Electrophysiological studies have shown that the spinosolitary tract-dorsal column postsynaptic (SST-DCPS) neurons may project to both the dorsal column and solitary tract nuclei. In order to demonstrate the neurons morphologically, fluorescein dyes, PI and Bb, were injected into the dorsal column nuclei and the solitary tract nucleus respectively. A total 282 cells were found to be retrogradely labeled in the spinal dorsal horn in 10 adult rats. Of them, 51 (18%) cells were PI-Bb doubly labeled; 120 (43%) were PI labled alone; and 111 (39%) were Bb singly labled. Most of these double-labled cells were concentrated in laminae III-V. The existence of double projection neurons that project to both the dorsal column and solitary tract nuclei, namely the physiologically identified SST-DCPS neurons, is morphologically confirmed in the present study. These neurons may transmit information to both visceral and somatic sensory nuclei, indicating they may play an important role in the convergence of somato-visceral afferents.

20?mm?Hg, nonpulmonary hypertension group (control group n=9), with preoperative mean pulmonary artery pressure

Objective To measure the morphological parameters of the acromion with CT and to analyze their match with the hook plate. Methods From October 2009 to February 2010,spiral CT scanning (with Somatom Emotion16) and three-dimensional reconstruction of bilateral shoulders were conducted in 61 Chinese subjects.They were 24 men and 37 women,aged from 20 to 83 years (average,45.2 years).The thickness,length and width of the acromion were measured and the subacromial shape was observed with software of the CT system to analyze the match between the hook plate and the acromion.Results The mean thickness of the acromion was 0.85 ± 0.13 cm in all subjects,0.94 ± 0.12 cm in males and 0.79 ± 0.10 cm in fe males,with a significant difference between males and females ( t =2.382,P =0.202).The mean acromion length was 2.08 ± 0.20 cm in all subjects,2.09 ± 0.21 cm in males and 2.06 ± 0.18 cm in females,with no significant difference between males and females( t =1.541,P =0.129).The mean acromion width was 3.81 ± 0.52 cm in all subjects,4.34 ± 0.32 cm in males and 3.47 ± 0.25 cm in females,with a significant difference between males and females ( t =2.296, P =0.025 ). Conclusions The acromial morphology varies significantly between genders in Chinese population,particularly in the thickness and width.It is,therefore,necessary to modify the morphological parameters of the hook plate to match better the gender difference in Chinese population.It is optimal that the hook plate should allow individualized pre-moulding to enhance its therapeutic efficacy.

BACKGROUND: Artificial humeral head replacement is an effective method for the treatment of complex proximal humeral fractures, which has received good results in relieving pain. However, the final functional recovery is unpredictable. OBJECTIVE: To compare biomeshanical stability between anatomical and overlapping reconstruction of the greater tuberosity in cadaveric humeral head replacement models.METHODS: Eight pairs of fresh-frozen shoulder cadavers (16 shoulder joints) were match-paired into two groups. Standardized humeral head replacement procedure was performed in all specimens, and anatomical and overlapping reconstruction of thegreater tuberosity was adopted in each group respectively. For overlapping group, the greater tuberosity was reattached to the proximal humeral shaft in an overlapping style, which was achieved by an additional 5 mm bone osteotomized from the medial cortex of the humeral diaphysis. Custom mounting apparatus and fixation jigs were designed for designated shoulder motion.RESULTS AND CONCLUSION: When the shoulder was external rotated to neutral position, the mean displacement of greater tuberosity in the anatomical reconstruction group was smaller than that of the overlapping reconstruction group (P < 0.05). When the gleno-humeral joint was elevated to 30～ and 60～ forward flexion (accounting for 45° and 90° shoulder forward flexion), there was no significant difference of greater tuberosity displacement between the anatomical group and overlapping group. The findings demonstrated that, although overlapping reconstruction can increase the bone healing area between the greater tuberosity and the humeral diaphysis, there may be some loss in mechanical stability as the trade-off. Even though we strictly follow the standardized postoperative rehabilitation protocol after humeral head replacement, prominent displacement between the greater tuberosity relative to the humeral diaphysis was detected. Accordingly, postponing of the postoperative rehabilitation program after humeral head replacement for a decent period may improve tuberosity healing.

ObjectiveTo evaluate the safety and efficacy of biological meshes (human aceUular dermal matrix mesh) in single-stage repair of infected or contaminated abdominal abdominal wall defects and abdominal hernias. MethodsSeventeen patients with abdominal wall defects or abdominal hernias were enrolled. The wounds of all these patients were infected or contaminated due to the existence of enterocutaneous fistula or stoma, wound infection and synchronous colonic resection. The diagnosis included enterocutaeneous fistula 8 cases, incisional hernia 6 cases, incarcerated inguinal hernia 1 case and cylindrical abdominoperineal resection for rectal cancer for 2 cases. The sizes of abdominal defects ranged from 3 cm × 2 cm to 6 cm × 17 cm, and all the cases were repaired with human acellular dermal matrix mesh(RENOV(R)). Most of the patients were repaired with intraperitoneal onlay mesh technique( IPOM, for 12 cases), and other methods included Lichtenstein operation for 1 case, inlay repair for 2 cases and sublay for 2 cases. Results All the 17 patients recovered uneventfully. For 12 patients, the wounds were sutured at operation and only one case of delayed healing occurred due to fat liquefaction. For the other 5 patients, the wounds were left open and healed after vacuum assisted closure (VAC) therapy or wet- to- dry dressing changes. On follow up for 8.3 ±4.5 months ( 1 to 15 months), no occurrence of incisional hernia or recurrence was found. laxity of abdominal wall occurred in one case. A patient complained intermittent pain of the site of suture for mesh fixing two months after operation and the pain resolved spontaneously one month later. ConclusionsThe biological mesh, acellular dermal matrix mesh, could be used in single- stage repair of infected or contaminated abdominal wall defects safely and effectively, although the long-term outcome still needs further evaluation.

Objective To analyze retrospectively the therapeutic effect and safety of minimally invasive transthoracic device closure of perimembranous ventricular septal defect (PVSD).Methods One hundred and twenty-nine patients with PVSD from January 2011 to December 2011 in our hospital were selected and a 3 to 5 cm incision was made in the inferior sternum,which performed minimally invasive transthoracic device closure of ventricular septal defect (VSD).Right ventricular free wall was punctured and guided by transthoracic echocardiography (TEE),and then the occluder was released after a delivery sheath passed through the VSD.Location of occluder,effect on heart valve,fastness and residual shunt were evaluated by TEE instantly during operation.All patients were followed up intimately after operation,echocardiogram and electrocardiogram were rechecked regularly.Results One hundred and fourteen cases were successfully occluded.Fifteen cases were performed VSD repair operation with cardiopulmonary bypass.The amounts of concentric occluder and eccentric occluder were 96 and 20,respectively.The patients performed minimally invasive transthoracic device closure of VSD had no severe complications after operation.Conclusion Although the short-term therapeutic effect of minimally invasive transthoracic device closure of PVSD is definitely and has favourable prospect of application,the long-term follow-up remains to be studied.

The fungus Trichophyton schoenleinii (T. schoenleinii) is the causative agent of Trichophytosis and Tinea favosa of the scalp in certain regions of Eurasia and Africa. Human innate immune system plays an important role in combating with various pathogens including fungi. The inflammasome is one of the most critical arms of host innate immunity, which is a protein complex controlling maturation of IL-1β. To clarify whether T. schoenleinii is able to activate the inflammasome, we analyzed human monocytic cell line THP-1 for IL-1β production upon infection with T. schoenleinii strain isolated from Tinea favosa patients, and rapid IL-1β secretion from THP-1 cells was observed. Moreover, applying competitive inhibitors and gene specific silencing with shRNA, we found that T. schoenleinii induced IL-1β secretion, ASC pyroptosome formation as well as caspase-1 activation were all dependent on NLRP3. Cathepsin B activity, ROS production and K⁺ efflux were required for the inflammasome activation by T. schoenleinii. Our data thus reveal that the NLRP3 inflammasome plays an important role in host defense against T. schoenleinii, and suggest that manipulating NLRP3 signaling can be a novel approach for control of diseases caused by T. schoenleinii infection.
Animals ; Bone Marrow Cells ; cytology ; Carrier Proteins ; metabolism ; Caspase 1 ; metabolism ; Cell Line ; Dendritic Cells ; cytology ; metabolism ; microbiology ; Enzyme Activation ; Hot Temperature ; Humans ; Inflammasomes ; metabolism ; Interleukin-1beta ; biosynthesis ; metabolism ; Lysosomes ; metabolism ; Mice ; Monocytes ; cytology ; metabolism ; microbiology ; NLR Family, Pyrin Domain-Containing 3 Protein ; Potassium ; metabolism ; Reactive Oxygen Species ; metabolism ; Signal Transduction ; Trichophyton ; physiology

OBJECTIVEThe migrant population is a vulnerable group for HIV infection in China. Understanding potential epidemic trends among migrants is critical for developing HIV preventative measures in this population.

