Objective To evaluate the clinical significance of CT angiography(CTA)in the diagnosis of arterioportal shunts(APS)associated with hepatocellular carcinoma(HCC).Methods One hundred and twenty-seven consecutive HCC patients accepted both dynamic enhancement CT and DSA examinations.The interval between CT and DSA exam was from 3 to 15 days.Based on transverse CT images in hepatic artery phase,CTA was performed for all the patients.By contrast with DSA results,the capabilities of transverse CT and transverse images combined with CTA in APS diagnosis were analyzed. Results In all 127 HCC cases,52 cases with APS were confirmed by DSA(40.94%),33 with central type of APS and 19 with peripheral type.Diagnostic sensitivity of APS based on transverse CT and combined CTA with transverse CT images were both 94.23%(49/52).However,specificity was 84.00%(63/75) and 97.33%(73/75),respectively,accuracy was 88.19%(112/127)and 96.06%(122/127),the predictive value of positive cases was 80.33%(49/61)and 96.08%(49/51),and the predictive value of negative cases was 95.45%(63/66)and 96.05%(73/76).Combined with CTA,false positive cases of 4 central type of APS and 6 peripheral type of APS were excluded which were demonstrated by transverse CT images.By contrast with DSA,the coincidence rate of the type of APS diagnosed by transverse images combined with CTA was 88.46%(46/52),including 90.91%(30/33)of central type of APS and 84.21%(16/19)of peripheral type.The supplying arteries of central type of APS were intuitively displayed by CTA in 23 cases,19 from proper hepatic artery and 4 from gastro-duodenal artery.Conclusion CTA techniques based on the dynamic enhancement CT exams could effectively promote the specificity and the accuracy of APS diagnosis.

Objective To examine the effects of sodium phenylbutyrate on the apoptosis of human tongue squamous cancer cell line and expression of p21 and survivin genes.Methods The inhibition effects of sodium phenylbutyrate on Tca8113 and human tongue squamous cell carcinoma (TCSSA) cell lines were detected by methyl thiazoly terazolium (MTT) and the apoptosis of the cancer cells after being induced by sodium phenylbutyrate examined by flow cytometry(FCM).The expression of p21 and survivin genes were observed with Western blotting and RT-PCR Results Compared with control group,the level of p21 mRNA and protein of Tca8113 cellline increased to 0.09±0.08 and increased 0.72±0.10,that of TCSSA cellline increased 1.34±0.12 and 1.56±0.09(P <0.05).Compared with control group,the level of surrive mRNA and protein of Tca8113 cellline decreased to 1.10±0.05 and 1.14±1.10,that of TCSSA cellline decreased to 0.12±0.08 and 0.94±0.09 (P < 0.05) .Sodium phenylbutyrate inhibited the cell proliferation ,promoted cell apoptosis and arrested the cells in G1/G0 phase.The amount of p21 mRNA and protein were increased,and the expression of survivin gene was decreased.Conclusions Sodium phenylbutyrate exhibited remarkable inhibitory effects on human tongue squamous cancer cell proliferation and induced cancer cell apoptosis.The mechanism may be due to up-regulation of p21 gene and downregulation of survivin gene.The mRNA level of p21 gene and survivin gene showed a strong correlation.

Splint fixation is an external fixation system,composed of retainer, splint, paper pad and traction. Pressure under retainer is the power source of splint fixation in treatment of fractures. Now we have a review literature about the progress of type and biomechanics of fixation retainer of splint, to offer the scientific parameters for modern reform of fixation retainer of splint.
Biomechanical Phenomena ; Humans ; Splints ; classification

BACKGROUNDIntractable secondary glaucoma with severe ocular contusion involving the posterior segment is difficult to treat. In this study, we evaluated the safety and efficacy of combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment.

METHODSThis retrospective interventional study enrolled 18 eyes from 18 consecutive cases with uncontrolled intraocular pressure, angle recession exceeding 180°, dense vitreous hemorrhage, and/or limited retinal detachment after severe ocular contusion. Combined trabeculectomy and vitrectomy was performed after giving the patient sufficient anti-inflammatory and intraocular pressure (IOP)-lowering medication. Follow-up averaged 26.2 (range, 6.0- 48.0) months.

RESULTSThe mean IOP decreased from (36.4 ± 10.0) mmHg on maximum IOP-lowering medications to (14.6 ± 4.4) mmHg on (0.7 ± 1.2) topical medications at the final follow-up (P < 0.0001). During the first postoperative month, four eyes (22%) had a short hypertensive phase and six eyes (33%) had early hypotony, including one case (5.6%) of bleb leakage. Seven eyes (39%) developed recurrent hypertension 3- 6 months postoperatively, five of which were controlled by topical medications. Ten (55.6%) eyes were classified as a complete success, five (27.8%) as a qualified success, and three eyes (16.7%) as failures. Kaplan-Meier survival analysis for complete and cumulative success showed 53.5% and 80.0% survival at 48 months, respectively. Visual acuity was improved in 15 eyes (83.3%). Three eyes (16.7%) had unchanged visual acuity, one (5.6%) of which developed atrophia bulbi despite a normal intraocular pressure. No recurrent retinal detachment or vitreous hemorrhage developed.

CONCLUSIONCombined trabeculectomy and vitrectomy is a viable surgical procedure for the management of intractable glaucoma with severe ocular contusion involving the posterior segment in selected cases.

Adult ; Aged ; Female ; Glaucoma ; physiopathology ; surgery ; Humans ; Intraocular Pressure ; physiology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Retrospective Studies ; Trabeculectomy ; methods ; Vitrectomy ; methods

Objective To investigate the effect of reducing blood lipid in three effective parts of Rheum palmatum L.based on variation coefficient weight.Methods First of all,the SD rat model of hyperlipidemia was given the water extract,the ethanol extract and the ethyl acetate extract of Rheum palmatum L.,then the content of total cholesterol (TC),high densitylipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG) in serum were determined and general survival of rats was analyzed.Then using fuzzy matter-element model on variation coefficient weight to evaluate the comprehensive reducing blood lipid effect of different extract parts of Rheum palmatum L..In the end,combining with the result of the value of Euclid approach degree,compared the effect of normal group (M1),the model group (M2),the positive control group (Xuezhikang,M3),the water extract group(M4),the ethanol extract group (M5),the ethyl acetate extract group (M6) of blood lipid.Results Compared with model group,the water extract part and the ethanol extract part of Rheum palmatum L.could reduce the congtents of TC,LDL-C,TG and rise HDL-C.Combining with the result of the value of Euclid approach degree,the water extract was 0.74,the ethanol extract was 0.54.Combining with the result of the value of Euclid approach degree,the order of its magniude is M3 ＞ M4 ＞ M1 ＞ M5 ＞ M6 ＞ M2.Conclusion The water extract part is the effective part of reducing blood lipid.The method and model can be used to objectively evaluate the comprehensive effect of reducing blood lipid of Rheum palmatum L.'s three extracted parts.

OBJECTIVETo evaluate the effect of combined use of stanazolol (ST) on the final adult height (FAH) in girls with idiopathic central precocious puberty (ICPP) and apparently decreased linear growth during gonadotropin-releasing hormone analog (GnRHa) therapy.

METHODSixty-three girls with ICPP and decreased velocity of growth of height (HV<4 cm/yr) during GnRHa therapy were divided into 3 groups based on the following types of interventions:group 1 (n = 20), GnRHa+ST [25-30 µg/(kg·d) every 3-month followed by 3-month discontinuation], group 2 (n = 21), GnRHa+recombinant human growth hormone [rhGH, 1-1.1 U/(kg·w)], group 3 (n = 22), GnRHa alone.HV, the advancement of bone age (BA) for chronological age (CA) (ΔBA/ΔCA) and FAH were compared among groups.

RESULT(1)Total duration of ST combination therapy was (12.22 ± 3.62) months, while total duration of combination of rhGH was (13.22 ± 6.80) months. (2)HV increased significantly in both group 1 [ (2.79 ± 0.60) cm/yr vs. (6.27 ± 1.98) cm/yr, P < 0.01] and in group 2 [(2.80 ± 0.50) cm/yr vs. (6.25 ± 1.98) cm/yr, P < 0.01] during combined therapy, but maintained at low levels in group 3 [(3.95 ± 1.10) cm/yr vs. (3.34 ± 0.95) cm/yr, P > 0.05].No significant differences of ΔBA/ΔCA were found among the three groups [0.25(0.11∼0.28), 0.22(0.15∼0.31),0.19(0.10∼0.32), P > 0.05]. (3)FAH was significantly higher than predicted adult height (PAH) before combined therapy, as well as higher than target height (THt) in both group 1 [(156.25 ± 2.90) cm vs. (150.78 ± 3.70) cm, P < 0.01, (156.25 ± 2.90) cm vs. (153.94 ± 2.62) cm, P < 0.01], and in group2 [ (157.33 ± 4.69) cm vs. (152.61 ± 3.92) cm, P < 0.01, (157.33 ± 4.69) cm vs. (154.39 ± 4.72) cm, P = 0.01].In group 3, FAH was similar to PAH [(153.88 ± 2.6) cm vs. (152.54 ± 5.86) cm, P > 0.05], and was less than THt [(153.88 ± 2.6) cm vs. (155.60 ± 4.52) cm, P = 0.02]. (4)In girls treated with ST, no hirsutism, clitorism or hoarse voice was recorded.No polycystic ovary syndrome was found by B-mode ultrasound.

