Airway edema, stenosis, obstruction and even asphyxia are easy to occur in patients with extensive burn, deep burn of head, face, and neck area, inhalation injuries, etc., which threaten life. Timely tracheotomy and intubation is an important treatment measure, but lack of knowledge and improper handling in some hospitals resulted in airway obstruction. The technique of percutaneous tracheotomy and intubation provides convenience for emergency treatment of critical burns and mass burn. The Burn and Trauma Branch of Chinese Geriatrics Society organized some experts in China to discuss the indications, timing, methods, extubation, and precautions of tracheotomy and intubation for burn patients. The (2018 ) .
Airway Obstruction ; prevention & control ; Burn Units ; Burns ; complications ; therapy ; China ; Consensus ; Humans ; Intubation, Intratracheal ; methods ; Practice Guidelines as Topic ; standards ; Smoke Inhalation Injury ; therapy ; Tracheotomy ; methods

Airway edema, stenosis, obstruction and even asphyxia are easy to occur in patients with extensive burn, deep burn of head, face, and neck area, inhalation injuries, etc., which threaten life. Timely tracheotomy and intubation is an important treatment measure, but lack of knowledge and improper handling in some hospitals resulted in airway obstruction. The technique of percutaneous tracheotomy and intubation provides convenience for emergency treatment of critical burns and mass burn. The Chinese Geriatrics Society organized some experts in China to discuss the indications, timing, methods, extubation, and precautions of tracheotomy and intubation for burn patients. The (2018 ) .
Airway Obstruction ; prevention & control ; Burns ; complications ; therapy ; China ; Consensus ; Edema ; Emergency Treatment ; Female ; Humans ; Intubation ; Neck ; Practice Guidelines as Topic ; standards ; Reference Standards ; Tracheotomy

OBJECTIVETo observe relative effects of acupuncture at Guangming (GB 37) and Taichong (LR 3) in central different regions.

METHODSNineteen healthy volunteers were randomly divided into 3 groups: group I (n=7) received visual stimulation and acupuncture at one side; group II (n=6) received visual stimulation and acupuncture at both sides; and group III (n=6) received acupuncture at both sides. Functional magnetic resonance imaging (fMRI) was used to investigate reactions of the different visual cortexes and relative cerebral regions in acupuncture at Guangming (GB 37) and Taichong (LR 3).

RESULTSThere was no significant change in blood oxygen saturation levels in the visual cortex at visual stimulation and insertion of the needle, but there were changes in blood oxygen saturation level in relative cerebral regions when continuous stimulation was given to one-side or both sides.

CONCLUSIONAcupuncture at one-side or both sides can improve blood oxygen saturation level in relative cerebral regions, which is not related with manipulation method and visual stimulation.

Acupuncture Points ; Acupuncture Therapy ; Humans ; Magnetic Resonance Imaging ; Needles

OBJECTIVE The invasive sea lamprey (Petromyzon marinus) has devastated the ecosystem of the Laurentian Great Lakes. Application of pheromones to manipulate adult sea lamprey behavior is among the options considered for alternative sea lamprey control techniques. The male sea lamprey sex pheromone is hypothesized to be possess multiple functions through actions of multiple components, some of which have yet to be characterized. Our objective is to isolate and characterize the bioactive components from water conditioned with sexually mature male sea lamprey. METHODS The water conditioned with sexually mature male sea lamprey was extracted by solid phase extraction and concentrated in vacuo. The compounds were isolated by liquid chromatography and elucidated by spectrometry and spectroscopy. Their biological activities were evaluated by electro-olfactogram recordings and two-choice maze behavioral assays. RESULTS Five novel bile salts, petromyzene A and B and petromyzone A-C, have been characterized. Petromyzene A and B featured either a unique, rearranged side chain or a rare cis-11,12-diol on the steroidal B-ring. Petromyzone A-C represented three novel highly oxidized sulfated bile alcohols possessing different hydroxylation, oxidation, and double bond patterns, which exemplify the chemical diversity of bile salts. These five bile salts were potent odorants that stimulated the adult sea lamprey olfactory epithelium in a concentration dependent manner and showed detection thresholds between 10–13 mol·L-1 and 10–11 mol·L-1(paired t-test, P<0.05). Experi?ments in the two-choice maze showed that all isolated compounds induced behavioral responses in ovulated females. CONCLUSION The five novel compounds are likely additional components of phero?mones released by sexually mature male sea lamprey, and may provide useful behavioral manipulation tools to be implemented with the integrated management of the destructive and invasive sea lamprey in the Laurentian Great Lakes.

