Objective To evaluate the clinical efficacy of long-pulsed 1064 nm Nd ∶ YAG laser combined with intralesional injection of triamcinolone in the treatment of keloids.Methods A total of 78 cases were randomly divided into two groups.The treatment group was treated with long-pulsed 1064 nm Nd ∶ YAG laser combined with intralesional injection of triamcinolone.The control group was only given intralesional injection of triamcinolone.The efficacy and adverse reactions were determined at the end of the first and the second course,respectively,and follow-up for one year was conducted in order to observe the recurrence.Results When the first course was over,cure rate of 21.95 ％ and efficiency rate of 73.17 ％ were observed in the treatment group,while they were 10.81％ and 45.95 ％,respectively,in the control group; the efficacy rate was statistically significant different in these two groups (P＜0.05).After two courses,cure rate of 70.73 ％ and efficiency rate of 100 ％ were observed in the treatment group while they were 45.95 ％ and 83.78 ％,respectively,in the control group,showing that both of the rates were statistically higher in the treatment group (P＜0.05).Conclusions Compared to intralesional injection of triamcinolone,long-pulsed 1064 nm Nd ∶ YAG laser combined with injection of triamcinolone has a more satisfactory effect on keloids.

Background Diclofenac sodium eye drops,pranoprofen eye drops and bromfenac sodium hydrate eye drops are three clinical commonly used nonsteroidal anti-inflammatory drugs(NSAIDs).The variation of cytoxicity among these drugs and whether the cytoxicity is related to the supplements are also unknown.Objective This study was to compare the cytotoxicity of three non-steroidal anti-inflammatory eye drops and their active components with cultured human corneal epithelial cells (HCECs) in vitro,and to discuss toxic origins of these drugs.Methods HCECs were cultured in different drugs with the final concentration of 0.10％,0.05％,0.02％ and 0.01％.Cell proliferation was evaluated by MTT assay.Then,0.002％ eye drops (1∶50) was added,and the migration and damage of the cells were deceted by transwell migration assay and lactate dehydrogenase (LDH) assay.Results The cytotoxicity of three nonsteroidal anti-inflammatory eye drops on HCECs was concentration-dependent (all at P=0.00).Diclofenac sodium eye drops showed the most dominant effects on the proliferation,migration and damage of HCECs among the three eye drops,while bromfenac sodium eye drops showed the least effect on the cell damage (proliferation:Fdrug =20.25,P=0.00;migration:F =103.43,P =0.00;damage:Fdrug =164.16,P =0.00).Compared with the eye drops,their active components showed less cytoxicity.Pranoprofen appeared the least effects on the proliferation,migration and damage of HCECs (proliferation:Fdrug =332.27,P =0.00;migration:F =332.27,P =0.00;damage:Fdrug=154.83,P=0.00).Conclusions The cytotoxicity ofdiclofenac sodium eye drops is more obvious than that of pranoprofen eye drops or bromfenac sodium hydrate eye drops.The cytotoxicity of the three eye drops originates from their supplements or the interaction between the supplements and active components.

Background Limbal stem cells (LSCs) play an important role on the stability of corneal epithelium and corneal transparency.Rho-associated coiled-coil containing protein kinase (ROCK) inhibitor can promote cell proliferation and reduce apoptosis,such as human embryonic stem cells and karatin epithelial cells.Objective This study was to investigate the improving effect of Y-27632,a ROCK inhibitor,on the activity of rabbit LSCs in corneal preservation medium.Methods Corneal preservation solution was prepared by adding 12.5％ chondroitin sulfate,10.0％ low molecular dextran,20.0 mg/L dexamethasone,100 mg/L tobramycin sulfate,9.5 g/L Hepes and 0.375 mg/L L-glutamine in MEM.The corneas of New Zealand white rabbits were collected and preserved in the corneal preservation solution with or without Y-27632 for 4,7,14 days,and the density and morphology of corneal endothelial cells were examined by using 0.25％ trypan blue staining and 0.2％ alizarin red staining.Isolated corneal epithelial cells were seeded on 3T3 feeder layer and cultured for 7-10 days until colonies formation.Colony shape of LSCs was observed under the light microscope,and colony-formation efficiency was analyzed after Giemsa staining by Image J software.Results The morphology and density of corneal endothelial cells were normal in the corneal preservation solution with and without Y-27632 for 4 days.In the seventh day after preservation,the cells remained the regular hexagon in shape in the preservation solution with Y-27632,however,the cellular membrane was slightly shrinking with the positive staining for alizarin red in the preservation solution without Y-27632.The density of corneal endothelial cells in the corneal preservation solution without Y-27632 was (2 262-± 75) cells /mm2,while in the preservation solution with Y-27632 was (2 425 ±95) cells/mm2(P＜0.001).The cloning spheres of LSCs were similar in preservation solution both with and without Y-27632 in the freshly isolated cornea or preserved corneas and exhibited more cells inside.But in 7 days and 14 days after preservation,the cloning spheres were much smaller in the preservation solution without Y-27632 group than those in the preservation with Y-27632 group.No significant differences were found in the cloning-formation rate and survival rate of corneal epithelial cells in corneas freshly isolated or preserved for 4 days in both groups (all at P＞0.05).In 7 days and 14 days after preservation,the active rates of corneal epitheli.al cells were (73.00±2.12)％ and (56.00±0.71)％ in the preservation solution with Y27632,which were significantly higher than (66.00 ± 4.00) ％ and (49.00 ± 0.71) ％ in the preservation solution without Y-27632,showing statistically significant differences between them (t =3.098,P =0.018;t =9.798,P =0.000).In addition,the cloning-formation rates of LSCs were (11.05±0.21)％ and (3.10±1.97)％ in the preservation solution with Y-27632 in 7 days and 14 days after preservation,revealing significantly elevation in comparison with (2.05 ± 1.20) ％ and (0.40 ±0.14) ％ in the preservation solution without Y-27632 (t =18.107,P =0.000;t=3.184,P=0.017).Conclusions Y-27632 promotes the vitality and cloning-formation ability of LSCs in corneal preservation medium,suggesting its potential use during storage of cornea.

BACKGROUND: Whether the injured peripheral nerve in a late stage has repairing value still remains a problem. If irreversible changes happen in substance P and calcitonin gene-related peptide, the feeling function will lose even after repairing.OBJECTIVE: To quantitatively study the changes of substance P(SP) and calcitonin gene-related peptide(CGRP) in the spinal dorsal horn 24 weeks after peripheral nerve injury.DESIGN: A self-controlled quantitative experiment.SETTING: Institute of Orthopaedics of the Fourth Military Medical University of Chinese PLA.MATERIALS: This experiment was performed in the Institute of Orthopaedics of the Fourth Military Medical University of Chinese PLA from October 2002 to May 2003. Totally 55 SD rats were divided into 11 groups according to time points(1, 2, 3, 4, 6, 8, 10, 12, 16, 20 and 24 weeks after sciatic nerve transection).INTERVENTIONS: Sciatic nerve injury model was set up by transecting one side of sciatic nerve and ligating the proximal stump of sciatic nerve; the other side was set as the control side. Computer-assisted image analysis was used to measure the immunologic reaction areas of substance P and CGRP.MAIN OUTCOME MEASURES: Changes of the distribution of the positive fibres of SP and CGRP in rat spinal dorsal horn in each group.RESULTS: Fifty-five rats entered the result analysis. The distributions of SP immunoreactivity in the spinal dorsal horn following sciatic nerve injury showed a significant reduction during 2-6 weeks, followed by a slow rate of increase,and reached almost complete restoration at 16 weeks after deafferentation. No obvious advanced changes happened at 20 and 24 weeks. The ratios for ipsilateral and cotralateral sides of positive fibre and distribution area injury in spinal dorsal horn CGRP were 1.14 at week 1, 1.13 at week 6, and 0. 29 at week 24. The ratios were similar at each time point( P ＞ 0. 05).CONCLUSION: At the late stage of peripheral nerve injury, neurons in the spinal dorsal horn and dorsal root ganglion still remain their functions to synthesize and secrete SP and CGRP. Spinal dorsal horn remains at a balanced status and still has the neurologic basis to recover the sensory function.

