Objective To study clinical application and complication of heavy silicon oil (Densiron68) in the treatment of traumat- ic proliferative vitreoretinopathy.Design Non-comparatives,retrospective case series.Participants Twenty patients with proliferative vitreoretinopathy resulting from ocular trauma were recruited,whose retinal detachment arising from inferior or posterior retinal breaks. Methods Heavy silicon oil was applied to patients during vitrectomy.Silicone oil or gas was applied to patients with redetachment after heavy silicon oil was removed.Main Outcome Measures The rate of retinal attachment,vision,intraocular pressure,inflammatory re- action of anterior segment and silicone oil emulsification period.Results The rate of retinal attachment with one operation using heavy silicon oil was 50%(10/20 eyes)and 15%(3/20 eyes)with further surgery.The average follow-up time was 3.90?1.41 months.At the end of the follow-up,all tamponade agents were removed in 50% patients.Patients' logMAR vision after the surgery was 2.19?0.86,which was better than before the surgery (2.63?1.00) (P=0.037).There was little evidence of high intraocular pressure,excessive inflammatory reaction of anterior segment and cornea endothelial cell damage,but cataract became more serious without exception.Emulsification rate was 100% and the average emulsification period was 2.18?0.87 months.Conclusions Heavy silicon oil tamponade in vitreoretinal surgery for traumatic proliferative vitreoretinopathy has good efficacy and relatively few complications.However,its emulsification period is relatively short,which may constraint its application to a certain extent.

Three cases of Langerhans cell histiocytosis (LCH)with central diabetes insipidus as the first manifestation were reported, with the summary of their clinical manifestations, laboratory examinations, imaging examinations, pathological results, diagnosis process, and treatment response. All three patients presented with central diabetes insipidus in the early stage. The pituitary magnetic resonance imaging (MRI)showed thickened pituitary stalks, and all lost the normal high signal of the posterior pituitary. Two patients showed isolated hypothalamic-pituitary lesions, while one case showed pituitary and thyroid systems involvement. Pathological findings showed typical Langerhans cells, immunohistochemistry showed positive for S-100, CD1a, Langerin. The clinical manifestations of LCH manifested distinct heterogeneity, which is easy to be misdiagnosed and left out. The diagnosis should be confirmed by pathological examination. The biopsy of isolated hypothalamic-pituitary lesions is difficult. It is recommended to actively screen other organs to increase the probability of biopsy. LCH-induced neurohypophysis requires life-long hormone replacement therapy.

Objective To analyze the clinical manifestations,diagnosis and treatment of idiopathic left ventricular tachycardia(ILVT)in infants and young children.Methods The clinical data,including manifestations,lab results and treatments of 37 cases of ILVT in infants and young children were analyzed retrospectively.Results ILVT were seen more in young children older than 1 year old and male infants.A total of 37 cases with ILVT showed diverse clinical manifestations,5 children had cardiac insufficiency with oliguria and edema,2 children had syncope.There were 8 children without any symptoms,and 22 children had some symptoms,which mainly included agitation and crying,weakness and sweaty,vomitting and pale com-plexion.Holter showed incessant ILVT in 20 cases(54.1%),and paroxysmal in 17 cases(45.9%).Of the 37 cases,9 cases presented tachycardia-induced cardiomyopathy(TIC),8 of them were secondary to the in-cessant ILVT.Children with TIC compared with those without TIC,the ventricular rate were faster[(206.2 ± 38.7)beats/min vs.(171.8 ±38.7)beats/min,P<0.05],the duration were longer[(22.6 ± 15.3)days vs. (9.8 ±6.0)days,P<0.05].A total of 34 cases were given by antiarrhythmic drugs,verapamil was higher effective in reversion to sinus rhythm.Radiofrequency ablations were conducted in 8 cases,resulting in ven-tricular tachycardia elimination.All of children were fine during following up periods.After successful control of tachycardia,left ventricular end-diastolic diameter and left ventricular ejection fraction in patients with TIC gradually recovered[(35.4 ± 7.2 )mm vs.(28.9 ± 5.6 )mm,P <0.05;(46.7 ± 4.0 )% vs.(70.1 ± 1 .5 )%,P<0.0 1 ] .Conclusion ILVT in infants and young children are rare,and present different manifes-tions.An incessant ILVT with faster ventricular rate and longer duration are more frequently complicated by TIC.Radiofrequency ablation is the effective way of radical cure of the disease.The diagnosis and treatment for the tachycardia are particularly important in early time,and the prognosis are good.

OBJECTIVETo investigate the abirritation and antiinflammation effects of Monkshood Root and Peony Root used singly and in combination, and to find the enhanced effects of the two drugs used in combination; To observe the effect of Monkshood Root and Peony Root used singly and in combination by studing the immunoregulation function in experimental animals.