Purpose: To assess the quality and readability of online health information on vasectomy using validated readability and quality assessment tools. Materials and Methods: The top 50 search results for "vasectomy" on Google, Bing, and Yahoo were selected. Duplicate links, advertisements, blog posts, paid webpages, and information intended for healthcare providers were excluded. Flesch Reading Ease score, Flesch–Kincaid Grade level, Gunning Fog Index, and Simple Measure of Gobbledygook (SMOG) index were used to assess readability, with optimal readability level for online health information established as being at sixth grade reading level. DISCERN Instrument and JAMA Benchmark were used to assess the quality of selected webpages. Inter-assessment score correlation and results by webpage type were analyzed. Results: We analyzed 44 webpages, including 16 academic, 5 hospital-affiliated, 6 commercial, 13 non-profit health advocacy, and 4 uncategorized sources. The average readability of the evaluated webpages was at a 10th grade reading level as measured by the Flesch Kincaid Assessment tool, and an undergraduate reading level per the SMOG and Gunning Fog indices. Non-profit health advocacy webpages had the best reading level but still was not at the recommended level of grade 6 to 7. The overall DISCERN quality of the webpages was “fair”, with non-profit health advocacy pages performing best. Conclusions The assessed webpages offer education on vasectomy in a language that is too complex for the general population to understand. Furthermore, several sources for online health information, such as non-profits, outperformed webpages by academic institutions. Increased healthcare collaboration and dedication to producing quality online patient resources is necessary to address these shortcomings and build trust among patients to increase utilization of vasectomy and decrease decisional regret.

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.
Adult ; Cone-Beam Computed Tomography ; methods ; Follow-Up Studies ; Fused Teeth ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; methods ; Male ; Maxilla ; Molar ; abnormalities ; Molar, Third ; abnormalities ; Pulpitis ; diagnostic imaging ; Root Canal Therapy ; Tooth Root ; abnormalities ; Tooth, Supernumerary ; diagnostic imaging ; Tooth, Unerupted ; diagnostic imaging

OBJECTIVE: To describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum. MATERIALS AND METHODS: The CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images. RESULTS: Ascites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565). CONCLUSION: Ascites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.
Adult ; Aged ; Ascites/diagnosis ; Asteraceae/chemistry ; Cholecystography ; Female ; Gallbladder/pathology ; Hepatic Veins/pathology/radiography ; Hepatic Veno-Occlusive Disease/chemically induced/*diagnosis ; Hepatomegaly/diagnosis ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Phytotherapy/*adverse effects ; Pyrrolizidine Alkaloids/adverse effects ; Severity of Illness Index ; *Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo investigate the biological changes in myelodysplastic syndromes (MDS) myeloid blast cell line MDS-L after different duration and concentration of As2O3/TRAIL (TNF related apoptosis inducing ligand) treatment.

METHODSMDS-L cells were treated with As2O3 and TRAIL at 9 different concentrations and the treated cells were detected at 24 h, 48 h and 72 h for biologic indexes. The same detections were conducted in untreated MDS-L cells and normal and MDS marrow cells as controls. Apoptosis was assayed by flow cytometry after Annexin V-FITC labelling. Differentiation-induction effect of these drugs on the cells were detected by morphologic examination and CD34(+) proportion analysis after 24 hours treatment and further agar culture for 18 days; P15(ink4b) mRNA expression were detected by RT-PCR and its protein expression by DAB immunocytochemistry, P15(ink4b) DNA methylation by methylation specific PCR (Msp).

RESULTSAs2O3/TRAIL treatment promoted MDS-L cells to undergo apoptosis and As2O3 plus TRAIL showed obvious differentiation-induction effect on MDS-L. P15(ink4b) mRNA expression was upregulated in MDS-L cell line after different drug treatment but almost no protein expression increased. Increased P15 expression seemed to be related with DNA demethylation effect of these drugs.

CONCLUSIONSAs2O3 or/and TRAIL treatment could promote apoptosis of the clonal cells and induce incomplete cell differentiation. The drugs treatment could also increase P15(ink4b) expression in MDS-L cell line through their demethylation effects.

Antigens, CD34 ; analysis ; Apoptosis ; drug effects ; Arsenicals ; pharmacology ; Cell Differentiation ; drug effects ; Cell Line ; Cyclin-Dependent Kinase Inhibitor p15 ; genetics ; metabolism ; Dose-Response Relationship, Drug ; Flow Cytometry ; Humans ; Immunohistochemistry ; Myelodysplastic Syndromes ; genetics ; metabolism ; pathology ; Oxides ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; TNF-Related Apoptosis-Inducing Ligand ; pharmacology ; Time Factors

Adolescent ; Female ; Humans ; Sacrum ; pathology ; surgery ; Spondylolysis ; diagnosis ; pathology ; surgery