01 ± 0.82 μg/L vs. 3.94 ± 0.93 μg/L, t=5.304) in the treatment group were significantly lower than those in the control group ( P<0.01), and the walking distance of 6 minutes (450.66 ± 79.25 m vs. 384.49 ± 70.16 m, t=4.421) was significantly longer than that of the control group ( P<0.01). Conclusions:The Sini-Jia-Huanglian Decoction can improve the heart function and clinical symptoms of CHF patients with qi deficiency and blood stasis syndrome, and improve the clinical efficacy.

Objective To investigate the cytological pattern and distribution in nonfunctioning pancreatic endocrine tumors.Methods Using labeled streptavidin-biotin (LSAB), immunohistochemical staining for insulin, glucagon, somatostatin, pancreatic polypeptide and gastrin was performed on 30 nonfunctioning pancreatic endocrine tumors from 30 patients. The cellular composition and anatomic distribution in these tumors were analyzed.Results Of 30 tumor tissues, 22 (73.3%) were found to contain cells immunoreactive to 1-4 kinds of peptide hormones; 17 (56.7%) showed positive staining for more than one peptide and up to 4 peptides; and 8 (26.7%) showed negative immunoreaction to all antiserum applied. No tumor was found to contain immunoreactive gastrin. Among 17 multihormonal tumors, 4 contained 2 kinds of peptide hormones, 8 had 3 kinds, and 5 harbored 4 kinds of peptide hormones. In addition, the difference in the number and type of positive endocrine cells between the tumors arising from the head of the pancreas and those arising from the body and tail of the pancreas were statistically significant (P<0.05).Conclusions Immunohistochemically, the high positive rate to peptide hormones suggests that the nonfunctioning pancreatic endocrine tumors are actually not nonfunctioning; they are asymptomatic pancreatic endocrine tumors. Moreover, an uneven distribution of positive endocrine cells in the nonfunctioning pancreas endocrine tumors within the pancreas was identified.

Objective To investigate the therapeutic effect of different doses of methylprednisolone (MP) in smoke inhalation-induced acute lung injury (SI-ALI).Methods Adult male Sprague-Dawley (SD) rats were divided into control group (group A,n = 6), smoke inhalation group (group B, smoke inhalation 30 minutes,n = 30) and smoke+MP 40, 4, 0.4 mg/kg intervention group (groups C, D, E; intraperitoneal injection of MP at 1 hour before smoke inhalation, n = 30) according to random number table method. The survival status of rats in each group was observed at 24 hours, and murine smoke inhalation induced trauma score (MSITS) according to the symptoms and signs of rats at 3 hours after smoke inhalation were scored. The blood of abdominal aorta of rats was collected. Then the rats were sacrificed to harvest bronchoalveolar lavage fluid (BALF) and lung tissue. The levels of interleukin (IL-6, IL-17a) in plasma and BALF were detected by enzyme linked immunosorbent assay (ELISA); the total number of white blood cells and the proportion of leukocytes or macrophages in BALF were calculated; the histopathological changes of lung were observed and the lung injury score was given; the expression of myeloperoxidase (MPO) and high mobility group protein B1 (HMGB1) in lung tissue were detected by Western Blot.Results The 24-hour survival rate of group B rats was 33.67％. The survivalrate of groups C, D and E (65.73％, 85.17％, 60.07％) were significantly higher than that of group B (allP < 0.05), and the survival rate of group D was significantly higher than that of groups C and E. Diffuse inflammatory cell infiltration, intra-alveolar hemorrhage and a large amount of edema fluid were seen in the lung tissue of group B; and the lung injury score was significantly higher than that of group A. Compared with group B, the lung injury in different doses of MP group were decreased to different degrees, while the lung injury scores in groups C and D were significantly decreased (3.31±1.37, 2.62±0.98 vs. 5.52±0.97, bothP < 0.01); correlation analysis showed that MSITS score was significantly and positively correlated with lung injury score (r = 0.862,P < 0.001). The levels of plasma inflammatory factors and BALF protein, inflammatory cells and inflammatory factors, and the expression of MPO, HMGB1 in group B were significantly higher than those in group A. Compared with group B, the levels of inflammatory factors in plasma, and protein content, inflammatory cells and inflammatory factors in BALF in different doses of MP group were decreased to different degrees, with significant differences in groups C and D [plasma: IL-17a (pg/L): 49.28±27.12, 36.57±16.52 vs. 191.79±88.21; IL-6 (ng/L): 206.47±109.96, 197.52±113.86 vs. 669.00±299.60; BALF: protein content (mg/L):892.0±164.5, 566.1±120.9 vs. 1838.0±145.8; white blood cell count (×109/L): 5.40±1.67, 2.81±1.20 vs. 9.02± 2.06; neutrophil ratio: 0.315±0.081, 0.273±0.080 vs. 0.590±0.096; IL-17a (ng/L): 22.63±8.62, 18.92±8.43 vs. 43.31±19.17; IL-6 (ng/L): 156.49±46.94, 123.66±64.91 vs. 253.43±80.03; allP< 0.01]; in addition, the expression of MPO and HMGB1 protein in lung tissues of MP groups with different doses were significantly decreased, the expression of MPO in group D was significantly lower than that in group E [MPO/β-actin (fold increase from group A):2.14±0.97 vs. 4.35±0.87,P < 0.01], the expression of HMGB1 in groups C and D were significantly lower than that in group E [HMGB1/β-actin (fold increase from group A): 1.77±0.73, 1.23±0.67 vs. 3.65±1.08, bothP < 0.05]. Conclusions MP can significantly improve the survival rate of SI-ALI rats and reduce the acute pulmonary and systemic inflammatory response. The MP effect of 4 mg/kg was better than 40 mg/kg and 0.4 mg/kg.

