Objective To examine outcomes of superficial vein stripping for vein varicosis caused by combination of superficial and deep venous reflux and the effect on deep vein reflux. Methods From January 2004 to December 2006, twenty patients (22 lower extremities) with combined superficial and deep venous reflux were enrolled for evaluation, patients with superficial venous reflux alone worked as controls.All patients underwent superficial vein stripping and followed up for 2 years. Venous clinic severity score (VCSS) and color duplex ultrasound test were used to evaluate the change of clinic symptoms and valve reflux of deep veins. Results Preoperative VCSS of superficial and deep vein reflux group and superficial vein reflux group was 7.1 ± 2. 9 and 6. 6 ± 2. 0 respectively (P = 0. 44). At two years after operation the VCSS was 2. 3 ± 1.2 and 1.8 ± 0. 8 respectively without significant statistic differences, whereas comparing postoperative VCSS with individual preoperative parameters there was a significant decrease (P <0. 01). In combined superficial and deep vein group, deep venous reflux reduced in 7 limbs, progressed in 4 limbs, no change in 12 limbs. While in superficial reflux alone group, deep venous reflux occurred in 4 limbs.Conclusions Superficial vein stripping effectively improves symptoms of great saphenous vein varicosis of lower extremity caused by combination of superficial and deep vein reflux without a significant effect on the stares of deep vein reflux.

A case with horizontal and vertical bone deficiency at the maxillary esthetic area is reported.A titanium disk was applied to maintain the space for guided bone regeneration,and ridge splitting and bone compressing technique were used to prepare the site.Finally,the restoration of implant tooth with favorable esthetic outcome was obtained.

OBJECTIVETo study the expression of tumorigenesis-related stem cell markers Lgr5 and CD44 in different pathological types of intestinal polyps and their clinical significance in predicting tumorigenesis.

METHODSA total of 145 cases of colorectal polyps, adenomas and cancer tissues were obtained by colonoscopy biopsy. Immunohistochemistry was employed to detect the expression of Lgr5 and CD44 to analyze their relationship with the occurrence and prognosis of colon and rectal cancer.

RESULTSThe expression of CD44 in colon cancer tissue was 95.65%, significantly higher than that in normal mucosa (5%), inflammatory hyperplastic polyps (22.58%), tubular adenomatous polyps (55.26%) and villous polyps (75.76%) (P<0.05). The expression of Lgr5 in colorectal cancer was up to 95.65% while negative in normal colorectal tissue and was 16.12% in inflammatory hyperplastic tissues (P<0.05). The expression rate of Lgr5 was 86.84% in tubular adenoma and 93.94% in villous polyps, both comparable with that in colon cancer (P>0.05). Correlation analysis indicated that the expression of CD44 and Lgr5 were positively correlated with the progression of intestinal polyp tumorigenesis (rs=0.69377, P<0.0001; rs=0.81637, P<0.0001).

CONCLUSIONLgr5 and CD44 are highly expressed in colorectal cancer tissues in close correlation with the clinical and pathological features. The expression profiles of Lgr5 and CD44 represent a distinct feature to differentiate colorectal cancer from normal intestinal mucosa. Lgr5 is more closely correlated with tumor progression of polyps than CD44. This means detecting of the expression of Lgr 5 together with CD44 is important and necessary in clinical diagnosis of patients with early stage colorectal diseases such as polyps and their canceration.

Adult ; Aged ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Hyaluronan Receptors ; metabolism ; Intestinal Polyps ; metabolism ; pathology ; Male ; Middle Aged ; Prognosis ; Receptors, G-Protein-Coupled ; metabolism ; Young Adult

OBJECTIVE: To explore the clinical phenotype and pathogenic variants in a Chinese pedigree affected with Smith-Lemli-Opitz syndrome. METHODS: Peripheral blood samples were collected from five members, including two affected ones, from the pedigree for the extraction of genomic DNA. Whole exome sequencing was carried out, and candidate variants were verified by Sanger sequencing as well as reverse transcription sequencing at the RNA level. RESULTS: The proband and another affected child from the pedigree showed mental retardation, dyskinesia, microcephaly, micrognathia, anteverted nares, and 2/3 toe syndactyly. The proband also had hypospadia, single upper incisor, and lower serum cholesterol level. Both children were found to harbor a paternally derived c.278C>T (p.T93M) variant and a maternally derived c.907G>A (p.G303R) variant of the DHCR7 gene. Both were known pathogenic mutations. CONCLUSION The compound heterozygous mutations of c.278C>T (p.T93M) and c.907G>A (p.G303R) of the DHCR7 gene probably underlay the disease in this pedigree. Above finding has enabled early diagnosis and treatment of Smith-Lemli-Opitz syndrome.
Child ; Genetic Testing ; Humans ; Oxidoreductases Acting on CH-CH Group Donors/genetics* ; Pedigree ; Phenotype ; Smith-Lemli-Opitz Syndrome/genetics*

