Objective To explore the clinical effect of manual milk on acute mastitis caused by the milk siltation.Methods 118 patients with galactostasis induced acute mastitis were selected as the research subjects.They were divided into two groups according to the treatment sequence number and the single number,59 cases in each group.The control group was treated with routine drug therapy,the observation group was treated with manual drainage.The clinical therapeutic effect was analyzed.Results The effective rate of observation group was 96.61%,which was significantly higher than 81.36% in the control group,the difference was statistically significant (χ2=6.83,P<0.05).The scores of symptom and sign in the control group and observation group were (14.22±1.45)points and (4.02±0.44)points,which were significantly reduced than before treatment (t=6.63,9.52,all P<0.05),and the difference between the two groups was statistically significant (t=8.68,P<0.05).The tumor dissipation time[(1.89±0.23)d],milk patency time[(3.29±0.38)d],local pain relief time[(2.18±0.54)d]and body temperature return to normal time[(3.55±0.43)d]in the observation group were significantly shorter than those in the control group,the differences were statistically significant (t=7.30,6.88,7.81,6.57,all P<0.05).Conclusion The effect is superior to conventional drugs in the treatment of acute mastitis caused by the milk siltation,it can rapidly improve clinical symptoms,shorten the treatment time,and can be used as the first choice for clinical treatment.

OBJECTIVE: To investigate the relationship between the promoter methylation and protein expression of insulin-like growth factor binding protein-related protein 1(IGFBP-rP1) in laryngeal squamous cell carcinoma (LSCC). METHOD: Methylation specific PCR (MSP) approach and immunohistochemistry methods were used to examine the methylation status and protein expression of IGFBP-rP1 in 45 samples of laryngeal carcinoma and 18 samples of tissues beside cancer. RESULT: For the promoter site, methylation frequency of IGFBP-rP1 in tumor specimens (33.3%, 15/45) was significantly higher than that in corresponding normal tissues (5.6%, 1/18) (P < 0.05). The protein expression of IGFBP-rP1 in tumor tissues was significantly higher than that in corresponding normal tissues (P < 0.05) and was inversely correlated with its methylation status of promoter. CONCLUSION Epigenetic silencing of IGFBP-rP1 gene expression by promoter hypermethylation may play an important role in LSCC.
Adenocarcinoma ; genetics ; metabolism ; pathology ; Aged ; DNA Methylation ; Female ; Humans ; Insulin-Like Growth Factor Binding Proteins ; genetics ; metabolism ; Laryngeal Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged

Objective To observe the histological effect of acellular dermal matrix(ADM)on insufficiency in guide keratinized tissue regeneration. Methods 6 cases of single anterior tooth implantation in the hospital in 2016 were included in the study. 3 cases were treated with immediate tooth extraction and implantation. Bone substitution materials were grafted in the space between the tooth extraction socket and the implants. The keratin-ized tissue dehiscence was covered by double layers of acellular dermal matrix membrane(Heal-All?,ZH-BIO, China),which was fixed to the adjacent soft tissue by suturing. Another 3 cases were routinely treated with delayed implantation of single anterior tooth. All the cases were subject to harvesting of the cover soft tissues of implants with a punch 4 months later. The new grown soft tissues were histologically observed. Results All cases were sur-vived. The new grown keratinized tissues were observed. Conclusion Acellular dermal matrix can guide the aug-mentation of keratinized tissues.

Objective To explore the therapeutic strategy and clinical value of intraoperative chole-dochoscopy and electrohydraulic lithotripsy for refractory intrahepatic bile duct stones.Methods Liver pa-renchyma,intrahepatic bile duct and bile duct stones were explored under direct vision and intraoperative choledochoscope in 1 1 cases of refractory intrahepatic bile duct stones.Electrohydraulic lithotripsy and lithot-omy were performed to remove the stones and protect the liver parenchyma.If the stones could not be re-moved once,a secondary lithotripsy and lithotomy was performed through the fistula tract.Results All re-fractory calculi were crushed after one or two procedures and the clearance rate were 100%.No complica-tions occurred.Ten patients were followed up from 1 to 3 years except one.Three cases revealed recurrent stone during follow-up due to withdrawal of ursodeoxycholic acid capsules in 1 to 2 years.Seven others showed no stone recurrence within follow-up time.Conclusion Intraoperative choledochoscopy and electro-hydraulic lithotripsy is an easy technique and can effectively protect the liver parenchyma.The life quality of patients can be improved with low surgical risk and postoperative complications.

OBJECTIVE: The purpose of this study was to discuss the role of the combination of carbon nanoparticles and medical imaging to manage the cervical lymph nodes in patients with thyroid carcinoma. METHOD: Eighty one patients with thyroid carcinoma that primary treated were divided into two groups: trial group and control group. Carbon nanoparticles were injected into the thyroid gland of trial group patients. Central compartment (level VI) dissection, levels IIl and IV dissection, lateral node (levels II-V) dissection were performed respectively in all the patients on the basis of medical imaging and pathology. Total lymph nodes, metastasis lymph nodes, black stained lymph nodes and black stained metastasis lymph nodes of trial group were counted respectively in different dissection specimens. Total lymph nodes and metastasis lymph nodes of control group were counted respectively in different dissection specimens. Parathyroid glands of thyroid or central compartment dissection specimens were counted in two groups. RESULT: In trial group, rate of staining lymph node was 80.0% in central neck dissection tissue, 54.9% in levels III and IV dissection specimen, 39.1% in lateral node dissection specimen. In central compartment dissection tissue, lymph nodes on average in control group were less than in trial group (3.03 ± 2.07 vs. 4.72 ± 2.97) (P < 0.01). The same was in levels III and lV dissection specimen (5.53 ± 3.78 vs. 10.29 ± 3.36) (P < 0.01). As for lateral node dissection specimen,there was no statistic difference in the two group (13.4 ± 9.67 vs. 14.56 ± 6.28) (P > 0.05). There was no statistic difference between control group and trial group for the metastasis lymph nodes in difference dissection specimens. Parathyroid gland was found in 3 thyroid or central compartment dissection specimens among trial group, which was found in 9 specimens among control group, the difference had statistical significance (P < 0.05). CONCLUSION During levels III and IV dissection in cN0 patients or central compartment dissection, lymph nodes can be signed well by carbon nanoparticles, which can improve the lymph node detection rate, but can not increase the lymph node detection rate in cN+ patients. Parathyroid gland can be preserved by carbon nanoparticles during the thyroid gland resection and central neck dissection.
Carbon ; administration & dosage ; Diagnostic Imaging ; methods ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Nanoparticles ; administration & dosage ; Neck ; Neck Dissection ; methods ; Parathyroid Glands ; Staining and Labeling ; Thyroid Neoplasms ; diagnosis ; pathology ; Thyroidectomy

OBJECTIVE: To evaluate the role of the combination of ultrasound and enhanced CT in analyzing lymph node metastasis in thyroid papillary carcinoma (PTC) patients by compartment. METHOD: Clinical data of 115 cases (141 sides) with PTC were collected. All had undergone ultrasound in neck and enhanced CT both in neck and in mediastinum before surgery. They were divided into ultrasound group. CT group, and the combination of ultrasound and enhanced CT group to evaluate lymph node metastasis. RESULT: For the central compartment, the accuracy of ultrasound was 61.0%. CT was 48.9%, and the combination of ultrasound and CT was 62.4%. For the lateral compartment, ultrasound was 87.9%, CT was 78.7%, the combination of ultrasound and CT was 85.8%. Ultrasound had higher accuracy than CT in the central (P < 0.05) and lateral (P < 0.05) compartment. The combination of ultrasound and CT had higher accuracy than CT in the central compartment (P < 0.05), but there was no significant difference in the lateral compartment (P > 0.05). There was no significant difference in accuracy between ultrasound and the combination of ultrasound and CT neither in central (P > 0.05) nor in lateral (P > 0.05) compartment. Six cases of lymph node metastasis in mediastinum and 1 case in parapharyngeal space detected by CT were pathologically proven. CT found that five patients with pulmonary metastasis. CONCLUSION The combination of ultrasound and CT or single ultrasound has higher accuracy in preoperative evaluation than single CT for lymph node metastasis in PTC. CT can assess some compartments such as mediastinum which can't be detected by ultrasound, and at the same time to evaluate lung metastasis. To evaluate lymph node metastasis in PTC, the combination of ultrasound and CT is more accurate and considerate than single method.
Adolescent ; Adult ; Aged ; Carcinoma ; diagnostic imaging ; pathology ; Carcinoma, Papillary ; Child ; Female ; Humans ; Lymphatic Metastasis ; diagnostic imaging ; Male ; Middle Aged ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Color ; Young Adult

Regulatory T cells ( Treg) play important role in immune homeostasis in physics and hamper the anti-tumor immunity. Depletion of intra-tumor Treg is a critical step to boost the anti-tumor effect in immune therapy. Radiotherapy can induce secretion of TGF-βand IL33 from tumor cells and then increase Treg proliferation and recruitment into tumor through Langerhans cell. Depletion of Treg could increase the local control and abscopal effect of radiotherapy.

OBJECTIVETo analyze the clinical characteristics of pediatric neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD).

METHODA retrospective analysis was performed evaluating clinical and laboratory characteristics of ten NMO and NMOSD children who were seen in our hospital from December 2010 to May 2014. Median age at onset was 8.9 years (range 0.8-13.8 years). Seven cases were female and three were male. Median disease duration was 1.5 months (range 1-18.5 months).