Objective To explore the impact of glucocorticoid on coagulation through administrating on rats with smoke inhalation.Methods Totally 150 male S-D rats were randomly (random number) divided into 5 groups:control group (ambient air inhalation),smoke group (smoke inhalation for 30 min),smoke+high dosage methyl prednisolone group(MP 40 mg/kg,intraperitoneal injection,s+HMP group),smoke+medium dosage MP (4 mg/kg) group (s+MMP group),smoke+low dosage MP (0.4 mg/kg) group (s+LMP group) (all n=30).Survival rates were calculated 24 h after smoke inhalation.Lung tissues were collected for histopathology and wet to dry (W/D) ratio.Arterial blood was collected for blood gas test.Coagulation factors in lung and plasma were tested.Results Survival rates of three MP groups were markedly improved compared with the smoke group (all P＜0.05),and was significantly higher in the medium dosage group(85.17％) than those in the low and high dosage groups (65.73％ and 60.07％,all P＜0.05).The W/D ratio and blood gas test were markedly improved in the high and medium groups (all P＜0.05).Tissue factor (TF) and thrombin-antithrombin complex (TAT-c) in bronchoalveolar lavage fluid (BALF) increased dramatically after SI (P＜0.01,P=0.005) with a remarkable drop of factor Ⅱ (F Ⅱ) (P=0.007),all of which were attenuated by MP with dosage dependence.The mRNA expression of TF increased dramatically after SI and recovered significantly with MP administration,while the expression of thrombomodulin (TM) recovered in the opposite direction with MP,all of which were in a dosage dependent manner.TF,fibrinogen (FIB),TAT-c increased significantly in plasma after smoke inhalation (P＜0.01,P=0.027,P=0.005).F Ⅷ ％ increased with MP administration and TF was raised by high dosage MP compared with the smoke group.FIB and TAT-c were decreased in all MP groups,which were significant higher in the high and middle dosage groups.The change of TM and endothelial cell protein C receptor (EPCR) in circulation were similar with FIB or TAT-c with or without MP.Protein C (PC％) and antithrombin (AT Ⅲ ％) dropped dramatically after SI,high and middle dosages of MP could restore the activity significantly,while low dosage would restore AT Ⅲ ％ but not PC％.Conclusions Glucocorticoid can significantly improve local and systemical coagulation disorder caused by smoke inhalation,and high-and medium-dosage hormones are effective.The regulation of hormones on the coagulation system is an important mechanism in the treatment of smoke inhalation induced lung injury.