Background Recent researches show that oxidative stress is involved in the progress of keratoconus.Nuclear factor-E2-related factor 2-antioxidant response element (Nrf2-ARE) pathway plays a critical role in the defense against oxidative stress,but its function in keratoconus is unclear.Objective To investigate the differences of Nrf2-ARE signaling activation and matrix degenerating enzymes between keratoconus and normal corneal stromal cells.Methods Corneal stromal cells were isolated from keratoconus and normal cornea by using dispase and collagenase digestion.The cells were treated with hydrogen peroxide (H2O2) to mimic in vivo oxidative stress condition.Reactive oxygen species (ROS) production was measured by fluorescence substrate DCHF-DA incubation.Nrf2 level and the expression of Nrf2-ARE downstream antioxidant genes were analyzed by Western blot and real-time quantitative-PCR(RT-qPCR).The activity of matrix degenerating enzymes,including urokinase-type plasminogen activator (uPA)-uPA receptor (uPAR) system and matrix metalloproteinase-2 (MMP-2) were assessed by Western blot and gelatin zymography respectively.Results In normal culture,keratoconus corneal stromal cells assumed increased basal ROS and Nrf2 level when compared with normal cells(t =18.155,P＜0.01).However,after H2O2 treatment,the keratoconus corneal stromal cells showed increased ROS production,while decreased Nrf2 translocation and no significant difference in expression levels of Nrf2-ARE downstream antioxidant genes (Nrf2:t =62.123,P＜ 0.01 ; (nicotinamide adenine dinucleotide phosphate quinine oxidoreductase-1 [NQO-1]:t =2.209,P =0.092 ; hemo oxygenase-1 [HO-1]:t =0.293,P =0.784 ; superoxide dismutase [SOD2]:t =0.749,P =0.495).The contents of uPA-uPAR and the activity of MMP-2 also showed a higher level in keratoconus corneal stromal cells than normal cells,with significant differences between them (t =19.164,15.458,4.818,all at P＜0.01).Conclusions The defect of Nrf2-ARE signaling activation exists in the keratoconus corneal stromal cells,and correlats with the abnormal expression level of stromal degeneration enzymes,which suggests that the defect of Nrf2-ARE signaling activation may be involved in the progression of keratoconus.

Objective To investigate the clinical features and treatment principles of inflammatory myofibroblastic tumor of the urinary bladder (IMTUB).Methods From April 2013 to October 2016,6 cases of IMTUB patients were analyzed retrospectively.All cases were presented with gross hematuria.4 cases underwent ultrasonography,of which 3 cases showed solid mass in bladder,1 case showed inflammatory change.6 cases underwent CT examination,3 cases with bladder cancer,1 case with bladder sarcoma,1 case with malignant transformation of adenoma,1 case with rich blood supply.No lymph node metastasis.Bladder occupying lesions were considered in 2 cases of MRI examination.5 cases of cystoscopy showed bladder solid mass.In 6 cases involved,2 patients received partial cystectomy,2 patients underwent transurethral resection of bladder tumor,1 patient underwent radical resection of urachal carcinoma and the other one was treated with chemotherapy.Results Immunohistochemical staining was positive in ALK (100.0％) 、Vimentin(100.0％) 、CK(100.0％) 、SMA (83.3％) 、EMA(66.7％) and Ki-67 (5％-30％),negative in S-100 and Desmin.Final pathological diagnosis was IMTUB.So far,neither recurrence nor metastasis has been detected for 6 ～ 42 months in 5 cases and the other one lost to follow-up.Conclusions IMTUB is a kind of rare benign tumor of bladder.The golden standard of diagnosis is pathological diagnosis.Surgical resection is the first choice for treatment.Recurrence and metastasis are after the surgery treatment.All patients should be followed up closely.

Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.
Abscess ; Drainage ; Humans ; Rectal Fistula ; Suture Techniques ; Sutures

Objective:To investigate the clinical efficacy of multi-point acupuncture and lavage on removing facial filling material.Methods:From May 2015 to May 2020, the Department of Plastic Surgery of Tianjin Time Plastic Aesthetic Clinic removed the filling materials from 38 patients (4 males, 34 females; 19-55 years, with average 28 years). During the operation, multi-point acupuncture were performed with an 18G needle to perforate different cavities of the fillers to press them out; with injection syringe flushing fluid was injected with a needle into the filling material area with repeated lavage through puncture points.Results:On average, 90% of the filling materials were recovered by this method, 5 cases were removed twice; follow-up for 6-12 months after operation showed that postoperative appearance was natural, and no scar and hyperpigmentation occurred; there were no cases of postoperative infection with ideal effects.Conclusions:Multi-point acupuncture and lavage treatment can remove more facial filling material; although there is also small amount of filling material left, it is not affect clinical efficacy. This method basically does not damage the surrounding normal tissue, and therefore it is worthy of clinical application.

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines