Objective To investigate the pretreatment and post-treatment effect of reduced glutathione (GSH) on acute ischemia-reperfusion injury (IRI) of rat kidney. Methods Fifty adult SD rats were divided into 5 groups: control group (Sham group), ischemia reperfusion group (I/R group), GSH pretreatment group (pre-treatment group), and GSH post-processing group (post-treatment group), with ten rates in each group. Animals in pre-treatment group were injected 4% GSH 100 mg/kg intraperitoneally at 24th , 16th , 8th hour and 45th minute before surgery. Animals in post-treatment group were administrated GSH with the same dosage at 45th minute, 6th, 12th and 18th hour after surgery. Creatinine (Cr), urea nitrogen (BUN) level, the total superox-ide dismutase (T-SOD) activity, malondialdehyde (MDA) and nitric oxide (NO) levels in serum were measured at 24th hour after surgery. Histopathological changes were checked by H. E staining. Results Damage on kid-ney structure of animals in pre-treatment group was less than that in I/R group. There was little pathological change on kidney of those in pre-treatment group. Serum Cr, BUN, MDA and NO levels were all decreased but T-SOD activity increased in pre-treatment and post-treatment group when compared with those in I/R group (P <0.05), (P < 0.05). T - SOD activity in post-treatment group was higher than that in pre-treatment group (P <0.05). Conclusion GSH can protect rats against acute renal ischemia-reperfusion injury within 24 hours before and after kidney ischemia-reperfusion , especially after ischemia-reperfusion.

Objective To investigate the magnetic resonance imaging(MRI) in the diagnosis of congenital anorectal malformation.Methods Fourteen patients with congenital anorectal malformation received pelvic and sacrococcygeal MRI scan with 5 normal controls.The morphological changes of puborectalis and anal sphincter,and the abnormalities of anus,rectum,sacral vertebra and genitourinary system were observed.Results The best developed puborectalis and anal sphincter were showed in 13 cases,the better developed in 3 cases,the least developed in 3 cases,respectively.There were 7 cases with abnormalities of sacral vertebra and 5 cases with abnormalities of genitourinary system.Conclusion MRI examination plays an important role in the diagnosis of congenital anorectal malformation.The morphological changes of puborectalis and anal sphincter,and the abnormalities of sacral vertebra and genitourinary system can be determined by the MRI examination, which is important in clinical therapy planning and accessing the curative effect.

Objective To explore the value and method of using carbon nanoparticles in endoscopic treatment of papillary thyroid microcarcinoma.Method 74 cases were randomly divided into two groups,34 cases in experimental group which were injected with carbon nanoparticles,and 40 cases in the control group without any injection.All cases were analyzed in terms of the tumor size,the number of lymph nodes and parathyroid gland injury.Results All patients underwent the operation smoothly.The postoperative pathological specimens result showed there was no statistical difference of carcinoma size between the two groups.The number of lymph nodes dissected was 177 in the control group and 220 in the experimental group (the rate of lymph node black staining rate was 89％).In the experimental group,the average number of lymph node detected in each patient was 6.47±2.13,more than 4.42±1.91 in the control group.The number of parathyroid glands found in the experimental group was 3 and 11 in the control group,and the difference had no statistical significance.Postoperative temporary laryngeal recurrent nerve injury occurred to 2 cases in each group,and no statistical difference was found.Conclusion Using carbon nanoparticles in endoscopic treatment of papillary thyroid microcarcinoma can increase the detection rate of lymph node,and to some extent,reduce the parathyroid injury.It has a certain clinical significance,However,care should be taken to avoid contamination of the mirror field of view.

OBJECTIVE: To investigate the clinical characteristics and common etiology of vertigo. METHOD: The clinical data of 168 patients with vertigo in the department of otolaryngolology and neurology from December 2007 to March 2009 were retrospectively analyzed The patients were inquired and examined by pure tone average thresholds, videonystagmography, Dix-Hallpike test, cervical spine X-ray, skull CT and (or) MRI and transcranial Doppler. RESULT: One hundred and thirty-four patients with vertigo were of peripheral origin, with 66 cases benign paroxysmal positional vertigo, 30 cases Meniere's disease, 24 cases sudden deafness, 5 cases vestibular neuritis, 5 cases otitis media ,2 cases ear herpes zosters and 2 cases ototoxicity. Among 26 patients with vertigo of central, 20 patients were vertebrobasilar TIA. CONCLUSION The most common etiology of the vestibular peripheral vertigo is the benign paroxysmal positional vertigo. Detailed history and the features of vertigo, particular about the duration of vertigo and hearing change, may provide the important evidences for the accurate diagnosis and differential diagnosis of vertigo.
Adolescent ; Adult ; Aged ; Electronystagmography ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vertigo ; diagnosis ; etiology ; physiopathology ; Young Adult

