[ ABSTRACT] AIM:To investigate the distribution of mast cells ( MCs) and the expression of transforming growth factor-β(TGF-β) on tryptase positive MCs in different types of human periapical diseases.METHODS:Total 78 cases of specimens were involved in this study, including healthy control, periapical cyst and periapical granuloma.The tissue sam-ples were fixed in 10% formalin for at least 48 h, stained with hematoxylin and eosin for histopathological examination, stained with toluidine blue staining for identifying MCs and MCs degranulation, and stained with double immunofluores-cence for identification of tryptase-TGF-βdouble positive MCs.RESULTS:The density of tryptase-TGF-βdouble positive MCs in the periapical lesions was significantly higher than that in the healthy controls ( P<0.01) .The number of TGF-βpositive MCs in the periapical cyst was significantly higher than that in the periapical granuloma ( P<0.01 ) .Compared with toluidine blue staining, the number of MCs with double immunofluorescence staining significantly increased ( P <0.01).CONCLUSION:The TGF-βpositive MCs may play an important role in the pathogenesis of human chronic peria-pical diseases, particularly in the formation of fibrous tissue in periapical cyst.Double immunofluorescence staining is more sensitive than the traditional toluidine blue staining for identifying MCs.

Objective:To explore an effective treatment method for mycobacterial infection of multiple abscesses in the face and breast after autologous fat injection.Methods:Six patients with non-tuberculous mycobacterial infection after autologous fat injection in the face and chest were treated from June to September in 2018. All patients underwent preoperative ultrasound localization. The small incision was opened for debridement and the necrotic granular tissues were completely scraped. Vacuum aspiration therapy in the sinus was used to promote wound growth, in line with the standard anti-tuberculosis drug treatment.Results:All six patients in this group were being followed up for 10-14 months. The average follow-up time was 12 months. All the infected patients were recovered, and the appearance of the infected site was satisfied by the patients.Conclusions:Small incision debridement with vacuum aspiration therapy combined with a variety of anti-tuberculosis drugs can effectively treat non-tuberculous mycobacterial infection after autologous fat injection, and achieve good results.

ObjectiveTo investigate the value of liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) based on FibroTouch (FT) transient elastography combined with serum adenosine deaminase (ADA) in predicting severe esophageal varices (EV) in patients with hepatitis B cirrhosis. MethodsRelated clinical data were collected from 120 patients with hepatitis B cirrhosis who attended Department of Infectious Diseases, Changsha First Hospital, from December 2017 to June 2020. FT was used to measure LSM and SSM, and related examinations were performed, including electronic gastroscopy and serum levels of ADA, hemoglobin, albumin, alanine aminotransferase, and aspartate aminotransferase and platelet count. The serum liver fibrosis markers aspartate aminotransferase-to-platelet ratio index (APRI), aspartate aminotransferase/alanine aminotransferase ratio (AAR), and fibrosis-4 (FIB-4) were calculated. According to the severity of EV under gastroscopy, the subjects were divided into severe EV group with 58 patients and non-severe EV (without EV or with mild-to-moderate EV) group with 62 patients. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The Spearman rank correlation test was used to investigate the correlation of LSM, SSM, and ADA with severe EV. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of LSM, SSM, and ADA in the diagnosis of severe EV, and sensitivity and specificity were calculated. A multivariate binary logistic regression analysis was performed to calculate the area under the ROC curve (AUC) of the combined indicators, and the Z test was used for comparison of AUC. ResultsThere were significant differences in LSM, SSM, and ADA between the two groups (all P＜0.05). LSM, SSM, and ADA were positively correlated with severe EV, with a correlation coefficient of 0.686, 0.743, and 0.723, respectively (all P＜0.05). The optimal cut-off value was 22.35 kPa for LSM, 45.25 kPa for SSM, and 34.50 U/L for ADA in predicting severe EV, with an AUC of 0746, 0.802, and 0.791, respectively, a sensitivity of 82.8%, 75.9%, and 58.6%, respectively, and a specificity of 65.6%, 77.4%, and 90.2%, respectively. LSM+ADA, SSM+ADA, and LSM+SSM+ADA had an AUC of 0.826, 0.853, and 0.907, respectively, in predicting severe EV (all P＜0.05). ConclusionLiver/spleen stiffness combined with serum ADA has a good value in predicting severe EV, which can provide a preliminary diagnostic basis for severe EV in patients who refuse to undergo gastroscopy.