METHODSThe Estimation and Projection Package (EPP) model was used to process prefecture and county-level surveillance data to generate HIV prevalence and epidemic trends for migrant populations in China.

RESULTSThe prevalence of HIV among migrants in 2009 was estimated at 0.075% (95% CI: 0.042%, 0.108%) in China. The HIV epidemic among migrants is likely to increase over the next 5 years, with the prevalence expected to reach 0.110% (95% CI: 0.070%, 0.150%) by 2015.

CONCLUSIONAlthough the 2009 estimates for the HIV/AIDS epidemic in China indicate a slower rate of increase compared with the national HIV/AIDS epidemic, it is estimated to persistently increase among migrants over the next 5 years. Migrants will have a strong impact on the overall future of the HIV epidemic trend in China and evidence-based prevention and monitoring efforts should be expanded for this vulnerable population.

China ; epidemiology ; Condoms ; Epidemics ; statistics & numerical data ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Models, Theoretical ; Prevalence ; Risk Factors ; Safe Sex ; Sexual Behavior ; Transients and Migrants

Objective To analyze retrospectively the results of single-patch with elevation of the left-sided atrioventricular valve repair for complete atrioventricular septal defect(CAVSD) in therapeutic effects and safety.Methods Fourteen consecutive patients (2 males and 12 females) with CAVSD were enrolled in the study from April 2012 to December 2017.All patients underwent single-patch with the elevation of left-sided atrioventricular valve repair for CAVSD by regular sternotomy.The median age at operation was 12.5 months(range,11.7 months to 63 months) and the duration of follow-up was(3.27 ± 2.02)years.Echocardiography and electrocardiogram were used during follow-up according to the protocol.Results Compared with pulmonary arterial pressure(PAP) during pre-and post-operation (65.92 ± 6.91 and 62.97 ± 17.29) mmHg (1 mmHg =0.133 kPa),PAP(53.29 ± 20.99) mmHg decreased significantly during follow-up period.There were significant difference during post-operation and follow-up for LAVVR and RAVVR.The extent of regurgitation of atrioventricular valve statistically decreased during follow-up period.None of patients suffered from atrioventricular block and reoperation during follow-up.Conclusion Single-patch with elevation of the left-sided atrioventricular valve repair for CAVSD yields good outcomes,without occurrence of severe LAVVR,during early and mid-term follow-up period.

Chronic fatigue syndrome(CFS)is a chronic comprehensive disease with a slow course and often accompanied by a variety of physical and psychiatric symptoms.At present,the incidence rate is on the rise.Based on the theory of"qi-pulse smooth and unobstructed",the pathogenesis of CFS is considered to be the loss of spleen and kidney and the deficiency of qi-pulse as the root;liver and lung disorders,qi-pulse stagnation as the pivot;wind fire invasion,phlegm blood stasis as the superficiality.Treatment should focus on tonifying the spleen and tonifying the kidneys to treat its root cause.According to the degree of deficiency of spleen and kidney and the emphasis of deficiency of qi-blood yin-yang,Buzhong Yiqi Decoction,Guipi Decoction,Shengyang Yiwei Decoction,Linggui Zhugan Decoction and Shenqi Pills should be selected flexibly.The methods of soothing the liver and regulating the lungs to regulate their pivot,harmonizing the liver and lungs,and using both ascending and descending functions should be used.Chaihu Shugan Powder,Xiaoyao Powder,Sini Powder,Guizhi Decoction,Shengmai Powder,etc.could be selected flexibly according to the disease location and disease focus.Clearing wind and clearing heat,eliminating phlegm and promoting blood circulation should be used to treat its superficiality,emphasizing tonifying deficiency and resolving depression.According to the different pathogenesis of patients,the corresponding treatment method should be flexibly chosen to supplement with medication.One medical case was attached in this article as the evidence,in order to provide reference for the TCM treatment of CFS.