Objective:To describe and analyze the clinical manifestations of patients with orofacial pain of temporomandibular disorders (TMD).Methods:A retrospective study on orofacial pain was conducted for 3 425 patients diagnosed as TMD based on clinical symptoms and signs in the Department of Temporomandibular Disorders and Orofacial Pain, School of Stomatology, The Fourth Military Medical University. The patients included 1 158 males and 2 267 females with a median age of 32 years. The gender, age, course of disorders, pattern and site of pain, CT imaging diagnosis of temporomandibular joint (TMJ) were analyzed. The distribution of gender, age and disorder course interval were described. The differences in frequency of the pattern and site of pain, imaging diagnosis in different gender, age and disease course interval were compared. Chi-square test and non-parametric rank sum test were performed using software SPSS 23.0.Results:Of the 3 425 patients, 29.1% (997/3 245) had signs of joint popping, and 40.1% (1 373/3 425) had restricted opening. The pain frequency was higher in males who had disorder course less than 1 month ( P<0.01) and also in males who had open-and-close and/or lateral excursion and/or protrusion pain without tenderness or other pain without tenderness ( P<0.05). However, the pain frequency was higher in females who had tenderness ( P<0.01). The pain frequencies in those over 56 years old with tenderness combined with open-and-close and/or lateral excursion and/or protrusion pain were higher than in patients of other ages ( P<0.01). In patients with unilateral TMJ pain, the frequency in males was higher than females( P<0.01), while the frequency in females was higher in patients with unilateral TMJ pain combined with unilateral or bilateral myalgia and the frequency was higher in patients under 15 years old having bilateral TMJ pain and/or unilateral or bilateral myalgia ( P<0.05). In patients with unilateral TMJ pain, the frequency in those with disorder course≤1 month was higher than in those with other disease duration intervals ( P<0.01), while in patients with bilateral myalgia or TMJ pain plus unilateral or bilateral myalgia, the frequency in those with disorder course>3 years was higher than in those with other disease duration intervals( P<0.01). In patients with unilateral TMJ pain, the frequency was higher in those having open-and-close and/or lateral excursion and/or protrusion pain ( P<0.01). In patients with unilateral myalgia and bilateral myalgia, the frequency was higher in those having tenderness ( P<0.01). The frequency of TMJ space changes in male patients was higher than females and the frequency of hyperosteogeny and resorption in females were higher than males ( P<0.05). The frequency of TMJ space changes and developmental problems were higher in patients aged 16 to 35 years, while the frequencies of hyperosteogeny, bone resorption and cystis in those over 56 years were higher than other ages ( P<0.01). The frequency of TMJ space changes in patients with disorder course≤1 month was higher than in those with other disease duration intervals ( P<0.01), while the frequency of hyperosteogeny was higher in patients with disorder course>3 years ( P<0.01). Conclusions:The male to female ratio in the present patients with orofacial pain of TMD was about 1 to 2. Most of the patients visited hospital within half a year after the disorders occurred. The pattern and site of the orofacial pain, signs on TMJ CT images showed some distribution regularities in views of gender, age and disorder course.

Objective:To evaluate the effectiveness and safety of phacoemulsification cataract extraction combined with intraocular lens implantation (PEI) plus goniosynechilysis (GSL) and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG).Methods:An observational case series study was performed.Fifty eyes of 50 patients with advanced PACG were enrolled in Zhongshan Ophthalmic Center from August 2020 to June 2021.All the patients received PEI+ GSL+ GT and were followed up for over 6 months, with a mean follow-up of 7.5 (6, 10) months.Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer.Best corrected visual acuity (BCVA) was examined with an ETDRS chart and converted to logarithm of the minimum angle of resolution (LogMAR) units for analysis.Types and number of anti-glaucoma medications applied before and after surgery, and the surgical complications were collected.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) with a reduction of 20% from baseline without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.Qualified success was defined as an IOP of 5-18 mmHg with a reduction of 20% from baseline with or without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.This study adhered to the Declaration of Helsinki.This research protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center (No.2021KYPJ177). Written informed consent was obtained from each subject before entering the cohort.Results:The mean preoperative IOP was (28.81±7.81)mmHg, and the IOP at the end of follow-up was (13.41±4.10)mmHg, showing a statistically significant decrease ( t=12.260, P<0.001). The postoperative IOP was decreased by 13.80 (9.10, 19.40)mmHg, with a percentage decrease of 51.1% (38.6%, 67.1%). The mean preoperative and postoperative BCVA was (0.92±0.11) LogMAR and (0.88±0.10) LogMAR, respectively, and no significant difference was found ( t=-0.560, P=0.580). The number of anti-glaucoma medications was reduced from 2 (1, 3) before operation to 0 (0, 0) after operation.The complete success rate of surgery was 80% (40/50), and the qualified success rate was 94% (47/50). Surgical complications mainly included hyphema in 7 eyes, IOP spike in 7 eyes, and corneal edema in 3 eyes.No vision-threatening complication occurred. Conclusions:PEI+ GSL+ GT is preliminarily effective and safe for advanced PACG by reducing IOP and application of anti-glaucoma medications with few complications.