Asian Continental Ancestry Group ; Head ; surgery ; Humans ; Neck ; surgery ; Otolaryngology

BACKGROUND: Nowadays, it is reported that vessel structural abnormity is the main morphological basis of vertigo due to vertebrobasilar arterial insufficiency abroad, but the report of vascular structural abnormality in vertebrobasilar arterial insufficiency is rare at home.OBJECTIVE: To observe the manifestation and clinical significance of vessel structural abnormity tested by digital substraction angiography (DSA)in patients with vertigo induced by vertebrobasilar arterial insufficiency.DESIGN: Case analysis.SETTING: Department of Neurology, Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University and Department of Neurology, Huaihua Hospital Affiliated to Nanhua University.PARTICIPANTS: A total of 57 patients, who were diagnosed as having episodic vertigo with or without nausea or vomiting, and hospitalized in the Department of Neurology, Huaihua Hospital Affiliated to Nanhua University from August 2003 to May 2004 and Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University between October 2004 and May 2005, were enrolled.METHODS: Fifty-seven patients with vertigo induced by vertebrobasilar arterial insufficiency hospitalized in the recent two years were treated with digital subtraction radiography in aortic arch and aortocranial angiography:Applying retrograde angiography of femoral artery puncture, Optiray nonionic contrast agent with syringe pattern to perform aortic arch angiography. Digital subtraction machine displayed bilateral carotid artery, vertebral artery, ranged from carotid artery to siphon of carotid artery from multiple angles. Measurement and evaluation were conducted by 2 doctors from department of neurology.MAIN OUTCOME MEASURES: Type, distribution and proportion of vesselstructural abnormity of aortic arch, carotid artery and vertebrobasilar system.RESULTS: Of the 57 patients, 1 patient was dropped out, because the left vertebral artery (LVA) could not be entered. A large area cerebral infarction was occurred in another patients during aortic arch angiography was performed, and the operation was stopped. Totally 55 patients were involved in the result analysis. It was found that 71%(39/55) of patients had vessel structural abnormity in cervical part and intracalvarium, 11%(6/55)of patients with simple anterior circulation lesion, 60% (33/55) of patients with posterior circulation lesion, of which 9 cases (16%) with compound lesion of anterior circulation abnormity. Two or above vessels in 24 cases (24/55,44%) were involved. Vertebral artery complicated with other angiostegnosis was the most common, and there was no vessel structural abnormity in other 16 cases (16/55,29%).CONCLUSION: Various types of vessel structural abnormity are the main etiological factors of vertigo induced by vertebrobasilar arterial insufficiency. Gold standard of diagnosing vertigo due to vertebrobasilar arterial insufficiency is DSA.

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (Mtb), is still one of the significant threats to human life. In recent years, the continuous exploration of small molecule inhibitors represented by bedaquinoline has brought new vitality into the field of tuberculosis. However, small molecule inhibitors will inevitably occur acquired drug resistance during clinical medication. As a new pharmacological mechanism, targeted protein degradation (TPD) achieves efficacy by destroying rather than inhibiting protein targets. It might be an excellent strategy to develop anti-tuberculosis drugs based on the TPD concept to solve drug resistance. This article reviews the protein degradation pathways of Mtb, such as the Pup proteasome system and the ClpP-ClpC1 complex enzyme system. The future development of these strategies into TPD drugs was prospected and summarized.

Adult ; Aged ; Dermis ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; pathology ; Reconstructive Surgical Procedures ; methods ; Wound Healing

Objective To investigate the acute toxicity, subacute toxicity, nasal membrane local toxicity of the Magnolia biondii Pamp volatile oil nanometer bangosome. Methods Kunming mice and SD rats were selected as experimental material. Kunming mice were used in the acute and subacute toxicity tests by intragastric administration of Magnolia biondii Pamp volatile oil nanometer bangosome with different dosage and different time, and SD rats were used in the nasal membrane local toxicity test by nose dropping, while the control group was treated with intragastric administration of or nose dropping with normal saline for the same dosage. The treatment course lasted fifteen days. At the end of the tests, the general condition, routine blood test, function index of live and kidney, organ humid weight index, histological changes of liver and kidney and ultra microstructure change of rat nasal membrane were obtained and compared with the control group. Results In the acute toxicity test, the daily maximum tolerant dosage by intragastric administration was equal to 222.7 times of the clinical routine, with no marked toxic reaction. In the subacute toxicity test, the general condition, blood test, organ humid weight index and histological changes of live and kidney in different dosage groups were similar to the control group. While in the function index of live and kidney, uric acid was stepped down in the middle and large dose groups, and total bilirubin was decreased in the large dose group. The nasal membrane local toxicity test revealed that there was little change in the ultra microstructure of rat nasal membrane.Conclusion The Magnolia biondii Pamp volatile oil nanometer bangosome may have little toxicity by intragastric administration and nose dropping.

