Objective To analyze the clinical manifestations,diagnosis,treatment and prognosis of patients with splenic abscess.Method The clinical data,including baseline clinical data,clinical features,past history,pathogen culture result,treatment and the prognosis were retrospectively analyzed in the patients with the discharge diagnosis splenic abscess from January 1991 to March 2012 in Peking Union Medical College Hospital.Results The media time from onset to Peking Union Medical College Hospital of the 19 patients were 29 days.Among them,9 patients were cured,8 were improved and 2 died.Risk factors,such as tumor burden,diabetes,and using immunosuppressive agents etc,can be found in most patients with splenic abscess.All the 19 patients had splenic image changes and non-specific clinical features.The most common three clinical symptoms were fever(18 cases),chills (12 cases) and shivering (11 cases).The most common three signs were abdominal tenderness (9 cases),left upper quadrant sensitive to percussion (7 cases) and splenomegaly (4 cases).The most common etiological culture results were gram negative bacilli (9 cases),gram positive coccus (8 cases),and fungi (4 cases).Conclusions Clinical features are non-specific in splenic abscess patients.Related exam such as ultrasound should be performed on patients with splenic abscess risk factors to avoid misdiagnosis.Empiric antibiotic administration should begin right after the diagnosis based on the image.Pathogen culture should be timely conducted after pus collection.Individual therapeutical protocol should be chosen according to patient's condition.

BACKGROUND: After internal fixation is applied to femoral shaft fracture with medial cortical defect, the fixation device is often bended and broken due to the stress on it. So far, reliable methods have not been found to solve this problem in clinic.OBJECTIVE: To evaluate the biomechanical stability of the allograft bone plate after a bony defect of the medial cortex is reconstructed with allograft bone plate.DESIGN: A randomized controlled experimental study.SETTING: This trial was conducted in the Department of Orthopaedics, the 175 Hospital of Chinese PLA, and Laboratory of Biomechanics, First Military Medical University of Chinese PLA.PARTICIPANTS: This trial was conducted in Laboratory of Medical Biomechanics, First Military Medical University. MTS858 Biomix biomaterial testing machine was used to simulate model of femoral shaft fracture on 3male adult femurs donated voluntarily by their relatives, aged 23, 24 and 28years old.INTERVENTIONS: The fracture model of medial cortical defect was made in the femurs. Different kinds of fixation were applied and the results were compared between fixated femurs and the normal ones. The fixations included steel plate fixation(fixation for group 1 ), steel plate with allograft bone plate fixation(fixation for group 2), steel plate with allograft bone plate fixation and reduction of the medial cortical fragment(fixation for group 3).MAIN OUTCOME MEASURES: The vertical compression displacement under 500 N load, three-point bending strength under 10 N and anti-torsional angle under 300 N load are all measured.RESULTS: The vertical compression displacement and three-point bending strength of the control group were insignificantly different from those of the fixation group 3 ( P ＞ 0.05), but significantly different from those of the fixation group 1 and 2 ( P ＜ 0.05). The anti-torsional angle of the control group was significantly different from that of the three fixation groups( P ＜ 0. 05) . The result of fixation in fixation group 1 was the worst, better in fixation group 2and the best in fixation group 3.CONCLUSION: When there is a medial cortical defect in the femur, reconstruction with a bone plate can recover the integrity of the femoral medial cortex, and the successful rate of the plate internal fixation is increased.

AIM:To observe the effect of B-HT933, a selective α2-adrenoceptor agonist, on lipopolysaccha-ride ( LPS )-induced TNF-αproduction in neonatal rat cardiomyocytes and to explore the underlying mechanisms . METHODS:The neonatal rat cardiomyocytes were cultured .The localization of α2A-adrenoceptor in the cardiomyocytes was examined by immunofluorescence staining .The cardiomyocytes were exposed to LPS or/and B-HT933 for different time.The level of TNF-αin the supernatants and the mRNA expression of TNF-αwere detected by ELISA and real-time PCR, respectively.In addition, LPS-associated signal molecules in the cardiomyocytes were also examined by Western blotting.RESULTS: Immunofluorescence staining showed that α2A-adrenoceptors were localized in the cardiomyocytes . LPS stimulated TNF-αproduction in the cardiomyocytes in a dose and time-dependent manner .B-HT933 pretreatment sig-nificantly inhibited the expression of TNF-αat mRNA and protein levels in LPS-treated cardiomyocytes .Furthermore, LPS exposure induced IκBαand p38 phosphorylation in cardiomyocytes and only IκBαphosphorylation was prevented by B-HT933 treatment.CONCLUSION:α2A-adrenoceptors are present in neonatal rat cardiomyocytes and its agonist B -HT933 inhibits LPS-induced TNF-αproduction in cardiomyocytes via suppressing IκBαphosphorylation .

Objective To evaluate the value and short-term efficacy of Miccoli for cervical lymph node dissection in patients with thyroid papillary carcinoma.Methods From Mar.2017 to Jan.2018,15 patients with thyroid papillary carcinoma received cervical lymph node dissection in Department of Thyroid and Breast Surgery of Nanjing Chinese Traditional Medicine Hospital,and they were divided into open surgery group (8 cases) and Miccoli surgery group (7 cases).The operation time,incision length,intraoperative blood loss,total number of dissection lymph nodes,incidence of postoperative complications and length of hospital stay between the two groups were analyzed.These groups were followed up for 6 months after surgery,in terms of neck comfort,incidence of enlarged lymph nodes in the cervical region and blood thyroglobulin level.Results There was no obvious difference between the two groups in intraoperative blood loss(P=0.651),total number of dissection lymph nodes(P=0.887),the incidence of postoperative complications(P=0.52),incidence of intumescent lymph node(P=1.000) and blood thyroglobulin level(P=0.826) after 6 months.The operation time of Miccoli group was longer than that of the open group(P=0.001),but the incision length(P=0.001),length of hospital stay(P=0.001)and postoperative neck comfort(P=0.001)were superior to those of the open surgery group.Conclusion Miccoli operation can be used to perform cervical lymph node dissection for PTC patients,which can achieve the curative effect of open surgery,without increasing the risk of postoperative complications,and the postoperative neck comfort was better.

Acidosis, regardless of hypoxia involvement, is recognized as a chronic and harsh tumor microenvironment (TME) that educates malignant cells to thrive and metastasize. Although overwhelming evidence supports an acidic environment as a driver or ubiquitous hallmark of cancer progression, the unrevealed core mechanisms underlying the direct effect of acidification on tumorigenesis have hindered the discovery of novel therapeutic targets and clinical therapy. Here, chemical-induced and transgenic mouse models for colon, liver and lung cancer were established, respectively. miR-7 and TGF-β2 expressions were examined in clinical tissues (n = 184). RNA-seq, miRNA-seq, proteomics, biosynthesis analyses and functional studies were performed to validate the mechanisms involved in the acidic TME-induced lung cancer metastasis. Our data show that lung cancer is sensitive to the increased acidification of TME, and acidic TME-induced lung cancer metastasis via inhibition of miR-7-5p. TGF-β2 is a direct target of miR-7-5p. The reduced expression of miR-7-5p subsequently increases the expression of TGF-β2 which enhances the metastatic potential of the lung cancer. Indeed, overexpression of miR-7-5p reduces the acidic pH-enhanced lung cancer metastasis. Furthermore, the human lung tumor samples also show a reduced miR-7-5p expression but an elevated level of activated TGF-β2; the expressions of both miR-7-5p and TGF-β2 are correlated with patients' survival. We are the first to identify the role of the miR-7/TGF-β2 axis in acidic pH-enhanced lung cancer metastasis. Our study not only delineates how acidification directly affects tumorigenesis, but also suggests miR-7 is a novel reliable biomarker for acidic TME and a novel therapeutic target for non-small cell lung cancer (NSCLC) treatment. Our study opens an avenue to explore the pH-sensitive subcellular components as novel therapeutic targets for cancer treatment.