Object To study the antiinflammatory effect of matrine and its active mechanism. Methods The matrine effects on activities of secretory phospholipase A 2 (sPLA 2) in peripheral serum and cytosolic phospholipase A 2 (cPLA 2) in leucocyte were measured with Escherichia coli membrane incorporated by arachidonic acid as the substrate; the Ca 2+ level of leucocyte was determined using Frua2 AM loading method, and the rat plantar swelling test was used to examine the antiinflammatory effect of matrine. Results One hour after ip 30 mg/mL matrine, the inhibitory rate of sPLA 2 activity was (81.9?1.8)% , cPLA 2 (28.4?6.0) %, while Ca 2+ concentration was (157.10?20.56) nmol/L which was 15.3% higher than that of the control. Plantar swelling test showed that matrine had a significant anti inflammatory effect. Conclusion Matrine is a novel PLA 2 inhibitor with anti inflammatory effect.

To improve the teaching quality of neonatal diseases,we analyzed the diseases register of 760 neonates hospitalized in one year,two editions of textbook of pediatrics and the teaching outline,8 times of examination after the students had finished the exercitation.Accounted for 88.55%,673 cases of the neonates suffered from 15 diseases,which were included in the 17 diseases required by the teaching outline.Among the 669 cases of the neonates suffering from 10 common diseases,105 cases suffered from 5 diseases,which were not required by the teaching outline.As the second common disease,neonatal pneumonia was asked to be familiar with instead of mastering by the students.Accounted for 58.82%,10 diseases were required by the teaching outline without having them in the exams.Therefore it is important:1.to stand out the keystone on the clinic teaching of neonatal diseases such as neonatal jaundice,premature,and pneumonia which were required by the teaching outline as well as herpangina,vomit,humid lung-which were common diseases.2.to put neonatal vomit into the textbook and ask the students to master neonatal pneumonia.3.to perfect the setting of test paper:in the test paper neonatal diseases accounting for 20.00%,the diseases required by the teaching outline accounting for 85.00%.The proportion of important diseases to common diseases is 1.80∶1.

Objective To explore the clinical value of the level of granzyme B and perforin mRNA in urine for the diagnosis of renal transplantation patients with delayed graft function (DGF). Methods Twenty-four cases of renal transplantation patients with DGF were included in this study. Seventy-three u-rine specimens were obtained from these patients who received graft biopsies. Among the 24 cases, ureteral obstruction occurred in 2 cases, vascular thrombosis in 1 case, acute CsA intoxication in 3 cases, acute tubu-lar necrosis (ATN) in 7 cases, ATN complicating borderline change in 2 cases, ATN complicating acute re-jection (AR) in 3 cases, AR in 6 cases. Total RNA was isolated from the urinary cells. Messenger RNA (mRNA) encoding the cytotoxic proteins perforin and granzyme B gene were measured with the quantitative polymerase-chain-reaction assay-(RT-PCR). SPSS13.0 software was used for data analysis. Levels of mRNA were log-transformed before analysis. Results The levels of perforin and granzyme B mRNA in u-rine among the ureteral obstruction group, vascular thrombosis group, acute CsA intoxication group and ATN group were very low. There was no significant difference among these groups (P>0.05). However,among the ATN complicating borderline change group 1.22, 0. 97 fg/μg, ATN complicating AR group (1.20±0.39), (1.07±0.30)fg/μg, and AR group(11.13±0. 33), (1.01±0.19)fg/μg, the levels were increased significantly(P<0.001). Conclusion Measurement of mRNA encoding the cytotoxic proteins perforin and granzyme B gene in urinary cells in renal transplantation patients with DGF could be helpful to etiological diagnosis of DGF, and might be used as an index for the appropriate management of the borderline change.

OBJECTIVETo design and fabricate the custom-made titanium mandibular condyle by the reverse engineering technology combined with selective laser melting (SLM) technology and to explore the mechanical properties of the SLM-processed samples and the application of the custom-made condyle in the temporomandibular joint (TMJ) reconstruction.

METHODSThe three-dimensional model of the mandibular condyle was obtained from a series of CT databases. The custom-made condyle model was designed by the reverse engineering software. The mandibular condyle was made of titanium powder with a particle size of 20-65 µm as the basic material and the processing was carried out in an argon atmosphere by the SLM machine. The yield strength, ultimate strength, bending strength, hardness, surface morphology and roughness were tested and analyzed. The finite element analysis (FEA) was used to analyze the stress distribution.

RESULTSThe complex geometry and the surface of the custom-made condyle can be reproduced precisely by the SLM. The mechanical results showed that the yield strength, ultimate strength, bending strength and hardness were (559±14) MPa, (659±32) MPa, (1 067±42) MPa, and (212±4)HV, respectively. The surface roughness was reduced by sandblast treatment.

CONCLUSIONSThe custom-made titanium condyle can be fabricated by SLM technology which is time-saving and highly digitized. The mechanical properties of the SLM sample can meet the requirements of surgical implant material in the clinic. The possibility of fabricating custom-made titanium mandibular condyle combined with the FEA opens new interesting perspectives for TMJ reconstruction.

Dental Materials ; Finite Element Analysis ; Hardness ; Humans ; Lasers ; Mandibular Condyle ; Prostheses and Implants ; Prosthesis Design ; Titanium

Objective:To explore the clinical safety and efficacy of transurethral oral mucosa urethroplasty for urethral meatus and navicular fossa stricture reconstruction.Methods:Retrospective analysis of 9 patients who underwent transurethral repair of urethral meatus and navicular fossa stricture by oral mucosa in our hospital from October 2021 to December 2022. The average age was (58.4±10.4) years old. 5 patients had a history of transurethral endoscopic surgery, 2 had penile lichen sclerosis, and 2 had no obvious causes. Nine patients were diagnosed with urethral meatus and navicular fossa stricture through retrograde urethrography before surgery. The average maximum preoperative urine flow rate was(3.2±0.7)ml/s. Surgical procedure: The incision was firstly made at 6 o'clock using ophthalmic scalpel, the entire layer of urethral scar was opened, and gradually penetrated into the urethral cavity until it reached the normal mucosa of the urethra. A fan-shaped wound was obtained by cutting the scar of 4 to 8 o'clock. The enlarged urethral lumen could smoothly pass through the F24 urethral probe. Measure the stricture length and width, and trim the oral mucosa to the appropriate shape. One arm of the 5-0 absorbable suture passed through the tip of the oral mucosal flap and the normal urethral mucosa outside the apex of the urethral fan-shaped wound, and then passed through the skin on the ventral side of the penis. The other arm of the suture passed through the apex of the fan-shaped wound and passes through the skin on the ventral side of the penis. Tighten the suture to bring the oral mucosa into the urethral cavity and cover the wound surface. If the narrow length was longer, we could suture three stitches to fix the oral mucosa with the V-shaped apex of the fan-shaped wound in a similar way, and the rest could be sutured and fixed with the urethral wound edge in direct vision. The actual measured average length of urethral stricture during the surgery was(1.6±0.5) cm. The appearance of the glans penis, stricture recurrence, maximum urine flow rate, and patient's urination symptoms were recorded after surgery 1 to 3 months. Functional success was defined as the lack of patient reported obstructive voiding symptoms, satisfaction with the appearance of the glans penis, and a slit like external urethral orifice.Results:All 9 patients successfully completed the surgery and the average maximum urine flow rate was(21.5±3.7)ml/s after 3 months of follow up. The overall successful rate was 100%.One patient experienced spraying urination 1 month later after removing the catheter. Examination revealed that protrusion and separation were found at the urethral anastomosis, and symptoms disappeared after urethral dilation. The other patients did not have any obvious complications, satisfactory with the appearance of the penis head and urination.Conclusions:Transurethral oral mucosal repair of urethral meatus and navicular fossa stricture could be a safe, and effective surgical method. It not only solves the problem of urination, but also takes into account the cosmetic effect of penis.

AIM:This study aims to investigate the histopathological and ultrastructural alterations in the lung tissues of rats induced by a single intratracheal administration of bleomycin,with the objective of establishing a reliable model for future applications.METHODS:Six to eight-week-old SD rats were randomly allocated into two groups:the control group and the model group(n=12).Pulmonary fibrosis was induced in the rat models by a single intratracheal in-stillation of bleomycin(3 mg/kg),while an equivalent volume of saline was administered to the control group.The rats were executed on the 42nd day.Twelve rats remained in the control group,while nine rats remained in the model group.Lung tissue imaging was conducted using CT scans.Lung function tests were performed to assess changes in forced vital capacity(FVC)and dynamic lung compliance(Cdyn).Lung stiffness was determined through Young's modulus testing using a rheometer.The pathological structure of lung tissues was examined using both HE and Masson staining methods.Additionally,transmission electron microscopy was employed to evaluate collagen deposition in lung tissues,alveolar type Ⅱ epithelial cells,macrophages,and ultrastructural changes of the respiratory membrane.RESULTS:CT scans revealed honeycomb patterns in the lungs of model rats,along with partial bronchiectasis/bronchiectasis.In comparison to the con-trol group,the model group exhibited significantly lower FVC and Cdyn values,while lung stiffness were increased.HE and Masson staining demonstrated that rats in the model group exhibited alveolar structure destruction,alveolar septum thickening,inflammatory cell infiltration,and collagen deposition in alveolar septum.Transmission electron microscopy revealed several abnormalities in the model group:increased collagen fibers in the alveolar septa,misalignment of micro-villi in alveolar type Ⅱ epithelial cells,wrinkled nuclei with increased heterochromatin,swollen cytoplasmic mitochon-dria,fractured or haphazardly structured mitochondrion cristaes,and a significant decrease in their number(P＜0.05).Furthermore,lamellar bodies were vacuolated and reduced in number(P＜0.05),and dilated endoplasmic reticulums with degranulation were observed.There was an increase in alveolar macrophages and interstitial macrophages(P＜0.01).The respiratory membrane displayed structural disruptions and an increase in thickness(P＜0.01).CONCLUSION:Bleomycin induces decreased lung compliance,alveolar epithelial injury,alveolar septum thickening,collagen deposi-tion,and an increase in interstitial macrophages,ultimately resulting in pulmonary fibrosis in rats.

OBJECTIVES: Programmed death 1 (PD-1) associated fulminant type 1 diabetes (PFD) is a rare acute and critical in internal medicine, and its clinical characteristics are still unclear. This study aims to analyze the clinical characteristics of PFD patients to improve clinical diagnosis and treatment. METHODS: We retrospectively analyzed the clinical data of 10 patients with PFD admitted to the Second Xiangya Hospital of Central South University, combined with the data of 66 patients reported in the relevant literature, analyzed and summarized their clinical and immunological characteristics, and compared the patients with PFD with different islet autoantibody status. RESULTS: Combined with our hospital and literature data, a total of 76 patients with PFD were reported, with the age of (60.9±12.1) years old, 60.0% male and body mass index of (22.1±5.2) kg/m2. In 76 patients, the most common tumors were lung cancer (43.4%) and melanoma (22.4%). Among PD-1 inhibitors, the most common drugs are nivolumab (37.5%) and pembrolizumab (38.9%). 82.2% of PFD patients developed diabetes ketoacidosis. The median onset time from PD-1 related inhibitor treatment to hyperglycemia was 95 (36.0, 164.5) d, and the median treatment cycle before the onset of diabetes was 6 (2.3, 8.0) cycles. 26% (19/73) of PFD patients had positive islet autoantibodies, and the proportion of ketoacidosis in the positive group was significantly higher than that in the negative group (100.0% vs 75.0%, P<0.05). The onset time and infusion times of diabetes after PD-1 inhibitor treatment in the autoantibody positive group were significantly lower than those in the autoantibody negative group (28.5 d vs 120.0 d; 2 cycles vs 7 cycles, both P<0.001). CONCLUSIONS After initiation of tumor immunotherapy, it is necessary to be alert to the occurrence of adverse reactions of PFD, and the onset of PFD with islet autoantibody positive is faster and more serious than that of patients with autoantibodies negative. Detection of islet autoantibodies and blood glucose before and after treatment with PD-1 inhibitors is of great value for early warning and prediction of PFD.
Humans ; Male ; Middle Aged ; Aged ; Female ; Diabetes Mellitus, Type 1 ; Programmed Cell Death 1 Receptor ; Immune Checkpoint Inhibitors/therapeutic use* ; Retrospective Studies ; Ketosis ; Autoantibodies