CONCLUSIONIntermittent combined use of low dose ST therapy can increase HV and thus improve FAH in girls with ICPP and apparently decreased linear growth during GnRHa therapy.

Body Height ; drug effects ; Bone Development ; Child ; Child Development ; drug effects ; Drug Therapy, Combination ; Female ; Gonadotropin-Releasing Hormone ; administration & dosage ; analogs & derivatives ; therapeutic use ; Growth Disorders ; drug therapy ; Human Growth Hormone ; administration & dosage ; therapeutic use ; Humans ; Puberty, Precocious ; drug therapy ; physiopathology ; Stanozolol ; administration & dosage ; therapeutic use ; Treatment Outcome

OBJECTIVETo analyze the influence of topical application of nerve growth factor (NGF) on nerve ending regeneration of large skin grafts in patients.

METHODSSixty wounds from 48 adult patients with small or moderate burn area and scar excision were randomly divided into NGF and control groups, with 30 wounds in each group. The wounds in control group were treated with simple saline solution, while those in NGF group, the graft was first wrapped in a piece of gauze holding 100 ml saline solution containing 9000 AU NGF before operation, and then flushed with same amount of NGF saline underneath skin after application of the graft. From 20 post-operative day on, NGF was injected at multiple points every other day for one month. In control group, only normal saline was used. The texture of the graft, pain sensation, temperature and two - point discrimination, BMRC grade were observed for 12 months. Skin specimens were obtained from 6 wounds in control group, 5 wounds in NGF group, and 4 specimens from normal skin for immunohistological examination of protein gene product 9.5 (PGP 9.5), synaptophysin (SYN), and neuron specific enolase (NSE). The nerve endings regeneration and distribution were also observed.

RESULTSCompared with those in control group, each index of feeling recovered earlier and better in NGF group, with better two - point discrimination ratio and BMRC grade. One year after operation, 17 skin grafts in NGF group reached S4 grade, with two - point discrimination ratio of 1.11 +/- 0.14, while only 5 grafts in control group reached S4 grade, with two - point discrimination ratio of 1.56 +/- 0.73. Six months after operation, rich nerve endings, with integral adnexae were observed in microvascular bed of skin - graft region and tissue interspace around fibromas tissue in subcutaneous tissue in NGF group, while nerve endings were found to be scanty and slender in subcutaneous tissue in control group.

CONCLUSIONLocal application of NGF can promote nerve regeneration and sensory recovery of grafted skin.

Adolescent ; Adult ; Burns ; rehabilitation ; surgery ; Cicatrix ; rehabilitation ; surgery ; Female ; Humans ; Male ; Nerve Growth Factor ; therapeutic use ; Nerve Regeneration ; Postoperative Care ; Sciatic Nerve ; Sensory Receptor Cells ; Skin Transplantation ; rehabilitation ; Surgical Flaps ; Wound Healing ; Young Adult

OBJECTIVETo investigate the feasibility of transfection of recombinant human endothelial nitric oxide synthase (eNOS) into human hypertrophic scar fibroblasts (HSFbs), and to observe NO secretion and the synthesis of collagen I and III.

METHODSRecombinant human eNOS with karyocyte expressive vector was constructed in vitro, then was transfected into HSFbs which was isolated from hypertrophic scar tissues and cultured in vitro (T group). The HSFbs untransfected (normal culture) or transfected with empty-vector was used as control group and empty-vector group respectively. The mRNA expression of eNOS, collagen I and III was determined by Realtime PCR. The content of NO was determined by NO assay kit.

RESULTSThe expression of eNOS mRNA in T group was 5.92 +/- 0.21, which was obviously higher than that in empty-vector group (0.98 +/- 0.13, P < 0.05). The expression of collagen I mRNA (0.76 +/- 0.15), and collagen III (0.79 +/- 0.08) in T group was significantly lower than those in empty-vector group (0.98 +/- 0.15, 1.02 +/- 0.12, P < 0.05, respectively). The content of NO in T group (36.1 +/- 0.8 micromol/L) was obviously higher than that in empty-vector group (28.4 +/- 1.0 micromol/L, P < 0.01) and control group (27.7 +/- 1.3 micromol/L, P < 0.01).

CONCLUSIONHSFbs can be the target cells for eNOS gene transfection. The transfected cells can express eNOS and produce NO, which inhibit the synthesis of collagen.

Cicatrix, Hypertrophic ; metabolism ; Collagen Type I ; genetics ; metabolism ; Collagen Type III ; metabolism ; Fibroblasts ; metabolism ; Humans ; In Vitro Techniques ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; genetics ; RNA, Messenger ; metabolism ; Transfection

OBJECTIVETo investigate the therapeutic effect of recombinant human parathyroid hormone(1-34) [rhPTH(1-34)] on osteoporosis of ovariectomized rats.

METHODSThe model of osteoporosis was formed after 3 months of ovariectomy with 6-month age of 80 rats. Another 20 rats was control of sham operation. rhPTH(1-34) was subcutaneously injected once daily with 5, 10, 20, 40 micrograms/kg for 3 months. There were 10 rats in each group. The control of therapy included Salmon Calcitonin to 10 rats and Alendronate sodium to 10 rats. The bone weight of dry and ash, bone mineral density, bone biomechanical property, trabecular area, bone mineral deposition and serum alkaline phosphatase, Ca, P and urinary Pyridinoline/creatin (Pyd/Cr) were measured after the end of therapy.

RESULTSWhen administered to animals as a single subcutaneous injection once daily, rhPTH(1-34) increased obviously bone mass, bone biomechanical property and trabecular area, as well as bone deposition compared with the animals of control group. The bone architecture was ultimately improved by rhPTH(1-34) therapy.

CONCLUSIONSRats of ovariectomized-induced osteoporosis possess obvious effect of treatment with low dose of rhPTH(1-34) administered once daily.

Animals ; Female ; Osteoporosis ; drug therapy ; etiology ; Ovariectomy ; Rats ; Recombinant Proteins ; therapeutic use ; Teriparatide ; therapeutic use

Objective: To evaluate clinical outcomes of autologous and allogeneic peripheral blood stem cell transplantation (PBSCT) for aggressive peripheral T-cell lymphoma (PTCL). Methods: From June 2007 to June 2017, clinical data of PTCL patients who underwent PBSCT were assessed retrospectively. Results: Among 41 patients, 30 was male, 11 female, and median age was 38(13-57) years old. Seventeen patients with autologous PBSCT (auto-PBSCT) and 24 patients with allogeneic PBSCT (allo-PBSCT) were enrolled in this study. Eight patients (8/17, 47.1%) in auto-PBSCT group were ALK positive anaplastic large cell lymphoma (ALCL), 7 patients (7/24, 29.2%) with NK/T cell lymphoma and 9 patients (9/24, 37.5%) with PTCL-unspecified (PTCL-U) in allo-PBSCT group (P=0.035). There were 58.8% patients (10/17) in complete response (CR) status and 11.8% (2/17) in progression disease (PD) status before transplantation in auto-PBSCT group, and 8.3% (2/24) in CR status and 45.8% (11/24) in PD status before transplantation in allo-PBSCT group (P=0.026). The 2-years cumulative overall survival (OS) were (64.0±10.8)% and (53.5±9.7)% for auto-PBSCT and allo-PBSCT respectively (P=0.543). The 2-years cumulative disease-free survival (DFS) were (57.1±12.4)% and (53.5±10.6)% for auto-PBSCT and allo-PBSCT respectively (P=0.701). In patients with dead outcomes after PBSCT, 83.3% (5/6) of death cause was relapse in auto-PBSCT and 41.7% (5/12) of death cause was relapse in allo-PBSCT. Conclusion: Both auto-PBSCT and allo-PBSCT were effective for PTCL. Allo-PBSCT maybe was better than auto-PBSCT for high-risk PTCL with poor prognosis.
Adolescent ; Adult ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma, T-Cell, Peripheral/therapy* ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies ; Transplantation, Autologous ; Transplantation, Homologous ; Treatment Outcome ; Young Adult