Aged ; Humans ; Male ; Middle Aged ; Mycoses ; complications ; Nasal Septal Perforation ; complications ; microbiology ; Sinusitis ; complications ; microbiology

Objective To investigate etiology and clinical features of acute pancreatitis (AP) in young patients. Methods In total, 423 patients with AP admitted to Renmin Hospital of Wuhan University, Wuhan, Hubei province during January 2006 to December 2009 were retrospectively analyzed, 55 cases aged 34 years or less as young group and another 55 cases aged more than 34 years as middle- and elderly-age group. Their etiology, clinical features and illness scores based on some standard criteria were assessed. Results Proportion of varied etiologies of AP in young group was different from that in middle- and elderly-age one (x2 = 17. 107, P = 0. 009) , mainly as biliary and idiopathic pancreatitis in young group and as biliary and alcoholic pancreatitis in middle- and elderly-age one. Incidence of diet-related and idiopathic pancreatitis were higher in young group than that in middle- and elderly-age one ( x2 =4. 853, P = 0. 028 and x2=4. 274, P = 0. 039 ). Scores of the acute physiology and chronic health evaluation II ( APACHE II ) , Ranson criteria and the bedside index for severity in acute pancreatitis ( BISAP) were all lower in young group than those in middle- and elderly-age one (t = 5. 381 , P = 0. 000; t = 4. 388 , P = 0. 000 and t=3. 083, P = 0. 003 ) . There was no statistically significant difference in scores of computed tomography severity index ( CTSI) between young group and middle- and elderly-age one (t = ±0. 750, P > 0. 05 ) . Recurrence rate of AP was lower in young group than that in middle- and elderly-age one ( x2 =4. 251, P = 0. 039). Cholecystitis was more complicated in young group, pregnancy was more complicated in young group (x2 =4. 151 , P =0. 042) , and elevated blood glucose was more complicated in middle- and elderly-age one (x2 = 13. 285 , P = 0. 000 ) . Conclusions Etiology of AP varies in young patients with more dietary factors, occurrence of systemic complications and risks for death are lower in young group than those in middle- and elderly-age one, and there was no statistically significant difference in local complications and severity of illness between the two groups.

Objectives To investigate the possible role of perforin (PFN) in the pathogenesis of severe preeclampsia.Methods Thirty-two cases of severe preeclampsia were included in the study.Thirtytwo cases of normal pregnancy were selected as control group in random.The expression of PFN mRNA in the peripheral blood mononuclear cells (PBMC) was detected by reverse transcription (RT)-PCR, and its correlation with mean arterial pressure was analyzed in severe preeclamptic patients.The expression of PFN protein in the decidua was detected by immunohistochemistry.Results ( 1 ) The expression of PFN mRNA in PBMC:the PFN mRNA level in severe preeclamptic group was 1.19 ± 0.31, and that in normal pregnancy group is 0.82 ± 0.28.The PFN mRNA level in severe preeclamptic group was significantly higher than that of control group (P ＜ 0.0l ).(2)Correlation analysis:the mean blood pressure in severe preeclampsia group was (133 ±5) mm Hg( 1 mm Hg =0.133 kPa).There was significant positive correlation between level of PFN mRNA in PBMC and mean blood pressure in severe preeclamptic patients ( r = 0.701, P = 0.000).(3)Decidual PFN protein expression:PFN protein was mainly expressed in lymphocytes and the cytoplasm of decidual stromal cells.The positive ratio of PFN in the decidua of severe preeclamptic patients was 84% ( 27/32), significantly higher than that of control group (53%, 17/32, P ＜ 0.01 ).Conclusions Expression of PFN was significantly increased in severe preeclampsia, and it was of significant positive correlation with mean blood pressure.PFN may participate in the pathogenesis of severe preeclampsia.

