Apolipoprotein A5(ApoA5)level and other indices were determined in patients with type 2 diabetes mellitus and healthy individuals.Compared to control group,ApoA5 level in the diabetic group was lower (P

Misdiagnosis and missed diagnosis are common in forensic appraisal of orbital fracture. Now imaging technology is very important for studying the forensic features of orbital fracture and evaluating the degree of injury. This article reviews the classification, pathogenesis and imaging diagnosis of orbital fracture. It may do some help to forensic appraisal of orbital fracture.
Forensic Medicine ; Humans ; Magnetic Resonance Imaging ; Orbital Fractures/diagnosis* ; Tomography, X-Ray Computed

Objective To observe the effect of early goal directed therapy (EGDT) on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.Methods A prospective observational study was carried out in 20 patients with early septic shock admitted to ICU within 24 hours after onset.Patients with one of following conditions,including stroke,brain injury,other types of shock,severe heart failure,acute myocardium infarction,ages below 18,pregnancy,terminal stage of disease,cardiac arrest,extensive bums,mouth bleeding,oromandiblular dyetonia (difficult to open the mouth),and the time elapsed over 24 hours after onset of septic shock,were excluded.The eligible patients were treated with the standard procedure of EGDT.The partial pressure of transcutaneous oxygen and carbon dioxide (PtcO2,PtcCO2) was monitored and hemodynamic data were recorded.Sidestream dark field imaging device was applied to detect the sublingual microcirculation.Hemodynamics,tissue oxygen,and sublingual microcirculation were compared before treatment and after EGDT.When the variables met the normal distribution,t test was applied.Otherwise,Wilcoxon test was used.Correlation between variables was analyzed with Pearson Correlation Analysis.Results Of 20 patients,19 met all 4 elements in criteria of EGDT after treatment and were eligible for study.PtcO2 and PtcCO2 were monitored in 19 patients.Sublingual microcirculation was obtained in four of them.(1) After the criteria of EGDT were entirely met,PtcO2 increased from (62.7 ± 24.0) mm Hg to (78.0 ± 30.9) mm Hg (P ＜ 0.05) ; tissue oxygenation index (PtcO2/FiO2) was (110.7 ± 60.4) mm Hg before treatment and (141.6 ± 78.2) mm Hg after EGDT (P ＜ 0.05).PtcCO2 and PaCO2 gap (difference between PtcCO2 and PaCO2) decreased significantly after EGDT (P ＜ 0.05).(2) Both proportion of small vessels with perfusion (PVP) and microcirculatory flow index of small vessels (MFI) showed a trend of increase after EGDT,but there were no significant differences between pre-and post-EGDT (P was 0.051 and 0.074 respectively).(3) PtcO2,PtcO2/FiO2,and PtcCO2 were not linearly related to central venous saturation,lactate,oxygen delivery,and oxygen consumption (All P ＞ 0.05).Conclusions Peripheral perfusion improved after EGDT in patients with septic shock but those hemodynamic variables might not exactly reflect the authenticity of global perfusion.

BACKGROUND: This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock. METHODS: Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 months), and they didn't meet the criteria of EGDT. Patients who had one of the following were excluded: stroke, brain injury, other types of shock, severe heart failure, acute myocardial infarction, age below 18 years, pregnancy, end-stage disease, cardiac arrest, extensive burns, oral bleeding, difficulty in opening the mouth, and the onset of septic shock beyond 24 hours. Patients treated with the standard protocol of EGDT were included. Transcutaneous pressure of oxygen and carbon dioxide (PtcO2, PtcCO2) were monitored and hemodynamic measurements were obtained. Side-stream dark field (SDF) imaging device was applied to obtain sublingual microcirculation. Hemodynamics, tissue oxygen, and sublingual microcirculation were compared before and after EGDT. If the variable meets the normal distribution, Student's t test was applied. Otherwise, Wilcoxon's rank-sum test was used. Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method. RESULTS: Twenty patients were involved, but one patient wasn't analyzed because he didn't meet the EGDT criteria. PtcO2 and PtcCO2 were monitored in 19 patients, of whom sublingual microcirculation was obtained. After EGDT, PtcO2 increased from 62.7±24.0 mmHg to 78.0±30.9 mmHg (P<0.05) and tissue oxygenation index (PtcO2/FiO2) was 110.7±60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT (P<0.05). The difference between PtcCO2 and PCO2 decreased significantly after EGDT (P<0.05). The density of perfused small vessels (PPV) and microcirculatory flow index of small vessels (MFI) tended to increase, but there were no significant differences between them (P>0.05). PtcO2, PtcO2/FiO2, and PtcCO2 were not linearly related to central venous saturation, lactate, oxygen delivery, and oxygen consumption (P>0.05). CONCLUSION: Peripheral perfusion was improved after EGDT in patients with septic shock, and it was not exactly reflected by the index of systemic perfusion.

OBJECTIVEParkinson's disease (PD), a neurodegenerative disorder, has been reported to be associated with brain neuroinflammation in its pathogenesis. Herein, changes in peripheral immune system were determined to better understand PD pathogenesis and provide possible target for treatment of PD through improvement of immune disorder.

METHODS1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was intraperitoneally injected into mice to prepare PD model. Expression levels of pro-inflammatory and anti-inflammatory cytokines and transcription factors of CD4+ T lymphocyte subsets in spleen and mesenteric lymph nodes and concentrations of the cytokines in serum were examined on day 7 after MPTP injection. Percentages of CD4+ T lymphocyte subsets were measured by flow cytometry.

RESULTSMPTP induced PD-like changes such as motor and behavioral deficits and nigrostriatal impairment. Expression levels of the pro-inflammatory cytokines including interferon (IFN)-γ, interleukin (IL)-2, IL-17 and IL-22, in spleen and mesenteric lymph nodes were upregulated and their concentrations in serum were elevated in PD progression. But, the concentrations of the anti-inflammatory cytokines including IL-4, IL-10 and transforming growth factor (TGF)-β were not altered in the two lymphoid tissues or serum of PD mice. In addition, expression of T-box in T cells (T-bet), the specific transcription factor of helper T (Th) 1 cells, was downregulated, but expression of transcription factor forkhead box p3 (Foxp3), the transcription factor of regulatory T (Treg) cells, was upregulated. In support of the results, the numbers of IFN-γ-producing CD4+ cells (Th1 cells) were reduced but CD4+CD25+ cells (Treg cells) were elevated in both the lymphoid tissues of PD mice.

CONCLUSIONPD has a dysfunction of peripheral immune system. It manifests enhancement of proinflammatory response and CD4+ T cell differentiation bias towards Treg cells away from Th1 cells.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; CD4-Positive T-Lymphocytes ; pathology ; Cell Differentiation ; Cytokines ; blood ; Disease Models, Animal ; Flow Cytometry ; Forkhead Transcription Factors ; metabolism ; Interferon-gamma ; blood ; Interleukin-10 ; blood ; Interleukin-17 ; blood ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Interleukins ; blood ; Lymph Nodes ; cytology ; Lymphocyte Activation ; Mice ; Parkinson Disease ; immunology ; physiopathology ; Spleen ; cytology ; T-Box Domain Proteins ; metabolism ; T-Lymphocytes, Regulatory ; Th1 Cells ; Transforming Growth Factor beta ; blood

OBJECTIVEWe used an animal model of collagen-induced arthritis (CIA) to study changes and roles of tyrosine hydroxylase (TH) expressed by CD4+ T cell subsets, and then explore the relationship between CD4+ T cell subset-derived catecholamines and inflammatory responses in CIA.

METHODSThirty-six male DBA/1 mice were randomly divided into control group, CIA model group (day 35) and CIA model group (day 55) (n = 12). CIA model was induced by type II collagen (CII) in DBA/1 mice. On the 35th and 55th day following primary immunization, the joints of the mice were observed for clinical score of swelling and the level of anti-CII IgG antibody in serum was examined. Expression of specific transcription factors and cytokines of Th1, Th17, Th2 and Treg cells and TH in mesenteric lymph nodes was measured by means of Western blot. The changes of TH expressed by CD4+ T cell subsets in mesenteric lymph nodes were determined by flow cytometry.

RESULTSClinical score and anti-CII antibody level increased in CIA compared with that in intact mice. Specific transcription factors and cytokines expressed by Th1 and Th17 cells were upregulated and cytokines expressed by Th2 and Treg cells were downregulated in mesenteric lymph nodes in CIA mice. Expression of TH was upregulated and the increased expression of TH in CD4+ T cells was attributed to Th1 and Th17 cells in mesenteric lymph nodes of CIA.

CONCLUSIONThe increase in catecholamines from CD4+ T cell subsets in mesenteric lymph nodes of CIA may be related to inflammatory alleviation in CIA progression.

Animals ; Arthritis, Experimental ; immunology ; CD4-Positive T-Lymphocytes ; enzymology ; Collagen Type II ; adverse effects ; Cytokines ; metabolism ; Disease Models, Animal ; Lymph Nodes ; immunology ; Male ; Mice ; Mice, Inbred DBA ; T-Lymphocyte Subsets ; immunology ; Transcription Factors ; metabolism ; Tyrosine 3-Monooxygenase ; metabolism

Objective To investigate the incidence of auditory nerve pathway injury complicated with cere- bral palsy(CP) and its related factors relationship between the incidence rate of it and sexes,classification and risk factors. Methods The clinical data of 272 children with CP,including the data of brainstem auditory evoked po- tentials,were retrospectively reviewed.The incidence of auditory nerve pathway injury and the related factors were analyzed.Results In the 272 CP children,the incidence of auditory nerve pathway injury was 29.8% (81:272), which had a significantly relationship with the clinical types of CP (P0.05).In addition,it was found that the pathological jaundice (OR=2.945,95% CI:1.649-5.260) and intrauterine infection (OR=3.319,95% CI:1.037-10.625) were significantly related to auditory nerve pathway injury. Conclusion The auditory nerve pathway injury is common in CP children,especially in those with athetosis and mixed CP.Pathological jaundice and intrauterine infection are the risk factors of auditory nerve pathway injury.

Objective To investigate the possible role of interstitial cell of Cajal (ICE)in the pathogenesis of diabetic gastroparesis and the protective effect of"Xiaopi prescription (消痞方)".Methods Fifty healthy male Spregue-Dawley (SD) rats were randomly divided into 5 groups (each n=10):normal, model,and 3 Xiaopi prescription groups:low,middle and high dosages.Diabetes was induced by intravenous injection of alloxan,and equal amount of normal saline was intravenously injected in the normal group.Gastric lavage method was used to administer the traditional Chinese medicine decoction of Xiaopi prescription in corresponding amount (5,10 and 20 g?kg~(-1)?d~(-1)) in respective low,middle and high dosage groups.In the normal control group and diabetic model group,only equal amount of normal saline was administered into the stomach.Gastric emptying rate was measured by method of nutritious semisolid paste;c-kit positive cells of ICC were quantitatively measured with immunohistochemistry assay and computer image analysis system;c-kit mRNA positive cells were quantitatively measured with in situ hybridization and computer image analysis system.Results①Gastric emptying rate:The rate was significantly lower in the model group than that in the normal control group (P0.05),but higher than those in the model group and the low dosage group (all P0.05).②c-kit immmunohistochemistry:c-kit positive cell presented yellow in color,and its membrane was stained yellow,this kind of cells primarily were distributed around the neural plexus in the inter-space between the circular and longitudinal muscular fibers, and around the ganglionic cells forming"sheath-like"structure.The results of numbers of c-kit positive cells in the various groups:the number of the cells in the model group was significantly lower than that in the normal group (P0.05),but the numbers in the former two dosage groups were obviously higher than those in the model group (all P0.05),being significantly lower than that in the normal group,middle and high dosage groups (all P0.05),but obviously higher than those in the model group (all P0.05),being significantly lower than that in the normal,middle and high dosage groups (all P

The artificial seeds of Dendrobium huoshanese was produced with Auxiliary buds, Protocorm-like bodies, and adventitious shoots. By using orthogonal experiment, we studied the effect of Maltose (%), hormone rate between 6-BA (mgx L(-1)) and NAA (mgL(-1)), active carbon (%), sodium alginate (%), time of ion exchange (min) on germination rate of artificial seeds of D. huoshanese. Then the leaking rate of maltose and variation of pH value of artificial seed capsule during vegetating of artificial seeds of D. huoshanese was measured. The results show that maltose played the most important role in inducing D. huoshanese artificial seeds to germinate. The optimal combination was: maltose 4%, hormone rate between 6-BA (mg x L(-1)) and NAA (mg x L(-1)) 10:1, active carbon 0.1%, sodium Alginate 4%, time of ion exchange is 10 min. Protocorm-like bodies were appropriate propagartor, the germination rate of artificial seeds of D. huoshanese takeing Protocorm-like bodies as the propagartors is 90.1%. After germination, the survival rate of seedlings of artificial seeds was 80.6%, the leaking rate of maltose of artificial seed capsule was 0.52%, and the pH value of artificial seed capsule decreased during the process of vegetation of artificial seeds. After having been stored at 4 degrees C for 20 d, the germination rate of artificial seeds of D. huoshanese takeing Auxiliary buds, Protocorm-like bodies, Adventitious shoots as the propagartors were 3.3%, 10.6%, 5.2%. Under natural conditions the germination rate was 13.8% after 10.0 g/L carbendazim was appended into artificial seed capsule. This result provides a foundation of manufacture and further study of the artificial seeds of D. huoshanese.
Alginates ; pharmacology ; Charcoal ; pharmacology ; Culture Techniques ; methods ; Dendrobium ; growth & development ; Germination ; Glucuronic Acid ; pharmacology ; Hexuronic Acids ; pharmacology ; Maltose ; pharmacology ; Plant Shoots ; growth & development ; Seeds ; growth & development

OBJECTIVETo compare curative effects of various surgical procedures of bile duct stones.

METHODSTwo thousand nine hundred and fifty-five patients with intrahepatic bile duct lithiasis who had undergone various surgical procedures were analysed with Meta-analysis. Some of these cases were reported in Chinese Medical Journals from January 1990 to March 2001 and others were from Tongji Hospital.

RESULTSThere was a significant difference between curative effects of non-hepatectomy and that of hepatectomy (chi(2) = 62.945, P < 0.01), and the outcomes of hepatectomy were much better than those of non-hepatectomy with OR(S) equalled to 0.303 (0.222 - 0.413). There was not a significant difference between curative effect of interposed jejunum and that of hepatectomy (95% CI of RR from 0.98 to 1.04). All the other operation, effects were worse than hepatectomy (upper limit of 95% CI of RR < 1).

CONCLUSIONSHepatectomy is the most ideal surgery for intrahepatic bile duct stones and operation methods should be diversified since good effect could also be obtained when other operations are performed on suitable cases.

Bile Duct Diseases ; surgery ; Bile Ducts, Intrahepatic ; Choledochostomy ; statistics & numerical data ; Cholelithiasis ; surgery ; Follow-Up Studies ; Hepatectomy ; statistics & numerical data ; Humans ; Treatment Outcome