Objective To study the way in showing collateral ligaments of knee by MRI and MRI findings of the normal collateral ligaments.Methods MR imaging examinations were performed in 55 healthy volunteers . MR imaging included T1WI and PDWI sequence on the coronal, sagittal and coronal posterior oblique plane, in order to observe the collateral ligaments, and to measure the medial collateral ligament and the lateral collateral ligament dimension, which were compared with the results of the cadaver published in the related anatomic literatures.Results (1)On sagittal MRI, the angle between the line of medial collateral ligament and the tibia long axis was 0.55°±0.25°,the angle between the line of lateral collateral ligament and the long axis of the fibular neck was 11.47°±1.61)°.(2)On coronal MRI, 96% of the medial collateral ligaments was completely showed on only one slice, at the same time, 82% of the lateral collateral ligaments was completely showed on only one slice .On 11°coronal posterior oblique plane,90% of the lateral collateral ligaments was completely showed on only one slice .(3)The normal medial and lateral collateral ligaments were hypointense string on both T1WI and PDWI coronal MR images , with an average length of 11.53 cm for the medial collateral ligament and 5.31 cm for the lateral collateral ligament.Conclusion Using sagittal plane completely shown the tibia and fibular neck as the standard plane and thickness of 3mm in examining the collateral ligaments of knee by MR imaging can display the medial and the lateral collateral ligament clearly .

Objective To evaluate the effect of pre-emptive analgesia on pain and inflammation control in patients with severe multiple trauma.Methods Severe multiple trauma patients treated in the emergency department from September 2014 to December 2014 were prospectively included based on the inclusion criteria including injury severity score (ISS) of 16 to 25,Glasgow Coma Scale (GCS) ≥ 13 and visual analogue scale (VAS) ≥ 4.The patients were assigned to pre-emptive analgesia group,traditional analgesia group and non-analgesia group,according to the random number table.Pre-emptive analgesia group had patient-controlled intravenous analgesia (PCIA) with sufentanil and tramadol on admission.Traditional analgesia group were administered intramuscular pethidine or subcutaneous morphine for temporary analgesia when the pain could not be tolerated.Non-analgesia group received no analgesia.VAS,systemic inflammatory response syndrome (SIRS) score and serum interleukin (IL)-6 concentration were compared among the groups on admission day,24,48,72,120,168 and 240 h after admission.Results Fifty-seven patients (46 males and 11 females) were included,and age was (39.61 ± 12.05)years.There were 18 patients in pre-emptive analgesia group,20 patients in traditional analgesia group,and 19 patients in non-analgesia group.Comparison between pre-emptive analgesia,traditional analgesia and non-analgesia groups showed no significant differences on admission with respect toVAS [(6.5±1.5),(6.6±1.4),(6.4 ±1.4)points],SIRS [(3.3±0.7),(3.4±0.6),(3.4±0.8) points] and IL-6 concentration [(109.2 ± 47.9),(99.9 ± 44.3),(106.3 ± 50.0) ng/L] (P ＞0.05).Compared to traditional analgesia and non-analgesia groups,VAS and SIRS score in pre-emptive analgesia group differed significantly at 24,48,72,120,168 and 240 h after admission,and IL-6 in pre-emptive analgesia group differed significantly at 48,72,120,168 and 240 h after admission (all P ＜0.05).VAS,SIRS score and IL-6 concentration declined faster in pre-emptive analgesia group than other two groups (P ＜ 0.05),while there were no significant differences between traditional analgesia and nonanalgesia groups (P ＞ 0.05).Positive correlation was noted between VAS and SIRS score,and between VAS and t IL-6 concentration (P ＜ 0.05).Conclusion Pre-analgesia provides quick and effective pain relief and attenuate excessive systemic inflammation response that contributes to stabilization and recovery of the severe multiple trauma patients.

