OBJECTIVE: To study clinical characteristics, diagnosis, pathological types and therapy methods of nonsquamous cell neoplasm in subglottis, in order to improve comprehension of this rare disease. METHOD: To analysis 3 patients' clinical data with noosquamous cell neoplasm in subglottis by reviewing related literature, and to generalize the symptoms, differentiation and treatment experience of nonsquamous cell neoplasm in subglottis. RESULT: Among the 3 patients, one's main complain was hoarseness and the other two's main symptom was inspiratory dyspnea. As diagnosis was definite and acute obstruction of airway was relieved, the neoplasms were removed totally. Two patients were undergone operation through oral cavity by using suspended laryngoscope, and one patient was done surgery by neck approach. Paraffin wax result showed that one patient suffered epithelial-myoepithelial carcinoma, who received radiotherapy after surgery. There is no recurrence in all patients by following up more than 1 year. CONCLUSION The occurrence of nonsquamous cell neoplasm in subglottis is relatively low, and the subglottis should be inspected carefully to avoid missed diagnosis. Operation is the preferred method to treat this kind of disease. To choose a suitable operational manner according to size, location of the neoplasm is crucial.
Female ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged

Objective To discuss the influence of comprehensive rehabilitative nursing by traditional Chinese medicine(TCM)the neural function impairment, activity of daily living(ADL)and accompanying complications of patients in acute phase of cerebral apoplexy. Methods 238 patients from 3 cooperative hospitals from September in 2004 to September in 2006 were randomly chosen and divided into the test group(117 cases)and the control group(121 cases).The medication treatment in the two groups were basically the same. The comprehensive rehabilitative nursing with traditional Chinese medicine was adopted in the test group and the control group received routine nursing intervention. The clinical nerve function limitation score(CNS)and the ADL were evaluated within the first week and the 4th week after intervention. The incidence rate of complications was also determined. Results The CNS and ADL results in the observation group were better than those in the control group(P＜0.01).The incidence rate was lower than that in the observation group. Conclusion The comprehensive rehabilitative nursing by TCM could facilitate the functional recovery of limbs and improve activity of daily living.This intervention could be applied in clinic, family and community because of its characteristics such as simplicity, feasibility and little adverse effect.

Objective:To study short-term effects of PM10(particulate matter of aerodynamic diameter

Objective: To analyze the uncertainty of quercetin concentration determination in Sicao Tongmai capsules by HPLC. Methods: The source of uncertainty was confirmed by analyzing the HPLC determination process. The uncertainty components were quantified by statistics, and the extended uncertainty and confidence level were finally obtained. Results: The extended uncertainty of the measurement results was 0. 19 μg · g-1 . Quercetin concentration in Sicao Tongmai capsules was (353. 65 ± 0. 19)μg·g-1 . Conclusion: The uncertainty analysis method is suitable for the standard limit formulation for Sicao Tongmai capsules, and it is important to establish uncertainty analysis methods for traditional Chinese medicines.

Objective To assess the effectiveness of iterative metal artifact reduction (IMAR) on metal artifacts reduction in thorax scan.Methods Thoracic phantom with two pedicle screws implanted in both sides of the T5 vertebrae was used,with the scan parameters of 130 kV and CARE Dose 4D,the phantom was scanned with and without the screws respectively.Images without screws were reconstructed with FBP.Images with screws were reconstructed with FBP and IMAR respectively.Three ROIs were selected on tissues including aorta,pulmonary and paravertebral soft tissue on image slice adjacent to the screws.The CT value and standard deviations (noise) of ROIs were measured,and the deviation of CT value (△HU) was calculated as the difference between CT values in images with and without screws.Twenty-six cases who received chest CT examination and with pedicle screw implant in scanning range were collected.The scanning parameters and image reconstruction methods were the same as phantom scan.The CT value (HU) of metal artifacts adjacent to vertebrae and dorsal soft tissue was measured,and the image quality of reconstructed image by two skilled radiologists independently was evaluated.Results In the phantom after implanted screws,the noise were significantly reduced by IMAR compared to FBP in all the three ROIs of aorta,pulmonary and paravertebral soft tissue (P＜0.05),and the △HU was significantly smaller in IMAR compared to that with FBP (P＜0.01).In 26 patients,there were significant differences in CT value of vertebral bone tissue and dorsal soft tissue between FBP and IMAR (P＜0.05),and the subjective evaluation scores of the two image reconstruction methods showed a statistically significant difference (P＜0.05).Conclusion IMAR can significantly reduce streak artifacts of metal implant and adjuste the CT values of artifact affected tissues to make it more close to the true value without metal implant.

Rapid progression or aggravation of jaundice, coagulation abnormalities and liver-related complications in patients with alcoholic hepatitis indicates that they may develop severe alcoholic hepatitis. Some of these patients can progress acute-on-chronic liver failure with acute insults, such as infection and binge drinking and binge, showing as acute decompensation, organ failure and high 28-day mortality rate. Early identification and effective intervention can improve the prognosis of acute-on-chronic liver failure. Intestinal barrier dysfunction and liver-gut axis imbalance play an important role in the development of severe alcoholic hepatitis and acute-on-chronic liver failure. It is important to improve the basic nutritional status of patients. Effective drug therapies are limited in improving the condition and prognosis of acute-on-chronic liver failure. Early liver transplantation can bring great benefits to these patients.

The American College of Gastroenterology published the clinical guideline on alcohol-associated liver disease （ALD） in January 2024 in American Journal of Gastroenterology. This guideline elaborates on the epidemiology and disease burden of ALD and alcohol use disorder， the risk factors for ALD， the diagnosis and treatment of alcohol use disorder， the disease spectrum of ALD， the management of ALD， and public policy and prevention. This article gives an excerpt of the recommendations and key points/statements in this guideline.

Objective To explore the protective effect and mechanism of hydrogen-rich water (HRW) on ethanol-induced acute gastric injury.Methods The experimental study was conducted.Forty kunming mice were divided into the 4 groups by random number table method:normal control group [0.01 mL/g normal saline (NS)+ 0.03 mL/g NS],HRW group (0.01 mL/g NS +0.03 mL/g HRW),ethanol model group (0.01 mL/g 56°alcoholic drinks +0.03 mL/g NS),HRW treated group (0.01 mL/g 56°alcoholic drinks +0.03 mL/g HRW).Ten mice in each group were administrated twice a day for 7 days.Testing indicators:(1) gastric ulcer index was measured,(2) pathological examination of gastric tissues,(3) activity of serum superoxide dismutase (SOD) and expressions of malondialdehyde (MDA),interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured,(4) expressions of SOD and MDA in gastric tissues were measured,(5) protein expressions of apoptosis related factors (caspase-3,bax,caspase-9,fas and caspase-8) in gastric tissues were measured by immunohistochemistry,(6) relative expressions of mRNA of apoptosis related factors (caspase-3,bax,caspase-9,fas and caspase-8) in gastric tissues were measured by realtime polymerase chain reaction (RT-PCR).Measurement data with normal distriburion were presented as (x)±s.Comparisons among groups were done using the one-way ANOVA and comparison between groups was done using the LSD-t test.Results (1) Gastric ulcer index was measured:gastric ulcer index of mice in the normal control group,HRW group,ethanol model group and HRW treated group were respectively 0,0,10.40± 1.64 and 3.92 ± 0.23,with statistically significant differences (F=175.050,P＜0.05).There was a statistically significant difference between the ethanol model group and normal control group or HRW treated group (t =19.835,12.352,P＜ 0.05).(2) Pathological examination pathological examination of gastric tissues:① Macropathology of gastric tissues:the surface of the gastric mucosa was normal and smooth in the normal control group and the HRW group,without ulcer,erosion and inflammation.The partial gastric mucosal erosion and ulcer in the ethanol model group was large and very severe.Compared with the ethanol model group,the area of gastric mucosal lesion was reduced in the HRW treated group.② Results of pathological examination of gastric tissues:gastric mucosa in the normal control group and HRW group were integrity.Compared with the normal control group,the partial gastric surface epithelium was degenerate and impaired in the ethanol model group.Compared with the ethanol model group,the gastric mucosal erosion and inflammatory cell infiltration were alleviated in the HRW treated group.(3) Expressions of serum SOD,MDA,IL-6 and TNF-α:expressions of serum SOD,MDA,SOD/MDA and IL-6 were respectively (70±6)U/mL,(7.52±0.23) μmol/L,9.40 ± 1.07,(6.3 ± 1.8) ng/L in the normal control group and (74 ± 4) U/mL,(7.61 ±0.91) μmol/L,9.91 ± 1.55,(5.1 ± 1.6)ng/ L in the HRW group and (101 ± 4) U/mL,(16.95 ± 0.66) μmol/L,5.99±0.17,(19.2±4.9) ng/L in the ethanol model group and (115±5) U/mL,(14.02±0.58) μmol/L,8.23±0.32,(7.1±1.8)ng/L in the HRW treated group,with statistically significant differences among the 4 groups (F=97.405,269.950,16.486,25.663,P＜0.05).The serum TNF-α levels were respectively (53± 14) ng/L,(67± 17) ng/L,(52± 13) ng/L,(58±21) ng/L in the above 4 groups,with no significant difference (F=0.862,P＞0.05).(4) Expressions of SOD and MDA in gastric tissues were measured:expressions of SOD and MDA and SOD/MDA were respectively (93 ± 18) U/mL,(7.90± 1.72) μmol/L,12.48±4.54 in the normal control group and (93±13) U/mL,(6.96± 1.49) μmol/L,13.83±3.40 in the HRW group and (121±31) U/mL,(17.10±4.88) μmoL/L,7.88± 3.70 in the ethanol model group and (143 ± 26) U/mL,(7.31 ± 1.58) μmoL/L,20.00±4.68 in the HRW treated group,with statistically significant differences among the 4 groups (F=5.463,15.051,7.388,P＜ 0.05).(5) The expressions of apoptosis related factors in gastric tissues:the results of immunohistochemistry showed that the levels of caspase-3,bax and fas were repectively 0.065 5± 0.003 7,0.065 7±0.003 0,0.225 4±0.024 3 in the normal control group and 0.065 7±0.002 7,0.064 9±0.003 0,0.246 0±0.022 3 in the HRW group and 0.330 7±0.017 3,0.335 4±0.033 3,0.397 0±0.028 5 in the ethanol model group and 0.096 7±0.003 0,0.084 8±0.001 7,0.375 0±0.035 6 in the HRW treated group,showing statistically significant differences among the 4 groups (F=1 004.222,309.171,48.555,P＜0.05).The levels of caspase-9 and caspase-8 were respectively 0.049 2±0.000 4,0.151 5±0.010 2 in the normal control group and 0.047 9±0.002 0,0.154 00.013 5 in the HRW group and 0.047 0±0.003 7,0.157 2±0.006 2 in the ethanol model group and 0.048 7±0.000 8,0.153 9±0.006 3 in the HRW treated group,with no statistically significant difference among the 4 groups (F=0.998,0.297,P＞0.05).(6) The mRNA expressions of apoptosis related factors in gastric tissues:resutls of RT-PCR showed that relative expressions of mRNA of caspase-3,bax,caspase-9 and fas were respectively 1.00±0.00,1.00±0.00,1.00±0.00,1.00±0.00 in the normal control group and 0.72±0.43,0.66±0.26,1.57±0.31,0.50±0.19 in the HRW group and 3.19±0.87,1.58±0.76,3.04± 1.15,2.84±0.98 in the ethanol model group and 0.49±0.16,0.69±0.25,2.98±0.85,0.53±0.24 in the HRW treated group,showing statistically significant differences among the 4 groups (F=32.106,5.038,9.706,23.387,P＜0.05).The mRNA levels of caspase-8 were respectively 1.00±0.00,1.50±0.60,1.36±0.34,1.32±0.43 in normal control group,HRW group,ethanol model group and HRW treated group,with no significant difference among the 4 groups (F=1.337,P＞0.05).Conclusions Hydrogen-rich water could alleviate ethanolinduced acute gastric injury by antioxidant,anti-inflammatory and anti-apoptosis.Hydrogen-rich water is safe and reliable,without toxic and side effects on the body.

Chronic and heavy alcohol consumption is one of the causes of heart diseases. However, the effects of ethanol on insulin sensitivity in myocardium has been unclear. To investigate the effects of ethanol on the expression of AMP-activated protein kinase (AMPK), myocyte enhancer factor 2 (MEF2) and glucose transporter 4 (GLUT4), all of which are involved in the regulation of insulin sensitivity, in the myocardium, we performed three parts of experiments in vivo and in vitro. I: Rats were injected with 5-amino-4-imidazolecarboxamide ribonucleotide (AICAR, 0.8 mg.kg(-1)) for 2 h. II: Rats received different dose (0.5, 2.5 or 5 g.kg(-1).d(-1)) of ethanol for 22-week. III: Primary neonatal rat cardiomyocytes were isolated and treated with or without 100 mM ethanol or 1 mM AICAR for 4 h. The cardiac protein and mRNA expression of AMPKalpha subunits, MEF2 and GLUT4 were observed by western-blotting and RT-PCR, respectively. Serum TNFalpha levels were assessed by ELISA. The results showed chronic ethanol exposure induced insulin resistance. Ethanol decreased the mRNA levels of AMPKalpha1 and alpha2, the protein levels of total- and phospho-AMPKalpha in cardiomyocytes. Similarly, ethanol showed inhibitory effects on both the mRNA and protein levels of MEF2A and 2D, and GLUT4 in a dose-response-like fashion. Correlation analysis implied an association between phospho-AMPKalpha and MEF2A or MEF2D, and between the levels of MEF2 protein and GLUT4 transcription. In addition, ethanol elevated serum TNFalpha level. Taken together, chronic ethanol exposure decreases the expression of AMPKalpha and MEF2, and is associated with GLUT4 decline in rat myocardium.
AMP-Activated Protein Kinases/genetics/*metabolism ; Aminoimidazole Carboxamide/analogs & derivatives/pharmacology ; Animals ; Enzyme Activation/drug effects ; Ethanol/*administration & dosage/*pharmacology ; Feeding Behavior/*drug effects ; Gene Expression Regulation/drug effects ; Glucose Transporter Type 4/genetics/*metabolism ; Insulin/pharmacology ; Insulin Resistance ; Male ; Myocardium/*enzymology ; Myogenic Regulatory Factors/antagonists & inhibitors/genetics/*metabolism ; Protein Isoforms/antagonists & inhibitors/genetics/metabolism ; RNA, Messenger/genetics/metabolism ; Rats ; Rats, Wistar ; Ribonucleotides/pharmacology ; Time Factors ; Tumor Necrosis Factor-alpha/blood

OBJECTIVE: To carry out genetic analysis for 21 patients with methylmalonic acidemia (MMA) and provide genetic counseling for their families. METHODS: Next generation sequencing (panel) was used to detect the pathogenic variants underlying the disease. RESULTS: In total 29 variant sites of MMUT, MMAA, MMUT were identified in the 21 patients, with common variants including c.323G>A (10%), c.917C>T (10%), c.984delC (10%) of MMUT gene, and c.609G>A (45%), c.80A>G (10%) , c.567dupT (10%) of MMACHC gene. Among these, c.2000A>G of MMUT, c.298G>T of MMACHC and c.734-7A>G of MMAA gene were unreported previously. CONCLUSION Genetic testing for MMA patients can clarify the cause of the disease and provide a basis for the clinical diagnosis. Discovery of novel variants has enriched the mutational spectrum of MMA.
Amino Acid Metabolism, Inborn Errors/genetics* ; Genetic Testing ; High-Throughput Nucleotide Sequencing ; Humans ; Mutation ; Oxidoreductases/genetics*