We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.

Objective To confirm the optimal tissue sampling location of current injury combined with the histopathological observation in specific parts of electrocution based on previous animal experiments. Methods Twenty-three human cases from the autopsy through the hand-to-foot circuit pathway were analyzed. Additional ten autopsy patients who died from traffic accidents and sudden cardiac attacks were used as the control group. All cases were extracted the soft tissues from the upper anterior wrist and medial malleolus to further observe and analysis the L/S axis ratio of the nuclei of the skeletal muscle cells (SkMCs) and artery smooth muscle cells (ASMCs). Results The age of the 23 eligible electrical deaths ranged from 19 to 59 years, including 19 cases were male and 4 cases were female. 3 cases were high-voltage 20 cases were low voltage. The occurrence rate of electric marks averaged 31.18% in all cases. The incidence of the classical arborizing pattern of fine branching was 36.4%, appearing on the pleura in 5 cases (22.7%). The nuclei of the SkMCs and ASMCs nuclei in the anterior wrist and medial malleolus within the electrical current pathway were obviously stretched, narrowed, and coalesced, presenting a nuclear polarization and arranging as line-like and moniliform patterns. The L/S axis ratio of those nuclei in the anterior wrist and medial malleolus were markedly increased as compared with the control group (p < 0.001). Through the ROC curve analysis, the critical diagnostic values of the L/S axis ratio of those nuclei were respectively 4.84 and 3.81. Conclusion These findings suggest that the soft tissues of the anterior wrist and/or the medial malleolus, as the narrowest parts of the limbs, could be used as the sites for tissue sampling and considered as necessary locations for histopathological examinations to determine the electrocution in medicolegal identification.

Objective: To investigate oral health related quality of life and associated factors of adolescents between 12 and 15 years old, and to provide countermeasures and suggestions for oral health promotion of adolescents. Methods: This cross-sectional study recruited 3 840 adolescents aged 12-15 through multi-stage stratified cluster sampling method. The oral clinical examination and oral health questionnaire were conducted. Descriptive analysis, non-parametric testing and logistic regression analysis were used to analyze the oral health-related quality of life and associated factors. Results: Oral problems showed moderate to severe impact on quality of life,especially on eating (27.1%). Ordinal Logistic regression analysis showed that low sugar intake frequency, few teeth with gingival bleeding, no history of dental pain in the past 12 months,no history of tooth injuries, and administrative region of residence (Nanhai, Shunde) were associated with higher oral health-related quality of life,(OR=0.6-0.8，P<0.05). Conclusion The oral health-related quality of life of adolescents in Foshan was slightly better than the average national level. It is recommended to accurately formulate and ensure the full implementation of oral public health measures based on the comprehensive analysis of the local area, and combine various efforts to strengthen education on reducing excessive intake of sugar, prevent gingival bleeding, relieve and treat toothache in time, pay attention to adolescents with histories of dental trauma, and update the concepts of receiving oral health examination for the adolescents themselves, parents and teachers, and help adolescents develop the habit of regular oral examinations.

Objective To investigate the effect and mechanism of isorhapontigenin (ISO) in the protection of mice from the lipopolysaccharide (LPS)-induced acute lung injury (ALI). Methods RAW264.7 cells were cultured in vitro with different concentrations of ISO and the viability of the cells was measured by CCK-8 assay.Further,RAW264.7 cells were induced with 200 ng/ml LPS and then treated with ISO and the autophagy inhibitor 3-methyladenine (3-MA).Western blotting was employed to determine the expression of inflammatory cytokines [interleukin (IL)-1β,IL-6,tumor necrosis factor-α (TNF-α),P65,phospho-P56 (p-P65),IκB,phospho-IκB (p-IκB),inducible nitric oxide synthase (iNOS),cyclooxygenase-2 (COX-2),and high mobility group box-1 (HMGB1)] and autophagy markers (LC3Ⅱ/Ⅰ,Beclin1,and P62).The reactive oxygen species (ROS) production of the cells was measured with the DCFH-DA probe.The mouse model of ALI was established by intraperitoneal injection of LPS (15 mg/kg).The pathological changes of the lung tissue were observed via HE staining.The expression of inflammatory cytokines and autophagy markers in the lung tissue was determined by Western blotting and the content of ROS in bronchoalveolar lavage fluid (BALF) by flow cytometry. Results ISO down-regulated the expression of IL-1β,IL-6,TNF-α,iNOS,COX-2,and HMGB1 and inhibited the ROS production in the LPS-induced RAW264.7 cells (all P<0.05).Furthermore,it promoted the expression of LC3Ⅱ/Ⅰ and Beclin1 and inhibited the expression of P62,thereby activating autophagy (all P<0.05).However,the addition of 3-MA up-regulated the expression of p-P65/P65,p-IκB,iNOS,COX-2,and HMGB1,down-regulated that of IκB (all P<0.001),and promote the production of ROS.ISO mitigated the pathological changes in the lung tissue of ALI mice.It down-regulated the expression of p-P65/P65,p-IκB,iNOS,COX-2,and HMGB1 and up-regulated that of IκB in the lung tissue (all P<0.001) and decreased the ROS production in BALF.However,such protective effect was reversed by 3-MA. Conclusion ISO may induce autophagy of macrophages to protect mice from LPS-induced ALI.
Animals ; Mice ; Acute Lung Injury/pathology* ; Beclin-1/pharmacology* ; Cyclooxygenase 2/metabolism* ; Cytokines ; HMGB1 Protein/metabolism* ; Interleukin-6 ; Lipopolysaccharides ; Lung/pathology* ; NF-kappa B/metabolism* ; Reactive Oxygen Species/metabolism* ; Tumor Necrosis Factor-alpha/metabolism*