Objective:Explore the hydrogen-nuclear magnetic resonance ( 1H-NMR) application potential of metabolomics in early screening of vitamin A deficiency(VAD). Methods:From January to June 2019, 40 cases of left-behind children with confirmed VAD <1 year old were enrolled in Zunyi area as VAD group, and 40 healthy children were selected as healthy control group.Urine from the 2 groups of children was collected and 1H-NMR spectrum was measured.By combining metabonomics technology and multivariate statistical analysis, the 2 groups of metabolites were compared, and the differential metabolites of children with VAD were screened out. Results:Compared with VAD group [(0.56±0.10)μmol/L], the difference in the serum retinol concentration of healthy control group [(1.35±0.18)μmol/L] was statistically significant ( t=23.93, P<0.001). Compared with healthy group, VAD group showed higher level of methylmalonate, 2-ketoisovalerat, N-acetyl glycoprotein signal, dimethylglycine and betaine, with statistically significant differences (| r|>0.602, all P<0.05). The level of Isovalerylglycine, 2-hydroxyisobutyrate, creatine, phosphate choline/glycerophosphocholine, 4-PY and Hippurate were significantly decreased, with statistically significant differences (| r|>0.602, all P<0.05). Conclusions:Compared with healthy children, children with VAD have differences in urine Metabolites.Differential metabolites are closely correlated with intestinal microecological ba-lance, digestive system diseases, respiratory system diseases, immune-related diseases, energy metabolism, growth and development.Urine 1H-NMR metabolomics analysis has potential application value in the early screening of VAD.

Objective:To investigate the ocular clinical manifestations in pediatric patients with incontinentia pigmenti (IP).Methods:A case series study was carried out and a retrospective analysis was performed.Clinical data of 13 pediatric patients with IP treated from January 2013 to December 2019 in Xijing Hospital were collected.All the patients underwent regular ophthalmologic examination.Three patients accepted fundus fluorescein angiography and six eyes of five patients were treated with retinal photocoagulation or anti-vascular endothelial growth factor (VEGF) intravitreal injection according to severity of the condition.The follow-up period ranged from 6 months to 6 years.The medical history, family history, systemic manifestations, ocular characteristics, diagnosis, treatment as well as ocular and systemic changes during follow-up were recorded and analyzed.This study followed the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Xijing Hospital, Fourth Military Medical University (No.KY20203287-1).Results:All the 13 patients were female aged from 5 days to 42 months at first visit, with the average age of 2.0 (1.0, 8.5) months.As for the main skin lesions at first visit, there were 4 cases in erythematous vesicle stage, 3 cases in verrucous exanthema stage, and 6 cases in hyperpigmented stage.There were 7 cases in shrinkage stage during follow-up.Among the 26 eyes of 13 patients, 18 eyes of 10 patients showed ocular anomalies, accounting for 76.9% of total patients (69.2% of total eyes). Among the 13 patients, 8 patients presented bilateral ocular involvement, 2 patients showed unilateral anomalies, and 3 patients had no ocular lesions.The retina was involved in all patients with ocular manifestations.The typical retinal lesions included avascular zone of peripheral retina in 13 eyes, tortuous and dilated retinal vessels in 10 eyes, increased vascular branch in 7 eyes, white linear retinal arteries and partial vascular occlusion in 4 eyes, retinal neovascularization in 3 eyes, total retinal detachment in 2 eyes, and retinal fold with macular lamellar hole in 1 eye.In addition, there was retinal hemorrhage in 11 eyes, retinal pigment changes in 4 eyes, grey ridge lesions in 3 eyes, macular dysplasia in 2 eyes, choroidal atrophy in 1 eye, optic gliosis in 1 eye and yellowish-white retinal exudate in 1 eye.There were also 4 patients with other ocular manifestations, such as strabismus and eyeball atrophy.Retinal photocoagulation was performed in 4 eyes of 3 patients and anti-VEGF intravitreal injection in 2 eyes of 2 patients.The retinal lesions regressed and the condition of patients kept stable during follow-up.Conclusions:The ocular clinical manifestations in patients with IP are usually typical and diverse, and the retinal vascular lesion is the main type.Early diagnosis and timely treatment are of great significance.

BACKGROUND AND OBJECTIVEWhether gemcitabine plus platinum chemotherapy is superior to gemcitabine or platinum single-agent chemotherapy for patients with non-small cell lung cancer (NSCLC) is still in dispute, and the aim of this study is to evaluate the efficacy and safety of gemcitabine combining platinum chemotherapy for patients with NSCLC.

METHODSWe searched relevant randomized controlled trials (RCTs) from VIP, CBM, CNKI, the Cochrane library, PUBMED and EMBASE. We traced the related references and experts in this field and communicated with other authors to obtain the information that has not been found. We made quality assessment of qualified RCTs assessed by the exclusion and inclusion criteria and used RevMan 5.0 provided by the Cochrane Collaboration to perform meta-analysis.

