The patient was a 29-year-old male with a history of hemophilia for more than 10 years. After 6 hours of botulinum toxin injection into the masseter muscle, the redness and swelling of the right face gradually worsened, accompanied by local pain, and restricted mouth opening, etc. The hematoma was absorbed and the swelling subsided significantly after the infusion of coagulation factor Ⅸ. Such cases of large-scale hematomas after botulinum toxin injection in hemophiliacs is rarely reported. This article summarized the diagnosis and treatment process of this case and combines with literature review to provide clinical experience for diagnosis, treatment and prevention of similar complications.

The patient was a 29-year-old male with a history of hemophilia for more than 10 years. After 6 hours of botulinum toxin injection into the masseter muscle, the redness and swelling of the right face gradually worsened, accompanied by local pain, and restricted mouth opening, etc. The hematoma was absorbed and the swelling subsided significantly after the infusion of coagulation factor Ⅸ. Such cases of large-scale hematomas after botulinum toxin injection in hemophiliacs is rarely reported. This article summarized the diagnosis and treatment process of this case and combines with literature review to provide clinical experience for diagnosis, treatment and prevention of similar complications.

Hemophilia B is a genetic disorder caused by coagulation factor Ⅸ(FⅨ) deficiency, mainly manifesting as joint, muscle and deep tissue bleeding. Hemophilia pseudotumor is a mass formed by soft tissue liquefaction and necrosis caused by repeated bleeding. Most pseudotumors occur in the bone and muscle. We report a case of hemophilia B with pseudotumor formation in the pelvis and abdomen, where lesion location is relatively rare. After active and effective hemostasis, the patient's hematuria symptom gradually improved. This case suggests that early and timely hemostatic treatment is crucial for patients with hemophilia.

Objective:To evaluate the role of brain-derived neurotrophic factor-antisense long-chain non-coding RNA (BDNF-AS) in amygdala in the development of neuropathic pain (NP) in rats.Methods:Healthy clean-grade male Sprague-Dawley rats, aged 2 months, weighing 200-260 g, were used to develop NP model via ligation of left L 5-6 spinal nerve, while control group was only subjected to the exposure of L 5-6 spinal nerve without ligation.This study was performed in two parts.Experiment Ⅰ Fifty-six rats were divided into 3 groups by the random number table method: sham operation group (Sham group, n=8), NP group ( n=24) and BDNF ( n=24). In BDNF group, exogenous BDNF was injected into bilateral amygdala at 1, 3, 6, 13 and 20 days after development of the model, with 100 pmol at each side.Eight rats were sacrificed at 7, 14 and 21 days after the model was developed in NP and BDNF groups and after the model was developed in Sham group, the brains were removed, and the amygdala was isolated for determination of the BDNF content (by enzyme-linked immunosorbent assay), the number of BDNF-positive cells (by immunohistochemistry), and expression of BDNF-AS (by real-time quantitative polymerase chain reaction). Experiment Ⅱ Thirty-two rats were divided into 4 groups ( n=8 each) using the random number table method: Sham operation group, NP group, BDNF group and siRNA group.At 1, 3, 6, 13 and 20 days after development of the model, exogenous BDNF 100 pmol and siRNA-BDNF-AS 50 nmol were injected into the amygdala at each side in BDNF group and siRNA group, respectively.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before development of the model (T 0) and at 4, 7, 14 and 21 days after development of the model (T 1-4). After the last behavioral test was completed, the rats were sacrificed, and the spinal cord tissues were collected to measure the contents of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α). Results:Experiment Ⅰ Compared with Sham group, the content of BDNF and the number of BDNF positive cells were significantly decreased, and the expression of BDNF-AS was up-regulated at each time point after development of the model in group NP ( P<0.05). Compared with NP group, the content of BDNF and the number of BDNF positive cells were significantly increased, and the expression of BDNF-AS was down-regulated at each time point after development of the model in group NP ( P<0.05). Experiment Ⅱ Compared with Sham group, MWT was significantly decreased and TWL was shortened at T 1-4, and the contents of IL-1β, IL-6 and TNF-α were increased in NP, BDNF and siRNA groups ( P<0.05). Compared with NP group, MWT was significantly increased and TWL was prolonged at T 1-4, and the contents of IL-1β, IL-6 and TNF-α were decreased in BDNF and siRNA groups ( P<0.05). Conclusions:The mechanism underlying the development of NP may be related to the up-regulation of BDNF-AS expression in amygdala, inhibition of BDNF synthesis and promotion of inflammatory responses in the spinal cord of rats.

