Objective To study the cardiac function effect of allopurinol for hypemricemia combined with dilated cardiomyopathy patients.Methods One hundred and twenty hypemricemia combined with dilated cardiomyopathy patients were divided into allopurinol group and control group according to the treatment method with 60 cases each.All the patients were given conventional treatment,the control group was added the nitroprusside treatment,and the allopurinol group was added the allopurinol and nitroprusside treatment.The treatment period was 3 months.Results The total effective rate in allopurinol group was significantly higher than that in control group [90.0％ (54/60) vs.75.0％ (45/60)],there was statistical difference (P ＜ 0.05).After treatment,the left ventricular ejection fraction and left ventricular posterior wall thickness at end-systole in allopurinol group were significantly higher than those in control group [(67.85 ± 7.12)％ vs.(30.78 ±7.00)％ and (1.40 ±0.20) mm vs.(1.16 ±0.18) mm[,but the left ventricular internal diameter at end-systole,left ventricular internal diameter at end-diastole and left ventricular posterior wall thickness at end-diastole were significantly lower than those in control group [(4.72 ± 0.41) mm vs.(6.48 ± 0.47) mm,(2.93 ± 0.32) mm vs.(5.56 ± 0.62) mm and (0.77 ± 0.13) mm vs.(0.92 ± 0.18) mm],there were statistical differences (P ＜ 0.05).After treatment,The uric acid,urea nitrogen and creatinine were significantly lower than those in control group [(45.43 ± 11.24) μ mol/L vs.(167.23 ± 19.22) μ mol/L,(10.23 ± 7.12)mmol/L vs.(40.93 ± 8.09)mmol/L and (32.01 ± 8.34) mmol/L vs.(78.09 ±9.11) mmol/L],there were statistical differences (P ＜ 0.05).Conclusion Allopurinol used for treating hyperuricemia combined with dilated cardiomyopathy patients can reduce uric acid,early reversal the atherosclerosis and improve heart function,it should be widely applied research.

Objective:To observe the effect of triptolide on asthmatic mice IL-23, Th17 cells and their cytokine IL-17 expression,and to explore its effect on Th17 cell-mediated airway inflammation,and its mechanism of action,which provides targets for triptolide in treatment of asthma.Methods: 32 SPF level BALB/c mice were randomly divided into normal control group ( NC ) , asthmatic group ( A ) , triptolide group ( TA group ) and dexamethasone group ( DA group ) , n=8.Asthmatic group with ovalbumin sensitization and aluminum hydroxide;ovalbumin intranasal inhalation challernge.Mice of triptolide group and dexamethasone group were sensitized and challenged as asthmatic group, and the two groups were respectively given triptolide and dexamethasone by intraperitoneal injection 30 minutes before challenged.Mice of control group was sensitized and challenged by saline.The total number of white blood cells and the number of eosinophils of BALF were calculated by cell counter.IL-23 and IL-17 levels in BALF were measured by ELISA.Lung tissue were stained with hematoxyin and eosin(HE).IL-17 protein expression levels were detected by immu-nohistochemistry in lung tissue,and the mRNA expression levels of right lung tissue were detected by qRT-PCR.Th17 percentage of CD4+T lymphocytes were analyzed by flow cytometry.Results:Numbers of white blood cells( WBC) and eosinophils( Eos) of BALF, IL-23 and IL-17 levels of BALF,IL-17 protein and IL-17 mRNA expression in lung tissue,and Th17 cell frequencies in peripheral blood were all significantly increased in the asthmatic group compared to the control group(P<0.05),but reduced significantly in triptolide group and dexamethasone group compared to asthmatic group;there was no significant difference in the above mentioned indicators between in triptolide group and dexamethasone group ( P>0.05 ) .Conclusion: Triptolide can inhibit airway inflammation, which mechanism is possible by inhibiting IL-23/Th17(IL-17) inflammatory axis.

