Objective:Pyoderma gangrenosum(PG) is regarded as a possibly immunity-mediated ulcerative skin disease,which is difficult to be managed and easy to relapse.Few cases of PG have been reported to be treated successfully in the world.This study aimed to investigate the clinical characteristics and difficulties and strategies in the management of mosquito bite-induced ulcer by PG.Methods: We analyzed the clinical characteristics and difficulties in the treatment of a case of mosquito bite-induced leg ulcer complicated by PG.Following the TIME(tissue removal,infection/inflammation control,moisture imbalance correction,and edge of wound revision) principles of wound bed preparation,we treated the ulcer by silver ion dressing + infrared rays,hypertonic saline dressing + infrared rays,hypertonic saline dressing + electrotherapy,and honey dressing + medication at different times.The ulcer size and scores on pain and healing were assessed before each wound care,and the results of each method were analyzed by the SPSS11.0 software.Results: The pain score was continuously reduced with the treatment and the ulcer size and healing score were gradually decreased in the later stage,while in the earlier stage,the ulcer size was even enlarged,with one ulcer becoming two,and the healing score obviously increased.The differences were statistically significant(P

Objective: Vacuum-assisted closure(VAC) is a new technique for wound treatment,whose clinical application at home is but at the initial stage.The aim of this study was to investigate the procedure,therapeutic course and the effectiveness of the technique in the treatment of chronic wounds.Methods: This study included 12 cases of chronic or infected wound,which were more than 100 cm2 in size,either undermined,or drainage-obstructed,or difficult to heal despite over a month of previous treatment.We used the Freedom Negative Pressure Wounds Therapy Machine and the Ten-Step Management Procedure for a regular course of 30-50 days.We recorded and analyzed the pre-and post-treatment PUSH(pressure ulcer scale for healing) scores,healing modes,healing time and cure rate of all the cases.Results: The 12 cases were treated by VAC for(27.7 ? 22.6) days,of which 9 were cured,1 improved and 2 healed after moisture therapy followed by further treatment in the surgical department.The average healing time was(59.36 ? 22.88) days and the total cure rate was 91.7%.Age is positively correlated with healing time,but other factors showed no significant correlation with healing time and cure rate.Conclusion: The VAC technique is applicable to chronic wounds in patients of all ages,and the best therapeutic course is 30-50 days,which helps to raise the cure rate of intractable wounds.

Objectives To evaluate the performances of transcranial Doppler (TCD) and vessel-encoded arterial spin labeling MRI perfusion imaging (VE-ASL) in the evaluation of collateral circulation of cerebral arteries. Methods Thirty patients with unilateral ICA or MCA stenosis diagnosed by TCD and carotid duplex ultrasound and confirmed by MRA underwent VE-ASL. Peak systolic velocity (PSV) of bilateral MCA in the same depth, distal to the stenosis site, was recorded. Cerebral blood flow (CBF) in bilateral MCA territories was measured by VE-ASL. The detection rates of collater-al flow using TCD and VE-ASL were compared. Results TCD revealed that PSV in the ipsilateral and contralateral MCA were (31.6 ± 10.5) cm/s and (83.1 ± 9.2) cm/s, respectively. VE_ASL revealed that CBF in the ipsilateral and contralateral MCA territory were (22.5±9.8) mL·min-1·100g-1 and (31.7±8.3) mL·min-1·100g-1, respectively. The PSV ratio of the ipsi-lateral/contralateral MCA was significantly lower than the CBF ratio of the ipsilateral/contralateral MCA(0.37 ± 0.173 vs. 0.66±0.141, P=0.001). The detection rates of collateral flow using TCD were lower than those using VE-ASL. The detec-tion rate was 26.7% vs. 70% on TCD vs. VE-ASL in anterior collateral circulation (P=0.001), was 16.7% vs. 60% (P<0.001) on TCD vs. VE-ASL in posterior collateral circulation. The total display rate of collateral flow was 36.7%vs. 86.7%on TCD vs. VE-ASL (P<0.001). Conclusions TCD is inferior to VE-ASL in evaluating the collateral circulation because of the limitations including the anatomical variations of the circle of Willis and formation of leptomenigeal anastomoses.

Objective: To study the psychological status and influencing factors in patients with nephritic syndrome(NS) before and after percutaneous renal biopsy(PRB).Methods: 235 cases of NS were examined by Symptom Check List-90(SCL-90) and STAI 24 hours before and 6 hours after PRB.Results: Before PRB,factorial anxiety and phobic anxiety were higher than norm,while after the procedure,only somatization score was still higher than norm;In men,there was a higher score than that of women after PRB,all indices were seen decreased significantly;Higher scores were seen in under-60 years old than over-60 years old.Conclusions: Before and after PRB,many factors were involved in and responsible for patients' psychological symptoms.

Objective To investigate the changes of insulin resistance and islet β cell function in gout patients with different status of glucose metabolism, and to analyse metabolic features in gout patients with hyperglycemia. Methods Ninety-six patients with gout were consecutively enrolled into the study and were divided into normal glucose tolerance group ( NGT, n = 35 ) , impaired glucose regulation group ( IGR, n = 27 ) , and diabetic group (DM, n=34). Height, weight, blood pressure, fasting plasma glucose, fasting insulin, HbA1C,serum uric acid, C-reactive protein (CRP), total cholesterol (TC), and triglycerides were determined in all subjects. Body mass index (BMI), homeostasis model assessment for insulin resistance index (HOMA-IR),homeostasis model assessment for β cell function index (HOMA-B), and insulin sensitivity index (ISI) were calculated. Results Compared with the NGT group, the levels of BMI, 2hPG, fasting insulin, HbA1C,TC,triglycerides, CRP, HOMA-IR in the DM and IGR groups were higher while ISI was lower (0.023±0.018 and 0.024±0.017 vs 0. 052±0. 026, P<0.05 ). HOMA-B was significantly different among the three groups ( 87.6±25. 1,126.46±34. 2, and 173.75±32.1, P<0.05). Family history of diabetes was more commonly seen in DM group than NGT group ( 41.17% vs 11.4%, P< 0.05 ). Logistic analysis showed that age, BMI, systolic blood pres(s)ure, triglyceride, CRP, and ISI were independently associated with diabetes, but not with uric acid.Conclusions Severe insulin resistance, β cell dysfunction, increased BMI and CRP, lipid disorders, and hereditary susceptibility may be the main metabolic features of gout patients with hyperglycemia.

OBJECTIVE: To screen and identify the frequency and characteristic of mutation in stereocilium-related gene Taperin of Chinese prelingual nonsyndromic hearing impairment with DNA microarray combined with PCR. METHOD: One hundred and thirty-four patients of prelingual nonsyndromic deafness and one hundred health individuals in China were investigated in this study. Genomic DNA was extracted from the patients and was subjected to DNA microarray to screen mutations in 4 most common genes. The samples that carried none of the common mutant alleles were subjected to PCR and sequenced to detect mutations in Taperin gene. RESULT: Ninteen out of one hundred and thirty-four patients of prelingual nonsyndromic deafness were detected carring common deafness gene with DNA microarray. Taperin gene were detected in one hundred and fifteen patients with PCR. A187S was detected in Taperin as hetrozygous state in 2 patients and their unaffected members of their family. It occurred at the evolutionary conservation of the amino acids of taperin according to alignment analysis. Two polymorphism, 157C>T and 318C>T, were found in the patients and the control group. CONCLUSION A novel Taperin mutation, A187S was detected in Chinese patients with prelingual nonsyndromic hearing loss, which may be relevant to hearing loss. Two polymorphism, 157C>T and 318C>T, were found in Chinese in our research. The carrier frequency for Taperin mutation is about 1.74% of prelingual nonsyndromic deafness in Chinese patients.
Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; China ; Deafness ; genetics ; Female ; Humans ; Male ; Mutation ; Proteins ; genetics ; Young Adult

Objective To explore the relationship of plasma NT-proBNP level and severity of chronic congestive heart failure (CHF) and investigate the curative effect and security of meglumine adenosine cyclophosphate (MAC) combined with perindopril on patients with CHF.Methods From June 2011 to June 2013,126 inpatients with chronic congestive heart failure were randomly divided into A group (42 cases,routine therapy),B group (41 cases,routine therapy and perindopril) and C group (43 cases,routine therapy and perindopril plus MAC),all cases treated for 14 days.The left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) by echocardiography and plasma NT-proBNP levels were evaluated before and after 14 days therapy.Results The plasma NT-proBNP levels in NYHA Ⅱ ～ Ⅳ classes were significantly difference compared each other between any two classes (P ＜0.05) and the levels was positively correlated with NYHA cardiac function class and LVEDD (r =0.617,P ＜ 0.01 ; r =0.412,P ＜ 0.01),negatively correlated with LVEF (r =-0.372,P ＜ 0.01).After 14 days therapy,compared with A group,the LVEF and LVEDD significantly improved (P ＜ 0.05) and NT-proBNP level significantly decreased (P ＜ 0.05) in B,C groups; Compared with B group,C group had lower NT-proBNP level (P ＜ 0.05) although no further improvement in cardiac function.Conclusions The plasma NT-proBNP level is correlated closely with the severity of CHF and it is a good examination of diagnose,therapy and evaluating prognosis of CHF.Perindopril may significantly decline plasma NT-proBNP level and improve cardiac function of CHF patients,combined with MAC may further decline plasma NT-proBNP level although not further improved LVEF.Giving MAC and perindopril to patients with CHF was secure and patients tolerated it well.