RESULTSFour RCTs were eligible and included 984 patients. Meta analysis results suggested that: compared with gecitabine single-agent chemotherapy, the combination had a statistically significant benefit in increasing the response rate (OR = 3.29, 95% CI: 1.79-6.05, P = 0.000 1) and 2-year survival rate (OR = 3.22, 95% CI: 1.45-7.12, P = 0.004) while increased the risk of the incidence of adverse reactions, especially the grade 3-4 thrombocytopenia (RR = 8.16, 95% CI: 1.71-39.07, P = 0.009); compared with cisplatin single-agent chemotherapy, the combination had a statistically significant benefit in increasing the response rate (OR = 3.51, 95% CI: 2.20-5.60, P < 0.01) and 1-year survival rate (OR = 1.67, 95% CI: 1.16-2.41, P = 0.006) while increased the risk of the incidence of adverse reactions, especially the grade 3-4 thrombocytopenia (OR = 28.55, 95% CI: 14.06-57.04, P < 0.01).

CONCLUSIONCompared with single-agent chemotherapy, the combining can significantly improve the efficiency and survival rate while increase the toxicity rare. The results still need to be proved by high quality RCTs.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; Deoxycytidine ; adverse effects ; analogs & derivatives ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; Platinum ; adverse effects ; therapeutic use ; Treatment Outcome

OBJECTIVETo evaluate the down stream involvement of the bile duct in hepatolithiasis.

METHODSMechanical damage to bile duct epithelia and long standing cholangitis as result of hepatolithiasis play an important role in the carcinogenesis of bile duct epithelia and stricture of the intra- and extra-hepatic bile duct. Macromorphological and microscopic changes in bile duct mucosa of 100 consecutive patients with hepatolithiasis were investigated using intra- or post-operative cholangioscopy. Biopsy specimens of lesions obtained during cholangioscopy were studied with immunohistochemical staining and flow cytometry to determine proliferative activity and DNA content. Five cases of well-proven cholangiocarcinoma were simultaneously studied as controls.

RESULTSOf the 100 patients, those with chronic cholangitis accounted for 86% (86/100), proliferative lesions 11% (11/100), adenomatous polyps 1% (1/100), and adenocarcinoma 2% (2/100). The obvious mucosal lesion associated with hepatolithiasis was located down-stream of the bile duct, predominantly in the hilar region, e.g. orifices of the right/left hepatic duct and common hepatic duct (73% mucosa lesions in the hilar region). The intensity of cancer embryonic antigen stain and the proliferative cell nuclear antigen index increased with the development of bile duct lesions. Aneuploid DNA presented mainly in the high degree malignant adenocarcinomas (> 80% of cases).

CONCLUSIONSThe obvious mucosal lesions associated with hepatolithiasis were located down-stream of the bile duct, predominantly in the hilar region (73% of mucosal lesions). The proliferative activity of examined bile duct mucosa lesions increased with the development of pathological deterioration, which may contribute to the development of hilar bile duct stricture and hilar cholangiocarcinoma.

Adult ; Aged ; Bile Ducts ; pathology ; Carcinoembryonic Antigen ; analysis ; Cholangiocarcinoma ; etiology ; Humans ; Lithiasis ; complications ; pathology ; Liver Diseases ; complications ; pathology ; Middle Aged ; Proliferating Cell Nuclear Antigen ; analysis

Objective To detect the spatial temporal distribution of mumps in Gansu by means of spatial statistics.Methods The county-based incidence of mumps from 2009 to 2013 was used to calculate the global Moran' s I and local G statistics, and analyze its spatial temporal distribution characteristics.Results The incidence of mumps in Gansu were spatial auto-correlated from 2009 to 2013 respectively (P＜0.001), and the hot spots were mainly distributed in Hexi area,while the cold spots were distributed in Tianshui, Longnan and Qingyang.Spatial temporal analysis showed that the high incidence of mumps was most likely to be detect in Hexi area (RR=3.05, LLR=4 670.995, P＜0.001), and the low incidence was most likely to be detect in Longdong area (RR=0.36,LLR=1 980.686,P＜0.001).Conclusion The spatial and spatial temporal clustering of mumps existed in Gansu from 2009 to 2013, the results can be used in the development of mumps prevention and control measure in Gansu.