OBJECTIVETo establish a animal model of hepatic steatosis induced by chronic viral hepatitis in C(57)BL/6 mice.

METHODSC(57)BL/6 mice were randomly assigned to control group, high-fat diet group, mouse hepatitis virus strain A59 (MHV-A59) virus infection group, and high-fat diet plus virus infection group. At 13 weeks of the experiment, serum samples were collected to detect MHV antibodies and transaminase and lipid levels. The hepatic pathologies of the mice were examined with Oil red O staining of the frozen sections the and HE staining of paraffin-embedded sections.

RESULTSThe mice in the two virus infection groups showed strong positivity of MHV antibodies in the serum. Compared with the control group, the mice in high-fat diet group and the two virus infection groups had significantly increased AST and ALT levels with also elevated TC and LDL-C levels. The two virus infection groups both exhibited obvious pathologies in the liver characteristic of chronic viral hepatitis with increased lipid accumulation in the hepatocytes.

CONCLUSIONWe have successfully established a mouse model of hepatic steatosis induced by chronic viral hepatitis, which provides the basis for further study of the disease mechanism.

Animals ; Antibodies, Viral ; blood ; Chronic Disease ; Diet, High-Fat ; Disease Models, Animal ; Fatty Liver ; virology ; Hepatitis, Chronic ; virology ; Mice ; Mice, Inbred C57BL ; Murine hepatitis virus

Objective:To explore the early warning value of laboratory parameters in patients with severe hemorrhagic fever with renal syndrome (HFRS).Methods:The clinical data of 101 patients with HFRS hospitalized in the Department of Infectious Diseases of the First Hospital of Changsha from December 2013 to December 2020 were collected and analyzed. The differences of clinical routine laboratory parameters between mild and severe HFRS patients were compared and analyzed. The statistical methods including independent sample t test, rank sum test, chi-square test, Spearman rank correlation analysis, logistic regression analysis and receiver operator characteristic curve were used. Results:Among 101 patients with HFRS, 38 cases were in severe group and 63 cases in mild group. White blood cell count, aspartate aminotransferase (AST), prothrombin time (PT), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), serum creatinine, urea nitrogen and D-dimer in severe group were higher than those in mild group, while platelet count and albumin were lower than those in mild group, and the differences were all statistically significant ( t=8.61, Z=-3.76, t=4.19, Z=-2.84, Z=-7.23, t=4.98, t=4.64, t=36.02, Z=-5.49 and t=4.14, respectively; all P<0.050). Severe HFRS was positively correlated with white blood cell count, AST, PT, activated partial thromboplastin time (APTT), CK-MB, serum creatinine, urea nitrogen and D-dimer ( r=0.629, 0.376, 0.549, 0.471, 0.723, 0.500, 0.341 and 0.588, respectively; all P<0.001). White blood cell count, albumin, PT and CK-MB were independent influencing factors for the progression of severe HFRS (odds ratio ( OR)=0.922, 1.374, 0.730 and 0.938, respectively; all P<0.050). The area under curve (AUC) of white blood cell count, albumin, PT and CK-MB for the early warning prediction of severe HFRS were 0.869, 0.739, 0.785 and 0.931, respectively, with the optimal thresholds for prediction of 26.38×10 9/L, 26.05 g/L, 15.95 s and 35.5 U/L, respectively.And the AUC of the combined detection of the above laboratory parameters was 0.950, with the sensitivity of 87.3% and the specificity of 94.7%. Conclusions:White blood cell count, albumin, PT and CK-MB could be used as independent influencing factors for early warning of severe HFRS. Combined detection is more helpful for early warning of severe HFRS than single detection.

Objective To investigate the opportunity and skill of surgery for pancreatic sinistral portal hypertension.Methods Clinical data were retrospectively analyzed on 15 cases of pancreatic sinistral portal hypertension admired from Dec 2015 to Dec 2017.Results All fiften cases underwent surgical treatment,among them three cases were initially treated conservatively in the early stage and treated surgically for gastrointestinal bleeding,12 cases with definite pancreatic disease and pancreatic sinistral portal hypertension treated in the first stage.Three patients underwent second surgery for recurrent gastrointestinal bleeding.The patients were followed up for 6 to 18 months with symptoms significantly impioved without deaths.Conclusions Splenectomy combined with esophagogastric devascularization is the basic surgical treatment for pancreatic sinistral portal hypertension.