METHODThe response of delayed type hypersensitivity in mice, the phagocytosis of abdominal macrophages in mice, and the production of special antibodies in mice were observed.

RESULTThe two drugs used in combination could increase phagocytosic function of mononuclear macrophagocyte in hypoimmuitic model mice, and inhibit the responses of delayed type hypersensitivity in the hyperimmunitic model mice and the nonimmunosuppressive treated mice, with nosignificant effect on the production of special antibodies in mice.

CONCLUSIONIn accordance with the mechanism of the disorder between the anti-inflammation effect and the induce-inflammation effect on arthritis in the immune system, these data show the bidirectional effect of the two drugs used in combination on the immune responses, which may be one of the main mechanisms of treating arthralgia due to wind-dampness.

Aconitum ; chemistry ; Adjuvants, Immunologic ; therapeutic use ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Experimental ; drug therapy ; immunology ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Female ; Hypersensitivity, Delayed ; drug therapy ; Male ; Mice ; Paeonia ; chemistry ; Phytotherapy ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

AIM:To observe the structural basis of ocular motility abnormalities in patients with congenital fibrosis of the extraocular muscles type Ⅰ ( CFEOM Ⅰ) due to missense mutations in the developmental kinesin KIF21A using high - resolution magnetic resonance imaging ( MRI) .
METHODS: Totally 11 affected individuals reported KIF21A mutations were correlated with MRI studies demonstrating extraocular muscles ( EOMs ) size, location, contractility, and innervation. EOMs and the motor nerve in the orbits were imaged with T1 weighted in a triplanar scan using a dual-phased coils with 2. 0mm thick. Motor nerves were imaged at the brainstem using head coils and 3D-FIESTA with 0. 6-mm thick.
RESULTS: Patients with CFEOM Ⅰ exhibited different degrees of hypoplasia of oculomotor nerve, the abducens nerve and the trochlear nerve were also affected, of which 8 cases of orbital section could see the signal of abnormal nerve dominated by oculomotor nerve to lateral rectus. The both sides of six EOMS in all patients exhibited variable atrophy and abnormal bright internal signal on T1 imaging, particularly severe for the superior rectus and levator muscles.
CONCLUSION: High - resolution MRI can directly demonstrate pathology of motor nerves,affected EOMs, and ‘Pulley' hypoplasia caused by CFEOM Ⅰ due to mutations in KIF21A,and these findings suggest that the neuronal hypoplasia is the etiological factor of CFEOM.

Objective:To report the diagnosis, treatment, and follow-up of a 21-hydroxylase deficiency boy with central precocious puberty caused by complex heterozygous mutation of CYP21A2 gene.Methods:The child was symptomatic of rapid growth and secondary sexual characteristics at the age of 6. The diagnosis of central precocious puberty was confirmed by serum testosterone, gonadotropin levels, and gonadotropin-releasing hormone (GnRH) stimulation test. 21-hydroxylase deficiency was diagnosed clinically based on the serum adrenocorticotropic hormone (ACTH), 17-hydroxyprogesterone levels, and images on the computed comography (CT) of the adrenal glands.Results:The CYP21A2 gene was detected to have a compound heterozygous mutation by Sanger sequencing and multiplex ligation-dependent probe amplification. During the 3 years follow-up, the effects of glucocorticoids, GnRH analogs, and recombinant human growth hormone were regularly monitored and evaluated.Conclusions:Glucocorticoid replacement followed the principle of the lowest effective dose. GnRH analogs showed an effective inhibition of the hypothalamus-pituitary-gonadal axis, while recombinant human growth hormone had no such growth-promoting effect.

OBJECTIVETo make a comparison between the single and combined use of Monkshood Root and Peony Root to observe the anti-inflammation effect in the experimental animals.

METHODThe experimental inflammatory models were adopted, i.e. adjuvant-induced polyarthritis carrageenan-induced or formaldehyde-induced rat paw edema, and cotton pellet-induced granuloma formation in rats xylene-induced mouse ear edema, exudation of abdominal blood capillaries of mice, etc.

RESULTThe anti-inflammafion effect of Monkshood Root was weaker than that of Peony Root or Peony Root combined with Monkshood Root. It was found that anti-inflammation effect with the drug-cooperation was enhanced more significantly in the formaldehyde-induced or adjuvant-induceed arthritis models than in the carrageenan-induced rat paw edema and other inflammatory models either in the large dosage of 1:1 proportion or in the small dosage of 1:2 proportion.

CONCLUSIONThe drug-cooperation has a good selective and synergic effect on anti-inflammation.

