Primary tuberculosis (TB) of the hard palate is very rare. A 74-year-old man was presented with 6-month history of dysphagia along with an irregular mass in the hard and soft palate. Magnetic resonance imaging (MRI) revealed thickened and increased signal intensity within hard and soft palate. Tissue biopsy showed focal caseating granulomatous-like lesion and the histochemical staining using Ziehl–Neelsen stain for acid-fast bacilli was positive. Positive histochemical studies provided evidences that the hard palate mass was most likely due to TB. Thus, the patient was started on antituberculous therapy

BACKGROUND: Whether or not the excitation-contraction (EC) uncoupler, diacetyl monoxime (DAM) and cytochalacin D (Cyto D) alter the ventricular fibrillation activation patterns is unclear. METHODS: We recorded single cell action potentials and performed optical mapping in isolated perfused swine right ventricles at different concentrations of DAM and cyto D during ventricular fibrillation and dynamic pacing. RESULTS: Increasing concentration of DAM results in progressively shortened action potential duration measured to 90% repolarization (APD90), reduced slope of the action potential duration restitution(APDR) curve, decreased Kolmogorov-Sinai entropy, and reduced number of ventricular fibrillation wavefronts. In all right ventricles, 15 to 20 mmol/l DAM converted ventricular fibrillation to ventricular tachycardia. The ventricular fibrillation could be reinduced after the DAM was washed out. In comparison, cyto D (10 to 40 mol/l) has no effects on APDR curve or the dynamics of ventricular fibrillation. The effects of DAM on ventricular fibrillation are associated with reduced number of wavefronts and dynamic complexities in ventricular fibrillation. CONCLUSION: These results are compatible with Restitution Hypothesis of ventricular fibrillation and suggest that DAM may be unsuitable as an EC uncoupler for optical mapping studies of ventricular fibrillation in the swine right ventricles.
Action Potentials ; Diacetyl ; Entropy ; Heart Ventricles* ; Swine* ; Tachycardia, Ventricular ; Ventricular Fibrillation*

Whole-exome sequencing(WES)has been widely used in the genetic diagnoses of diseases in clinical practice because of its cost-effectiveness and validity. In this article, we focus on the application of WES in the clinical diagnoses of primary immunodeficiency diseases(PID), summarize pathogenic and novel pathogenic genes of PID detected by WES, and assort these genes in to two groups: transcription factor associated genes and non-transcription factor associated genes, which is expected to contribute to clinical genetic diagnoses.

Objective: To investigate the effect of lipopolysaccharide (LPS) on the expressions of epithelial-mesenchymal transition (EMT) markers and fi-catenin in the breast cancer MDA-MB-231 cells, and to clarify its possible mechanism. Methods: The breast cancer MDA-MB-231 cells were divided into control group and different concentrations (5, 10, 20, and 40 mg • L _ 1 ) of LPS groups. Inverted microscope was used to observe the morphology of MDA-MB-231 cells in various groups. Immunofluorescence test was used to detect the β-catenin expression and location in the MDA-MB-231 cells in various groups. Real-time quantitative PCR (RT-qPCR) and Western blotting methods were used to detect the expression levels of the E M T markers E-cadherin, Vimentin and β-catenin mRNA and proteins in the MDA-MB-231 cells in various groups. Results: The morphology of MDA-MB-231 cells in control group was epithelial phenotype, and the morphology of MDA-MB-231 cells in different concentrations of LPS groups were the phenotype of mesenchymal cells. The results of immunofluorescence staining showed that the expression of β-catenin was mainly located in the nucleus. Compared with control group, the expression levels of Vimentin and β-catenin mRNA and proteins in the MDA-MB-231 cells in different concentrations of LPS groups were increased (P < 0. 05 or P < 0. 01), especially in 20 mg • L _ 1 LPS group. Compared with control group, the expression levels of E-cadherin mRNA and proteins in the MDA-MB-231 cells in different concentrations of LPS groups were decreased (P < 0. 05 or P < 0. 01), especially in 20 mg • L _ 1 LPS group. Conclusion: LPS could promote the E M T, invasion and metastasis of the breast cancer MDA-MB-231 cells by down-regulating the E-cadherin expression and up-regulating the Vimentin expression, and its mechanism may be related to Wnt/ fj-catenin signaling pathway.

