Objective To investigate the protective effect of standard dose prednisone(starting dose about 0.4 mg/kg bw) combined with glutamine(2 g/d) for Graves' ophthalmopathy(GO) after 131I treatment.Methods The prospective randomized controlled trial was performed and included 116 consecutive patients with mild-to-moderate GO or no active GO after 131I treatment,but with high risk factors.The experimental group(59 cases) started to take oral prednisone(0.44 ± 0.13)mg/kg at 2 d atter theatment,meanwhile replenishing glutamine,and prednisone was gradually decreased by 5mg per 2 weeks and stopped until 2 months;the control group(57 cases) received the initial dose prednisone(0.43± 0.14)mg/kg without replenishing glutamine,and the rest was same as the experimental group.The GO change and prednisone adverse reactions in 2,4,6 months after treatment were evalua ted in the two groups.Results The baseline characteristics had no significant difference between the two groups.In comparison of the experimental group and control group after 6-month treatment,the CAS score was (2.8 ± 0.8 vs.3.5 ± 0.9),exophthalmos degree was (19.6±8.1)mm vs.(21.7±3.0)mm,eyelid width was (11.3±2.9)mm vs.(13.8±3.1)mm,the improvement degree in the experimental group except for degree was superior to the control group (P＜0.01).No new onset GO or deterioation oc curred in the two groups;the experimental group had 42 cases(71.2 ％) of GO improvement and 17 cases(28.8 ％) of stability,while the control group had 39 cases(68.4％) of GO improvement and 18 cases(31.6％) of stability,and the curative effects had no sttis-tical difference between the two groups(P＞0.05).The side effects in the control group were more than those in the experimental group(63.1％ vs.30.5％,P＜0.05).the body mass increase was more obvious [(3.8±1.8) kg vs.(1.4±1.2)kg,P＜0.01],and SBP and DBP in the two groups were slightly increased[(10±4)mm Hg vs.(9±5)mm Hg P＞0.05].Conclusion Using the initial dose of oral prednisone(about 0.4 mg/kg) for 2 months and simultaneously replenishing glutamine (2 g/d)can effectively improve mild-moderate GO,and effectively reduce the adverse reactions of GC.However it is needed to extend the follow-up time to assess whether it can truly prevent the deterioration of GO,and to conduct a further study for the role of glutamine.

Objective To evaluate the possible mechanism of traumatic brain injury (TB1) affecting the speed of bone fracture healing.Method TBI combined with unilateral tibial fracture (group A) was used to build multiple injury model and simple unilateral tibial fracture (group B),and the FOS,JUN,bFGF,and VEGF protein expression in different time points between the two groups were compared,and roentgenogram was used for the evaluation of bone healing.Results The expression of FOS,JUN,bFGF,and VEGF protein of the cerebral tissue was low in the normal rats,but was slightly enhanced in group B.There was consistence of development for FOS and JUN expression in the brain tissue in group A,reaching peak at post-TBI 3 hours,and then reducing to control level after 12 hours.The bFGF and VEGF reached peak at post-TBI 12 hours and 24 hours and reduced to control level after 72 hours,respectively.In group A and group B,an increase in the FOS,JUN protein expression around the fracture site was observed at 3 hours after injury,which reached the peak at 6 hours,and reduced to the control level after 24 hours;the comparison between group A,group B and the control group at 3 hours,6 hours and 12 hours had significant difference (P

BACKGROUNDMycoplasma pneumoniae (M. pneumoniae) is one of the common pathogens causing atypical pneumonia. In recent years, resistance to macrolides has become more common, especially in China. Previous studies have confirmed that the mutation at position 2063 in domain V of the 23S rRNA is the most prevalent, followed by the mutation at position 2064. Reported molecular detection methods for the identification of these mutations include direct sequencing, restriction fragment length polymorphism analysis, real-time polymerase chain reaction (PCR) with high-resolution melt analysis, and nested PCR-linked with capillary electrophoresis, etc. The most commonly used method for monitoring resistance-conferring mutations in M. pneumoniae is direct DNA sequencing of PCR or nested PCR products. However, these methods are time-consuming, labor-intensive or need expensive equipments. Therefore the development of rapid and sensitive methods is very important for monitoring the resistance globally.