Aconitum ; chemistry ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Edema ; drug therapy ; Female ; Granuloma, Foreign-Body ; drug therapy ; Male ; Mice ; Paeonia ; chemistry ; Phytotherapy ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rats

The total RNA was extracted from ginseng leaves of Panax ginseng. The Cu/Zn-SOD gene was amplified via RT-PCR and the pET-28(a)-Cu/Zn-SOD expression vector was constructed. The pET-28 (a)-Cu/Zn-SOD recombinant plasmid was transformed into Escherichia coli BL21 (DE3) competent cells and was induced by IPTG in order to select optimal induction of expression conditions. The target protein was purified by the nickel ions (Ni ) affinity chromatography and the target protein enzyme activity was determinated by the xanthine oxidase method. The similarity of the Cu/Zn-SOD gene sequences and the Cu/Zn-SOD gene sequences of Korean ginseng in NCBI was 99. 00%. The target protein expression level was about 44.42%, and the molecular weight was 16.30 kDa after the pET-28(a)-Cu/Zn-SOD recombinants were induced by IPTG. The purified Cu/Zn-SOD protease activity reached 10,596.69 U x mg(-1). The P. ginseng pET-28(a)-Cu/Zn-SOD prokaryotic expression vector was built by the method of molecular biology, which provided the foundation for studying the Cu/Zn-SOD biology function.
Cloning, Molecular ; Escherichia coli ; genetics ; Gene Expression ; Genetic Engineering ; methods ; Genetic Vectors ; genetics ; Panax ; enzymology ; genetics ; Sequence Analysis ; Superoxide Dismutase ; genetics ; isolation & purification ; metabolism

Objective:To investigate the correlation between the location and volume of cerebral microbleeds (CMBs) and lacunar infarction (LI) in patients with cerebral small vessel disease (CSVD).Methods:Participants from the CSVD cohort in the Department of Neurology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University from February 2017 to March 2019 were enrolled retrospectively. All participants underwent magnetic resonance imaging scans, standardized clinical assessment and diagnosis. AccuBrain, an automatic brain segmentation and quantification software developed by the Chinese University of Hong Kong, was used to quantitatively analyze the volume of CMBs and white matter hyperintensities (WMHs). Ordered multi-class logistic regression analysis was used to determine the independent influencing factors of LI, and then multiple linear regression analysis was used to investigate the correlation between the volume of deep or infratentorial CMBs (DI-CMBs) and the number of LI. Results:A total of 317 patients with CSVD were included in the analysis, including 214 (67.5%) in the non-LI group, 43 (13.6%) in the single LI group, and 60 (18.9%) in the multiple LI group. The comparison of the three groups showed that older age, male, smoking, drinking, history of previous stroke or transient ischemic attack (TIA), lower levels of high-density lipoprotein cholesterol, larger CMBs and WMHs volume, higher enlarged perivascular spaces (EPVS) grade might be the risk factors for LI. Ordinal multivariable logistic regression analysis showed that male (odds ratio [ OR] 2.058, 95% confidence interval [ CI] 1.084-3.909; P=0.027), previous stroke or TIA history ( OR 1.962, 95% CI 1.089-3.535; P=0.025), larger WMH volume ( OR 8.716, 95% CI 4.034-18.832; P<0.001), higher EPVS grade ( OR 1.915, 95% CI 1.292-2.839; P=0.001), larger DI-CMB volume ( OR 1.022, 95% CI 1.006-1.038; P=0.008) or more DI-CMB number ( OR 1.187, 95% CI 1.005-1.403; P=0.044) were the independent related factors of LI. Multiple linear regression analysis showed that there was a significant correlation between the volume of DI-CMB and the number of LI ( r=0.330, P<0.001). Conclusion:In patients with CSVD, there is a significant correlation between DI-CMBs and LI.

Objective To investigate the association of first permanent molars caries prevalence with primary molar caries experience.Methods Cluster,stratified and random sampling method,was used and 3680 children 6-to 10-year-old were randomizly selected from primary schools of Jinan city.Caries status of first permanent molars,decayed-missed-filled surfaces (DMFS,dmfs),decayed-missed-filled teeth (DMFT,dmft),were examined.Chi-square test was used to analyze the relationship among the caries incidence and the age,sex and to analyze the relationship between the first permanent molars DMFT,DMFS and the primary molars dmft,dmfs.Results Twenty point seven percent(763/3680) of children had first permanent molars caries,significantly higher(P ＜ 0.01) in girls [28.9％ (509/1762)] than in boys [13.2％ (254/1918)],a positive correlation (r =0.31,P ＜ 0.01) was found between caries experiences of primary molars (dmft) and caries of first permanent molars (DMFT).Higher permanent molar caries was found in subjects with dmft higher than 3 or dmfs higher than 19.Conclusions Sex,age and the caries experience of primary molars were factors closely related with the caries rate of the first permanent molars.Enhanced prevention is suggested on the first permanent molars of children who has higher prevalence of caries in primary molars.