Objective To investigate the role of TRIM65 on DSS induced colitis and the underlying molecular mechanisms. Methods Trim65+/+ and Trim65-/- mice were administered with 3% (w/v) DSS in their drinking water for 5 consecutive days and then were switched to sterile water for 2 days. DSS treated mice were monitored daily for the clinical symptoms (bodyweight, stool consistency and rectal bleeding score). Mice were sacrificed on day 7 to measure colon length. Colon homogenates were collected to measure MPO activity and detect cleaved caspase-1 and mature IL-1β by Enzyme linked immunosorbent assay (ELISA) and Western blot. Trim65-/- mice were intraperitoneally injected with NLRP3 inflammasome inhibitor MCC950, and were given the above treatment to determine the effect of MCC950 on colitis in Trim65-/- mice. Results The results showed that deletion of Trim65 significantly enhanced weight loss and colon shortening in DSS mice, increased disease activity index and histopathological score, induced the activity of MPO, and promoted the F4/80+ immune cell infiltration, the activation of caspase-1 and the secretion of mature IL-1 in the colon of DSS mice. The NLRP3 inflammasome inhibitor MCC950 alleviated DSS induced colitis symptoms and inflammation levels in trim65 deficient mice. Conclusion TRIM65 plays an anti-inflammatory role in DSS induced colitis mice by inhibiting the activation of NLRP3 inflammasome.

Objective:To investigate the effect of miRNA-106b (miR-106b) on human laryngeal squamous cell carcinoma Hep-2 and TU212 cells and its mechanism.Methods:Hep-2 and TU212 cells were divided into miR-106b inhibitory sequence transfected group (the experimental group), miR-106b competitive negative sequence transfected group (the negative control group) and non-intervention group (the blank group). The inhibitory effect of miR-106b inhibitory sequence on the expression of miR-106b was verified by using reverse transcription quantitative polymerase chain reaction (qRT-PCR). Whether phosphatase and tensin homolog (PTEN) was the target gene of miR-106b was analyzed by using bioinformatics and luciferase report vector. PTEN small interfering RNA (siRNA) was used to inhibit the expression of PTEN in Hep-2 and TU212 cells. Transwell method and Western blot were used to detect the change of invasion ability of Hep-2 and TU212 cells after miR-106b silencing or the PTEN intervening, and the expression change of PTEN, epithelial cadherin and vimentin.Results:The relative expression levels of miR-106b in Hep-2 and TU212 cells in the experimental group were 0.110 ± 0.037 and 0.074 ± 0.009, respectively, which were lower than those in the negative control group (1.013±0.059 and 1.035±0.062, respectively; all P < 0.05). In Transwell experiments, the number of invasive cells in each field of Hep-2 and TU212 cells in the experimental group was less than that in the negative control group [(37.09±4.02) vs. (95.65±4.77), (29.16±2.49) vs. (103.19±6.08), all P < 0.05]. The bioinformatics analysis results showed that 3'-UTR region of PTEN mRNA was complementary to 3'-UTR region of miR-106b. Dual-luciferase reporter system analysis showed that the luciferase reporter activity of wild-type PTEN gene transfected with miR-106b was decreased to (22.84±2.68)%, and that of mutant PTEN gene transfected with miR-106b was almost unchanged [(92.08±3.44)%], and the difference was statistically significant ( P < 0.001). The expression level of PTEN protein of Hep-2 and TU212 cells in the experimental group was higher than that in the negative control group. Transwell method showed that the number of invasive cells in each field of Hep-2 and TU212 cells in the experimental group with the inhibition of PTEN expression was more than that in the experimental group without the inhibition of PTEN expression [(65.08±3.57) vs. (26.72±2.58), (57.38±4.96) vs. (31.81±2.97), all P < 0.05]. Western blot showed that the expression level of epithelial-cadherin was up-regulated and vimentin was down-regulated of Hep-2 and TU212 cells in the experimental group with the inhibition of PTEN expression. Conclusions:The human laryngeal squamous cell carcinoma Hep-2 and TU212 cell miR-106b can influence the downstream invasion-related protein of PTEN and change the cell invasion ability through the targeted regulation of PTEN expression.

