IgG4-related disease (IgG4-RD) is a newly recognized disease entity. IgG4-RD is characterized by a single or multiple masses in one or more organs; a lymphoplasmacytic infiltrate with a high percentage of plasma cells within the lesion staining for IgG4; a peculiar pattern of fibrosis known as "storiform" fibrosis; and elevated serum IgG4 concentrations. IgG4-RD can occur in various organs, including pancreas, kidneys, lungs, retroperitoneum, and prostate gland. The head and neck involvements of IgG4-RD have been chiefly described in Mikulicz disease (MD), Küttner's tumor, orbital? inflammatory pseudotumor, and idiopathic hypertrophic pachymeningitis (IHP) previously. Recent studies reported that IgG4-RD could also involve ear, nose and throat. Here we reviewed the literatures about ear, nose and throat involvement by IgG4-RD, in order to provide some theoretical bases for the diagnosis and treatment of IgG4-RD.
Autoimmune Diseases ; physiopathology ; Ear ; physiopathology ; Fibrosis ; Humans ; Immunoglobulin G ; Nose ; physiopathology ; Pharynx ; physiopathology ; Plasma Cells ; pathology

Objective To investigate the relationship among the spinous process open degree,the relative displacement of the lumbar facet joints(LFJ),and the morphologic change of the intervertebral foramina.Methods From Nov 2010 to Jun 2012,a total of 6 human fresh cadaveric spines was used in this study.All the ligaments were kept.The relative displacement of the corresponding segments LFJ,and the change of height and width of intervertebral foramen were measured through the corresponding open L3-4 and L4-5 spinous process,respectively.Results Lumbar degeneration was described with the following indices including the proliferation and displacement of LFJ,deformation of the intervertebral foramen morphogenesis,nerve root oppression,and lumbar intervertebral stenosis.When the interspinous process spacer was opened up to 2 mm,lumbar intervertebral foramen heights at the L3-4 and L4-5 [(15.62 ± 0.73) mm,(14.67 ± 0.75) mm] were significantly increased (t =26.00,16.02,P ＜ 0.01) compared to the original state [(13.89 ± 0.77) mm,(12.48 ± 0.80)mm].When the interspinous process spacer was opened up to 4mm,lumbar intervertebral foramen heights at the L3-4 and L4-5 [(17.13 ± 0.78) mm,(16.74 ± 0.76) mm] were significantly increased (t =36.15,30.69,P ＜ 0.01) compared to the original state.The foraminal height with a 4 mm distraction was significantly greater than the 2 mm distraction (t =20.82,21.72,P ＜0.01).When the interspinous distraction was 2 mm,L FJ displacement at the L3-4and L4-5 [(0.31 ±0.04) mm,(0.34 ± 0.07) mm] was significantly better than the original state [(0.63 ± 0.03) mm,(0.56±0.05)mm] (t =61.97,58.91,P ＜0.01).When the interspinous distraction was 4 mm,LFJ displacement at the L3-4 and L4-5 [(0.10 ±0.04) mm,(0.12 ±0.06) mm] was significantly better than the original state (t =18.69,18.88,P ＜0.01).No significant difference was found in the change of the intervertebral foramen width [(8.65 ± 0.38) mm,(7.78 ± 0.37) mm] at the 2 mm interspinous distraction compared to the original state(P ＞ 0.05),but a statistically significant difference was found at the 4 mm interspinous distraction compared to the original state [(9.03 ± 0.41) mm,(8.05 ± 0.32) mm] (t =7.78,7.97,P ＜ 0.01).Conclusions Spinous process shove off can effectively improve LFJ displacement,and increase the intervertebral foramen height,but the increase of its width needs to shove off enough distance.

Objective To discuss the short-term currative effect of horizontal osteotomy across injured vertebral forⅤdegree old frac-ture-dislocations of thoracolumbar spine.Methods The data of 4 patients who received horizontal osteotomy across injured vertebral internal fixation in our hospital from April 2010 to October 2012 were retrospectively analyzed,of which 1 case with T8-9 fracture dislocation,2 cases with T10-11 fracture dislocation,1 case with T11-12 fracture dislocation.The Franke1 classification of all patients were grade A.Results All 4 cases were achieved completely fracture reduction and followed-up for 2-14 months(an average of 7.4 months),who could get sitting posi-tion with the support of brace 1 week after operation.The postoperative follow-up indicated that all 4 cases got fusion,but there was no improve-ment for Franke1 classification.Conclusion The method of horizontal osteotomy across injured vertebral forⅤdegree old fracture-dislocations of thoracolumbar spine has good short-term clinical effect,with the advantages of shorter operation time,less bleeding and good reduction effect.

