Objective To observe the adhension and stracking of leukocyte in the capillary vessels, and investigate the relationship between leukocyte and microvascular morphologic changes in retinal microvessels of rats with early diabetes. Methods A total of 90 healthy adult male Wistar rats were randomly divided into control and diabetes (induced by Streptozotocin, STZ) groups with 45 rats in each group. The rats in the diabetic group were further divided into 3, 7, and 14 days groups with 5 rats in each group, and 30, 90, and 180 days groups with 10 rats in each group. The right eyes of rats in each group were prepared for retinal digest preparations. The expression of leukocyte common antigen (CD45) was detected by immunohistochemical staining. Results Few CD45 positive cells in the retinal capillaries were seen in the control group. The expression of CD45 was significantly increased in the retinal capillaries 3 days after diabetes induction, and reached a peak at the 14th day. Morphological changes including capillary telangiectasia, atresia, and irregularity of capillary caliber were found in the retinal capillaries of rats 90 days after diabetes induction. The changes were aggravated 180 days after diabetes induction. Conclusion Leukocyte adhesion occurs in the early stage of diabetic retinopathy (DR), and is the beginning of the microvascular pathological changes. Leukocyte adhesion may play an important role in the occurrence and development of DR as the foundation of microvascular morphological changes.

Objective To observe the ultrastructural characteristics of human retinal progenitor cells cultured in vitro. Methods Six 5-month-old human fetuses(12 eyes)without eye diseases were selected. Retinal progenitor cells from the retina of one eye of each fetus were cultured in vitro,and observed by transmission electronic microscopy(TEM); while those from the other eye were directly observed by TEM. Results Abundant heterochromatin were found in the karyon of 5-month embryonic retinal neuroepithelial cells,and the figure of the karyons was irregular.A few scattered initial cells were seen in retinal neuroepithelial layer with large karyon,smooth surface,abundant euchromatin,and distinct nucleolus.The human retinal progenitor cells cultured in vitro had the same ultrastructural characteristics as the initial cells:with huge karyon which almost occupied the whole cell,little cytoplasm,distint nucleolus,abundant euchromatin,and little heterochromatin.The cells clung to each other in the neural globoid cell mass.The size of the outer cells was large,and karyokinesis could be found. Conclusion The cultured human retinal progenitor cells are provided with the same ultrastructure characteristics as the initial cells.

Objective To investigate the effects of crocodilian plasma on 12 bacteria(including G+ bacteria and G-bacteria) lines in vitro.Methods The bacteria CFUs on nutrient broth agar plates were determined after bacteria and crocodilian plasma incubated together for 1h.Then effects of the samples on the survival rate of various concentrations of bacteria were calculated.To evaluate the antibacterial spectrum of crocodilian plasma,the zones of bacterial inhibition were measured through agar disk method.Results and Conclusion Crocodilian plasma had superior bactericidal effects on Escherichia coli M421C1,O111B4,E240-3 LT,Micrococcus catarrhalis,Shiga's bacillus,Pseudomonas aeruginosa and Diplococcus pneumoniae.The results indicated why wound of crocodilian by tearing each other was not susceptible,and crocodilian plasma could be developed a natural antibacterials.

Objective To observe the changes of VEGF and Ang-2 expression in streptozotocin(STZ)-induced diabetic rat retina after insulin therapy and explore possible roles of insulin in the development of diabetic retinopathy. Methods Diabetes was induced in 8-week-old male wistar rats by a single intraperitoneal injection of STZ. After three weeks,animals were randomly divided into four groups:(1)diabetic rats received intensive insulin therapy for 20 days;(2)diabetic rats received unregular insulin therapy,which caused the abrupt fluctuation of glycemic level;(3)diabetic control rats; and (4)normal control rats. After treatment,the animals were sacrificed with an overdose of anesthesia,and the eyes were enucleated and fixed in 4% paraformaldehyde immediately. Paraffin sections of retina were prepared.Expression of VEGF and Ang-2 was assessed by immunofluorescence stain and images analysis. Results Quantitative analysis showed VEGF and Ang-2 protein expression was increased by 2.38-fold and 2.41-fold in diabetic rats retinas as compared to non-diabetic rats retinas respectively (P0.05). Conclusion Intensive insulin therapy could decrease VEGF and Ang-2 expression in retina and has protective effect on diabetic retinopathy in STZ-diabetic rats.

OBJECTIVE: To investigate the possibility and anatomy landmark of the frontal beak approach of endoscopic frontal sinusotomy to the frontal sinus lesions. METHOD: (1)Twenty cases of frozen cadaveric head underwent spiral computed tomography scans. Then data were transferred into the Mimics image workstation to reorganize CT images in the coronal, sagittal, and axial planes. The anatomic parameters related to surgical approach points were measured, such as the distance between vertical plate of the middle turbinate and lamina papyracea and the thickness of the frontal beak. (2) 3D visual model of the frontal cell and the drainage way of the frontal sinus was produced with the application of Sinuses Trachea I software. (3)The endoscopic frontal sinus surgery were performed on 20 cases of subjects (objects)to find out the anatomy landmarks of the frontal beak approach, measure the parameters such as the distance between middle turbinate and lamina papyracea, and evaluate the potential surgical complications during operation. RESULT: (1)The frontal beak is a white bony arcs located at the attachment point of middle turbinate front inserted to the skull base. Its position was relatively constant, before frontal sinus above. (2)The distance between the middle turbinate vertical plate and lamina papyracea was (7. 61 ± 1. 34) mm. The thickness of the frontal beak in surgical approach was (3. 27 ± 0. 91) mm. (3) 3D visual structure of the frontal sinus and its ventilation pathway: the shape of unilateral frontal sinus looked like the cone, which was transited by the drainage pathway of the frontal sinus. The front part of the frontal sinus ostium is surrounded by the frontal beak. The upper part the frontal beak connected to the floor of the frontal sinus. (4) Frontal beak can be used as an landmark of frontal beak approach in the endoscopic frontal sinus surgery. But the lateral view of frontal sinus still was limited in the operation. CONCLUSION The endoscopic frontal sinus surgery with the approach of the frontal beak is easy to operate and learn. In this area between the double "L", the operation is safe.
Anatomic Landmarks ; Endoscopy ; methods ; Frontal Sinus ; surgery ; Humans ; Skull Base ; Software ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Turbinates ; anatomy & histology

AIM: To investigate the properties of human retinal microvascular endothelial cells (RMECs) at two different age groups. METHODS: Human RMECs with high affinity were isolated from donors at two age groups: 30 d (group A) after birth and 40 - 60 years of age (group B). The RMECs were characterized for expression and localization of endothelial cell markers by immunofluorescence staining of CD31, yon Willebrand factor(vWF) and uptake of acetylated low - density lipoprotein. The ability of tube formation was assessed on Matrigel, and vWF distribution in- cells was ob-served by confocal immunofluorescence microscope and Western blotting analysis, respectively. RESULTS: High purity RMECs can be obtained readily from each group with modified methods. At 6 hours, cells from both groups formed tube structures successfully, but there was a significantly higher incidence of branching in RMECs of infant group (group A) by 27.2%±2.2% compared with adult group (group B) at 12 h (P<0.05). Group A maintained intact structure even at 30h, but group B partially lost the basic tube structure. In addition, vWF was translocated from cytoplasm to nucleus with aging. CONCLUSION: Human RMECs at different ages have specific properties. Cell properties related with age of the donors should be considered in in vitro studies.

OBJECTIVETo prepare ginkgolide B-loaded self microemulsifying drug delivery system (SMEDDS) and evaluate its quality.

METHODThe solubility of ginkgolide B in different oil, surfactant and co-surfactant were measured by HPLC-ESI-MS. The GB-SMEDDS formulation was optimized by the self emulsifying efficiency of various combinations of oil and mix-surfactant evaluated by using pseudo-temary phase diagram. The preliminary stability of GB-SEMEDDS was evaluated by the variety of loading rate of GB and dispersed medium. The morphology, the particle size and the formulation stability were evaluated after diluting by 0.1 mol x L(-1) HCl.