Objective Epithelial mesenchymal transition (EMT) has a role in the proliferation and metastasis of various types of cells.This study investigates the hepatic oval cell's mechanism of EMT induced by histone deacetylase inhibition and the resulting cell motility increase from EMT.Methods Hepatic oval cell stem cell markers and marker changes were detected by flow cytometry,and after histone deacetylase inhibition induced EMT,the morphological changes were recorded.Western blot and quantitative real-time polymerase chain reaction detected the expression of E-cadherin,vimentin and Snail.Furthermore,confocal microscopy analysis recognized the nuclear translocation of Snail.Results Flow cytometry revealed no changes in the stem cell properties of hepatic oval cells in the cell culture process.Oval cell EMT,induced by HDACi,was observed through morphological changes,a reduction of the epithelial cell marker E cadherin,and an increase of the mesenchymal cell marker Vimentin.HDACi can promote the expression and nuclear translocation of Snail,which is the key hepatic oval cell transcription factor for both EMT and enhanced motility.Therefore,Snail RNA interference can suppress HDACi induced EMT in hepatic oval cells.Conclusions In conclusion,histone deacetylase inhibition induces hepatic oval cell epithelial-mesenchymal transition by Snail.

Objective: To investigate the effects of Yiguanjian Decoction, a compound traditional Chinese herbal medicine, on collagen metabolism of hepatic tissues in rats with carbon tetrachloride (CCl(4))-induced liver fibrosis. Methods: Liver fibrosis was induced in rats by intraperitoneal injection of 50% CCl(4)-olive oil solution at a dose of 1 mL/kg body weight, twice per week for 9 consecutive weeks. Six rats were sacrificed for dynamic observation at the end of the 3rd and 6th week respectively, and the other rats were divided into 9-week untreated group and Yiguanjian Decoction group which was given Yiguanjian Decoction intragastrically in the subsequent 3-week modeling period. Another 6 rats were used as normal group. Rats in the normal group and 9-week untreated group were treated with distilled water. At the end of the 9th week, all rats were sacrificed, and their blood serum and liver tissue were collected for measuring hepatic histology and expressions of α-smooth muscle actin (α-SMA), tissue inhibitor of metalloproteinase (TIMP)-1, TIMP-2, matrix metalloproteinase (MMP)-13, MMP-14, collagen type I (Col I), and activities of MMP-2 and -9. Results: Compared with the normal group, collagen fiber deposition, expressions of α-SMA, Col I, TIMP-1, TIMP-2, MMP-13 and MMP-14 and activities of MMP-2 and -9 in the liver tissues gradually increased in the untreated group (P<0.05, P<0.01). These changes were significantly suppressed by Yiguanjian Decoction. Conclusion: Yiguanjian Decoction exerts inhibition on formation of CCl(4)-induced cirrhosis in rats. The therapeutic mechanism may be related to inhibiting hepatic stellate cell activation, collagen secretion, and promoting collagen fiber degradation.

Objective To investigate the change in body weight over time in rectal cancer patients receiving radiotherapy and the correlation between setup errors and weight loss,and to establish the image-guided radiotherapy regimens in different periods of treatment.Methods A total of 24 postoperative patients with rectal cancer admitted to our hospital in 2016 were selected.Before each fraction of radiotherapy,the body weight was recorded,and the patients underwent cone-beam computed tomography (CBCT) with different frequencies in every week.The planning CT was matched with CBCT to obtain setup errors.The paired t test was used for difference analysis;the Pearson method was used to analyze the correlation between setup errors and weight loss.Results Body weight was measured 456 times in the 24 patients,and these patients underwent CBCT scans and image registration 456 times.Two patients were excluded because of treatment discontinuance.In the first and second weeks,there was no significant change in body weight.In the third week,the mean weight loss was 1.53 kg.In the fourth week,the mean weight loss was 2.48 kg.In the fifth week,the mean weight loss was 3.24 kg.The setup errors obtained by CBCT image registration in the superior-inferior (SI),anterior-posterior (AP),and left-right (LR) directions were 0.19 cm,0.20 cm,and 0.18 cm,respectively,in the first week,0.18 cm,0.17 cm,and 0.15 cm,respectively,in the second week,0.20 cm,0.22 cm,and 0.21 cm,respectively,in the third week,0.19 cm,0.25 cm,0.24 cm,respectively,in the fourth week,and 0.34 cm,0.33 cm,and 0.31 cm,respectively,in the fifth week.The Pearson correlation analysis showed that weight loss increased the setup errors,with P values of 0.140,0.046,and 0.044 in the SI,AP,and LR directions,respectively.Conclusions For rectal cancer patients receiving radiotherapy,the body weight decreases significantly in the late period (especially in the fifth week),which influences the setup errors.Therefore,in the fourth and fifth weeks of radiotherapy for rectal cancer,the weight loss should be closely monitored,and the number of CBCT scans can be increased before the treatment fraction to ensure the accuracy and optimization of treatment.