ObjectiveTo evaluate the efficacy of hypertonic saline (HS) treatment in cardiopulmonary resuscitation (CPR) in animal models of cardiac arrest (CA).Methods PubMed and EMBASE data were retrieved from January 1st, 1966 to September 30th, 2014, and Wanfang data and CNKI were searched from January 1st, 1990 to September 30th, 2014 for randomized controlled trials (RCTs) regarding CPR intervention of CA animal models with HS. HS was intravenously infused at the initiation of CPR in HS group, without limiting its dosage or concentration. The same volume of normal saline (NS) was given in NS group. Meta-analysis concerning the rate of restoration of spontaneous circulation (ROSC), the serum sodium concentration before CA and during CPR, and related hemodynamic parameters, including mean arterial pressure (MAP) and coronary perfusion pressure (CPP) at the immediate beginning of CPR and 90 minutes after ROSC was conducted by RevMan 5.3 software.Results A total of 8 RCTs were included. Meta-analysis showed that compared with NS group, the rate of ROSC [relative risk (RR) = 1.23, 95% confidence interval (95%CI) = 1.05-1.43,P = 0.010], serum sodium concentration during CPR [weight mean difference (WMD) =17.44, 95%CI = 12.57-22.31,P< 0.01], and the level of MAP at 90 minutes after ROSC (WMD = 4.81, 95%CI =1.58-8.03,P = 0.003) were significantly improved in HS group. There was no significant statistic difference in other hemodynamic parameters, including serum sodium concentration before CA (WMD = 0.78, 95%CI = -0.26-1.82,P =0.14), MAP (WMD = 5.43, 95%CI = -0.74-11.59,P = 0.08) and CPP at the immediate beginning of CPR (WMD =6.82, 95%CI = -5.54-19.19,P = 0.28), and CPP at 90 minutes after ROSC (WMD = -0.77, 95%CI = -10.33-8.80, P = 0.88) between two groups. It was showed by funnel chart that bias was not significant in the published articles. Conclusion This systematic review indicates that HS infusion is followed by an improved ROSC rate, serum sodium concentration during CPR, and MAP at 90 minutes after ROSC in animal models of CA.

Objective To investigate the effect of recombinant human growth hormone on the PingPang Racket flap survival.Methods Every two PingPang Racket flaps were designed on the both sides of 40 adult SD rats's back.The pedicle size was 1.0 cm × 1.0 cm,while the flap size was 3.0 cm in diameter circular.Longitudinal axis of flap was perpendicular to the center line of the rats back,to which the distance from proximal pedicle was about 1 cm.The flaps on the left side served as Ⅰ group,and the other side served as Ⅱ group,which were subdivided into Ⅰa and Ⅰb,Ⅱa and Ⅱb,respectively.And there were 20 rats in each subgroup.On the flap surfaces in group Ⅰ,it was 6 uniform injection poinsts,subcutaneously injecting with rhGF (the dose was 0.1IU · Kg-1 · d-1) for 7 days from the beginning of operation,that were designed.It goes the same way to the group Ⅱ,while normal saline was instead of rhGF.In subgroup Ⅰa and Ⅱa,the flaps were generally observed every day.The percentage of the flap survival area was determinated 7 days after operation.In subgroup Ⅰb and Ⅱb,specimens were collected at the distal end of flap at intraoperative(before injecting rhGF)and 1 st,3rd,5th,7th day after operation.Immunohistochemistry and enzyme-linked immunosorbent were applied to examine the expression of TGF-β1 and CD34,and the microvessel density of the flaps was calculated.Results According to the 7 days' observation after the surgery,the flap survival area percentage of subgroup Ⅰa was (97.00 + 2.12) ％,which was significantly higher (P ＜ 0.05) than that of subgroup Ⅱ a,whose was (81.00 +3.43)％.On 1st,3rd,5th and 7th day postoperatively,the expression of TGF-β1,CD34 in both subgroup Ⅰb and Ⅱb were elevated and reached peak on the 5th day.Content of GF-β1 and CD34 in Ⅰb were 1571.40 ± 13.32 pg/ml and 60.40 ±0.32 pg/ml,respectively,and in Ⅱb were 691.43 ± 11.06 pg/ml and 20.43 ± 0.06 pg/ml.At the same point of time,the expression of TGF-β1,CD34 were significant higher in Ⅰb subgroup than that in Ⅱb (P ＜ 0.05).In subgroup Ⅰb and Ⅱb,the number of microvessels increased on postoperative 1 st,3rd,5th and 7th day,especially on 3rd,5th and tended to be stable at 7th day.At the same point of time,the number of microvessels in Ⅰb was always higher than that in Ⅱb (P ＜ 0.05).Conclusion Subcutaneous injection of rhGH on flaps can enhance the expression of TGF-β1,CD34,promote microvascular generation of the flap tissue directly or indirectly,and also improve the survival of PingPang Racket flaps.