Capsid ; Cell Line ; Dependovirus ; genetics ; Genetic Therapy ; Genetic Vectors ; genetics ; Hepatitis B virus ; genetics ; Humans ; Liver Diseases ; therapy ; Plasmids ; Recombination, Genetic ; Transfection

OBJECTIVETo investigate if a recombinant adenoviral vector carrying antisense matrix metalloproteinase-2 (MMP2) gene would inhibit the growth of hepatocellular carcinoma (HCC) in vivo.

METHODSUsing the recombinant adenoviral vector carrying antisense MMP2 gene (Ad-MMP2AS) which was constructed by us previously, to infect the human HCC cell line (Bel-7402). Then the invasiveness of the Bel-7402 cells was assayed in Matrigel, and the production of MMP2 in the Bel-7402 cells was detected with Western blotting analysis and Gelatin zymography. Then the Ad-MMP2AS-infected cells were subcutaneously inoculated in nude mice. After tumors developed, Ad-MMP2AS was injected intratumorally into pre-existing tumors. The tumors were removed, sectioned, and stained with H E.

RESULTSCompared with PBS or Ad-CMV-infected cells, the infected Bel-7402 cells with Ad-MMP2AS injections significantly reduced their MMP2 enzyme activity and invasiveness about 52.05% in Matrigel assays, and the tumor volumes in nude mice resulted in a 3.3-fold reduction. In addition, direct intratumoral injection of Ad-MMP2AS into pre-existing tumors significantly prevented further expansion of the tumor masses and resulted in a 63.06% reduction in tumor cell growth.

CONCLUSIONThe recombinant adenovirus with antisense MMP2 can effectively inhibit the invasiveness and growth of Bel-7402 cells in vitro and in vivo, and it has a therapeutic potential for HCC.

Adenoviridae ; genetics ; Animals ; Carcinoma, Hepatocellular ; pathology ; Gene Transfer Techniques ; Genetic Vectors ; genetics ; Humans ; Liver Neoplasms, Experimental ; pathology ; Male ; Matrix Metalloproteinase 2 ; genetics ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Oligonucleotides, Antisense ; genetics ; Recombinant Proteins ; genetics ; Tumor Cells, Cultured

OBJECTIVESTo construct a recombinant adenoviral vector carrying antisense matrix metalloproteinase-2 (MMP2) and to study its inhibitory effects on the invasiveness and migratory capacity of hepatocellular carcinoma (HCC) cell line HepG2 in vitro.

METHODSTotal RNA was extracted from HCC. Then a 500 bp fragment at the 5' end of the human MMP2 cDNA sequence was synthesized by polymerase chain reaction (PCR) and was reversely inserted into the multiclone site (MCS) of the shuttle plasmid pAdTrack-CMV. With the resultant plasmid and the backbone plasmid pAdEasy-1, the homologous recombination took place in the E.coli BJ5183 and the recombinant adenoviral plasmid carrying the antisense MMP2 gene was constructed. The adenovirus (Ad-MMP2AS) was packaged and amplified in the HEK 293 cells and the viral titer was checked by GFP. Using the Boyden chamber model, the influence of Ad-MMP2AS on the invasion ability of HepG2 cells was determined in vitro.

RESULTSThe recombinant adenovirus vector carrying antisense MMP2 was constructed successfully and a strong green fluorescence was observed in HepG2 cells under a fluorescence microscope. The viral titer was 1 x 10(8); Ad-MMP2AS can effectively inhibit the penetrating capacity of HepG2 cells through Matrigel in vitro.

CONCLUSIONThe recombinant adenovirus with antisense MMP2 can effectively inhibit the invasiveness and migratory capacity of HepG2 in vitro and may have potential in treating HCC.

Adenoviridae ; genetics ; Carcinoma, Hepatocellular ; pathology ; Genetic Vectors ; Humans ; Liver Neoplasms ; pathology ; Matrix Metalloproteinase 2 ; biosynthesis ; genetics ; pharmacology ; Neoplasm Invasiveness ; Oligonucleotides, Antisense ; biosynthesis ; genetics ; pharmacology ; RNA, Antisense ; genetics ; pharmacology ; Recombinant Proteins ; biosynthesis ; genetics ; pharmacology ; Tumor Cells, Cultured