Head ; surgery ; Humans ; Neck ; surgery ; United States

Objective To observe the effect of ligustrazine on the changes of collagen, transforming growth factor- ?1(TGF- ?1) content in airway wall of asthmatic rats. Methods Forty SD rats were randomly divided mto normal group,model group, desametha-sone group, low - dose and high - dose of ligustrazine group, 8 rats in each group. The changes of collagen and TGF - ?1 content in the atrway wall were measured by the computerized image analysis system. Results The contents of collagen type Ⅲ and TGF -?1 in air-way wall in model group were significantly higher than controls group(P ail

Objective To investigate the flexibility of both the covered stents specially designed for use in intracranial vasculature and the delivering system in passing through the bone tube and the physiological curves of the cranial internal carotid artery(CICA)to reach the targeted area,the performance (adherence)of the covered stents in occluding vascular wall diseases and the impact on the vascular branches of the covered segment.Methods The covered stents specially designed for use in intracranial vaseulature were used to treat 13 patients with CICA diseases using endovascular techniques.There were 4 huge pseudoaneurysms,4 giant aneurysms,3 small wide-necked aneurysms,1 giant pseudoaneurysm with concurrent internal carotid cavernous fistula(CCF),and 1 CCF.Prior to the detachment of the covered stents,balloon occlusion test(BOT)of the internal carotid artery on the diseased side and whole-brain digital subtraction angiography(DSA)were performed in all the patients.Three to 16 months following procedure,DSA and clinical follow-ups were performed.Results Thirteen patients all tolerated the BOT well with the DSA demonstrating well-opened anterior and posterior communicating arteries.The covered stents and the delivering systems all successfully passed CICA to reach the targeted diseased area,with the diseased segments of the internal carotid artery including C3—C4 in 4 cases,C4—C5 in 4 and C6—C7 in 5.Immediately following the detachment of the covered stents,DSA demonstrated that 7 aneurysms were completely occluded,4 aneurysms had slight endoleak,and 1 CCF had markedly-decreased blood flow through the fistula.In the patient with concurrent pseudoaneurysm and CCF,the pseudoaneurysm disappeared and the blood flow through the fistula was markedly-reduced immediately following the stenting procedure.Apart from one patient with aneurysmal subarachnoid hemorrhage who died due to extensive vascular spasm on the 9th day following the stenting procedure,all the other 12 patients had unobstructed stented vessels on the follow-up DSA images,with 2 demonstrating slight stenosis.In the 6 patients with post-procedure endoleak,DSA showed that the endoleak in 4 patients had disappeared,one endoleak disappeared following the second stenting,and one CCF remained low-flow fistula.There was no sequela related to the occlusion of branches in the covered arterial segment.Conclusion The covered stents specially designed for use in the intracranial vasculature and the delivering system are both flexible enough to pass the tortuous CICA to reach the intracranial diseased artery,and are effective in managing CICA diseases.Further follow-up is still needed to determine the long-term effect of the covered stents,and the adherence of the covered stents needs further investigation.

OBJECTIVETo explore the fixation methods in treatment of tibial fracture in adolescents by comparing the results and complications of three fixation methods and to determine the factors related to those complications.

METHODSFrom January 2007 to January 2012, 83 diaphyseal tibial fractures in 79 adolescents were treated with elastic stable intramedullary nail fixation, plate fixation, or external fixation respectively. There were 55 males and 24 females with an average age of 13.9 years (ranging from 11 to 17.6 years). Outcomes were compared in terms of the hospital stay,time to union, complications, and reoperation rates.

RESULTSAll patients were followed up for 15.8 months in average. The time to union was significant associated with the pattern of fixation, energy of the injury, multiple and open fracture. The time of bone union of external fixation group was longer than that of elastic stable intramedullary nail fixation and plate fixation groups. But complication rates of external fixation group were higher than that of elastic stable intramedullary nail fixation and plate fixation groups. Four patients were treated with elastic nail fixation underwent a reoperation (loss of reduction in 2 cases, delayed union and nonunion in each 1 case). Six patients were treated with external fixation required a reoperation (loss of reduction in 3 cases, malunion in 2 cases, and replacement of a pin canal infection in 1 case). Two fractures were treated with plate fixation required refixation following nonunion and malunion. A multivariate analysis with adjustment for baseline differences showed external fixation to be associated with a 7.56 times (95% confidence interval=3.74 to 29.87) greater risk of loss of reduction and (or) malunion than elastic stable intramedullary nail fixation. At the final follow-up,there were agreeable results among three groups and no significant differences among them in final therapeutic effect (P>0.05).

CONCLUSIONExternal fixation for treatment of tibial fracture in adolescents has the highest rate of complications than the other two fixation methods. Elastic stable intramedullary nail fixation can achieve the same effect of other fixed system and avoid most of the complications. Operation method choice depends on the experience of doctors and patients' basic situation and the fracture types.

Adolescent ; Bone Plates ; Child ; Female ; Fracture Fixation ; instrumentation ; methods ; Fracture Fixation, Intramedullary ; Fractures, Open ; surgery ; Humans ; Male ; Retrospective Studies ; Tibial Fractures ; surgery

Objective To investigate the influence of cryopreservation on bone marrow stromal cells'(BMSC)capability of enhancing periodontal regeneration.Methods Twenty-six artificial periodontal defects were established in 5 Beagle dogs and divided into 3 groups at random.Only collagen membrane,the complex of cryopreserved and uncryopreserved BMSC and collagen scaffold were transplanted in the blank control group,cropreserved and uncryopreserved groups respectively.The periodontal regeneration was observed 8 weeks after transplantation.Results The percentage of periodontal regeneration in cryopreserved and uncryopreserved groups was significantly greater than that of the blank control group(P<0.05),but no statistical difierence was found between cryopreserved and uncryopreserved groups.Conclusions Cryopreservation had no significant negative effects on BMSC capability of enhancing periodontal regeneration.

Adolescent ; Bronchoscopy ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Respiratory Tract Diseases ; diagnosis

Bronchiolitis Obliterans ; diagnosis ; Child ; Humans

OBJECTIVETo investigate changes in serum complement, immunoglobulins and lymphocyte subsets in children with common and severe bronchial pneumonia, and the role of immune function testing in bronchial pneumonia.

METHODSTwenty children with common bronchial pneumonia, 20 with severe bronchial pneumonia and 20 healthy children (as controls) were enrolled in this study. Immunization rate scattering turbidimetry and six-color flow cytometry were used to detect changes in serum levels of IgA, IgG and IgM, complement C3 and C4 and CD3(+), CD4(+), CD8(+), CD16(+), CD56(+) and CD19(+) cells.

RESULTSThe IgA levels of children with common and severe pneumonia were significantly lower than in the control group (P<0.05). The IgG level of children with severe pneumonia was significantly lower than in the control group (P<0.05). There were no significant differences in the levels of IgM and complement C3 and C4 between the two pneumonia groups and the control group (P>0.05). Compared with the controls, the children with severe pneumonia showed significantly lower CD4(+) and CD3(+) counts (P<0.05) and a significantly higher CD19(+) count (P<0.05), and the CD16(+) and CD56(+) counts of children with severe pneumonia were significantly lower than in the controls and in children with common pneumonia (P<0.05). There were no differences in CD8(+) count and CD4(+)/CD8(+) ratio between the two pneumonia groups and the control group (P>0.05).

CONCLUSIONSImmune dysfunction exists in children with bronchial pneumonia, especially those with severe pneumonia. Changes in immune function are correlated with the severity of pneumonia. Immune function testing in children with pneumonia has important clinical significance.

Bronchopneumonia ; immunology ; Child, Preschool ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Infant ; Killer Cells, Natural ; immunology ; Male ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo study the clinicopathologic features and immunophenotype of renal cell carcinomas, and to discuss their diagnostic value.

METHODSThe clinicopathologic features of 114 cases of renal cell carcinoma were reviewed and categorized on the basis of 2004 WHO classification. Immunohistochemical study for a panel of antibodies (including CK, CD10, vimentin, CD117, AMACR, CK7 and TFE3) was carried out. The follow-up data, if available, were also analyzed.

RESULTSThe cases were reclassified into 5 subtypes, including 77 cases (67.5%) of clear cell carcinoma (CCRCC), 11 cases (9.6%) of papillary renal cell carcinoma (PRCC), 14 cases (12.3%) of chromophobe renal cell carcinoma (chrRCC), 10 cases (8.8%) of renal carcinoma associated with Xp11.2 translocations/TFE3 gene fusions (Xp11.2RCC) and 2 cases (1.8%) of unclassified renal cell carcinoma (unRCC). Immunohistochemical study showed that the expression rates of CK, CD10 and vimentin in CCRCC were 93.5% (72/77), 93.5% (72/77) and 75.3% (58/77), respectively. On the other hand, all the 11 cases of PRCC studied were positive for AMACR. The expression rate of CD117 in chrRCC was 78.5% (11/14). In the 10 cases of Xp11.2 RCC studied, the expression rates of TFE3, AMACR, CD10 and CK were 100% (10/10), 100% (10/10), 90% (9/10) and 70% (7/10), respectively.

CONCLUSIONSThe various subtypes of renal cell carcinomas are heterogeneous in histologic appearance and demonstrate distinctive immunophenotype. The expressions of CD10, vimentin, CD117, AMACR, CK7 and TFE3 are helpful in the differential diagnosis.

Adenocarcinoma, Clear Cell ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; genetics ; immunology ; metabolism ; Biomarkers, Tumor ; analysis ; genetics ; Carcinoma, Papillary ; immunology ; pathology ; Carcinoma, Renal Cell ; immunology ; metabolism ; pathology ; Female ; Gene Fusion ; Humans ; Immunophenotyping ; Kidney Neoplasms ; immunology ; metabolism ; pathology ; Male ; Middle Aged ; Neprilysin ; analysis ; Racemases and Epimerases ; analysis ; genetics ; Translocation, Genetic ; Vimentin ; analysis ; World Health Organization ; Young Adult

OBJECTIVETo study the clinicopathologic features and prognosis of primary lymphoma of breast.

METHODSForty cases of primary breast lymphoma, diagnosed according to the 2008 World Health Organization classification of hematopoietic and lymphoid tumors, were retrospectively studied. Immunohistochemistry was performed by SP method. The follow-up data were analyzed.

RESULTS(1) All the patients were females and the median age was 47 years. Unilateral and bilateral breast involvement were noted in 36 and 4 patients, respectively. The number of tumor were 31 cases (77.5%, 31/40) less than 3, and 9 cases (22.5%, 9/40) were 3 and more than 3. According to Ann Arbor staging system, 33 cases (82.5%) were in stage I to II and 7 cases (17.5%) in stage III to IV. The level of LDH in 9 cases (24.3%, 9/37) went up. For ECOG scores, 34 cases (85.0%) were 0 to 1 score and 6 cases (15.0%) were more than 2 scores. With respect to international prognostic index, 83.8% (31/37) were of score 0 to 2 and 16.2% (6/37) were of score 3 and more than 3. The axillary lymph nodes of 21 patients (53.8%, 21/39) were involved by the malignancy. (2) Histologically, 38 cases (95.0%, 38/40) were classified as B-cell lymphoma [including 27 cases (67.5%) of diffuse large B-cell lymphoma, 8 cases (20.0%) of mucosa-associated lymphoid tissue lymphoma, 2 cases of follicular lymphoma and 1 case of lymphoplasmacytic lymphoma]. The remaining cases included one case of peripheral T-cell lymphoma and one case of lymphoblastic lymphoma. Immunohistochemically, expression of CD20+/- CD79a were demonstrated in the 38 cases (95.0%) of B-cell lymphoma. The staining for CK was negative in all cases. In 33 cases, the positive rates of MUM-1, bcl-6 and bcl-2 were 57.6% (19/33), 30.3% (10/33) and 72.7% (24/33), respectively. Three cases were germinal center B cell phenotype and 21 cases were non-germinal center B cell phenotype. (3) Follow-up information was available in 37 patients (92.5%, 37/40). Twenty-three patients (62.2%, 23/37) were still alive and fourteen ones (37.8%, 14/37) died. For the 27 cases with diffuse large B-cell lymphoma, the five-year and disease-free survival rates were 48.0% and 36.0%, respectively.

CONCLUSIONSPrimary breast lymphoma is a rare disease entity. Diffuse large B-cell lymphoma is the commonest histologic type and the majority show a non-germinal center B cell phenotype. The level of LDH, number of tumor and international prognostic index are of prognostic significance.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; CD79 Antigens ; metabolism ; Cyclophosphamide ; therapeutic use ; Disease-Free Survival ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Interferon Regulatory Factors ; metabolism ; L-Lactate Dehydrogenase ; blood ; Lymphatic Metastasis ; Lymphoma ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, B-Cell, Marginal Zone ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, Follicular ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, T-Cell, Peripheral ; drug therapy ; metabolism ; pathology ; surgery ; Mastectomy ; methods ; Middle Aged ; Neoplasm Staging ; Prednisone ; therapeutic use ; Retrospective Studies ; Survival Rate ; Vincristine ; therapeutic use ; Young Adult