Diagnosis, Differential ; Histiocytoma, Benign Fibrous ; metabolism ; pathology ; Histiocytosis, Langerhans-Cell ; metabolism ; pathology ; Histiocytosis, Sinus ; metabolism ; pathology ; surgery ; Humans ; Infant ; Male ; S100 Proteins ; metabolism ; Xanthogranuloma, Juvenile ; metabolism ; pathology

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Hypothalamus ; metabolism ; Male ; Physical Conditioning, Animal ; physiology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study clinical value of shear wave elastography (SWE) in the evaluation of neck-shoulder myofascial pain syndrome.

METHODSFrom December 2013 to July 2014,30 patients diagnosed as neck-shoulder myofascial pain syndrome were in the treatment group,including 17 males and 13 females, with an average age of (44 ± 3) years old. Thirty healthy people were in the control group, including 22 males and 8 females, with a mean age of (37 ± 5) years old. The patients in the treatment group were treated with manipulation, once every other day, total 7 times. The SWE was used to detect tension part of trapezius muscle of patients in the treatment group before and after treatment, as well as to detect muscle belly at the descending part of trapezius muscle in the control group. The tissue elasticity and Yang's modulus value were recorded and compared.

RESULTSThe tissue elasticity chart of patients in the treatment group before treatment was mainly greenish blue with the score of 3.70 ± 1.53, and the Yang's modulus was (43.4 ± 15.6) kPa. The tissue elasticity figure after treatment was mainly blue with the score of 2.40 ± 0.87, and the Yang's modulus was (29.0 ± 5.9) kPa. Whereas in the control group, the tissue elasticity figure was mainly blue with the score of 1.60 ± 0.72, and the Yang's modulus was (24.0 ± 7.6) kPa. These were statistical differences between the two groups (P = 0.000).

CONCLUSIONSWE can be used as an evaluation method of manipulation treatment for neck-shoulder myofascial pain syndrome, which is an objective and sensitive detection method.

Adult ; Elasticity Imaging Techniques ; methods ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Myofascial Pain Syndromes ; diagnosis ; therapy ; Neck ; Shoulder

OBJECTIVETo summarize our experiences in anesthetic management for the resection of tracheal masses.

METHODSThe clinical data of 15 patients with tracheal masses in Peking Union Medical College Hospital from 2002 to 2012 were analyzed retrospectively. Remarkable dyspnea and tracheal stenosis were observed in 12 patients. Standard orotracheal intubation was carried out in patients with less than 50% of tracheal lumen obstructed. The location of masses was critical for those with severe tracheal stenosis. Local anesthetics were applied and tracheostomy were performed in patients with masses located at the upper part of the trachea. Intubation above the masses was established in patients with masses located at the lower part of the trachea. Percutaneous cardiopulmonary support was introduced before anesthetic induction in a patient with severe respiratory distress and hypercapnea,then an endotracheal tube successfully passed the stenosis guided by a fiberoptic bronchoscope. General anesthesia was induced intravenously and muscle relaxants were applied in all patients. Succinylcholine was administrated in 5 of 6 difficult patients.

RESULTSAirway management and anesthesia were performed successfully in all the 15 patients. After the operations,patients were extubated and discharged from the hospital without difficulty in respiration.

CONCLUSIONSThe successful airway management of tracheal masses depends on the degree and location of stenosis and the severity of dyspnea. Extracorporeal circulation is an optimal choice for those with critical airway occlusion and adequate oxygenation can not be accomplished with conventional anesthesia.

Adolescent ; Adult ; Aged ; Airway Management ; methods ; Anesthesia ; Extracorporeal Circulation ; Female ; Humans ; Intubation, Intratracheal ; Male ; Middle Aged ; Retrospective Studies ; Tracheal Stenosis ; surgery ; Tracheostomy ; Young Adult

Objective To master the implementing progress of preventive measures for control of endemic arsenicosis,to observe the dynamic changes and provide the basis for prevention of national drinking-water-born endemic arsenicosis.Methods The surveillance was strictly carried out according to “The Monitoring Project for the National Drinking-Water-Born Endemic Arsenicosis(trial implementation)” in 2010.According to the results of previous investigation,11 provinces and Xinjiang Production and Construction Corps were selected as the surveillance provinces; eighty six endemic arsenicosis villages which had exposed population over 100 persons were chosen as surveillance villages in each province; forty eight potential endemic arsenicosis villages were recognized as the monitoring villages which had over 100 exposed people too.We investigated the surveillance counties and villages about the running state of water-improving projects,the arsenic content in water from resident house in potential endemic arsenicosis villages and the survey on endemic arsenicosis status based on the residents who lived in the surveillance villages.Results ①Total of 219 water-improving projects in 32 counties were monitored and 1673 villages were covered,benefiting 69.07 million population.②Total of 134 villages with high level of water arsenic were investigated.Water quality improved villages was 86,accounting for 64.18％.Normal working projects accounted for 91.86％ (79/86),intermittentl y working accounted for 4.65％ (4/86) and abandoned projects accounted for 3.49％(3/86).Passing rate of water arsenic of the projects was 91.86％(79/86).Total of 48 villages without water-improving project were investigated,and families with excessive level of water arsenic was 35.04％ (356/1016).③Total of 20 885 persons were examined in villages with improved water,incidence of endemic arsenicosis was 4.44％ (928/20 885).Among them,patients with mild arsenicosis was 3.27％ (682/20 885),with moderate was 0.80％(167/20 885) and serious patients was 0.37％(78/20 885),and detection of skin cancer 1 person.Totally 6166 persons were checked in the villages without water-improvement,incidence of endemic arsenicosis was 3.08％ (189/6166).Among them,mild patients was 2.69％ (166/6166),moderate was 0.28％ (17/6166) and the serious was 0.10％ (6/6166); 20 new cases were diagnosed,and they came from Shanxi province.Conclusions The morbidity in water-improved villages remains higher than the water-unimproved.We should establish and perfect the long-term mechanism of surveillance as soon as possible,and strengthen the management and maintenance of water-improving projects.

ObjectiveTo study basic pattern of normal youth in gait analysis.Methods28 healthy young persons as experimental subjects were studied. The gait analysis system based on digital video and digital image processing was employed to obtain kinematic parameters.ResultsThe means and standard deviations of kinematic parameters of normal youth were obtained. The differences of gait patterns between males and females were compared. The correlations between gait parameters and height, weight were analyzed respectively.Conclusions It is recommended that the values of the gait parameters and the trends obtained can be used as a standard gait pattern of normal youth. Statistically significant differences exist between the males and the females for most of the gait parameters. Furthermore, the differences of the values of gait parameters between the males and the females are not led only by the difference of height except very few parameters.

Streptomyces hygroscopicus 17997 produces the antiviral and antitumor ansamycin antibiotic, geldanamycin. Studies on geldanamycin biosynthetic pathway will provide good tools for genetic manipulation of the antibiotic-producing strain to improve the productivity or to facilitate making novel geldanamycin analogs. The structural similarities between geldanamycin and ansamycins such as rifamycin or ansatrienin suggest that both geldanamycin and ansamycins has a closely related pathways of biosynthesis and that biosynthetic system for geldanamycin is similar to the one of type I polyketide synthase (PKS) enzyme system. To explore the possible PKS genes involved in geldanamycin biosynthesis, the degenerate primers were designed according to the conserved sequence of KS-AT region from erythromycin and oleandomycin type I PKS genes. Cosmids containing multiple PKS genes (pCGBK2,4,6,10,11,18) were obtained by hybridization with the PCR products, which were amplified from S. hygroscopisus 17997 genomic DNA. The designed primers above were used for PCR. Development of a Streptomyces temperate phage phiC31-derivative KC515( tsrR) transduction system was carried out for identification of cosmids containing the PKS gene related to biosynthesis of geldanamycin. Several factors, mainly the Ca2+ and Mg + concentrations in different culture media affecting the frequency of gene transfection, were optimized .Transfection efficiency could reach up to 10(3) /microg DNA on YMG medium supplemented with 10mmol/L MgSO4. Reversely, the transfection efficiency decreased when YMG medium was supplemented with 30mmol/L MgSO4. Gene transfection system based on the integration-defective phage KC515 had been established for S. hygroscopicus17997. Recombinant phages (ph111, 258, 287, 116, 105) were constructed by insertion of the homologous to PKS gene fragments into the KC515 phage vector. Gene disruption experiments were performed by transduction of recombinant phages into S. hygroscopicus 17997 genome, and disruption of geldanamycin production was observed as a result of homologous recombination between the cloned insert in recombinant phage and the S. hygroscopicus 17997 genome by integration. Thiostrepton resistant transductants were selected and integration event was analyzed by Southern hybridization. The fermentation broth extracts from five resistant transductants were analyzed by TLC and HPLC. The results showed that only G16 mutant failed to produce geldanamycin. This result showed that the integration of the insert DNA fragment in recombinant phage phl6 into the chromosome of S. hygroscopicus disrupted the expression of the geldanamycin biosynthetic genes. The original cosmid pCGBK10 containing this cloned insert was predicted to encode PKS genes in the geldanamycin biosynthesis. This study laid the foundation for cloning the PKS genes involved in geldanamycin biosynthetic gene cluster from S. hygroscopicus 17997.
Alcohol Oxidoreductases ; genetics ; metabolism ; Bacterial Proteins ; genetics ; metabolism ; Bacteriophages ; genetics ; Benzoquinones ; metabolism ; Blotting, Southern ; Chromatography, High Pressure Liquid ; Chromatography, Thin Layer ; Genetic Vectors ; genetics ; Lactams, Macrocyclic ; metabolism ; Multigene Family ; genetics ; physiology ; Polymerase Chain Reaction ; Streptomyces ; genetics ; metabolism

OBJECTIVETo observe the effect of Bushen Wenyang Huayu Recipe (BWHR) on hypoxia inducible factor-1α (HIF-1α), proline hydroxylase2 (PHD2), von Hippel Lindau disease (VHL) suppressor gene expressions in endometriosis (EM) rats with Shen yang deficiency blood stasis syndrome (SYDBSS), and to explore the pathogenesis of EM and the mechanism of BWHR for treating EM.

METHODSTotally 50 SD rats were randomly divided into five groups, i.e., the blank control group, the sham-operation group, the model group, the Chinese medicine (CM) group, and the Western medicine (WM) group, 10 in each group. Rats in the blank control group and the sham-operation group were fed routinely. Rats in the rest 3 groups received 30-day "extended refrigerator freezing and ice water immersion" and combined with " autotransplantation" to establish EM rat model with SYDBSS. One Milliliter BWHR at 3.33 g/mL was administered to rats in the CM group by gastrogavage. Gestrinone at the daily dose of 0. 5 mg/kg was administered to rats in the WM group by gastrogavage. Equal volume of normal saline was administered to rats in the model group, the blank control group, and the sham-operation group. The size and morphology of ectopic foci in rats were observed after 4 weeks of medication. Expressions of serum CA125, plasma cyclic adenosine monophosphate (cAMP), and plasma cyclic guanosine monophosphate (cGMP) were detected by radioimmunoassay. Morphological changes of eutopic endometrium and ectopic tissue were observed under the optical microscope by HE staining. Protein expressions and contents of HIF-lα, PHD2, and VHL were detected by immunohistochemical SABC method and Western blot. mRNA expressions of HIF-1α, PHD2, and VHL were detected by RT-PCR.

RESULTSThe ectopic foci grew significantly in the model group. Their volumes were obviously contracted after treated by CM and WM. Compared with the blank control group and the sham-operation group, serum CA125 and plasma cGMP obviously increased, cAMP obviously decreased (P < 0.05); expressions and contents of HIF-1α mRNA and protein all decreased (P < 0.05); mRNA and protein expressions and contents of PHD2 and VHL all decreased in the model group (P < 0.05). Compared with model group, levels of CA125 and cGMP obviously decreased; cAMP levels obviously increased, expressions and contents of HIF-1α mRNA and protein all increased, mRNA and protein expressions and contents of PHD2 and VHL all increased in the WM group and the CM group (P < 0.05). Compared with the CM group, PHD2 protein contents were higher in the WM group (P < 0.05). HIF-1α was negatively correlated with PHD2 (r = -0.799, P = 0.00). HIF-1α was negatively correlated with VHL (r = -0. 625, P = 0.003).

CONCLUSIONSBWHR could effectively treat EM. Its mechanism might be associated with reducing contents of HIF-1α, serum CA125, and plasma cGMP, and up-regulating expressions of PHD2, VHL, and cAMP.

Animals ; Cyclic AMP ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; metabolism ; Female ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Proline ; metabolism ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Up-Regulation ; Yang Deficiency ; drug therapy ; metabolism

BACKGROUND: Hypothermia is associated with poor outcome in trauma patients; however, hemorrhagic shock (HS) model with anesthetized swine was different from that of clinical reality. To identify the effects of environmental hypothermia on HS, we investigated hemodynamics and oxygen dynamics in an unanesthetized swine model of HS under simulating hypothermia environment.METHODS: Totally 16 Bama pigs were randomly divided into ambient temperature group (group A) and low temperature group (group B), 8 pigs in each group. Venous blood (30 mL/kg) was continuously withdrawn for more than 15 minutes in conscious swine to establish a hemorrhagic shock model. Pulmonary arterial temperature (Tp), heart rate (HR), mean arterial pressure (MAP), pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), central venous pressure (CVP), cardiac output (CO), hemoglobin (Hb), saturation of mixed venous blood (SvO2) and blood gas analysis were recorded at the baseline and different hemorrhagic shock time (HST). The whole body oxygen delivery indices, DO2I and VO2I, and the O2 extraction ratio (O2ER) were calculated.RESULTS: Core body temperature in group A decreased slightly after the hemorrhagic shock model was established, and environmental hypothermia decreased in core body temperature. The mortality rate was significantly higher in group B (50％) than in group A (0％). DO2I and VO2I decreased significantly after hemorrhage. No difference was found in hemodynamics, DO2I and VO2I between group A and group B, but the difference in pH, lactic acid and O2ER was significant between the two groups.CONCLUSION: Environmental hypothermia aggravated the disorder of oxygen metabolism after hemorrhagic shock, which was associated with poor prognosis.

Severe tracheal stenosis can not only cause critical medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on the physicians, particularly the anesthesiologist. Life-threatening airway obstruction can make the patient's gas exchange extremely difficult.Though several options could be offered regarding the treatment of tracheal stenosis, normally, tracheal resection and following reconstruction is the first choice for severe airway stenosis. Successful surgical intervention relies on the close communication and cooperation between surgeons and anesthesiologists. In these cases, airway management is the top issue for the anesthesiologist, and the level of difficulty varies with stenosis location, severity of stenosis, and surgical technique. Extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass (CPB), is rarely utilized for the surgery, but for those impossible airways due to nearly complete tracheal obstruction, ECMO or CPB could be the final choice for anesthesiologists. Here we report a case of successful urgent airway management for tracheal resection and reconstruction assisted by temporary CPB.
Cardiopulmonary Bypass ; Emergencies ; Female ; Humans ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Trachea ; surgery