OBJECTIVE: To propose the concept of rhinogenic otitis media and explore its pathomechanism through analyzing the diagnosis and treatment on secretory otitis media caused by unhealthy nasal cavity structure. METHOD: Conservative treatment and correlative operation under nasoscope were undertaken in 176 otitis media patients with unhealthy nasal cavity structure. RESULT: Of 176 cases, 156 cases recovered completely (88.64%), 18 cases got effective treatment (10.23%), and 2 cases got ineffective treatment (1.14%). CONCLUSION One important cause of the secretory otitis media is unhealthy nasal cavity structure, so correcting the unhealthy nasal cavity structure is the main ways to treat rhinogenic otitis media.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Otitis Media with Effusion ; diagnosis ; etiology ; surgery ; Young Adult

OBJECTIVETo delineate the clinical features and potential mutation of the ATP7A gene in a family affected with Menkes disease.

METHODSClinical data of a patient and his family members were analyzed. Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA) assays were performed to detect the mutation of the ATP7A gene.

RESULTSThe patient was admitted at the age of 5 months due to severe epilepsy and marked delayed psychomotor development. Significantly light complexion, pudgy cheeks and sparse fuzzy wooly hair were noted. Cranial magnetic resonance imaging and angiography revealed cortical atrophy, leukoencephalopathy and circuitous of intracranial vessels. The plasma ceruloplasmin was decreased. MLPA has identified a deletion spanning exons 8 to 12 of the ATP7A gene. His mother was found to be a heterozygous carrier of the same mutation.

CONCLUSIONThe clinical features and a novel mutation of the ATP7A gene of the family have been delineated.

Adenosine Triphosphatases ; genetics ; Adult ; Asian Continental Ancestry Group ; genetics ; Cation Transport Proteins ; genetics ; China ; Copper-transporting ATPases ; DNA Mutational Analysis ; Exons ; Female ; Heterozygote ; Humans ; Infant ; Male ; Menkes Kinky Hair Syndrome ; genetics ; Mutation ; Pedigree

Objective: To evaluate and compare the surgery prognosis of the papillary thyroid carcinoma (PTC) patients who underwent conventional and endoscopic thyroidectomies via areola. Methods: From January 2012 to December 2017, 887 patients with PTC underwent thyroidectomy. The A group of 693 patients underwent traditional thyroidectomy, and B group of 194 patients underwent endoscopic thyroidectomy. Clinicopathologic characteristics, surgical methods, pathological features and complications were analyzed and compared between two groups. Results: The mean age of A group was older than B group: (45.2 ± 11.5) years vs. (34.9 ± 9.4) years, P<0.01. The drainamount and drain maintenance in B group were significantly higher than those in A group (P<0.01). The operative methods in two group had significant difference (P<0.01). The patients in B group were successful in operation and no one transferred to open operation. The tumor size in the A group was larger than that in B group, and more bilateral multifocal tumors were in A group (P<0.01). The number of lymph nodes dissection in A group was more than that in B group (P<0.01). There was no significant difference in the postoperative complications (P > 0.05). Conclusions The results show that patients with PTC who underwent conventional and endoscopic thyroidectomies via areola have similar surgical prognosis.Therefore, choosing the appropriate cases for endoscopic thyroidectomy via breast areola approach may be regarded as an alternative surgical technique to conventional thyroidectomy which has the oncological safety and cosmetic results.

ObjectiveTo investigate the value of hepatic portal occlusion without hemihepatic artery control (hemihepatic occlusion) in liver resection for hepatocelluar carcinoma (HCC).Methods Clinical data of 422 patients with HCC undergoing liver resection in Department of Hepatobiliary Surgery, Nanfang Hospital of Southern Medical University from January 2007 to January 2013 were retrospectively analyzed. The informed consents of all patients were obtained and the ethical committee approval was received. The patients were divided into two groups according to the different hepatic inlfow occlusions:the hemihepatic occlusion group (n=140) and Pringle maneuver group (n=282). There were 114 males and 26 females in the hemihepatic occlusion group with a mean of (45±12) years old. Hemihepatic occlusion was performed in this group and the hepatic arterial branch of the healthy side was dissected up along the proper hepatic artery. The other hepatic pedicles including hepatic artery of the diseased side, hepatic portal vein and bile duct were occluded with occluding straps. There were 230 males and 52 females in the Pringle maneuver group with a mean of (47±13) years old and Pringle maneuver was performed. The differences were compared between two groups in the operation time, occlusion time, intraoperative blood loss, peak levels of blood alanine aminotransferase (ALT), total bilirubin (TB) within 5 days after operation and incidence of postoperative complications. The variation of patient quantity in the periods of 2007-2009 and 2010-2013 in two groups was observed. The data between two groups were compared byt test and the comparison of ratio was conducted by Chi-square test.ResultsThe peak levels of blood ALT, TB within 5 days after operation were (179±53) U/L, (24±9) μmol/L in hemihepatic occlusion group and were (291±126) U/L, (30±15) μmol/L in Pringle maneuver group accordingly, where signiifcant differences were observed (t=-12.757,-5.777;P<0.05). There was no signiifcant difference in the operation time, occlusion time, intraoperative blood loss and incidence of postoperative complications between two groups (P>0.05). From the year 2007 to 2009, the patients undergoing hemihepatic occlusion accounted for 24.2% (53/219) and increased to 42.9% (87/203) during the year 2010-2013. From the year 2007 to 2009, the patients undergoing Pringle maneuver accounted for 75.8% (166/219) and decreased to 57.1% (116/203) during the year 2010-2013. Signiifcant difference was observed in the variation of patient quantity between two groups (χ2=16.540,P<0.05).ConclusionsCompared with the Pringle maneuver, the hepatic portal occlusion without hemihepatic artery control causes lighter liver damage after liver resection in patients with HCC and it has been gradually widely used in clinic in recent years.

Objective:To explore the relationship between constitutional types of Chinese medicine and Alzheimer's disease (AD) and to construct an early warning model for AD risk.Methods:In the established multimodal interventions to delay dementia and disability in rural China (MIND-China) study, 4 033 elderly subjects aged ≥60 years old were included. The data including demographic, underlying disease and neuropsychological data were collected.The Chinese medicine service record form for the elderly was used to assess constitutional types of Chinese medicine and to apply the NIA-AA diagnostic criteria published by the National Institute on Aging and the Alzheimer's Association in 2011 for the diagnosis of clinically likely AD. Logistic regression analysis and AD risk prediction models were constructed using R statistical software, and the final prediction results were presented using columnar plots.Results:The MIND-China cohort was dominated by the abnormal constitution (69.28%), of which Phlegm-wetness type was the most common (58.05%), followed by Yang-deficiency type (23.85%). The most constitutional type of Chinese medicine among AD patients was Phlegm-wetness type (54.35%), followed by Qi-depression type (38.04%). Multi-factorial logistic regression analysis suggested that increasing age ( β=0.101, P<0.001, OR=1.107, 95% CI=1.069-1.146) and Qi-depression type ( β=0.622, P=0.016, OR=1.862, 95% CI=1.116-3.076) were able to increase the risk of developing AD, while education ( β=-1.047, P<0.001, OR=0.351, 95% CI=0.205-0.584) was able to reduce the risk of developing AD. By using the risk score model to calculate the total risk score for each subject and plotting the receiver operating characteristic curve (ROC), the area under the ROC was 0.769 and the calibration curve showed excellent consistency between prediction and reality. Conclusion:Older adults with Qi-depression type are significantly associated with an increased likelihood of AD.

Objective To analyze the correlation between inflammation,nutritional indicators and hy-poproteinemia in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Meth-ods The clinical data of patients with AECOPD admitted to the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Xiamen University from January 2020 to September 2022 were ret-rospectively analyzed,and the patients were divided into the hypoproteinemia group(n=73)and the non-hy-poproteinemia group(n=141)according to whether the serum albumin(ALB)was lower than 35 g/L.The clinical data,inflammatory indicators and nutritional indicators of the two groups were compared,Spearman correlation analysis was performed,and binary logistic regression analysis was performed to analyze the influ-encing factors of patients with AECOPD complicated with hypoproteinemia.Results There were statistically significant differences in age,length of hospital stay,and body weight between the two groups(P＜0.05).There were no significant differences in gender,number of hospitalizations in the past 1 year,height,diabetes,hypertension and proportion of coronary heart disease(P＞0.05).Compared with the non-hypoproteinemia group,the hypoproteinemia group had longer hospital stays and higher levels of C-reactive protein,neutrophil/albumin ratio(NAR),neutrophil to lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and systemic immunoinflammatory index(SII).The prognostic nutritional index(PNI),body mass index(BMI),hemoglo-bin and total protein levels were lower,and the difference was statistically significant(P＜0.05).Body weight,BMI,hemoglobin,total protein,PNI and AECOPD patients with hypoproteinemia were negatively cor-related(P＜0.05),while age,length of hospital stay,C-reactive protein,NAR,NLR,PLR,SII and AECOPD patients with hypoproteinemia were positively correlated(P＜0.05).Binary logistic regression analysis showed that PNI,SII and NLR were the influencing factors of hypoproteinemia in AECOPD patients.Conclusion In clinical practice,attention should be paid to and timely correction of hypoproteinemia in pa-tients with AECOPD,improvement of inflammatory indicators and nutritional status of patients,and preven-tion of acute exacerbation.