METHODSIn this study, we reported a fast and cost-effective method for detecting 2063 and/or 2064 macrolide resistant mutations from specimens using a modified allele-specific PCR analysis, and all results were compared with the sequencing data. We also analyzed the clinical courses of these samples to confirm the modified allele-specific PCR results.

RESULTSAmong 97 M. pneumoniae specimens, 88 were found to possess mutations by this method, and all modified allele-specific PCR analysis results were consistent with the sequencing data. The data of the clinical courses of these 97 cases showed that they suffered from severe pneumonia. Erythromycin showed better efficacy on cases from which no macrolide resistance mutation was found on their specimens. However, in some cases from which mutations were detected, erythromycin monotherapy had poor efficacy, and on these patients severe symptoms improved only when azithromycin was added to the treatment.

CONCLUSIONSThe drug-resistant M. pneumoniae is very common in Beijing, China. Our modified allele-specific PCR analysis can identify erythromycin resistant mutations more rapidly from specimens than any other method currently available. Erythromycin is still effective for treating patients infected with the mutation negative M. pneumoniae, but this treatment fails to work on mutant organisms. This method can facilitate clinicians in selecting appropriate therapy within short timescales.

Alleles ; Anti-Bacterial Agents ; pharmacology ; China ; Drug Resistance, Bacterial ; genetics ; Erythromycin ; pharmacology ; Mycoplasma pneumoniae ; drug effects ; genetics ; Polymerase Chain Reaction ; methods

Objective To explore the value of dual-phase contrast-enhancement multislice computed tomography (MSCT) in the assessment of acute myocardial infarction volume and perfusion in porcine models. Methods The distal left anterior descending coronary arteries of 5 pigs were balloon-occluded for 90 min and followed by reperfusion. MSCT was performed 1 min (early phase) and 5 min (delayed phase) after administration bolus of 100 mL of iodinated contrast material 30 min after reperfusion. On the same day, hearts were excised, sectioned in 8 mm short-axis slices, and stained with TTC. Infarction volume was defined as the sum of the hyper-enhanced area and surrounding hypo-enhanced area in all slices on delay enhanced phase of MSCT and the TTC-negative area on TTC staining slices. Infarction volume was expressed as percentage of total slice volume. Results Acute infarction detected by MSCT was characterized by early myocardial perfasion defects in the early phase of the contrast bolus (early defects) with surrounding residual defects and late enhancement observed in the late phase. Mean CT attenuation value of early defects was significantly different from CT attenuation value of remote myocardium [(213±55)HU vs (304±30)HU](P < 0.05), CT attenuation values of residual defects and late enhancement were also significantly different from those of remote myocardium [(360±75) HU vs (90±37) HU and (152±23) HU vs (190±37) HU, repectively](P < 0.01, P < 0.05). The mean infarction volume was (8.9± 1.0)% on MSCT and (9.2±1.4)% on TTC pathology images. The infarction volume assessed by MSCT compared well with TTC staining slices. Conclusion Acute reperfused myocardial infarction zone has specific enhancement pattens different to remote normal zone on dual phase MDCT, which is in good agreement with in vivo Trc pathology in the assessment of acute reperfused myocardial infarction shortly offer reperfusion.

