H5N1 subtype of avian influenza virus (AIV) has been prevailing in many countries over the world, which has threaten human health. The establishment of AIV animal models may provide a tool for the study on the infection, mutation of avian influenza virus and pathogenesis of the disease. The pathogenicity of H5N1 to mammalian such as cynomolgus macaques, ferrets, mice, rats, gerbils, cats were summarized in current review, which may provide meaningful help for the establishment and study on ideal experiment animal models.

Objective The beam data is compared with those obtained from Monte Carlo (MC)simulation and measurement to investigate their feasibility and reliability for X-ray small fields.MethodsThe beam data,including the total scatter factor (Scp),percentage depth dose (PDD) was acquired byneasurement and calculation with the field size ranging from 0.5 cm × 0.5 cm to 10 cm x 10 cm.The resultswere compared and analyzed.Results All the data is most consistent for the fields size of ≥3.5 cmx 3.5cm,but they are obvious different for the fields size of ≤ 3.0 cm × 3.0 cm.The measurements seem toreliable using the chambers of CC04 and CC13 for the fields size of ≥2.0 cm x 2.0 cm.Conclusions It isdemonstrated that the accurate measurements and calculations of Scp and PDD can be obtained for the fieldssize of ≥2.0 cm ×2.0 cm,but they needed morc rcscarchcs for thc smaller fields.

Abstract BACKGROUND: Alveolar bone deficiency wil not meet aesthetic and functional requirements for dental implants. OBJECTIVE:To observe the repair effect of passage 3 autologous bone marrow mesenchymal stem cels (BMSCs) and platelet-rich fibrin (PRF) on alveolar bone defects in rabbits. METHODS:Twenty-seven New Zealand rabbits were randomly divided into BMSCs/PRF group, PRF group and model group (n=9 per group). The left mandible incisors were extracted in al the rabbits under general anesthesia. BMSCs/PRF group was immediately implanted BMSCs/PRF composite into the alveolar socket, PRF group only implanted PRF, and model group implanted nothing. RESULTS AND CONCLUSION: In the model group, the alveolar crest and alveolar mucosa become sunken notably and narrowed. In the BMSCs/PRF and PRF groups, the thickness of alveolar bone wal, alveolar bone width, alveolar bone height difference, and bone mineral density were al increased, especialy in the former group. In addition, the trabecular arrangement was better in the BMSCs/PRF groups than the model and PRF group. Our findings indicate that alveolar socket filing with composite of BMSCs and PRF can achieve preservation of alveolar bone width and height after tooth extraction in rabbits.

Objective To compare the effect of different positive end-expiratory pressures (PEEPs) on the efficacy of volume therapy guided by global end-diastolic volume index (GEDVI) and central venous pressure (CVP) in patients with septic shock.Methods Twenty-five patients with septic shock complicated with respiratory failure,of both sexes,aged 18-64 yr,were enrolled in the study.Their APACHE [[scores were 13-31.The patients were endotracheally intubated and underwent volume-controlled ventilation,PEEP was 5-15 cmH2O,and pulse oxygen saturation was maintained ＞ 90 ％.The patients were divided into low PEEP (5-10 cmH2 O) group and high PEEP (11-15 cmH2 O) group depending on the different PEEP levels.6 ％ hydroxyethyl starch (200/0.5)6 ml/kg was infused over 30 min for volume therapy.Right internal jugular vein or subclavian vein was cannulated for CVP monitoring,and GEDVI was continuously monitored by pulse indicator continuous output monitoring (PiCCO) technology.CVP and GEDVI were recorded before and after volume therapy and the changing rate was calculated.Results Compared with CVP and GEDVI before volume therapy,CVP and GEDVI were significantly increased after volume therapy in low PEEP group (P ＜ 0.05),and GEDVI was increased after volume therapy (P ＜ 0.05) and no significant change was found in CVP after volume therapy in high PEEP group (P ＞ 0.05).Compared with low PEEP group,the changing rate of CVP was significantly decreased (P ＜ 0.05),and no significant change was found in the changing rate of GEDVI in high PEEP group (P ＞ 0.05).Conclusion High PEEP can decrease the efficacy of volume therapy guided by CVP,while exerts no effect on the efficacy of volume therapy guided by GEDVI in patients with septic shock.

OBJECTIVE: To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit. METHOD: Medical records for 30 patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele, some of them were operated auxiliary incision. Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up. RESULT: All cases were successfully performed surgery without complications after the surgeries, or the majority of symptoms. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay treatment can seriously compromise the recovery of vision impairment. Moreover, the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed. CONCLUSION Endoscopic surgery has effect on nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention,a good understanding of the disease and prompt imaging studies are important.
Adult ; Aged ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucocele ; pathology ; surgery ; Orbit ; pathology ; surgery ; Paranasal Sinus Diseases ; pathology ; surgery ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Young Adult

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Objective To investigate the prevalence of glomerular microthrombosis in lupus nephritis (LN) and the significance of antibodies to anti-coagulation related factors and anti-phospholipid antibodies in glomerular microthrombosis (GMT).Methods Kidney biopsy specimens and plasma samples were obtained consecutively from 124 patients with LN. Kidney biopsy specimens were examined for the presence of glomerular microthrombi.Plasma samples from 25 LN patients with GMT (LN-GMT group) and 99 LN patients without GMT (LN-non-GMT group) were tested for lupus anticoagnlant (LA) and antibodies to cardiolipin (ACL),β2 glycoprotein I (β2GP I ),plasmin,thrombin,tissue plasminogen activator (t-PA) and Annexin A II.Results The prevalence of GMT in LN patients was about 20.2%.Compared to LN-non-GMT group,LN-GMT group had elevated SLE disease activity indices (SLEDAI),elevated activity and chronicity indices of kidney tissue injury,and elevated serum creatinine,blood urea nitrogen and proteinuria levels,and also had a higher frequency of hypertension (P＜0.01).The positive rates of LA,IgG class anti-β2GP I and anti-thrombin antibodies were higher in LN-GMT group than in LN-non-GMT group (P＜0.05).The positive rates of IgG class antibodies to ACL,plasmin,t-PA and Annexin A II in LN-GMT group were not statistically different from those in LN-non-GMT group (P＞0.05).No difference was found in the positive rate of any IgM class antibody between the two groups (P＞0.05).Conclusion This study has shown that GMT occurs approximately in 20.2% of the LN patients.Patients with GMT have more severe kidney tissue injury and more poor renal outcomes than patients without GMT.LA and antibodies to β2GP I and thrombin play a role in glomerular microthrombosis in lupus nephritis.

Objective:To summarize the atypical manifestations and treatment strategies of serous microcystic neoplasm of the pancreas.Methods:Review the case data of 11 cases of pancreatic serous microcystic adenoma with atypical preoperative clinical imaging findings admitted to Peking Union Medical College Hospital from July 2008 to October 2019, and summarize their clinical manifestations, CT/MRI features, and preoperative clinical diagnosis, surgical methods, postoperative conditions.Results:The median age of the 11 patients was 50 (46-66) years old, 7 females, and 4 males. There were 8 cases with back pain and 6 cases with weight loss. The preoperative imaging examination found that the lesion was located in the head and neck in 8 cases, with pancreaticobiliary duct dilatation in 7 cases, suspected vascular invasion in 3 cases, and pancreatic parenchymal atrophy in 2 cases, 3 cases showed rich blood supply and solid space, and 2 cases were connected to the pancreatic duct. Preoperative diagnosis of pancreatic malignant tumors accounted for 4 cases, neuroendocrine tumors in 3 cases, solid pseudopapillary tumors in 3 cases, and intraductal papillary mucinous tumors in 1 case. All patients underwent surgical treatment, 3 cases of distal pancreatectomy (2 cases of using Kimura method to protect the spleen), 3 cases of pancreaticoduodenectomy, 1 case of total pancreatectomy, 2 cases of pancreatic head resection with duodenum preservation, 2 cases of local resection. All patients had no early postoperative deaths. There were 2 cases of grade B pancreatic fistula, 2 cases of biochemical leakage, 1 case of postoperative abdominal hemorrhage, and 2 cases of delayed gastric emptying, all of which were cured after active treatment. The median postoperative hospital stay was 18 (7-63) days.Conclusions:Pancreatic serous microcystic neoplasm could be accompanied by atypical features such as pancreatic/bile duct dilation, parenchyma atrophy, or even present vessel invasion. Understanding the atypical clinic and image features would help improving differential diagnosis and treatment. For those with invasive features, surgical exploration should be recommended.

BACKGROUND:For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE:To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed smal window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar smal window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of folow-up study was conducted, including: folow-up analysis of clinical efficacy and complications, colection of low-back pain visual analogue scores, colection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION:Folow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Stil in the last folow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaler than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.

Objective To study the clinicopathological features and differential diagnosis of bizarre parosteal osteochondromatous proliferation (BPOP). Methods The clinicopathological features of 3 patients with BPOP were analyzed , and related literature was reviewed. Results 3 patients included 2 males and 1 female with an average age 40 years old (24-53 years old). The lesions in three patients were located in the left side of the distal radius, the left side of the little finger inside and the right side of ulna coracoid, respectively. Histologically, characterized by unusual mineralized cartilaginous matrix (`blue bone'), the lesion was composed of a heterogeneous mixture of bone, cartilage and fibrous tissue. Conclusion BPOP is a rare benign surface osteocartilaginous lesion, and its diagnosis and differential diagnosis mainly depend on radiographic and histopathologic features.