Objective:To detect the expressions of COX-2 protein and BCL-2 protein in transitional mucosa adjacent to rectal carcinoma,and determine whether the transitional mucosa was the cancer precursor event.Methods:Mucin histochemical method was employed to detect the distal mucosa 2 cm away from rectal tumor and the transitional mucosa was found in 54 cases of rectal carcinoma.Immunohistochemical method was used to investigate the expressions of BCL-2 and COX-2 protein in the specimen of rectal carcinoma mass,transitional mucosa and non-transitional mucosa,and 20 cases of normal rectal mucosa,and the points of the expressions of COX-2 protein and BCL-2 protein were counted.Results:35.19%(19/54)of distal mucosa were characterized as the transitional mucosa.The expressions of COX-2 and BCL-2 protein were detected in carcinoma mass and distal mucosa.Significant difference was observed in carcinoma mass and transitional mucosa(p<0.01).But there were no significant differences between the expressions of those in transitional mucosa and non-transitional mucosa(p>0.05),as well as transitional mucosa and normal mucosa(p>0.05).Conclusion:The performance of transitional mucosa was not the cancer precursor event,but the non-specificity reaction of carcinoma or inflammation.

Objective To investigate the effect of histone deacetylase inhibitor trichostatin A (TSA) on the chemotherapy sensibility of 5-fluorouracil (5-Fu) in colorectal cancer cell line Lovo, and to explore the possible mechanisms.Methods According to the treatment methods, the cells were divided into control group, 5-Fu group, TSA group, TSA preconditioning group and combination group (TSA+5-Fu).MTT assay was used to detect cell proliferation at 24 h, 48 h and 72 h after drugs treatment.Transwell assay was used to test cell invasion after 24 h drugs treatment.Flow cytometer was applied to observe the apoptosis after 24 h drugs treatment.The expressions of thymidylate synthase (TS) were detected by Western blot after 24 h drugs treatment.Results Compared with control group, the 5-Fu group, TSA preconditioning group and combination group had a growth inhibition to Lovo cell at 24 h, 48 h and 72 h (P ＜ 0.05), and compared with 5-Fu group, the growth inhibition of TSA preconditioning group and combination group were distinctive at 48 h and 72 h (P ＜ 0.05).However, the inhibition between TSA preconditioning group and combination group were no significant (P ＞ 0.05).Interfered after 24 h, the number of cells penetrating the matrigel in control group, 5-Fu group, TSA group,TSA preconditioning group and combination group were (25.0±4.2), (16.8±2.8), (19.6± 2.5), (8.2±3.2) and (6.5±2.6), respectively (P ＜ 0.05), and the apoptosis rates were (4.26±1.36) ％, (11.66± 3.18) ％, (8.57±2.69) ％, (39.79±8.53) ％ and (45.18±10.07) ％, respectively (P ＜ 0.05).Compared with control group, the number of cells penetrating the matrigel in the experimental groups was significantly decreased, and the apoptosis rate was significantly increased (P ＜ 0.05).Compared with 5-Fu group, the numbers of cells penetrating the matrigel in TSA preconditioning group and combination group were markedly decreased, and the apoptosis rates were markedly increased (P ＜ 0.05), but the number of cells penetrating the matrigel and the apoptosis rate between TSA preconditioning group and combination group were not different (P ＞ 0.05).The difference of TS expression between control group and 5-Fu group was not significant (P ＞ 0.05).Compared with that in control group and 5-Fu group, TS expressions in TSA group, TSA preconditioning group and combination group were markedly decreased (P ＜ 0.05), but TS expressions among the last three groups were not different (P ＞ 0.05).Conclusion TSA can increase the chemotherapy sensibility of 5-Fu in Lovo cells, which may be dependent on reducing the TS expression.

OBJECTIVETo explore the clinical effect of the lobulated medial sural artery perforator flap in repairing soft tissue defect in hand or foot.

METHODSSince March 2012 to September 2014, 6 cases with soft tissue defects in hands or feet were treated by lobulated medial sural artery flaps pedicled with 1st musculo-cutaneous perforator and 2st musculo-cutaneous perforator of the medial sural artery. The size of the flaps ranged from 4.5 cm x 10.0 cm to 6.0 cm x 17.0 cm.

RESULTS5 cases of lobulated flap survived smoothly, only 1 lobulated flap had venous articulo, but this flap also survived after the articulo was removed by vascular exploration. All flaps had desirable appearance and sensation and the two-point discrimination was 6 mm in mean with 4 to 12 months follow-up (average, 7 months). Linear scar was left in donor sites in 3 cases and skin scar in 3 cases. There was no malfunction in donor sites.

CONCLUSIONSLobulated medial sural artery perforator flap is feasible and ideal method for the treatment of soft tissue defect in hand or foot with satisfactory effect.

Arteries ; Cicatrix ; Follow-Up Studies ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Perforator Flap ; transplantation ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Time Factors ; Wound Healing

Objective To investigate the ultrasonographic and pathological changes of peripheral pulmonary lesions in acquired immunodeficiency syndrome (AIDS) complicated with Penicillium marneffei pneumonia (PMP) and their clinical significance.Methods The ultrasonographic and pathological data of peripheral pulmonary lesions in 31 cases of AIDS complicated with PMP who were diagnosed in Fourth People's Hospital of Nanning were retrospectively reviewed.Results Among 31 cases of PMP,20 cases (64.5％) showed star-like diffuse sonogram,7 cases (22.6％) low solid echo and 4 cases (12.9 ％) black hole-like sonogram in ultrasonographic changes of peripheral pulmonary lesions.In pathological examination,Penicillium marneffei were seen in all samples:periodic acid-Schiff stain (PAS) and periodic acid-Schiff diastase stain (PAS-D) were all positive.Twenty four cases (77.4％) mainly showed infiltration of inflammatory cells,and 7 cases (22.6 ％) mainly showed necrosis and fibrous hyperplasia.Among 20 patients with star like diffuse sonogram,19 were mainly infiltration of inflammatory cells in pathological changes,and 19 were CD4+ T lymphocyte counts of 100-200/μL.Among 4 patients with black hole-like sonogram,all were necrosis in the central and hyperplasia in the peripheral in pathological changes,and CD4-T lymohocyte counts were all＜50/μL.Conclusions In AIDS patients complicated with PMP,ultrasonographic features were probably correlated with pathological changes in biopsy tissues and CD4-T lymphocyte counts.

OBJECTIVE: To discuss the diagnosis and management of pulsatile tinnitus of venous origin. METHOD: A retrospective study was conducted on 12 patients who were diagnosed with pulsatile tinnitus of venous origin and treated with ligation of internal jugular veins. We reevaluated the evidences of identifying pulsatile tinnitus of venous origin and reviewed the short-term and long-term postoperative effects and complications. We also reviewed associated articles in this report. RESULT: Seven patients got relief of tinnitus in less than one week after the surgery, while the other 5 patients had no relief. Seven patients were inquired in this study and the other five lost to follow-up. According to the long review (from one to five years postoperatively), two patients who acquired immediate effect got relief of tinnitus, four including complained of no relief and the seventh aggravated into roaring. Three patients who got no immediate relief got no improvement at all. No one in our review complained of any complications. CONCLUSION It's assumed that a history of pulsatile tinnitus, alleviation of tinnitus when pressing jugular veins, tinnitus changing with head position or posture and no occupying lesion in temporal CT scan or cranial MRI are inadequate in diagnosing pulsatile tinnitus of venous origin. Vascular imaging is also necessary to exclude other pathological changes like dura arteriovenous fistula, sigmoid diverticulum and so on. CT arteriography and venography are recommended preferentially. Ligation of internal jugular veins is controversial in patients who have no absence of transverse and sigmoid sinus and identified as pulsatile tinnitus of venous origin.
Adult ; Female ; Humans ; Jugular Veins ; surgery ; Middle Aged ; Retrospective Studies ; Tinnitus ; diagnosis ; surgery ; Vascular Surgical Procedures