AIM:To investigate the changes of choroidal thickness in patients with severe non-proliferative diabetic retinopathy (NPDR) after vitreous injection of ranibizumab,and to analyze the relationship between the thickness of choroid and the visual acuity of the patients.METHODS:Eighty patients with severe non-proliferative diabetic retinopathy were selected from January 1,2014 to January 1,2017.All patients were divided into observation group and control group according to the random number table,40 cases in each group.The control group was treated in a conventional manner,and the observation group was injected with ranibizumab in the vitreous.The thickness of the choroid in the macular area and the thickness of the retinal neuroepithelium in the macular area were compared between the two groups before and after treatment.The changes of the corrected visual acuity were analyzed at 1mo before and after treatment.The relationship between the thickness of the choroid and the thickness of the retinal neuroepithelium and the best corrected visual acuity were compared.The complications and adverse events were compared between the two groups after 6wk of treatment.RESULTS:The thickness of the choroid and the retinal neuroepithelium in the macular area before were 219.57± 51.24μm and 474.76 ± 95.56μm,respectively,in the observation group and the control group,217.56± 50.36μm and 473.27 ± 96.48μm,respectively.The thickness of the choroid and the thickness of the retinal neuroepithelium in the macular area after treatment were 180.15±42.06μm and 382.18±84.26,202.48±48.28μm and 407.88± 44.25μm,respectively.The difference between the two groups was statistically significant (P＜0.05).The best corrected visual acuity in the observation group and the control group were 0.47±0.19 and 0.53±0.25 respectively (P＜0.05).There was a positive correlation between the choroidal thickness and the best corrected visual acuity in the macular fovea (regression coefficient=1.12,S=0.48,OR=1.376,P＜ 0.05).There was a positive correlation between retinal neuroepithelial thickness and best corrected visual acuity in the macular area (regression coefficient =0.95,S=0.27,OR=1.020,P＜ 0.05).There were 2 eyes (5％) with subconjunctival hemorrhage,1 eyes (2.5％) of glaucoma,1 eyes (2.5％) of vitreous hemorrhage,0 of choroidal detachment,retinal detachment in 0 in observation group at 6wk after treatment.There were 4 eyes (10％) with subconjunctival hemorrhage,2 eyes (5％) of glaucoma,2 eyes of vitreous hemorrhage (5％),2 eyes of choroidal detachment (5％),retinal detachment in 2 eyes (5％) in the control group,and the difference between the two groups on the complications and adverse reactions was statistically significant (P＜0.05).CONCLUSION:The choroidal thickness of patients with macular edema in severe non-proliferative diabetic retinopathy is correlated with the best corrected visual acuity.Intravitreal injection of ranibizumab can effectively reduce the macular fovea choroidal thickness,reduce macular edema and improve vision,and less complications.

OBJECTIVETo investigate the role of lung fibroblast activation in radiation-induced lung injury.

METHODSThirty-five male Wistar rats were exposed to a single-dose 30 Gy irradiation of the right hemithorax or sham right lung irradiation. At 1, 7, 14, 28, 56 or 84 days after the irradiation, the rats were sacrificed for examination of alpha-smooth muscle actin (alpha-SMA) expression in the bilateral lung tissues using immunohistochemistry.

RESULTSalpha-SMA expression in fibroblast increased significantly in the out-field and in-field lung tissues within 24 h after irradiation after the irradiation (P<0.001).

CONCLUSIONActivation of the lung fibroblasts occurred within 24 h after irradiation and found in ont-field and in-field lung tissues, suggesting that radiation-induced lung injury may not have an obvious latency.

Actins ; genetics ; metabolism ; Animals ; Fibroblasts ; metabolism ; pathology ; Lung ; cytology ; pathology ; Male ; Radiation Injuries ; pathology ; Rats ; Rats, Wistar

OBJECTIVETo evaluate the efficacy and safety of transoral plate internal fixation for instability atlas fracture.

METHODSA retrospective study was performed in eight patients with instability atlas fractures, who were treated by a transoral plate internal fixation from July 2007 to June 2011. There were 6 males and 2 females,with an average age of 39.5 years old ranging from 23 to 48 years. Among them, 5 case were falling injury, 3 cases were traffic accident injury. Three patients had bilateral fractures of the anterior arch (prehalf Jefferson fractures, Landells type I), 5 had anterior are fracture associated posterior are fracture (Half-ring Jefferson fractures, Landells type II), and 2 had anterior and posterior are fracture associated with single lateral mass fractures (Landells type III).

RESULTSAll patients were followed up for 6 to 24 months after operation (av- eraged 13 months), and all the patients had the clinical symptoms improved to some extent. Operation time ranged from 80 to 140 min (averaged 98 min); the intra-operative blood loss was 120 to 300 ml (averaged 180 ml); and the average fluoroscopic time was 55 s. No patients happened neurological and vertebral artery injuries-related complications or other complications after operation. The followed-up X-ray and CT manifested osseous fusion in all the 8 patients,no loosening or breakage of the screws.

CONCLUSIONTransoral plate internal fixation for instability atlas fracture is a reliable and safety technique that allows maintenance of rotatory mobility in the C1,2 joint and restoration of congruency in the atlanto-occipital and atlanto-axial joints.

Adult ; Bone Plates ; Cervical Atlas ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo investigate the clinical outcomes of lower cervical spinous process laminar screw technique in open door laminoplasty.

METHODSFrom February 2005 to June 2010,12 patients with cervical myelopathy were treated with open door laminoplasty by lower cervical spinous process laminar screw technique. There was intervertebral disc herniation with degenerative stenosis in 5 patients, ossification of posterior longitudinal ligament with osteophyte in 6 patients, cervical traumatic instability with spinal cord injuries in 1 patient. Nerve function, complications, and the cervical canal to body ratio (CBR), range of motion (ROM) and the anteroposterior serial alignment were observed by Japanese Orthopedic Association (JOA) score, X-ray, CT and MRI.

RESULTSThe surgical time was from 1.5 to 2 h with an average of 110 min; blood loss during operation was from 450 to 800 ml with an average of 580 ml. Postoperative complication occurred in 1 case with upper limb pain and 1 case with cerebrospinal fluid leakage. All patients were followed up from 1 to 2 years with an average of 21.8 months. JOA score improved from preoperative 9.5 +/- 1.8 to postoperative 13.6 +/- 2.4 (P < 0.01). X-ray, CT, MRI showed CBR increased obviously (P < 0.01); ROM on flexion-extension and cervical lordosis decreased respectively from (40.0 +/- 10.0) degrees and (65.0 +/- 12.0)% before operation to (15.0 +/- 5.0) degrees and (42.0 +/- 8.0) % at the final follow-up (P < 0.01).

CONCLUSIONLower cervical spinous process laminar screw technique in open door laminoplasty for cervical syndrome is safe and can obtain satisfactory effects, has strong internal fixation and reduce the risk of re-closure.

Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Spinal Stenosis ; surgery

OBJECTIVETo compare the potential incidence of nerve root (ventral and dorsal ramus) injury caused by cervical transarticular screws and Roy-Camille lateral mass screws.

METHODSInsertion techniques with Klekamp transarticular screws and Roy-Camille lateral mass screws were respectively performed in this study. Each technique involved four specimens and 40 screws, which were inserted from C(3) to C(7). And 20-mm-long screws were used to overpenetrate the ventral cortex. The anterolateral aspect of the cervical spine was carefully dissected to allow observation of the screw-ramus relationship.

RESULTSThe overall percentage of nerve invasion was significantly lower with Klekamp (45%) technique than with Roy-Camille (85%) technique (P less than 0.05). The largest percentage of nerve invasion for Klekamp transarticular screws was found at the dorsal ramus (25%), followed by the ventral ramus (15%) and the bifurcation of the ventral dorsal ramus (5%). The largest percentage of nerve invasion for Roy-Camille lateral mass screws was found at the ventral ramus (80%).

CONCLUSIONThe potential risk of nerve root invasion is lower with Klekamp transarticular screws than with Roy-Camille lateral mass screws.

Adult ; Bone Screws ; Cervical Vertebrae ; injuries ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; surgery

Matrix-assisted laser desorption/ionization time-of-flight imaging mass spectrometry (MALDI-TOF-IMS) has been a classical technique for studying proteomics in present and a tool for analyzing the distribution of proteins and small molecules within biological tissue sections. MALDI-TOF-IMS can analyze multiple unknown compounds in biological tissue sections simultaneously through a single measurement which can obtain molecule imaging of the tissue while maintaining the integrity of cellular and molecules in tissue. In recent years, imaging mass spectrometry technique develops relatively quickly in all biomedical domain. This paper based on the relevant data and reviews the present developing level of MALDI-TOF-IMS, the principle of imaging mass spectrometry, methology and the prospect in forensic pathology.
Diagnostic Imaging ; Forensic Sciences/methods* ; Humans ; Male ; Proteins ; Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization