Acquired Immunodeficiency Syndrome ; drug therapy ; prevention & control ; Antiretroviral Therapy, Highly Active ; China ; Humans

· AIM: To evaluate the safety of eye anterior tissue when plasmin (Pm) and hyaluronidase (HS) are injected into pigs'vitreouses to induce posterior vitreous detachment(PVD).· METHODS: 15 pigs without ocular diseases were randomly assigned to groups A,B,C (5 in each group). For each pig, one eye was experimental, the other eye was control. The experimental eye received intravitreal injection with enzyme:group A: 50U(0.1mL) HS; group B: 0.5U(0.1mL) Pm; group C: 0.5U(0.05mL) Pm combined with 50U(0.05mL) HS; while the control eye received intravitreal injection with equivalent dose of balanced salt solution (BSS). Postoperative reactions in the eyes were carefully observed by clinical examinations such as slit-lamp microscopy and direct and indirect ophthalmoscopy and measurement of intraocular pressure (IOP). Eyeballs were extirpated 7 days after the operation and histological examination was carried out. The corneas and irises were observed under light microscope (LM). The epithelia of ciliary bodies and lens were studied with transmission electron microscope (TEM).· RESULTS: In all experimental eyes and control eyes of group A, B and C, histological examination showed: under LM ,the corneas and irises of experimental eyes had no histological abnormality in structure; Under TEM, epithelial cells of ciliary bodies and the lens were tightly arrayed with clear cellular boundaries, clear intracellular structure, intact cell membranes, and intact nuclei; There was no significant difference in the clinical examinations and in the change of IOP between preoperation and postoperation, between the experimental group and the control group.· CONCLUSION: With 0.5U Pm and HS 50U injected into pigs' vitreouses to induce PVD, alone or combined with two enzymes, evaluation revealed no evidence of toxicity on the eye anterior tissue. The dosage was proved to be safe for eye anterior tissue.

· AIM: To investigate the efficacy and safety of intravitreal injection of plasmin, hyaluronidase, or the combination of the two in inducing posterior vitreous detachment (PVD).· METHODS: 15 mini-type pigs were assigned to three groups (Group A, B and C), 5 in each group. One eye of each pig was intravitreally injected with the studying agent,and the fellow eye was used as control. Group A received a vitreous injection of hyaluronidase 50U (0.1mL); group B received plasmin 0.5U (0.1mL); group C received plasmin 0.5U (0.05mL) combined with hyaluronidase 50U (0.05mL). The fellow eyes in each group were injected with 0.1mL balanced salt solution (BSS). All the pigs were examined with slit-lamp biomicroscope, direct and indirect ophthalmoscope, B-scan and electroretinograph (ERG). After 7 days, the animals were killed and the eyes were enucleated and examined with light microscope, transmission electron microscope and scanning electron microscope.· RESULTS: B-scan examination showed that one eye of Group A and two eyes of Group B had partial PVD at 1st day after injection and one eye of Group C at 1 hour after injection. On the 7th day, B-scan, light microscopy and scanning electron microscopy demonstrated that all the eyes of Group A and Group B had partial PVD, while none of the control eyes had PVD. Rank sum test for scanning electron microscopy results of all the groups showed P ＜0.005.Furthermore, the comparisons between every two groups were made. The results of analyses were as follows: P＞0.05 between the drug injected eyes of Group A and Group B, P＜0.05 between Group B and Group C, Group A and Group C.The b-wave and a-wave amplitudes of ERG showed no significant difference either between preinjection and postinjection in all groups or between the drug injected eyes and the control eyes in each group. Light microscopy and transmission electron microscopy revealed no damage to the retinal structure.· CONCLUSION: Intravitreal injection of hyaluronidase 50U or plasmin 0.5U or their combination can produce PVD effectively and quickly without retinal functional or structural toxicity. The combination of the two proteases was proved to be synergetic.

Objective To compare differential diagnostic value of narrow-band imaging (NBI) magnifying endoscopy and magnifying chromoendoscopy.Methods A total of 92 lesions from 75 patients were examined with conventional colonoscopy,NBI magnifying endoscopy and magnifying chromoendoscopy to evaluate pit patterns and vascular morphology patterns.Endoscopic findings were compared with the pathological results.Results The detection rate of conventional endoscopy,NBI magnifying endoscopy and magnifying chromoendoscopy were 94.6％ (87/92),97.8％ (90/92) and 100.0％ (92/92),respectively.NBI magnifying endoscopy was superior to the magnifying chromoendoscopy (P =0.000) in the the lesion contour and microvessels pattern detection,but there was no difference in the pit patterns detected with the two techniques (P =0.394).Consistency,sensitivity,and specificity of NBI magnifying endoscopy in diagnosis of colorectal neoplastic lesions were 91.3％ (84/92),83.9％ (26/31),95.1％ (58/61),respectively,while these variables of magnifying chromoendoscopy were 89.1％ (82/92),80.6％ (25/31),93.4％(57/61),which were not statistically significant (P ＞ 0.05).Conclusion Differential diagnostic value of NBI magnifying endoscopy and magnifying chromoendoscopy for colorectal neoplastic and non-neoplastic lesions was similar,but NBI magnifying endoscopy displays the lesion contours and microvessels clearlier,and is easy to manipulate.

Objective:To investigate the effect of CCN1 on the chemosensitivity of colon cancer cells to 5-FU .Methods:Colon cancer and adjacent tissues, colon cancer cells and normal colon epithelial cells, HCT-116 and HCT-116/5/FU cells were collected, and the SCD1 mRNA expression levels were detected by RT-qPCR; HCT-116 cells were cultured and transfected with pcDNA3.1 and CCN1 expression vectors, or infected with shNC and shCCN1 lentivirus, CCK-8 assay was used to detect cell sensitivity to 5-FU, Western blot and RT-qPCR were used to detect SCD1 mRNA expression, and oil red O staining was used to detect the lipid content. Western blot was used to detect the distribution of transcription factor FoxO1 in the nucleus and cytoplasm. The effect of CCN1 and FoxO1 on the transcriptional activity of SCD1 promoter was detected by luciferase assay.Results:Compared with control group, the expression of SCD1 was up-regulated in colon cancer tissues, cell lines and HCT-116/5-FU cells (all P<0.05); overexpression of CCN1 reduced the sensitivity to 5-FU, increased intracellular lipid deposition, and up-regulated the expression of SCD1 ( P<0.05); Knockdown of CCN1 increased the sensitivity to 5-FU, reduced intracellular lipid content and down-regulate the expression level of SCD1 ( P<0.05); CCN1 can promote FoxO1 nuclear distribution, activation or inhibition of FoxO1 activity can promote or up-regulate SCD1 expression level and promoter activity ( P<0.05). Conclusion:CCN1 may up-regulate the expression of SCD1 by activating FoxO1 activity and inhibit the sensitivity of colon cancer cells to 5-FU.

Adult ; Asian Continental Ancestry Group ; genetics ; Female ; Humans ; Long QT Syndrome ; genetics ; Mutation, Missense ; Pedigree

Background Laser peripheral iridotomy(LPI) is used as the primary therapy for the eyes at risk of angle closure.But there are still 28% eyes with primary angle closure suspect occur angle closure within 2 years after LPI.It is necessary to explore the associated factors of the efficacy of LPI.Objective The aim of this study was to explore the changes of intraocular pressure(IOP) and anterior chamber angle in the fellow eyes of patients with unilateral acute attack of primary angle closure glaucoma (PACG) and analyze the relevant factors influencing the successful rate of LPI.Methods Eighty-seven fellow eyes received LPI from 87 patients with unilateral acute attack of PACG were included in this study and retrospectively analyzed.The IOP and gonioscopy were performed before and 1 week,3,6,9,12 months after LPI.Successful signs of LPI were defined as an IOP 6-21mmHg without any anti-glaucoma medication,none of glaucomatous neuropathy and the coincident visual field loss,and no need of additional glaucomatous medication or surgery.This study was approved by Ethic Committee of the First Hospital of Xinxiang Medical College,and written informed consent was obtained from each patient.Results Seventy-nine eyes of 79 cases finished the medical visit throughout the follow-up duration with the age 61.4±0.4 years and 33(41.8%) males and 46(58.2%) females.The mean IOP was lowed in various time points after LPI in comparison with before operation with the general difference among different time visiting groups(F=4.056,P＜0.01).Shaffer grade was increased in superior,temporal and nasal quadrants and significant differences were found between 1 week group,3 months group or 6 months group and before operation group (P＜0.05).LPI lessened the range of appositional angle closure (AAC) in postoperative 1 week group and 3 months group compared with pre-operative group (P＜0.05),but no statistically significant reduce was seen in range of AAC from 6 months through 12 months after LPI in comparison with pre-operation (P＞0.05).LPI was determined as successful in 61 cases (77.2%) during one-year fellow-up period.Several variables,such as preoperative IOP,Shaffer grade of each quadrant,mean Shaffer grade and the extent of AAC,were significantly different between LPI success and failure group(P＜0.01).Cox stepwise regression analysis found that the success rate was significantly associated with the extent of AAC (Wald=48.150,RR=1.963,P＜0.01) rather than pre-IOP,Shaffer grade of each quadrant,mean Shaffer grade,age and gender (P＞0.05).Conclusion LPI can widen the anterior chamber angle and low IOP in the fellow eyes of PACG attack eyes.The success rate of LPI is associated with the extent of pre-AAC,suggesting that it is necessary for LPI in consideration of the extent of pre-AAC.

