OBJECTIVE TTo evaluate the clinical manifestations of the laryngeal amyloidosis and its laryngoscopic characteristics.METHODS The clinical data of 11 cases with laryngeal amyloidosis confirmed pathologically was studied retrospectively. RESULTS There were 4 males and 7 females in this study.The age of the patients ranged from 16 to 64 years old (average 43.36?4.16).The duration of symptoms was 4 months to 10 years (average 2.85?0.87 years).Hoarseness presented in 10 patients (90.90%) and dyspnea in 4 patients.The false vocal cord was involved in 8 patients,laryngeal ventricle in 6 patients,true vocal cord in 5 patients and subglottic area in 3 patients observed with fibrolaryngoscope. The appearance of the lesions was mainly described as waxy yellow or yellow-gray submucosal plaques and nodules without ulceration of the overlying mucosa.The laryngostroboscopy demonstrated that the wave of the mucosa and vibration of the involved vocal cords were adynamic or disappeared.CONCLUSION The chief complaint of the laryngeal amyloidosis was hoarseness. Laryngeal amyloidosis is a slowly progressive disease. The lesions commonly involve the false vocal cord, laryngeal ventricle,true vocal cord and subglottic area.

BACKGROUND:Telomerase reverse transcriptase (TERT) plays an important role in telomerase activation.
OBJECTIVE:To construct the targeting short hairpin RNA plasmid vector expressing TERT gene from astrocytes by using pLentilox3.7.U6.
METHODS:By using two sequences from TERT gene, we synthetized sense and antisense strand template sequences of RNA interference molecular in vitro, and then obtained the complementary strands through annealing procedure. We connected the strands with pLentilox3.7.U6 that was sequenced and transfected into the Escherichia coli. In the end, we tested its effect of reducing the TERT gene expressing by using cultured astrocytes from rat spinal cord in vitro through western blot and immunofluorescence technique.
RESULTS AND CONCLUSION:Western blot and immunofluorescence assay showed that, compared with the control group, the interference groups had a lower TERT expression in astrocytes. The targeting short hairpin RNA plasmid vector expressing TERT gene is useful to reduce the TERT gene expression. The targeting short hairpin RNA plasmid vector expressing TERT gene is valid for us to do the further test learning the mechanism of astrocytes in spinal cord injury.

28 days after injury (P < 0.05). In the fracture+spinal cord injury group, the level of serum transforming growth factor beta 1 had a rapid increase on the 7th day, and reached the peak on the 14th day, and then, this level had no significant decrease until the 28th day. In the simple fracture group, the level of serum transforming growth factor beta 1 began to increase on the 2nd day, reached the peak on the 7th day, and then decreased gradualy. Remarkable changes of serum transforming growth factor beta 1 levels in patients with bone fracture combined with spinal cord injury may be associated with fracture healing in different periods.

BACKGROUND:Telomerase reverse transcriptase plays an important role in telomerase activation, and lentiviral vectors carrying human telomerase reverse transcriptase that can inhibit astrocyte expression are rarely reported to have effects on spinal cord injury. OBJECTIVE:To transfect rat astrocytes with telomerase reverse transcriptase gene lentiviral vectors and to observe the effect of telomerase reverse transcriptase gene lentiviral vectors on apoptosis of astrocytes. METHODS: Astrocytes from rats were subject to primary culture and subculture, and then transfected with siRNA lentiviral vector carrying telomerase reverse transcriptase gene (siRNA transfection group), simple lentiviral vector (lentiviral vector group) and nothing (blank group), respectively. Then, the transfection efficiency and apoptosis in different time periods after transfection were determined. RESULTS AND CONCLUSION:The transfection efficiency was up to 85%-90% after siRNA lentiviral vector and simple lentiviral vector transfection. The apoptosis rate of astrocytes in the siRNA transfection group was 50%-60% at 24-48 hours after transfection, but there was no significant change in the other two groups. These findings suggest that siRNA lentiviral vectors carrying telomerase reverse transcriptase gene can accelerate astrocytes apoptosis.

Objective To investigate the diagnosis,treatment and prognosis of isolated epidural hematoma (EDH) in children.Methods Clinical data of 83 children,45 males and 38 females (at age of 0.7-14 years),with EDH treated between January 2012 and October 2014 were retrospectively reviewed.Slipping and falling were the most commonly causes of injury.While motor-vehicle accident was noted with increased age.In 16 patients lesion of hematoma was frontal,in 28 patients temporal,in 13 patients parietal,in 9 patients occipital and in 17 patients posterior fossa.Results Of the 28 patients treated surgically,the outcome evaluated using the Glasgow Outcome Score (GOS) was good in 22 patients,mild disability in 2,moderate and severe disability in 1 and death in 3 (one died of venous sinus rupture and one large area infarction).Of the 55 patients treated conservatively,the outcome was good in 52 patients,mild disability in 1,and death in 2 (both presented with bilateral cerebral hernia on admission and one of them was unable to breath spontaneously).Conclusions Overall prognosis of the patients with isolated EDH in children is excellent.Complications of venous sinus rupture,foramen magnum hernia and large area cerebral infarction may contribute to poor prognosis.

Objective To investigate the inhibitory effect of paclitaxel on rat graft arteriosclero- sis and the mechanism.Methods The rat abdominal aortic allograft model was used.All rats were divided into three groups:isograft control group (Wistar to Wistar),allograft group (Wistar to SD) and allograft paclitaxel-treated group (Wistar to SD).Rats in allograft paclitaxel-treated group re- ceived paclitaxel (2 mg?kg~(-1)?d~(-1)) from the operation day to post-operative day 14 and others received same dosage of vehicle (0.9% normal saline).Animals were sacrificed and the grafts were harvested at 30th day after operation.Intimal proliferation was studied by light microscopy.The apoptosis of vascular smooth muscle cells (VSMCs) was detected by transmission electronic microscopy and termi- nal deoxynucleotidyl transferase biotin nick end-labeling (TUNEL) method.Results Morphological analysis showed that grafts had no change after operation in isograft control group,but in allograft group intimal proliferation,inflammatory cells infiltration in neointima and adventitia and stenosis of allografts were obvious.After treatment with paclitaxel,there was a significant decrease in intimal proliferation,inflammatory cells infiltration and stenosis.Apoptosis index of VSMCs was higher in the allograft paclitaxel-treated group than other groups.Conclusion Paclitaxel can inhibit intimal pro- liferation in aortic allografts and prevent the graft from arteriosclerosis possibly by inducing the apoptosis of VSMCs.

OBJECTIVETo evaluate the efficacy and safety of tiaogan Lipi Recipe (TLR) in treating non-alcoholic fatty liver disease (NAFLD) patients of Gan stagnation Pi deficiency syndrome (GSP-DS).

METHODSA randomized, double blind, placebo-controlled clinical trial was performed. Totally 99 NAFLD patients of GSPDS were randomly allocated into two groups, 66 patients in the treatment group (treated with-TLR, one dose per day) and 33 patients in the control group (treated with placebos, one dose per day). The therapeutic course for all was 12 weeks. All patients received lifestyle interventions including moderate aerobic exercise, moderate caloric restriction, and dietary changes. Clinical symptoms, CT indices, liver functions and blood lipids were observed before and after treatment.

RESULTSAfter 12 weeks of treatment, the total score of clinical symptoms decreased in the two groups (P <0. 01), and it was lower in the treatment group than in the control group (P <0. 05). Liver/spleen CT ratio increased in the treatment group (P <0. 01), and it was higher in the treatment group than in the control group (P <0. 01). After treatment levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT) all decreased in the treatment group (P <0. 05, P <0. 01), while levels of ALT decreased in the control group (P <0. 05). Besides, all the 3 levels mentioned above were lower in the treatment group than in the control group (P <0. 05). Levels of total cholesterol (CHO) and triglyceride (TG) decreased in the two groups (P <0. 05), and they were lower in the treatment group (P <0. 05). Total effective rates of TCM syndrome, abdominal CT, liver functions, and blood lipids were 79. 69% (51/64 cases), 54. 69% (35/64 cases), 67. 65% (23/34 cases), and 67. 39% (31/46 cases) in the treatment group, while they were 56. 25% (18/32 cases), 25. 00% (8/32 cases), 33. 33% (6/18 cases), and 55. 56% (10/18 cases) in the control group. All were superior in the treatment group (P <0.05, P <0.01, respectively).

CONCLUSIONTLR combined with lifestyle intervention could safely and effectively improve clinical symptoms of NAFLD patients of GSPDS, elevate liver/spleen CT ratios, and play a role in liver protection, anti-inflammation, and lowering blood lipids.

Alanine Transaminase ; metabolism ; Aspartate Aminotransferases ; metabolism ; Cholesterol ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Lipids ; Non-alcoholic Fatty Liver Disease ; drug therapy ; Syndrome ; Triglycerides ; gamma-Glutamyltransferase ; metabolism

OBJECTIVETo investigate the effects of locking plate fixation through lateral deltoid approach for proximal humeral fracture combined with micro-invasive percutaneous plating (MIPPO) technique.

METHODSFrom April 2009 to March 2012,26 patients with proximal humeral fractures were treated with proximal humeral locking system plate fixation through lateral deltoid approach, including 17 males and 9 females with an average age of 58 years old ranging from 28 to 76 years old. The time from injury to operation was 3 to 10 days (averaged 5.6 days). According to Neer typing for the proximal humeral fractures, 7 cases had 2 parts of fracture,15 had 3 parts of fracture,and 4 had 4 parts of fracture. The Neer score for shoulder function was evaluated.

RESULTSAll patients were followed up,and the duration ranged from 10 to 21 months (averaged 13.6 months). All patients were achieved bony union,the average healing time was 12.5 weeks (ranged from 10 to 21 weeks). No humeral head necrosis and axillary nerve injury occurred. According to Neer scoring system,the total score was 88.36 +/- 7.82, pain 30.82 +/- 3.24, function 23.76 +/- 5.71, activity 17.59 +/- 5.36, anatomical position 7.03 +/- 2.39; the result was excellent in 18 cases, good in 5 cases, fair in 2 cases, poor in 1 case.

CONCLUSIONLateral deltoid approach combined with locking plate fixation for treatment of proximal humeral fracture has advantages of small invasion,less blood lossing, short operative time, stable fixation, high rate of fracture healing, and satisfactory functional recovery.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Treatment Outcome

BACKGROUND:Telomerase reverse transcriptase (TERT) plays an important role in telomerase activation, however there is rare report addressing the construction of the lentivirus targeted its genes to inhibit its expression in the spinal cord astrocytes.
OBJECTIVE:To construct recombinant lentivirus vector expressing smal interfering RNA against TERT gene and to evaluate its potential for inhibiting the TERT expression.
METHODS:After shRNA-TERT sequence was designed and synthesized, the sequence was amplified by PCR and then connected to plasmid pLentilox3.7U6-hTERT to construct recombinant plasmid. The recombinant plasmid was then transfected to DH5αcel s to screen positive colony, and the sequence was identified. The recombinant plasmid pLentilox3.7U6-TERT was transfected in 293T cel s, generating recombinant lentivirus Le-TERT. The titer of recombinant lentivirus was determined and Le-TERT was transfected into the rat spinal cord astrocytes. The expression of TERT in astrocytes was detected by RT-PCR, western blot and immunofluorescence assay.
RESULTS AND CONCLUSION:The gene sequencing analysis confirmed that, recombinant plasmid pLentilox3.7U6-TERT was successful y constructed. The real-time quantitative PCR, western blot analysis and immunofluorescence assay indicated that, after Le-TERT was transfected in the astrocytes for 4 days, the inhibition rate of TERT mRNA was (63.98±2.6)%, and Le-TERT was lowly expressed in the transfected astrocytes. Recombinant expression vector pLentilox3.7U6-TERT can produce the lentivirus at high titer and effectively inhibit TERT expression in the transfected astrocytes.

Background Salivary transplantation or duct transposition can provide continuous physiological secretion of tear substitutes.This may be an ideal method in treatment of dry eye.But the relative anatomical literatures is few,and some of the conclusions in the literatures are still controversial,which limit its clinical application.Objective This study was to discuss the possibility and the advantage and disadvantage of applying three major salivary glands to treat xerophthalmia.Methods The relationship between the branches of the facial nerve out of the parotid gland and the salivary glands,the salivary glands size,origin of blood supply,out diameter of vessels and adjacent relation were observed in 34 sides pate specimens perfused with red latex under the operating microscope.To find the vessels in recipient site to anastomose,the vessels around fossa orbitalis and forehead were anatomized and observed.The parotid gland duct transfer operation,the submandibular gland free transplantation surgery and sublingual gland free transplantation surgery in the human anatomy specimens were simulated.Results The position of parotid duct was constant.The duct length was(4.20± 1.10) cm,duct diameter was (O.60±0.30) cm.The stensen's duct was likely to be prolonged by the cheek mucous membrane or venous andthe damage of buccal branch,zygomatic branch and temporal branches of facial nerve should be avoided during the operation of transplanting stensen' s duct.When submandibular gland was transplanted,facial vessel was taken as its pedicle,whose outside diameter was (2.70 ± 0.28) mm,and the length of the transplant vascular pedicle was (1.90 ± O.30) cm.Thc anastomosed vessel was superficial temporal vessel in recipient site.When sublingual gland was transplanted,sublingual(88.2％,30 sides) or submental vessel(11.8％,4 sides) was taken as its pedicle,whose outside diameter was(1.92±0.36) mm and (1.96±0.54) mm,and the length of the transplant vascular pedicle was(2.60± 1.10) cm and(3.50±0.40) cm,and the anastomosed vessel was the frontal branch of superficial temporal vessel in recipient site.Three sides of specimens lacked sublingual glands.Conclusions It is feasible that treating severe xerophthalmia by the operation of grafting the major salivary glands or transplanting stensen' s duct on the point of anatomical view.Parotid duct inversion and the submandibular gland transplantation have been applied to clinic.However,sublingual transplantation remains to be further confirmed by the animal experiments.