AIM: To report one case of huge fungal granuloma in the deep maxillofacial region with its clinical findings,diagnosis and treatment process to improve our understanding of fungal granuloma and lessen misdiagnosis.METHODS: The literature was reviewed with combination of case report.RESULTS: The clinical and imaging findings of fungal granuloma had no specificity and were very subject to misdiagnosis. Confirmed diagnosis needed histopathological examination and bacterial culture.CONCLUSION: Deepened understanding of this disease can decrease misdiagnosis and benefit prompt and proper treatment.

Objective To investigate the changes of QT dispersion and heart rate variability in children with ventricular contraction. Methods 50 healthy children who came for medical examinations at Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were selected as control group. 147 children with ventricular contraction admitted in Pediatric Intracardiac Department of Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were divided them into Benign Group (LownⅠ&LownⅡ) and Malignant Group(LownⅢ, LownⅣA, LownⅣB&LownⅤ) according to the results of Lown classification. Benign Group contained 90 cases while Malignant Group contained 57 cases. Difference in QT dispersion and indices of heart rate variability of the three groups were compared. Results There were no statistically differences between control group and benign group in QT dispersion (P > 0.05). QT dispersion of malignant group was much longer than that of control group and the differences had statistically meaning(P<0.001). SDNN(standard deviation of NN intervals) , SDANN (standard deviation of the averages of RR intervals ), SDNN index (index of standard deviation of the averages of NN intervals), rMSSD(root mean square of successive differences) and PNN50(percentage of successive normal sinus RR intervals>50 ms) of malignant group was much shorter than that of control group and benign group and the differences had statistically meaning (P< 0.01). SDNN, SDANN and SDNN index of benign group was shorter than that of control group and the differences had statistically meaning (P<0.05). Conclusions Heart rate variability of children with malignant ventricular contraction becomes significantly shorter and QT dispersion becomes significantly longer. Detection of QT dispersion and heart rate variability can effectively predict the risky degree of ventricular contraction in children.

Objective: To study the relationship between human herpes vi rus 6 (HHV-6) infection and oral squamors cell carcinoma. Methods: The serum anti-HHV-6 antibody titers from 16 cases of oral squamors cell carcinoma (OSCC) and 16 control subjects were detected by indirect immunofluores cence assay. HHV-6 DNA in peripheral blood mononuclear cells was amplified by P CR and the specificity was confirmed by Southern-blot hybridization with an int ernal probe oligonuclotide. An immunohistochemical staining was used to detect H HV-6 antigen in OSCC tissues. Results: Positive expression of s erum HHV-6 IgG antibody was found in all the cases of OSCC and in 12 of the 16 controls. Geometric mean titer of OSCC group and control group was 1∶118 and 1 ∶64 respectively (P

Objective? To investigate the status quo of quality of life (QOL), cognitive function and activities of daily living (ADL) in patients with ischemic cerebral stroke, explore cognitive function and ADL on QOL, and provide a reference for improving QOL in patients with cerebral stroke. Methods? Totally 140 patients with ischemic cerebral stroke hospitalized in the Department of Neurology of a hospital in Shanghai from September 2018 to January 2019 by convenient sampling and investigated with the demographic information questionnaire, Mini-Mental State Examination (MMSE), Barthel Index (BI) andWHO Quality of Life-BREF (WHOQOL-BREF). SPSS 22.0 and AMOS 22.0 were used to analyze the effects of cognitive function and ADL on QOL. Results? The total WHOQOL-BREF, BI and MMSE scores of the 140 patients with ischemic cerebral stroke was (52.56±5.34), [55 (40.00,67.25)]and[26 (23.25, 28.00)], respectively. Patients's QOL was positively correlated with ADL (r=0.173,P＜0.05) and cognitive function (r=0.276,P＜0.05). The path analysis revealed that both cognitive function and ADL had positive predictive power for QOL, whose path coefficient was 0.29 and 0.38. Conclusions? The QOL of patients with ischemic cerebral stroke stands at a medium level. Patients' cognitive function and ADL affect their QOL, which should draw attention in clinical practice, and measures should be taken for rehabilitation training of cognitive function and systematic interventions of ADL.

OBJECTIVETo establish serum proteome fingerprinting predictive models and search for proteins associated with colorectal cancer.

METHODSThirty-six randomly selected colorectal cancer patients and 36 cases with hernia or gall bladder diseases scheduled for elective operation were enrolled as cancer group and control group respectively. Peripheral venous blood samples were collected before the operations. Special serum protein or peptide fingerprint was investigated by using surface enhanced laser desorption/ ionization-time of flight-mass spectrometry (SELDI-TOF-MS) measurement after blood sample had been treated with weak cation exchange protein chip (CM10) for each case. The obtained data were analyzed by Biomarker Wizard software to screen serum proteome tumor markers and set up diagnosis predictive model for colorectal cancer. Blind validation of the model with 44 healthy controls and 88 colorectal cancer patients were carried out by using Biomarker Patterns Software.

RESULTSIn comparing colorectal cancer group with control group, 5 specific protein peaks (P < 0.05) were found. The predictive model had a sensitivity of 100% and a specificity of 97.2%. A sensitivity of 71.6% and a specificity of 72.7% was got with the blind validation. The specific protein peaks with a mass-to-charge ratio (m/z) of 8908 and 13,707 showed in all the results and it showed their strong relationship with colorectal cancer.

CONCLUSIONSThe predictive models built by the differences of serum proteome fingerprint could be a very useful diagnostic tool in colorectal cancer. Proteins with m/z of 8908 and 13,707 would possibly be the tumor markers of colorectal cancer.

Biomarkers, Tumor ; blood ; Blood Proteins ; analysis ; Colorectal Neoplasms ; blood ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Peptide Mapping ; Proteomics ; methods ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective To investigate the change of endomucin(EMCN) expression in diabetic retinopathy (DR) and its protective role in neurons apoptosis.Methods Fifty-six clean SD rats were randomly divided into 4 groups,including normal control group with intravitreal injection of normal saline,diabetes mellitus (DM) group with intravitreal injection of normal saline,EMCN transfection group with intravitreal injection of adenovirus associated virus(AAV)-EMCN and mCherry transfection group with intravitreal injection of AAV-mCherry,14 rats for each group.Intravitreal injection was performed 2 weeks before diabetes modeling.Western blot analysis was used to measure the expression of EMCN and phosphorylated Akt (p-Akt)/Akt.Flat-mounted retinas were performed to test the transfection efficiency.Hematoxylin-eosin staining was performed to examine the morphology of retinal tissue.The expression of cleaved caspase-3 in retinas of rats was assayed by immunofluorescence.The retinal apoptotic cells were detected by TUNEL.The use and care of the rats followed the ARVO Statement.Results The levels of fasting plasma glucose were significantly higher in the DM group,EMCN transfection group and mCherry transfection group than those in the normal control group (all at P＜0.001).The expression of EMCN protein at 4 weeks and 8 weeks after modeling in the DM group were significantly lower than that in the normal control group (t=3.71,P＜0.05;t =10.09,P＜0.001).The mCherry transfection group was strongly expressed red fluorescence,the expression of EMCN was significantly lower in retinal tissue of DM group than that in the normal control group (t=13.67,P＜0.001).The expression of EMCN was notably upregulated in retinas of EMCN transfection group,comparing with that of DM group (t =3.18,P＜0.05).The expression of EMCN in mCherry transfection group was similar to that in the DM group (t =2.31,P=0.08).Initial morphologic degenerative changes were found in the DM group and mCherry transfection group,such as inter limiting membrane (ILM) was thicken,the number of RGCs was decreased,and the cells in outer nuclear layer (ONL) and inner nuclear layer (INL) arranged irregularly.The histologic change of retinas in the EMCN transfection group was milder than that in the DM group.The expression of cleaved caspase-3 was upregulated in INL of DM group and mCherry transfection group,compared with that in the normal control group.Compared with the normal control group,the number of TUNEL-positive cells noticeably increased in the ONL of DM group and mCherry transfection group,and the number of TUNEL-positive cells markedly reduced in the EMCN transfection group.The relative expression of p-Akt/Akt was significantly lower in the retinal tissue of DM group than that in the normal control group (t =5.52,P＜0.01).However,the relative expression of p-Akt/Akt was notably upregulated in retinas of EMCN transfection group,compared with that in the DM group (t=3.14,P＜0.05).The relative expression of p-Akt/Akt in mCherry transfection group was similar to that in the DM group (t =0.81,P =0.46).Conclusions The overexpression of EMCN can protect diabetic retinas neurons from apoptosis,and its mechanism maybe associated with activation of Akt signaling pathway.

Objective To evaluate the prediction value of serum uric acid level in the occurrence of multiple metabolic disorders.Methods The subjects are from the Health Management Centre,Tianjin Medical University General Hospital.Four kinds of metabolic diseases,namely type 2 diabetes mellitus,hypertension,hyperlipidemia,and nonalcoholic fatty liver disease (NAFLD),were analyzed by four-cohort analysis.Sample sizes were 56 915,47 387,31 431,and 35 203.The average follow-up time for each cohort was (3.56±2.32),(3.31±2.24),(2.70±1.95),(2.90± 1.76) years,respectively.In each cohort,the population was divided into two groups,depending on the occurrence of type 2 diabetes,hypertension,hyperlipidemia,and NAFLD during follow-up.All relevant variables were tested for baseline and follow-up,including laboratory tests,lifestyle questionnaire,and physical examination.Statistical analysis by Cox proportional hazard regression model was performed for the relationships between the fifth percentile of the distribution of serum uric acid levels and incidence of type 2 diabetes,hypertension,hyperlipidemia,and NAFLD.Results During the follow-up period,the incidence of type 2 diabetes,hypertension,hyperlipidemia,and NAFLD were 3.5％,17.6％,33.4％,and 15.7％,respectively.After adjustment for confounding factors,with the increase in serum uric acid level,the hazard ratios (95％CI) of type 2 diabetes were 1.00,0.82 (0.70,0.95),0.80 (0.69,0.92),0.77 (0.67,0.88),and 0.83 (0.72,0.95) (P=0.02).Meanwhile,higher risk of hypertension,hyperlipidemia,and NAFLD were associated with elevated serum uric acid level.In the group with the highest serum uric acid level in each cohort,the hazard ratio (95％CI) of hypertension,hyperlipidemia,and NAFLD were 1.17 (1.09,1.25),1.20 (1.13,1.28),and 1.56 (1.43,1.70),respectively (P＜ 0.01),as compared to the group with the lowest level.Conclusion Serum uric acid levels have a positive predictive value for the occurrence of hypertension,hyperlipidemia,and NAFLD,but have a negative predictive value for type 2 diabetes.

Objective To analyze researches and hot issuses on tigecy-cline against Acinetobacter baumannii around the world.Methods Liter-atures were searched in Pubmed , Embase , Web of Science , and CNKI from the beginning to March , 2014.Endnote7.0 was used to sort out and summarize.Results A total of 227 English articles and 34 Chinese arti-cles were collected and the majority was characterized asoriginal article.Those articles were focused on the basic research of tigecycline against Acinetobacter baumannii in vitro, animal experiments and case analysis.Resistance mechanism , drug susceptibility test in vitro, and drug combi-nation were frequently involved.Conclusion The study on tigecycline against Acinetobacter baumannii increasingly has attracted global concern , especially the study on resistance mechanisms to tigecycline has gone fur-ther.

Objective To analyze the correlation analysis as on long-term low -dose off -label use of erythromycin with bibliometric approach, and to provide reference for study on off -label use of eryth-romycin.Methods Literatures were searched in PubMed, EmBase, Science Citation Index and CNKI data-bases from beginning to October 2014.EndNote was used to sort these articles and the bibliometric analy-sis was carried out in respect of published years, document type and research hotspot etc.Results The final document included a total of 694, including 451 foreign languages, Chinese 243.Among 694 papers, there were 545 pieces of original articles;the most frequently cited paper was cited for 275 times.First foreign language study on the long-term low-dose erythromycin treatment was published in 1974.Chinese from 1990 published his first articles.The research contents include clinical manifestations, present status of treatment,therapeutic effect and adverse drug reaction of long -term low -dose erythromycin application.Conclusion The current study found that long-term low-dose eryth-romycin on chronic inflammatory lung disease effectively, and erythromy-cin stomach action by promoting the use of pediatric clinical study is currently hot.

BACKGROUND:At present,there is a lack of an internal fixation system with good reduction and simple operation for the treatment of atlas burst fracture by posterior single-segment fixation. OBJECTIVE:Based on the atlas CT measurement data,a new posterior atlas fracture reduction and internal fixation system was designed and optimized,which was in line with the characteristics of human local anatomical structure,easy to operate and with good reduction. METHODS:CT images of 347 adults were analyzed retrospectively.In the images,the length of pedicle screw track with a medial inclination of 0°,the angle of the maximum medial inclination angle and the length of pedicle screw track at this time,the height of vertebral artery groove,the distance between the entry points of bilateral pedicle screws and the midline,the radius of the posterior arch of atlas,the distance between the posterior tubercle of the atlas and the posterior edge of the foramen magnum,and the distance between the posterior tubercle of the atlas and the upper surface of the axial arch were measured.The imaging data were analyzed and a reduction and internal fixation system was designed and optimized for atlas fracture in line with human anatomical characteristics. RESULTS AND CONCLUSION:(1)There was no statistically significant difference in the the length of pedicle screw track with a medial inclination of 0°,the maximum medial inclination angle and the length of pedicle screw track at this time,the height of vertebral artery groove,the distance between the entry points of bilateral pedicle screws and the midline,the radius of the posterior arch of atlas,the distance between the posterior tubercle of the atlas and the posterior edge of the foramen magnum,and the distance between the posterior tubercle of the atlas and the upper surface of the axial arch measured on the left and right sides of all subjects(P>0.05).There were statistically significant differences in each index measured between the male and female groups(P<0.05).(2)The new posterior atlas fracture reduction and internal fixation system has been successfully designed and obtained the national patent.The internal fixation system is suitable for the anatomical characteristics of the posterior arch of the atlas.It can not only effectively treat the atlas burst fracture,but also retain the movement function of the occipital atlantoaxial joint.