Objective　To study the diagnosis and treatment of perforated congenital choledochal cyst(PTCC). Methods　The clinical data of 10 children with PTCC were retrospectively analysed.Results　6 males, 4 females, average age 4.5 years old. The cyst perforted time within 12 hours was in 4 cases, 12～72 hours in 3, and more than 72 hours in 3. Of these cases, 2 had infection and the others had no obvious discomfort before perforation. Of 7 cases undergoing cyst excision and biliary reconstruction, 5 cases were recovered without complications; 2 occurred anastomostic leakaged(1 case had infection before perforation and the other with perforcted time more than 72 hours). 3 cases subjected to external drainage at first, and cyst excision and biliary reconstruction were performed on three months later. Conclusions　If PTCC is treated earlier, cyst excision and biliary reconstruction can be performed as a primary operation.

BACKGROUND:Humeral fractures can be treated by using rotary self-locking intramedulary nail. The previous spin in self-locking intramedulary nail has some limitations in application, so it should be improved in its design so as to obtain better biomechanical effect.
OBJECTIVE:To improve the design of the rotary self-locking intramedulary nail of the humerus, and to analyze its biomechanical characteristics and application effect, and to provide reference for the clinical treatment of humeral fractures.
METHODS: (1) The design of the rotary self-locking intramedulary nail was improved and tested by mechanics test. (2) A total of 63 cases of humeral fractures were randomly divided into two groups: control group (31 cases) and experimental group (32 cases). Patients in the control group received conventional rotary self-locking intramedulary nail, and patients in the experimental group received improved nail.
RESULTS AND CONCLUSION:Results of mechanical test concerning anti-axial compression, tensile, torsion and bending were obviously better after improvement than before improvement. No significant difference in range of motion was detected between the two groups (P > 0.05). Compared with that before treatment, the range of motion was significantly increased after treatment in both groups (P < 0.01 orP < 0.05). The range of motion was significantly higher in the experimental group than in the control group (P < 0.05). Simultaneously, the excelent and good rate was significantly higher in the experimental group than in the control group (P < 0.05). Thesedata suggest that the improved rotary self-locking intramedulary nail has better mechanical characteristics and can obtain better clinical effect.

Objective To explore the ultrasonic characteristics of cystic adventitial disease (CAD) and to evaluate the value of color Doppler ultrasound in diagnosis of CAD. Methods We retrospectively analyzed the ultrasonograms and other imaging methods of eight patients with CAD conformed by surgery in The first Hospital of China Medical University. Results Five of the eight CAD cases were confirmed by color Doppler ultrasound before surgery, and three were misdiagnosed. All the cases were single, with five in popliteal artery, two in iliofemoral artery, and one in external iliac vein. We divided the cysts into concentric cysts and eccentric cysts according to the cystic shape and the lumen stenosis. Six cases were eccentric cysts, in which two had septations;two cases were concentric cysts, and both had septations. The affected vessel expanded, but its shape did not change and the lumen was compressed. There were three layers of wall between the cyst and the lumen. The peak systolic velocity of the affected lumen increased and the distal end systolic peak velocity decreased when lesion occurred in artery. Distal end lumen reflux were slow when lesion occurred in distal veins. Angiography showed the stenosis of the affected lumen, which was described asscimitar sign. CT showed uniorlocular or multilocular cyst, and the compressed lumen. All of the eight patients underwent the diseased adventitia resected along with excision of the cyst. Conclusions The color Doppler ultrasound can display the location, shape, and internal echo of CAD, and thus it can accurately evaluate luminal stenosis and flow pattern. This is of important clinical significance for the diagnosis, treatment, and prognosis of CAD.

Objective To observe the effect and mechanism of HA1077 on bone mesenchymal stem cells (BMSCs) promoting wound healing. Methods (1) In vitro study: rats' BMSCs were har-vested and divided into three groups randomly, ie, control group, induction group and HA1077 group. In control group, culture medium was DMEM with 10% fetal bovine serum. In induction group, induction medium was DMEM which consisted of 10% FBS, 8μg/ml EGF and epithelium culture condition medi-um. In HA1077 group, culture condition medium was the induction medium pins 10 μmol/L HA1077. At day 7 after replanting, CK19 expression, PCNA expression and cell cycle among three groups were clarified by flow cytometry. (2) In vivo study: rabbit's BMSCs were isolated. Six pieces of full skin loss wound were created on the back of a rabbit, with three pieces of wound on the half side of back. The wound was round and 3 cm in diameter. Eight New Zealand rabbits were randomly divided into four groups, ie, control group (Group A), EGF control group (Group B), BMSCs group (Group C) and BMSCs + HA1077 group (Group D). Wounds were treated by normal saline in Group A and by EGF (50 U/cm2) in Group B. Besides EGF,1 ml of BMSCs suspension (2 × 106/ml) was used for wound re-pair in Group C. 0.5 ml HAIO77(20 μmol/L), BMSCs and EGF were used together for wound repair in GronpD. At days3, 7and 14 after injury, wound elosuroindex (WCI) was calculated. Results In vitro study:the positive rate of CK19 in the HA1077 group was (40.31±0.82)%, higher than (11.13±2.14)% in the induction group(P < 0.01). The PCNA positive rate and the S phase, cell quantity in HA1077 group were also higher than that in the induction group. In vivo study: WCI was (86.20±1.92) % in Group D at day 14 after injury, obviously higher than that in other three groups. Conclusions HA1077 can promote BMSCs' entering into S phase, expressing PCNA and differentiating and expressing CK19. In vivo combination of HA1077 with BMSCs may facilitate wound healing.

It is of great importance for the detection of epilepsy in clinical applications. Based on the limitations of the common used approximate entropy (ApEn) in the epilepsy detection, this paper analyzes epileptic EEG signals with the sample entropy (SampEn) approach, a new method for signal analysis with much higher precision than that of the ApEn. Data analysis results show that the values from both ApEn and SampEn decrease significantly when the epilepsy is burst. Furthermore, the SampEn is more sensitive to EEG changes caused by the epilepsy, about 15%-20% higher than the results of the ApEn.
Algorithms ; Data Interpretation, Statistical ; Electroencephalography ; methods ; Entropy ; Epilepsy ; diagnosis ; physiopathology ; Humans ; Nonlinear Dynamics ; Signal Processing, Computer-Assisted

Peak Torque(PT),Total Work(TW),Average Power(AP),Torque Acceleration Energy(TAE),Set Total Work(STW),Endurance Ratio (ER)and DOrsal/plantar ratio of ankle dorsal and plantarflexion were tested in 101 patients with lumbar disc protrusion using a Cybex一6000 isokinetic muscle test-ing instrument.The results showed the most tested of the affected side was signficantly lower than that onthe opposite side. The PT,TW and STW of the affected side was lower 70一80%than that on the oppo-site side. The rest was lower 20一30%than another side. No significant difference of endurance ratios be-tween the affected and unaffected sides was noted.

Objective:To investigate the effect of methylene blue (MB) on motor dysfunction and its mechanism in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease (PD) mouse models.Methods:Forty healthy male C57BL/6 mice were randomly divided into 4 groups: control group, model group, low-dose treatment group and medium-dose treatment group ( n=10); PD mouse models were established by intraperitoneal injection of 25 mg/kg/d MPTP for a consecutive 7 d; low-dose treatment group and medium-dose treatment group were pretreated intraperitoneally with MB 2 mg/kg/d or MB 10 mg/kg/d for a consecutive 3 d, respectively; and then, MPTP 25 mg/kg/d+MB 2 mg/kg/d or MPTP 25 mg/kg/d+MB 10 mg/kg/d were injected intraperitoneally into the low-dose treatment group or medium-dose treatment group for a consecutive 7 d (MPTP and MB were given at 12 h of interval). Eight d after modeling, open field experiment, pole climbing experiment and rod rotating experiment were carried out to evaluate the spontaneous movement, coordination, endurance and motor ability. And then, the mice were sacrificed; immunofluorescent staining was used to observe tyrosine hydroxylase (TH) expression in the substantia nigra; Western blotting was used to detect the expressions of TH, α-synuclein, nucleotide-binding oligomerization domain, leucine-rich repeat and pyrin domain-containing 3 (NLRP3), apoptosis-associated speck-like protein containing a CARD (ASC), cleaved-Caspase-1 and Gasdermin D (GSDMD) in the striatum and substantia nigra of mice. Contents of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-18 in the substantia nigra and striatum of mice were detected by ELISA. Results:Compared with the control group, the model group had shortened residence time in rod rotating, prolonged descent time in rod climbing, reduced total movement distance in open field, decreased number of TH-positive cells in the substania nigra, decreased TH protein levels in the substania nigra and striatum, and increased NLRP3, ASC, cleaved-Caspase-1, GSDMD and GSDMD-N protein levels in the substania nigra and striatum, and increased TNF-α, IL-1β and IL-18 contents in the substania nigra and striatum, with significant differences ( P<0.05). Compared with the model group, low-dose treatment group and medium-dose treatment group had prolonged residence time in rod rotating, shortened descent time in rod climbing, increased total movement distance in open field, increased number of TH-positive cells in the substania nigra, and increased TH protein levels in the substania nigra and striatum, decreased NLRP3, ASC, and cleaved-Caspase-1 levels in the substania nigra and striatum, and decreased TNF-α, IL-1β and IL-18 contents in the substania nigra and striatum, with significant differences ( P<0.05). No statistical differences in the above indexes were noted between the low-dose treatment group and medium-dose treatment group ( P>0.05). Conclusion:Low-/medium-dose MB can ameliorate motor dysfunction in PD mouse models, whose mechanism may be related to downregulate NLRP3 inflammasome and inhibit neuroinflammatory response to reduce dopaminergic neuron pyroptosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Culture Techniques ; methods ; Child ; Female ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Male ; Middle Aged

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

OBJECTIVETo investigate the effects of mouse adipose-derived stem cell conditioned medium (ADSC-CM) on apoptosis of keratinocytes (human epithelial cell line HaCaT) induced by thermal injury in vitro.

METHODS(1) Adipose-derived stem cells (ADSCs) from inguinal adipose tissue of 5 healthy BALB/c mice were isolated, cultured, and purified by collagenase digestion in vitro. The 3rd passage of cells were collected for morphologic observation, detection of expressions of surface markers CD31, CD34, CD45, CD90, and CD105 with flow cytometer, and identification of adipogenic and osteogenic differentiation. (2) HaCaT cells were incubated in water at 51.5 °C for 35 seconds to reproduce thermal injury model, and then the apoptosis rate was detected immediately after injury by flow cytometer. (3) Thermally injured HaCaT cells were divided into routine culture group (RC, cultured with DMEM containing 10% FBS), serum-free group (cultured with serum-free DMEM), 50%ADSC-CM group (cultured with DMEM containing 50%ADSC-CM), and 100%ADSC-CM group (cultured with 100%ADSC-CM) according to the random number table. After 24 hours, apoptosis of HaCaT cells was observed by acridine orange-ethidium bromide (AO-EB) staining; apoptotic rate was determined by flow cytometer; the mRNA and protein levels of Bcl-2 and caspase-3 were respectively determined by real-time fluorescent quantitative RT-PCR technique and Western blotting (protein level was denoted as gray value); the cell cycles were determined by flow cytometer. All above experiments were repeated for 3 times. Data were processed with one-way analysis of variance and LSD- t test.

RESULTS(1) The 3rd passage of cells proliferated well showing fusiform shape similar to fibroblasts. The positive expression rates of CD31, CD34, and CD45 were less than 10.0%, while those of CD90 and CD105 were above 90.0%. The cells could differentiate into adipocytes and osteoblasts. They were identified as ADSCs. (2) Immediately after injury, apoptotic rate of HaCaT cell was (9.8 ± 0.4)%. (3) The number of apoptotic cells was significantly higher in serum-free group than in the other three groups with AO-EB staining. The apoptotic rate of serum-free group [(8.1 ± 1.2)%] was significantly higher than that of 50%ADSC-CM group [(6.0 ± 0.8)%], group RC [(4.6 ± 0.8)%], or 100%ADSC-CM group [(3.1 ± 0.4)%], with t values respectively 3.02, 4.96, 6.60, P values below 0.01. There was no statistically significant difference in apoptotic rate between group RC and 100% ADSC-CM group (t = 1.50, P > 0.05), while statistically significant difference was found between 100% ADSC-CM group and 50%ADSC-CM group (t = 10.21, P < 0.01). (4) The mRNA level of Bcl-2 of serum-free group (0.34 ± 0.08) was significantly lower than that of group RC, 50%ADSC-CM group, and 100%ADSC-CM group (0.98 ± 0.04, 0.77 ± 0.05, 1.06 ± 0.04, with t values respectively 12.87, 8.07, 14.11, P values below 0.01). Compared with that of 100%ADSC-CM group, the mRNA level of Bcl-2 of group RC was slightly decreased (t = 0.08, P > 0.05) and that of 50%ADSC-CM group was significantly decreased (t = 8.08, P < 0.01). (5) The mRNA level of caspase-3 of serum-free group (1.15 ± 0.05) was obviously higher than that of 50%ADSC-CM group (0.72 ± 0.11), group RC (0.41 ± 0.03), or 100%ADSC-CM group (0.38 ± 0.11), with t values respectively 6.93, 13.97, 22.79, P values below 0.01. Compared with 100%ADSC-CM group, the mRNA level of caspase-3 was slightly increased in group RC (t = 0.05, P > 0.05) and significantly increased in 50%ADSC-CM group (t = 4.77, P < 0.01). (6) The protein level of Bcl-2 was significantly lower in serum-free group (0.93 ± 0.04) than in group RC, 50%ADSC-CM group, and 100%ADSC-CM group (1.74 ± 0.06, 1.32 ± 0.05, 1.90 ± 0.04, with t values respectively 20.45, 11.15, 31.38, P values below 0.01). Compared with that of 100%ADSC-CM group, the protein level of Bcl-2 of group RC was slightly decreased (t = 1.33, P > 0.05), but that of 50%ADSC-CM group was obviously decreased (t = 17.30, P < 0.01). (7) The protein level of caspase-3 was obviously higher in serum-free group (0.63 ± 0.08) than in 50%ADSC-CM group, group RC, and 100%ADSC-CM group (0.46 ± 0.03, 0.29 ± 0.08, 0.21 ± 0.03, with t values respectively 3.28, 5.05, 8.46, P values below 0.01). Compared with that of 100%ADSC-CM group, the protein level of caspase-3 of group RC was slightly increased (t = 0.08, P > 0.05), but that of 50%ADSC-CM group was significantly increased (t = 3.52, P < 0.05). (8) Compared with that of serum-free group, the percentage of cells in G2/M phase of each of the other 3 groups was significantly decreased (with t values respectively 6.88, 4.08, 7.28, P < 0.05 or P < 0.01). Compared with that in serum-free group, the percentage of cells in S phase was significantly increased in group RC and 100% ADSC-CM group (with t values respectively 2.67 and 2.40, P values below 0.05). There was no statistically significant difference in the percentage of cells in G0/G1 phase among all groups (F = 0.70, P > 0.05).

CONCLUSIONS100% xenogeneic ADSC-CM can suppress apoptosis of HaCaT cells induced by thermal injury through regulating the expression of Bcl-2 and caspase-3, and accelerate cell cycle progression by ameliorating the retardation of cell growth in G2/M phase, and all these effects may give rise to some potential in the treatment of burn wounds at early stage.

Adipocytes ; Adipose Tissue ; Animals ; Apoptosis ; physiology ; Burns ; Caspase 3 ; metabolism ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Culture Media, Conditioned ; Fibroblasts ; Humans ; In Vitro Techniques ; Keratinocytes ; metabolism ; physiology ; Mice ; Mice, Inbred BALB C ; Real-Time Polymerase Chain Reaction ; Stem Cells