OBJECTIVETo evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.

METHODSA total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.

RESULTSThe operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.

CONCLUSIONNo-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.

Adolescent ; Adult ; Circumcision, Male ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Postoperative Complications ; Young Adult

Abstract: Objective To establish an animal model of BALB/c mice infected with Burkholderia pseudomallei through the nose (inhalation route), provides a reliable animal model for the follow-up studies on the virulence of melioidosis and the pathogenesis of acute melioidosis. Methods　The experiment was carried out through infecting with Burkholderia pseudomallei through the nose (inhalation route). The pathophysiological response, visceral pathological damage and bacterial colonization of the mice infected with Burkholderia pseudomallei were observed by gross anatomy, histopathology and tissue homogenate count, and the biological characteristics of the mouse model of acute melioidosis were analyzed accordingly. Then we compared the physiological responses in BALB/c mice between the Burkholderia pseudomallei and non-pathogenic Burkholderia thailandensis. Results　In the model of acute nasal infection with Burkholderia thailandensis, most death happened between the 3rd to 5th day after infection, 3×105-3×106 CFU was the suitable dose for acute fatal melioidosis model of BALB/c mice, and the medium lethal dose was about 3×104-3×105 CFU. Both gross anatomy and tissue HE staining showed that abscesses or necrosis were found in the lung, spleen and liver, especially in the spleen and lung, which was positively correlated with the challenge dose. Viable bacteria was isolated from the blood, lung, spleen and liver of Burkholderia pseudomallei-infected mice, and the bacteria account colonization was related to tissue specificity. The concentration of live bacteria isolated from in the blood was the highest [Log2 value: (10.28±0.34) CFU/mL], and the organ with the maximum quantity of bacteria was the lung [Log2 value: (7.54±2.11) CFU/total organ]. It has been reported that the biological effects of Burkholderia pseudomallei and its homologous non-pathogenic Burkholderia thailandensis were similar at the cellular level, like multi-nuclear giant cell formation and active intracellular replication, while it is still unclarrified in the differences of virulence in mice. In this study, it was proved that Burkholderia thailandensis was not fatal to mice even at a high dose (8×107CFU), or detected from mice infected with it via nasal. Conclusion　We successfully established a reliable BALB/c mouse model (acute lethal model) of melioidosis via nasal infection, described its biological characteristics, and identified the different biological responses between Burkholderia pseudomallei and its homologous non-pathogenic Burkholderia thailandensis in mice.

OBJECTIVETo evaluate the histopathological characteristics and clinical implication of sarcolemma tissue in prepubertal concealed penis.

METHODSAfter measurement of the penile length, 10 prepubertal children with congenital concealed penis underwent modified Devine's operation (treatment group), and another 10 normal prepubertal children received circumcision (control group). The anatomic features of the penile sarcolemma tissue was observed intraoperatively, and its fibrosis was evaluated by Masson trichrome staining.

RESULTSThe penile length of the treatment group was significantly shorter than that of the control group preoperatively ([1.49 +/- 0.17 ] cm vs [4.26 +/- 0.23 ] cm, P < 0.01). The degree of penile concealment was correlated with the distal point of the attachment of its sarcolemma fibrous tissue: the closer the distal attachment point was to the coronary ditch, the more serious was penile concealment. The proportion of the area of collagen fibers in the penile sarcolemma tissue was significantly higher in the treatment group than in the control ([65.6 +/- 6.9]% vs [37.1 +/- 4.7]%, P < 0.01).

CONCLUSIONSarcolemma fibrosis was obvious in congenital concealed penis, and the key to its management is drastic removal of all the fibrous sarcolemma tissue.

Child ; Circumcision, Male ; Fibrosis ; Humans ; Male ; Penis ; abnormalities ; pathology ; surgery ; Phimosis ; pathology ; surgery ; Sarcolemma ; pathology