Objective To evaluate the diagnostic value of conventional and dynamic contrast- enhanced MRI in lymphoma of the orbit.Methods Thirteen cases of lymphoma of the orbit,including B-C (10 cases),T-C (1 case),T-NK-C (1 case)lymphoma,and multiple myeloma (1 case),were studied using conventional MR and dynamic contrast-enhanced MR imaging with 3D fast spoiled gradient echo sequence.Calculated values included time to peak (Tpeak),washout ratio (WR),slope and enhancement ratio (ER),and time-intensity curves (TICs),and Tpeak,WR,slope and ER were calculated preoperatively.Results Eleven of the 13 lymphomas of the orbit was seen in the anterior portion of the orbit including eyelid and lacrimal gland.On conventional MRI,10 cases showed iso-intensity on T_1WI and T_2WI and all 13 cases showed moderate enhancement after contrast administration.TIC of all 13 cases showed rapid enhancing and wash-out,Tpeak was (58.7?8.5)s,and WR was (30.9?9.4)%.The accurate diagnosis with only conventional MRI was achieved in 6 out of 13 cases,while the accurate diagnosis was achieved in all 13 cases by using combined conventional MRI and dynamic enhanment MRI.Conclusion onventional MRI combined with dynamic contrast-enhanced MRI is useful for the diagnosis of lymphoma of the orbit.

Objective To investigate the role of high mobility group protein2(HMGA2)and E-Cadherin in the development of prostate cancer(PCa). Methods A total of 60 paraffln-embedded specimens of PCa were collected from patients who underwent operation in Dalian Central Hospital from 2008 to 2016.The expression lev-els of HMGA2 and E-Cadherin in the specimens were examined by immunohistochemical staining.The correlations between the expression of HMGA2 and E-Cadherin and clinical features such as age,Gleason score,invasion,me-tastasis and TNM stage were studied. Results The expression levels of HMGA2 in PCas were significantly higher than that in controls(χ2=51.818,P<0.01),but the positive expression levels of E-Cadherin in PCas were lower than that in controls(χ2=53.494,P<0.01).The positive expression of HMGA2 and the loss of E-Cadherin were confirmed in PCa accompanied by metastasis,seminal invasion,Gleason score>7 and stageⅢ~Ⅳ(P<0.05). Overexpression of HMGA2 was associated with down-regulation of E-cadherin(Spearman′s r=-0.569,P<0.01). Conclusions Up-regulation of HMGA2 and down-regulation of E-Cadherin are cooperatively correlated with the invasion and metastasis in PCa.

Through researches of channels and collaterals and clinical practice of many years, the authors understand that Chinese medicine, which considers the human body as an interrelated, mutual constraints, whole, dynamic living system, has gradually become an important part of modern medicine. Channels and collaterals are a closed loop system which is communicated and linked by energy and information in the form of electromagnetic oscillation, reflecting many characteristics similar to quantum. Channels and collaterals are not a fixed organizational structure. Studies on channel and collaterals find that the track of the propagated sensation along channels (PSC) have the phenomenon drifting about. This exactly reflects the law of channels dynamically running. By information triggering and living resonance, channels and collaterals bring into play entirely regulative action. The innovative treatment of channels and collaterals followed by characteristics and laws of quantum can get a better curative effect. Theory of channels in the position of quantum information medical science provides an important breach for modernization of Chinese medicine.
Medical Informatics ; Medicine, Chinese Traditional ; trends ; Meridians

Objective To compare and analyze the epidemiological features of adult patients with distal femoral fracture between the east and west areas in China from 2010 to 2011.Methods The data of adult patients with distal femoral fracture treated from January 2010 through December 2011 in 63 hospitals were collected through the PACS system and case reports checking system.The data from 35 hospitals in the east area were classified as group A and those from 28 hospitals in the west area as group B.The analytic items included gender,age and AO classification.Results A total of 2,523 adult distal femoral fractures were collected,involving i,544 males and 979 females,with a male to female ratio of 1.58:1.The adult femoral fractures predominated in an age range from 41 to 50 years (18.94％) and their high-risk type was 33-A (50.18％).In group A of 1,650 cases,there were 1,027 males and 623 females,with a male to female ratio of 1.65:1 and a median age of 48 years;in group B of 873 cases,there were 517 males and 356 females,with a male to female ratio of 1.45:1 and a median age of 45 years.There were no significant differences in the age distribution and gender proportion between groups A and B (P ＞ 0.05).The age distribution showed that the peak ranges were from 31 to 60 years in both groups.The proportion of type 33-A was the most and that of type 33-B the least in both groups.The proportion of type 33-A in group B (53.49％) was significantly higher than in group A (48.42％) while that of type 33-B in group B (16.84％) was significantly lower than in group A (21.39％) (P ＜ O.05).Conclusions Adult distal femoral fractures were common in middle-aged males and their high-risk type was 33-A.Their peak age was from 31 to 60 years in both east and west areas in China.They were more common in men.The predominant fracture type was 33-A in both areas.The east area witnessed a significant higher proportion of type 33-B and a significant lower proportion of type 33-A than the west area.

OBJECTIVETo identify possible reasons of rotational mismatch between tibial component and femoral component in total knee arthroplasty and choose a right reference axis for placing the components in the operation and to decrease the complications.

METHODSForty normal Chinese knees were studied. There were 20 men and 20 women, and average age was 34 years (range, 18 - 42 years). The images of cross sections of the distal femur were obtained by spiral CT scanning (0.5 mm thickness). Scan direction was aligned to be in the plane perpendicular to the mechanical axis of the tibia. On the images of the distal femur and the proximal tibia, three baselines for the anteroposterior axis of the femoral component were drawn based on the clinical epicondylar axis and the surgical epicondylar axis and 3 degrees lateral rotated to the posterior condylar surfaces of the femur separately, and a baseline for the anteroposterior axis of the tibial component was drawn based on the medial 1/3 of the tibial tuberosity. The rotational mismatch angles were measured between each component by using the Autocad software.

RESULTSThe mean rotational mismatch angle between tibial component and femoral component is 2.94 degrees for the clinical epicondylar axis, 6.50 degrees for the surgical epicondylar axis and 6.83 degrees for 3 degrees lateral rotation of the femoral component referenced to the posterior condylar axis separately.

CONCLUSIONSLandmarks of each bone were the intrinsic cause of the rotational mismatch in total knee arthroplasty. The clinical epicondylar axis can be chosen for the ideal reference to rotational alignment of the femoral component because of its minimal rotational mismatch between each component.

Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Knee Joint ; diagnostic imaging ; physiopathology ; surgery ; Male ; Postoperative Complications ; prevention & control ; Range of Motion, Articular ; Tomography, Spiral Computed

OBJECTIVETo study the feasibility of application of ilium inner table to repair the articular surface defects of tibial plateau complex fractures.

METHODSTwenty-three patients with tibial plateau complex fractures included 17 males and 6 females with an average age of 28.3 years old ranging from 18 to 51 years. The area of the articular surface defects ranged from 1 cmx2 cm to 3 cmx3 cm, averaged 6.7 cm2. Taking ilium inner table with periosteum after trimmed and implanting into the articular surface defect area with the concavity upward and drilled with diameter 1.5 mm Kirschner pin interval 3 to 4 mm. Bone grafting were placed under the ilium inner table and were fixed by T-shaped or L-shaped plate. The wounded limb were braked by plaster for 4 weeks after operation.

RESULTSTwenty-three patients were followed-up for 8 months to 3 years, averaged 13.6 months. X-ray film showed solid union and the smooth articular surface in all cases. According to the Rasmussen evaluation system, the results were excellent in 11 cases, good in 8 cases,fair in 3 cases, poor in 1 case.

CONCLUSIONTaking ilium inner table to repair the articular surface defects of tibial plateau complex fractures is a good resolving measures. It can repaire major area of articular surface defects, restore the smooth articular surface and acquire good function of knee joint with easy to operate, less complications at donor area.

Adolescent ; Adult ; Bone Transplantation ; methods ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Ilium ; anatomy & histology ; Joints ; injuries ; transplantation ; Male ; Middle Aged ; Tibial Fractures ; pathology ; physiopathology ; surgery ; therapy ; Treatment Outcome ; Young Adult

Antibodies ; immunology ; therapeutic use ; Antigens, CD20 ; immunology ; Antilymphocyte Serum ; therapeutic use ; CD3 Complex ; immunology ; Diabetes Mellitus, Type 1 ; drug therapy ; immunology ; Humans ; Immunotherapy ; methods