Objective To detect the expression level of 4-aminobutyrate aminotransferase(ABAT)in bone marrow of patients with myelodysplastic syndrome(MDS),and analyze its influence on clinicopathological features and prognosis of patients.Methods From January 2016 to March 2020,92 patients with MDS and 30 patients with acute myeloid leukemia(AML)from the First Affiliated Hospital of Xingtai Medical College were retrospectively collected.Meanwhile,30 patients with immunothrombocytopenia who did not develop MDS or other clonal diseases of the blood system during a 3-year follow-up were collected as control group.Real-time quantitative fluorescent PCR(qRT-PCR)was used to detect the relative expression level and methylation level of ABAT mRNA of all patients,and the relative expression level and methylation level of ABAT mRNA among different clinical characteristics of MDS patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors affecting the adverse prognosis of MDS.The clinical value of detecting ABAT methylation level in predicting poor prognosis of MDS patients was analyzed by receiver operating characteristic(ROC)curve.Kaplan-Meier method was used to calculate the 3-year survival rate between groups with different ABAT mRNA relative expression levels and methylation levels,and log-rank test was used for their comparison.Results The expression level of ABAT mRNA in MDS group(0.42±0.08)was lower than that in control group(0.56±0.15)and AML group(0.52±0.10),while the methylation level of ABAT(32.51±5.32)was higher than that of AML group(26.21±4.58)and control group(10.25±4.31),and the differences were significant(t=4.251,4.562;10.415,8.326,all P<0.001).The methylation level of ABAT in high-risk patients(42.65±5.32)was higher than that in low-risk patients(25.63±4.16),intermediate-risk-1 patients(30.59±2.51)and intermediate-risk-2 patients(33.25±3.69)by IPSS risk grade,and the differences were significant(t=8.329,7.077,15.874,all P<0.001).Poor Karyotype analysis result[OR(95%CI):4.973(1.524～8.581),P=0.004],high IPSS risk grade[OR(95%CI):8.542(2.365～14.521),P<0.001]and ABAT hypermethylation level[OR(95%CI):6.178(1.589～13.021),P<0.001]were the risk factors affecting the poor prognosis of MDS.The cut-offvalue of ABAT methylation level to predict the poor prognosis of MDS were 30.54,and the area under the curve(AUC),the sensitivity and specificity were 0.92,0.874 and 0.851,respectively.The 3-year survival rate of the high ABAT methylation group(>30.54)was 66.67%,which was lower than that of the low ABAT methylation group(≤30.54)was 93.18%,with significant difference(Log-rank x2=9.814,P=0.002).Conclusion The ABAT methylation levels in MDS bone marrow increase,which is a risk factor affecting the poor prognosis of patients.ABAT basal level>30.54 is expected to become a factors predicting the poor prognosis of patients.

Objective:To observe the effect of Xuebijing injection on sepsis combined with acute gastrointestinal injury (AGI), and analyze the risk factors of sepsis combined with AGI.Methods:A retrospective cohort study was conducted. Patients with non-gastrointestinal origin admitted to the department of intensive care medicine of the First Hospital of Qinhuangdao from May 1, 2021 to October 30, 2023 were enrolled. The baseline data, source of sepsis infection, vital signs, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), laboratory tests, comorbidities, interventions during treatment, and the 28-day prognosis were collected. The patients were divided into Xuebijing group and non-Xuebijing group according to whether Xuebijing injection was used or not. According to whether AGI was merged or not, patients were divided into merged AGI group and non-merged AGI group. The main observational indexes were the difference in the incidence of AGI between the Xuebijing group and non-Xuebijing group and the difference in the magnitude of the decline in procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) at 7 days after admission, and the difference in the 28-day morbidity and mortality. Risk factors for AGI in septic patients were explored by univariate analysis, and statistically significant indicators were screened and included in binary Logistic regression analysis to determine independent risk factors.Results:A total of 129 patients with sepsis of non-gastrointestinal origin were enrolled, including 57 patients in the Xuebijing group and 72 patients in the non-Xuebijing group. Among 129 patients, 80 patients in the merged AGI group and 49 patients in the non-merged AGI group. There were no statistically significant differences between Xuebijing group and non-Xuebijing group in gender, age, body mass index (BMI), underlying disease, source of infection, vital sign, APACHEⅡscore, SOFA score, and clinical intervention, and there were no statistically significant differences in laboratory tests except for aspartate aminotransferase (AST) and blood urea nitrogen (BUN). The incidence of AGI was significantly lower in the Xuebijing group than that in the non-Xuebijing group [50.87% (29/57) vs. 70.83% (51/72), P < 0.05], and the 28-day mortality was slightly lower than that in the non-Xuebijing group [24.56% (14/57) vs. 30.56% (22/72), P > 0.05]. In the Xuebijing group, the decreases in CRP, PCT and WBC at 7 days after admission were greater than those in the non-Xuebijing group, with statistically significant differences in the decreases of CRP and PCT [CRP (mg/L): 47.12±67.34 vs. 7.76±111.03, PCT (μg/L): 14.08 (-1.22, 50.40) vs. 2.94 (-1.27, 14.80), all P < 0.05]. Univariate analysis showed that the use of acid suppressants, the use of analgesic sedation, the non-use of Xuebijing injections, pulmonary infections, and urinary tract infections were the risk factors for the development of AGI in patients with sepsis. Binary Logistic regression analysis further showed that the use of acid suppressants [odds ratio ( OR) = 2.450, 95% confidence interval (95% CI) was 1.021-5.883, P = 0.045], use of analgesic sedatives ( OR = 2.521, 95% CI was 1.074-5.918, P = 0.034), and urinary tract infection ( OR = 4.011, 95% CI was 1.085-14.831, P = 0.037) were independent risk factors for sepsis combined with AGI, in which the use of Xuebijing injection was a protective factor ( OR = 0.315, 95% CI was 0.137-0.726, P = 0.007). Conclusions:Xuebijing injection reduced the incidence of AGI in patients with non-gastrointestinal sepsis. PCT and CRP decreased more markedly than in patients who did not use Xuebijing injection. The use of acid-suppressing agents, analgesic and sedative agents, and urinary tract infections were independent risk factors for sepsis in combination with AGI, while the use of Xuebijing injection is a protective factor.

The sufficiency of hard and soft tissue at the implant site is the guarantee of long-term function, health and the appearance of implant denture. Problem of soft tissue recession at the implant site has always been bothering dentists. Traditional methods for augmentation of soft tissue such as gingival transplantation have disadvantages of instability of the increased soft-tissue and more trauma. Lately the methods that base on tissue engineering to increase the soft tissue of peri-implant sites have drawn great attention. This review focuses on the current methods of peri-implant restoration through tissue engineering, seed cells, biological scaffolds and cytokines.
Dental Implants ; Dental Research ; trends ; Gingiva ; Gingival Recession ; therapy ; Humans ; Tissue Engineering ; methods

OBJECTIVE： To study the vasodilatory effect of oxysophocarpine （OSC） on isolated thoracic aortic rings of rats and its possible mechanism. METHODS： Thoracic aortic rings of rats were collected （called “vascular ring” for short）. Using K-H nutrient solution as blank control and the diastolic rate as index， the effects of different concentrations （0.2-1.0 mg/mL） of OSC on normal vascular rings in basal state， normal or endothelium-free vascular rings pre-contracted by norepinephrine （PE， 1×10－6 mol/L） were investigated. After pre-culturing normal thoracic aortic rings by nitric oxide synthase inhibitor L-nitro-arginine methyl ester（L-NAME）and cyclooxygenase inhibitor indomethacin（INDO），as well as pre-culturing endothelium-free vascular rings by potassium ion channel blocker BaCl2，tetraethylammonium（TEA）and 4-aminopyridine（4-AP）， the diastolic effects of OSC of different concentrations （0.2-1.0 mg/mL） on the above vascular rings were investigated by using the same method. RESULTS： Compared with blank control， there was no significant effects of different concentrations of OSC on the diastolic rate of normal vascular rings in basal state （P＞0.05）， but 0.4-1.0 mg/mL OSC could significantly improve the diastolic rate of normal or endothelium-free vascular rings pre-contracted by PE （P＜0.01）， in concentration-dependent manner. After preculturing with L-NAME， INDO， 4-AP and BaCl2， different concentrations of OSC had no significant effect on the diastolic rate of normal or endothelium-free vascular rings pre-contracted by PE （P＞0.05）. After pre-culturing with TEA and Gli， 0.4-1.0 mg/mL OSC could significantly reduce the diastolic rate of endothelium-free vas- cular rings pre-contracted by PE （P＜0.01）. CONCLUSIONS： OSC did not significantly dilate the thoracic aortic rings of rats in the basal state within the dose range （0.2-1.0 mg/mL）， but OSC of 0.4-1.0 mg/mL have significant diastolic effects on the normal or endothelium-free thoracic aortic rings of rats pre-contracted with PE. The mechanism of thoracic aortic rings dilation is endothelium-independent， which may be associated with receptor operational calcium channel，Ca2+-activated potassium channels and ATP-sensitive potassium channels.