Lipoxygenase ; metabolism ; Oxidation-Reduction ; Teratogens

The diagnosis and treatment of Morton neuroma is reviewed in this paper.Intermetatarsal neuroma,often called Morton neuroma,is a commonly occurring disorder associated with symptoms of forefoot pain and paresthesias.It is a chronic compresive neuropathy believed to be caused by fibrosis of the epineural tissue.Current treatment of Morton neuromas includes nonoperative treatment,ultrasound-guided neuroma drug injections,endoscopic decompression of intermetatarsal nerve,excision of the neuroma,each way has merits and demerits,it is still controversial which is the best one.

Objective To observe the changes of the content of ATP,lactate and the activity of phosphofructokinase(PFK) in perihemotoma region in rabbit brain after intracerebral hemorrhage. Methods(The rabbits) were divided into 3 groups: normal group(N),hemorrhage group (H) and the sham group(S). The H and S groups were subdivided into 1 h, 6 h, 12 h, 24 h, 48 h and 72 h groups. A model of cerebral hemorrhage in rabbit with autologous blood infusion was set. The contents of ATP, lactate and water in perihemotoma region were measured and the metabolite concentration in edematous brain regions were corrected for dilution. The activity of phosphofructokinase was also determined.Results There was obvious edema in perihemotoma region at 1 hour postinfusion and getting more serious at 72 hours. ATP was moderately decreased at 1 hour, and remained in a similar level until 12 hours. There appeared another evident decrease in 24 hours [(13.29?2.92) ?g/g, about 58% of N group], and no obvious changes from 24 to 72 hours. The content of lactate increased in 1 hour and reached the peak at 12 hours [(21.01?0.18) ?mol/g]. Until 72 hours , the level of lactate [(12.89?0.25) ?mol/g] in hemorrhage group reach higher than in the normal and sham group. The activity of phosphofructokinase was decreased at 1 hour [(3.98?0.02) U/mg] and remained in a decreasing tendency to 72 hours. Conclusion The failure of energy metabolism occurs in 24 hours postinfusion,coming late somewhat to the brain edema. The result might be related to the changes of some enzymes, maybe a key role in energy metabolism.

In order to study the effect of pulse Nd:YAG laser on hypersensitive dentin and inner wall of root canal.The morphologi- cal changes were observed with a SEM.The results showed that the low power with high energy density.Laser irradiation did not do harm to normal teeth tissue.The melted layer of dentin matrix extended to dentinal tubles,and the dentinal tubles were sealed to a depth of 15 um.The conventional preparation of root canal with laser irradiation provided much advantage in clearing the stained layer of inner wall in comparison with conwentional preparation of root canal alone.

AIM:To investigate the effect of case-based learning ( CBL) teaching combination with paper review method in the teaching of ophthalmology residents. ·METHODS:The study was conducted from 2015 to 2016. The residents in Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital were included in the research. During the year of 2015, the traditional lecture-based learning ( LBL) method was applied (as a control group). During the year of 2016, the CBL teaching combination with paper review teaching method was applied (as an experimental group). At the end of the course, exams and questionnaires were conducted to evaluate the teaching effect of two different methods. The exams consisted of theoretical and operational assessment. The teaching satisfactions, learning interests, scientific research interests and clinical abilities were included in the questionnaires. The data was analyzed by SPSS 16. 0. ·RESULTS:The results of final exams indicated that the scores of the experimental group (88. 2±6. 5) were higher than the control group ( 75. 6 ± 6. 0 ). The difference showed statistically significant (t=6. 68, P<0. 05). The results of questionnaires indicated that students showed much more satisfied with CBL teaching combination with paper review teaching method ( 91%) than traditional teaching method (50%, x2 =8. 84, P<0. 05). Students in the experimental group improved learning interest ( x2 =6. 29, P<0. 05), increased research interest (x2=4. 54, P<0.05) and approved clinical ability (x2 =4. 25, P<0. 05). The comparison of two groups showed the statistically difference (P<0. 05). ·CONCLUSION: CBL teaching combination with paper review teaching method is beneficial to improve the teaching effect, and it is also beneficial to train residents'clinical skills and research abilities.

The construction of a network resource data base for clinical skill teaching aiming at sharing excellent teaching resources was completed by integrating all kinds of teaching resource including characters,eourseware,pictures,cartoons,videos and examination questions,etc.In view of the generally weak situation of the current domestic education resource data base construction,the contents,guiding ideology,principle,object,orientation,function and the management mechanism of the network resource data base construction were devised for clinical skills teaching.Suggestions for specific ideas and construction problems were proposed to promote the construction and optimization of the network resource database for clinical skills teaching.

Objective To evaluate the CT image features of urinary tract inflammatory myofibroblastic tumor (IMT) for use in clinical and differential diagnosis.Methods Eight pathologically proven IMT cases were retrospectively analyzed in this study.There were six female patients and two male patients.Patient average age was 35 (13-62) years.The main clinical manifestations were hematuria and urination pain.Tumors were found in the bladder in 5 cases,in ureter in 2 cases and in urethra in 1 case.All the 8 cases accepted CT scan five of which had contrast enhanced CT scan.The imaging features were then analyzed.Results Of the IMT in bladder,CT scan showed a cauliflower like bladder tumor or round soft tissue mass with even or uneven density of 11.5-36.0 HU.Three tunors were accompanied with necrosis.Four cases had associated adjacent bladder wall thickening and two cases were found with fuzzy surrounding fat space.Ureteral lesions in two cases showed a solid mass with smooth edges and even density of 40.3 HU compared to the surrounding muscle.The urethral lesions had clear mass realm of 17.5-22.6 HU accompanied with calcification.Enhanced CT scan showed that homogeneous or heterogeneous mild to moderate enhancement was found in the tumor.Delayed phase showed consistant enhancement of 102.7-118.6 HU.Conclusion Tumor CT imaging features,particularly the significant and consistant enhancement in delayed phase,provide important information for diagnosis and differential diagnosis of the urinary tract IMT.

Objective To discuss wound edge characteristics at different clinical periods and in-tervention of traumatic perforation of tympanic membrane. Methods A total of 494 patients wth trau-matic perforation of tympanic membrane were treated and grouped based on treatment time and size of per-foration. Group A (n = 154, within 12 hours after injury) were treated by residual tympanic membrane repair and gelfoam. Group B (n =149, 12 hours after injury) were treated by simple gelfoam. Group C (n = 116) and Group D (n =75) were treated by conventional therapy. The wound healing of peroration was observed after one month. Results Of all, there were 419 patients with maximum perforation diameter > 2.5 mm within five hours after injury, of which 349 patients (83.3%) were with residual tympanic membrane valgus of perforation rim, 29 (6.9%) with involution of perforation rim and 41 (9.8%) with complete loss of tympanic membrane. Of 75 patients with maximum perforation diameter <2.5 ram, residual valgus of perforation rim was found in 18 (24.0%) and tympanic membrane wrinkle near wound edge in the other patients. Under endoscopic repair of crimp tympanic membrane, maximum perforation diameter was reduced for (6.5±2.5)mm in 143 patients at 6th hour, (6.0±1.5)mm in 11at 7-11 hours, (2.0±1.5) mm in 27 at 13-24 hours, (1.5±1.0) mm in 59 at 25.5-48 hours, (1.0±0.5) mm in 49 at 51-73 hours and 0 mm in 14 at 75-192 hours. The follow up lasted for one month, which showed that healing rate of perforation in groups A, B, C and D were 85.3%, 71.2%, 59.2% and 81.4%, respectively. Healing time span was (10±4) days, (19±4) days, (25±2) days and (16±2) days, respectively. Conclusions Traumatic perforation of tympanic membrane is not com-plete tympanal deletion but residual tympanic membrane valgus of perforation rim,involution and tympanicmembrane crushing, which shows insignificant change with time. In time repair of residual tympanic membrane 12 hours(especially 6 hours) after injury may reduce the largest diameter of perforation and re-markably shorten the healing time of perforation.

Objective To analyze clinical and radiological characteristics in 5 cases of neuromyelitisoptica (NMO) with tumefactive-like demyelinating lesions (TDLs).Methods Five NMO patients with TDLs hospitalized during November 2007 and March 2012 were retrospectively analyzed for clinical and magnetic resonance imaging (MRI) features,as well as therapeutic efficiency and prognoses.Results The male-to-female ratio is 1∶4 and the range of onset ages is 15-44 years old.The median time when TDLs was developed was 36 months after the onset of NMO.The anti-aquaporin 4 was seropositive in all NMO patients with TDLs.Four patients had clinical manifestations of encephalopathy symptoms including coma (n =2),seizures (n =1),narcolepsy (n =1),homonymous hemianopia (n =1).All TDLs grew unilaterally.Two TDLs were located at parietal-occipital,1 at parietal,I at the cerebellum and 1 at the temporal.On MRI,there was no enhanced signal in 4 TDLs,and there was open-ring-like enhanced signals in 1 case.Three TDLs revealed mixed signals intensities on diffusion-weighted images and an increase in the apparent diffusion coeficient values.On the subsequent MRIs,the sizes of 5 TDLs were markedly reduced in 3 cases,disappeared in 1 and another 1 case remained the same.Meanwhile,3 lesions subsequently developed cavity forming.Five cases improved after treatment of high-dose corticosteroid and intravenous immune globulin.Conclusions TDLs is not uncommon in NMO.Encephalopathysymptoms are more frequently affected in NMO with TDLs.TDLs often accompany with extensive vasogenic edema,but without enhancement in acute stage.NMO-IgG antibody testing and brain MRI are important in the diagnosis of TDLs.The therapy of corticosteroid and intravenous immune globulin is recommended.

Objective To study the effect of Zusanli and Guanyuan electroacupuncture ( EA) on inflammatory reaction in patients with sepsis. Methods A prospective and randomized trial was carried out in 58 sepsis patients, and the patients were randomly divided into EA group and control group. Patients in both groups were given conventional western medicine treatment, and EA group received EA at acupoints of Zusanli and Guanyuan additionally. The hospitalization time in intensive care unit ( ICU) of the two groups was compared. The changes of serum lactic acid (LA) level and inflammatory indexes including white blood cell and neutrophil count, C- reactive protein (CRP), erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) of the two groups were observed before and after treatment. Results The hospitalization time in ICU of EA group was less than that of the control group, and the difference was statistically significant ( P<0.05) . On the seventh day after treatment, the serum LA level of EA group was significantly lower than that of the control group ( P<0.05) . Inflammatory indexes of EA group were decreased after treatment compared with those before treatment ( P<0.05) , and on seventh day after treatment, the inflammatory indexes of EA group were significantly lower than those of the control group ( P<0.05) . Conclusion EA at acupoints of Zusanli and Guanyuan is effective for the treatment of sepsis through reducing the inflammatory reaction of sepsis patients.