RESULTEight patients fulfilled diagnostic criteria for NMO and two patients fulfilled diagnostic criteria for NMOSD. The two NMOSD patients had recurrent longitudinally extensive transverse myelitis. Four cases had a monophasic disease course, and six cases had a recurrent course. In eight NMO patients, neuritis was the initial presentation. The two NMOSD patients had no neuritis in the first attack. Nine cases had clinical manifestations of myelitis, one case had asymptomatic spinal cord MRI anomaly. Among the ten patients, seven cases had brain lesions, wherein, four cases had the midbrain involvement and in four cases extensive hemispheric white matter was involved. Three cases had medullary involvement. And two cases had posterior limb of the internal capsule involvement, two cases had thalamus involvement. In one case there was pons, cerebellum or corpus callosum involvement, respectively. One case had accompanied brain symptoms. Of the five patients who had symptomatic brain lesions, four cases had encephalopathy accompanied by large hemispheric lesions on MRI, having a presentation similar to acute disseminated encephalomyelitis. And one case had multiple sclerosis like brain lesion. Of the ten patients tested, nine were seropositive for anti-aquaporin-4 autoantibody. One-patient was complicated with systemic lupus erythematosus. Oligoclonal bands were negative in all cases. All patients received treatment for acute attacks with high-dose intravenous methylprednisolone and intravenous gammaglobulin. The symptoms of 8 cases mitigated. Two cases whose symptoms showed no sign of improvement received plasmapheresis for acute attacks. Seven of the patients were followed up. The median duration of follow-up was 19 months (ranged from 13 months to 30 months). The median Expanded disability status (EDSS) score was 3 (range 1-7).

CONCLUSIONPediatric NMO and(or) NMOSD have a diverse clinical presentation which are more than just optic neuritis and transverse myelitis, including brain symptom. So it may be difficult to distinguish NMO and( or) NMOSD from acute disseminating encephalomyelitis and multiple sclerosis in the early stages of the disease. Antibodies to aquapoin-4 (AQP-Ab) testing is very important for differential diagnosis.

Adolescent ; Anti-Inflammatory Agents ; therapeutic use ; Aquaporin 4 ; Autoantibodies ; Brain ; Brain Diseases ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Methylprednisolone ; therapeutic use ; Multiple Sclerosis ; etiology ; Neuromyelitis Optica ; complications ; diagnosis ; drug therapy ; Retrospective Studies

Objective:To summarize the clinical characteristics and genetic features of tyrosine hydroxylase deficiency(THD) caused by TH gene variants for the improvement of the understanding of the disease. Methods:The clinical and genetic data of 33 children with THD caused by TH gene variants were diagnosed in the Department of Neurology of Beijing Children′s Hospital, Capital Medical University from May 2011 to January 2020 and their data were retrospectively collected and analyzed. Results:There were 19 females and 14 males.The age at onset was ranged from 0 to 6.3 years.13 patients developed diseases, accompanied with fever after infection, and 1 patient suffered from hypoxia, 19 patients suffered from no predisposing factors.There were 7 mild TH-deficient dopa-responsive dystonia cases, 16 severe TH-deficient infantile parkinsonism with motor delay cases and 10 very severe TH-deficient progressive infantile encephalopathy cases.Clinical symptoms were fluctuating, including 26 cases of diurnal fluctuation, 22 cases of infection aggravation, and 30 cases of fatigue aggravation.The initial symptoms included tiptoeing and numbness in the limbs(7 cases), motor development retardation or degression (26 cases), fremitus (8 cases), ptosis (2 cases), and status dystonicus (3 cases). Other clinical features had hypermyotonia (23 cases), hypomyotonia (27 cases), decreased movement (27 cases), decreased facial expression (24 cases), fremitus (18 cases), tiptoeing (20 cases), talipes equinovarus (7 cases), ptosis (8 cases), oculogyric crisis (10 cases), salivation (21 cases), dysphagia (12 cases), dysarthria (16 cases), dyspnea (3 cases), increased sleep (10 cases), decreased sleep (5 cases), irritable mood (15 cases), apathetic mood (2 cases), profuse sweating (8 cases), and status dystonicus (6 cases). A total of 6 patients′ right limbs were more severe, and 14 patients′ lower limbs were more severe.Eight patients had family history, and Levodopa treatment was effective for all patients.Ten patients suffered side effects, including dyskinesia and irritability.Four patients were lost follow-up, and 29 patients were followed up between 0.8 and 13.2 years old until Ja-nuary 2020.Totally, 22 patients almost had no such symptoms.Twenty-five TH gene pathogenic variants were discovered in 33 patients.There were 13 novel variants (c.1160T>C, c.1303T>C, c.887G>A, c.1084G>A, c.1097A>T, c.734G>T, c.907C>G, c.588G>T, c.992T>G, c.755G>A, c.184-6C>T, c.1510C>T, c.910G>A) and 2 patients had c. 910G>A variant.Meanwhile, there were 5 hot variants [c.698G>A(13 cases), c.457C>T(9 cases), c.739G>A(6 cases), c.1481C>T(4 cases), c.694C>T(3 cases)]. c.910G>A(2 cases) may be the foun-der variant of Chinese population. Conclusions:THD caused by TH gene variant mostly onsets from infant, with complex clinical features.Most of these patients were severe, and only a few were very severe and mild.Very severe and mild symptoms were easily misdiagnosed.Levodopa treatment was obviously effective.A possible founder variant of Chinese population (c.910G>A) was found.c.698G>A and c. 457C>T mutations mainly appeared in patients with severe and extremely severe THD, while c. 739G>A mainly appeared in patients with mild THD.