RESULTThe blank self microemulsified system was composed of ethyl oleate-( cremophor EL-lecithin-ethanol, 4: 1:2) (40: 60), the loading dosage was 2.5%. Little influence of GB and emulsified medium was observed on the stability of GB-SEMDDS. After diluted with 0.1 mol x L(-1) HCl, the morphology of the microemulsion was homogeneous small spherical drops observed under electro-microscope. The particle size was (41.6 +/- 1.11) nm, the self microemulsifing time was around 2 min. The formulation was stable within 8 h, without significant changes in particle size and separation of drugs.

CONCLUSIONGB-SMEDDS is easy to prepare and its quality is stable. The solubility of GB was significantly improved by SMEDDS.

Chemistry, Pharmaceutical ; instrumentation ; methods ; Drug Delivery Systems ; instrumentation ; methods ; Emulsions ; chemistry ; Ginkgolides ; chemistry ; pharmacokinetics ; Lactones ; chemistry ; pharmacokinetics ; Particle Size ; Solubility ; Surface-Active Agents ; chemistry

Objective:To investigate the efficacy and safety of low dose S-ketamine in analgesia of elderly patients with non-traumatic acute abdomen (NTAA) in emergency department.Methods:This was a randomized controlled trail. From January to August 2021, elderly patients with NTAA in the Emergency Department of the No. 904 Hospital of the Joint Logistic Support Force were selected. Analgesia was administered intravenously with 0.3 mg/kg S-ketamine or 0.1 mg/kg morphine injection for 15 min. Visual analogue score (VAS), respiratory rate, heart rate, non-invasive blood pressure and pulse oxygen saturation were recorded at 15 min, 30 min, 60 min and 90 min. The mini-mental state examination (MMSE) scores were recorded at 90 min after injection. The incidence of salvage analgesia, incidence of adverse reactions and diagnostic accuracy after analgesia were recorded in the two groups. VAS scores and vital signs were compared between the two groups by two-way repeated measures analysis of variance, and multiple comparisons between and within groups were performed.Results:A total of 137 elderly patients with NTAA were selected and randomly divided into two groups: S-ketamine group (SK group, 68 cases) and morphine group (M group, 69 cases). After the exclusion of patients with abscission, 39 cases were included in the SK group and 45 cases in the M group. VAS score of the SK group was significantly lower than that of the M group in 15 min after administration [(3.1±1.8) vs. (4.8±2.2)], and the difference was statistically significant ( P=0.013). There were no significant differences in vital signs and MMSE score between the two groups or within the group at each time point after medication (all P>0.05). However, the incidence of dizziness in the SK group was significantly higher than that in the M group (61.54% vs. 31.11%, P=0.005). Conclusions:Intravenous administration of low dose S-ketamine is not considered to be more effective than morphine in alleviating acute abdominal pain in elderly patients with NTAA. S-ketamine provides not only satisfactory analgesia but also short recovery time and high controllability. S-ketamine is one of the recommended analgesic alternatives of NTAA for elderly patients in emergency.

BACKGROUND:Atlantoaxial dislocation is often facilitated by interlaminar bone grafting.However,there are relatively few reports on the treatment of complex atlantoaxial dislocation with posterior atlantoaxial lateral mass interarticular release and fusion. OBJECTIVE:To explore the safety and effectiveness of atlantoaxial dislocation treated by simple posterior atlantoaxial lateral block interarticular release and fusion. METHODS:We retrospectively analyzed the clinical data of 30 patients with atlantoaxial dislocation who were treated from January 2017 to July 2021,all of whom suffered from reducible atlantoaxial dislocation.Posterior atlantoaxial lateral mass interarticular release and fusion were performed in all patients.During the surgery,patented instruments were used to release the atlantoaxial lateral mass joint,and posterior screw reduction and fixation were used with bone grafting in the lateral mass joint space.The postoperative follow-up period was 6 to 24 months,mean(13.0±5.4)months.During the follow-up period,cervical MRI was reviewed to observe the decompression of the upper cervical spine.X-ray films and CT scans were reviewed to observe the reduction of the upper cervical spine,as well as the internal fixation for looseness and breakage.CT scans were reviewed to assess interlateral block implant fusion.The Japanese Orthopaedic Association score was used to evaluate the improvement of spinal cord function.The neck disability index and the quality of life scale were used to assess the improvement of daily life function.The atlanto-anterior interspace and atlanto-planar spinal effective space were used to evaluate atlantoaxial repositioning and decompression. RESULTS AND CONCLUSION:(1)The surgery of 30 patients went smoothly,and no serious complications such as spinal nerve and vertebral artery injuries occurred during the operation.Postoperative review of cervical MRI showed that the spinal cord compression was lifted.X-ray film and CT showed that the atlanto-anterior gap was significantly reduced;the effective space of atlantoaxial spinal cord was significantly increased,and neurological dysfunctional symptoms were significantly reduced.(2)During the follow-up period,X-ray film and CT showed that the internal fixation was solid;no broken nails or rods occurred,and there was no recurrence of atlantoaxial dislocation.(3)The Japanese Orthopaedic Association scores,neck disability index,and quality of life scores were significantly improved at the last follow-up compared with the preoperative period(P<0.05).The average improvement rate of Japanese Orthopaedic Association scores at the last follow-up was 73.1%.The average neck disability index was 8.80%.All of the patients had a continuous bone-scalp connection between atlantoaxial lateral block joints to achieve osseous fusion.(4)These findings indicate that the use of simple posterior atlantoaxial lateral block interarticular release and fusion for the treatment of atlantoaxial dislocation can significantly increase the fusion rate and shorten the fusion time.

Objective:To systematically analyze the clinical features of severe fever with thrombocytopenia syndrome (SFTS) and to provide evidence for the prevention and treatment of SFTS.Methods:Relevant studies of SFTS from six databases, including China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, PubMed, Cochrane Library and Embase from January 2009 to May 2019 were systematically searched and identified. The literatures were screened and the data of patients′ epidemiology, clinical manifestations, laboratory examinations and prognosis were obtained. Revman 5.2 software was used for meta analysis.Results:Sixty-eight Chinese literatures and fourteen English literatures encompassing 6 780 patients with SFTS were included in the final analysis. Of these patients, 845 cases (12.46%) died. SFTS mostly occurred in mountainous and hilly areas, and farmers (3 637 cases) were the usual victims. The onset season was mostly in summer and the peak was from May to August each year. There were 1 434 patients had a clear history of tick bites, and 21 cases were human-to-human transmitted.There were 6 071 cases (89.54%) presented with fever, 5 407 cases (79.75%) presented with fatigue, 3 140 cases (46.31%) presented with muscle soreness, and 2 300 cases (33.92%) presented with chills.Using random effects model for meta analysis, the levels of creatine kinase (CK) (mean difference ( MD)=500.40, 95% confidence interval ( CI) 380.51-620.28, P<0.01) and lactic acid dehydrogenase (LDH)( MD=442.81, 95% CI 152.85-732.78, P=0.003) in severe patients were both higher than those in mild patients, and the difference were both statistically significant. The risk of death increased in patients aged>60 years( MD=8.19, 95% CI 4.03-12.36, P<0.01). The levels of CK( MD=530.92, 95% CI 29.27-1 032.56, P=0.040), LDH( MD=609.28, 95% CI 80.25-1 138.31, P=0.020), urea nitrogen ( MD=4.67, 95% CI 3.05-6.30, P<0.01) and creatinine ( MD=43.05, 95% CI 23.49-62.62, P<0.01) of patients in the death group were all higher than those in the survival group. The differences were all statistically significant. Conclusions:During the course of SFTS, the patients may show impaired blood system, heart, liver and kidney functions with high mortality. Clinicians should timely monitor the changes of blood routine, myocardial enzyme spectrum, liver and kidney functions and other indicators, so as to find cardiovascular and other system complications as early as possible. Timely treatment could not only reduce liver, heart and other organ injuries, but also reduce mortality.