Objective To identify Chinese character writing related cortex (WRC) and its relationship with hand motor cortical areas. Methods Ten native Chinese-speaking, right-hand volunteers were recruited in the study. NTMS mapping was conducted during picture naming task. The WRC were mapped based on nTMS-induced impairment of Chinese character writing. The extent and area of WRC was calculated. The right-hand motor representations were mapped while motor-evoked potentials were produced under nTMS stimulation. EMG data and coordinates of positive stimulus were recorded. The relationship between WRC and hand motor cortex (HMC) was analyzed on the basis of area comparison and distance calculation. Results The cortical areas related to Chinese character writing were mapped successfully in all subjects by nTMS. WRC was primarily centered in left posterior middle frontal gyrus (pMFG) (86%,55/64). The mean WRC area (161.03 mm2 ±62.58mm2) was significantly smaller than the mean HMC area (589.50 mm2±227.34mm2) (P<0.001). The WRC and HMC were not conjoined or overlapped in the dominant hemisphere. The distance between those two was 12.58mm±2.71mm. Conclusions NTMS can provide reliable assistance in mapping WRC areas. The WRC is relatively fixed and centralized in pMFG but is not overlapped with the HMC.

Objective To evaluate the effect of MRS-assisted stereotactic radiosurgery (SRS) for small recurrent high grade glioma (HGG).Methods A total of 54 patients with recurrent HGG were selected,the tumor diameter was less than 3 cm,the patients were divided into the conventional MRI group of 26 cases,and MRI+MRS group of 28 cases.The target region of the conventional MRI group was defined as the enhanced and short T1,long T2 area;MRI+MRS group was defined as the region of Cho/NAAindex (CNI) ≥1.6 in the surrounding short T1,long T2 and enhanced area.All the patients were followed up at least 12 months,analysed their therapeutic effect.Results Compared with the conventional MRI group,MRS+MRI group margin dose increased (19.46 Gy vs.13.58 Gy),the average diameter of target were smaller (2.6 cm vs.3.0 cm),progression-free survival was longer (6.8 months vs.5.6 months),the 1-year survival rate was higher (78.6％ vs.50.0％),and the occurrence rate of brain edema was lower (5 vs.17),the difference was statistically significant (P＜0.05).Conclusion MRI+-MRS assisted SRS helps to accurately identify the scope of HGG,its short term effect was superior.

Objective:To analyze the clinical outcomes of tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate for treatment of segmental bone defect.Methods:A retrospective analysis was conducted by enrolling 11 surgically treated patients with tibial segmental bone defect after the debridement for tibial infection or osteomyelitis who were admitted in Lower Limb Surgery Ward of Traumatic Orthopedic Department, Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from Jan. 2018 to Jan. 2020. The collected clinical materials and data included gender, age, injury mechanism, smoke or alcohol, comorbidities, intraoperative bleeding loss, bone defect length, resorption time of calcium sulphate, bone transport time, external fixation time, external fixation index, complications and Paley bone and functional criteria. SPSS 24.0 software was used to analyze the data.Results:Eleven patients were followed up for 8 to 31 months (average 23.2 months). All patients achieved bone healing and the infection was eradicated with no sign of recurrence. The mean length of defect was (8.1±1.6) cm, mean resorption time of calcium sulphate was (6.6±2.6) months, bone transport time was (11.4±2.8) weeks, external fixation time was (4.7±1.2) months, external fixation index was (0.58±0.07) month/cm and full weight bearing time was (6.1±1.4) months. The complication rate was 36.4% including deep vein thrombosis, delayed union of the docking site, pin tract infection and sterile draining of the wound. Paley bone evaluation results were excellent and good in 10 patients (90.9%) and functional results were excellent and good in 11 patients (100%).Conclusion:Tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate is a safe, reliable and successful method for segmental bone defect and eradication of infection which reduces external fixation time and complication rate, allows patients perform weight bearing and return to daily life earlier.