Objective: To evaluate the efficacy of ultrasound-guided caudal epidural block for postoperative analgesia in the infants undergoing lobectomy under general anesthesia. Methods: Sixty American Society of Anesthesiology physical status Ⅱ or Ⅲ pediatric patients of both sexes, aged 1-3 yr, weighing 10-16 kg, scheduled for elective lobectomy under general anesthesia, were divided into 2 groups (n=30 each) using a random number table method: control group (group C) and epidural block group (group E). Caudal epidural block was performed under ultrasound guidance after induction of general anesthesia and at 15 min before surgery in group E. An epidural catheter was inserted at T_{6, 7} interspace, 0.1% ropivacaine 1 mg/kg was injected at 5 min after injecting 1% lidocaine 3 ml, the diffusion of epidural fluid was controlled at T_3-10, and the epidural catheter was then removed.An analgesia pump was connected at the end of the surgery in two groups.Pain was evaluated using Face Legs Activity Cry Consolability scale.When Face Legs Activity Cry Consolability scale score>3, the pump was pressed.When pain was still unrelieved 5 min later, sufentanil 0.1-0.2 μg/kg was intravenously injected.The patients were followed up for 48 h after operation, and the requirement for additional remifentanil and sufentanil, and the occurrence of postoperative nausea and vomiting, respiratory depression, hypoxemia and over-sedation was recorded.The number of pressing times, extubation time and duration of intensive care unit stay were also recorded.Pain at 1 and 2 days after operation was evaluated using the Postoperative Pain Measure for Parents. Results: Compared with group C, the consumption of remifentanil, the number of pressing times and requirement for additional sufentanil were significantly decreased, the incidence of each index of the Postoperative Pain Masure for Patients was decreased at 1 day after surgery, the extubation time and duration of intensive care unit stay were shortened, and the incidence of nausea and vomiting and over-sedation was decreased in group E (P<0.05). Conclusion Ultrasound-guided caudal epidural block provides better efficacy and fewer side effects for postoperative analgesia in the infants undergoing lobectomy under general anesthesia.

Dexmedetomidine(DEX) is a new type of highly selective α₂ adrenergic receptor agonist with multiple effects, such as sedation, analgesic, anti-anxiety and inhibition of sympathetic nervous system activity.DEX is usually used as an anesthetic adjuvant and as an sedative and analgesic in PICU, also possessing effects of preventing and treating emergence agitation, counteracting postoperative shivering and organ protection.This paper summarized the clinical application of DEX in pediatric field.

Humans ; Diverticulum, Colon ; Fecal Impaction ; Hydrodynamics

Objective: To explore the feasibility of curettage combined with fenestration for jaw classic ameloblastoma treatment and to provide a basis for improving the treatment of classic ameloblastoma. Methods: Twenty-two patients with jaw classic ameloblastoma admitted to Liuzhou People’s Hospital from 2016 to 2019 were selected. They were treated by curettage combined with fenestration. Monthly follow-up visits were conducted after surgery, and orthopantomography was performed for reexamination to observe the recovery of bone and whether there was recurrence. Results : Tumors were completely scraped off in 22 patients, no pathological fracture occurred, and no wound infection occurred after surgery. After 1 to 3 years of follow-up, 19 patients showed excellent bone recovery in the original tumor area, and no recurrence was observed. Three patients relapsed and underwent a second curettage combined with fenestration, and the bone at the original tumor site recovered well. During the 12-month follow-up, no tumor recurrence was observed. After the second curettage combined with open surgery, the bone at the original tumor site recovered well. Eight patients underwent dental implants to repair dentition defects one year after surgery. Conclusion Curettage combined with fenestration is a convenient and effective treatment for jaw classic ameloblastoma.

Objective: To study the relation between the upper first molar root tips and the maxillary sinus floor in patients with different vertical facial patterns using cone-beam computed tomography (CBCT) and to explore the reference data for safe clinical orthodontic treatments. Methods: Three-dimensional images were reconstructed from CBCT data. The CBCT data from 120 adolescents and adults were divided into three groups (low-angle group, average-angle group, high-angle group) based on vertical facial type. For each subject, the distance from the maxillary sinus floor to the upper first molar root tips was measured, and the types of contacts were classified. ANOVA and LSD t tests were used for statistical comparisons and performed using SPSS 19.0. Results: Of the 120 samples, only 27% of the upper first molar root tips lost their contacts with the maxillary sinus floor, and the other 73% of the root tips contacted the sinus to different extents. Significant differences in the distances from the maxillary sinus floor to the upper first molar root tips were found for different vertical facial types (P < 0.05). The high-angle group had the lowest sinus floor, relative to the root tips, of the three adult groups (P < 0.05). In the adult group with a low angle, the measured value for the palatal root tips was the lowest and was significantly different from those in the other groups (P < 0.05). Conclusion Seventy-three percent of the upper first molar root tips contacted the maxillary sinus floor. The maxillary sinus floor tended to be lower relative to the first molar root tips in patients with a high-angle facial pattern than in others. The roots protruded into the sinus to a greater extent.

Objective: To explore the application value of digital 3D printing technology for repairing mandibular defects with fibular flaps and to provide a basis for accurate repair mandibular defects. Methods: Nine cases of mandibular defects were selected, and spiral CT and CTA of the lower limbs were performed before the operation. The osteotomy guide plate and plastic guide plate were created using computer software, and the titanium plate was rebuilt according to the printed mandibular model. During the operation, an osteotomy guide plate was used for mandibular resection; a fibula bone plastic guide plate was used to reconstruct the fibular flap and reconstruct the mandibular defects. Results: The entire fibula flap survived, and the occlusal relationship was good. There was no complications in the donor site. The patients were satisfied with the appearance of the repair. All patients were followed up for 3 to 6 months, at which point the bone was basically healed. Conclusion Using a digital 3D printing technique to repair mandible defects with a fibular flap can shorten the operation time, reduce the risks of operation, and better restore the maxillofacial shape and the function of the jaw, which is consistent with the concept of appropriate medical treatment. Additionally, this process provides a better method for the treatment of mandibular defects.