Objective ThispaperpresentedaninvestigationonthesimilaritiesanddifferencesintheclinicalfeaturesandCTfindings betweenallogeneichematopoieticstem celltransplantation (allo-HSCT)inducedandnon-transplantinducedair-leaksyndromes (ALS)inpatientssufferingfromhematopathy,toimprovetheunderstandingofALSinpatientswithhematopathy.Methods Retrospective analysesandcomparisonsofclinicaldataandCTimageswereconductedbetweenGroupA (12patientswithALSafterallo-HSCT) andGroupB (26patientswithnon-transplant-relatedALS).A M annG W hitney U testwasperformedtoevaluatethemeasurementdata, andthe χ 2testor Fisher exacttestwasconductedtoexaminetheenumerationdata.Differencethresholdsof P＜0.05from bothsides weretakentobethedeterminantforstatisticalsignificance.Results TheincidenceratesofALSinpatientswithhematopathyafter anallo-HSCTwerefoundtobesignificantlyhigherthanthoseinpatientsonwhomsuchtransplantshadnotbeenperformed(1.84%. vs.0.06%),P＜0.001.SymptomsofdyspneaweremuchmorefrequentlyobservedingroupAcomparedtogroupB (7/12vs1/26), P＜0.01;whereasthedifferencesforthesymptomsofchesttightness,chestpain,andpharyngalgia werenotadequateintermsofstatistical significance,P＞0.05.IngroupA,theoccurrencesofALSsecondarytolongonsetnon-infectionpulmonarycomplications(LONIPC) associatedwithchronicgraft-versus-hostdisease(cGVHD)werefoundin8/12patients,whereastheoccurrencesin15/26patients weresecondarytopulmonaryinfectioningroupB,P＜0.01.Therewerenostatisticallysignificantdifferencesinage,gender,BMI, backgroundblooddisease,basictreatmentcounts,CTtype,treatmentmethodsandCTdisappearancetimelengthbetweenthetwo groups,P＞0.05.Conclusion Thereweredifferencesintheincidencerates,basiclungdiseasesandclinicalsymptomsbetweenallo-HSCT inducedandnon-transplantinducedALSinpatientssufferingfromhematopathy.Hematopathy-associatedALSwascommoninyoung adultswithlankypostures,patientswithleukemiaasback-grounddisease,patientswithahistoryofchemotherapyandpatientswith pulmonarydiseases.Thecommonsymptomsofpatients with hematopathy-associated ALS were chesttightness and chest pain,andpatients’overallprognosisweregood,meanwhileCT manifestationsweremainlycharacterizedbymixedpulmonary interstitialemphysema(PIE)+pneumomediastinum (PM)andsimplepneumothorax (PT).

Objective To investigate the differences of acquisition protocols from continuous bed motion (CBM) and step-and-shoot (SS) modes and to observe their effects on image quality and standard uptake value (SUV) in 18 F-fluorodeoxyglucose (FDG) PET/CT.Methods A total of 30 patients (13 males,17 females;40-71 years) who underwent 18F-FDG PET/CT from June 2017 to September 2017 were selected.Simulated acquisition protocols for a specific range (upper margin of the skull to the lower edge of sciatic bone) were established with CBM and SS modes.The differences between 2 modes for actual length requiring for a specific acquisition range and the differences in CT radiation dose were compared.Real PET/ CT scans were performed using CBM and SS modes consecutively,and the differences in image quality and SUV were compared.Paired t test andx2 test were used to analyze the data.Results For the specific acquisition range,the average acquisition length of CBM was reduced by 6.65％ ((87.11 ± 3.78) vs (93.32 ±6.02) cm;t=-7.737,P＜0.001) and the CT radiation dose was reduced by 6.88％ ((812±170) vs (872±192) mGy · cm;t=-6.432,P＜0.001) for each patient compared with the results of SS.There were no significant differences in maximum SUV (SUVmax) and mean SUV (SUVmean) between SS and CBM in normal tissues including liver,bone and waist muscles (t values:from-1.895 to 0.132,all P＞0.05).The SUVmax of leg muscles at the end of the image was significantly higher in SS than that in CBM (1.24±0.53 vs 1.06±0.42;t=3.450,P＜0.01).There were no statistically significant differences in SUVmax and SUV between SS and CBM in 40 FDG high uptake lesions (t values:0.420 and-0.260,both P＞0.05).There were 73.33％ (22/30) patients had images with overall high quality during SS and the percentage was 80.00％ (24/30) during CBM (x2 =0.373,P＞0.05).The percentage of patients with images of high quality at the end was 16.67％(5/30) during SS,which was significantly less than that during CBM (63.33％,19/30;x2 =13.611,P＜0.001).Conclusions For the specific acquisition range,CBM can reduce unnecessary CT scan range and radiation dose compared with SS.There is no significant difference in image quality and SUV from normal tissue and lesion except for the end of the image.

Objective To observe the effects of standardized pain management on old patients with hip fracture. Methods From January, 2015 to June, 2016, 75 old patients (more than 58 years old) with hip fracture were randomly divided into control group (n=37) and observa-tion group (n=38). The control group accepted routine pain management, while the observation group accepted standardized pain manage-ment. They were assessed with Visual Analogue Score (VAS) of the most intensive pain, and their scores for satisfaction were compared. Re-sults There was no significant difference in VAS between two groups before operation (Z=0.845, P>0.05). The VAS was significantly lower in the observation group than in the control group postoperatively (Z=5.427, P<0.001). The scores of satisfaction was more in the observa-tion group than in the control group (t=21.346, P<0.001). Conclusion Standardized pain management can significantly reduce perioperative pain in old patients after hip fracture surgery, and improve the satisfaction.

Objective To evaluate the effects of a traditional Chinese medicine Rubia cordifolia L.aqueous extract (RCAE) on body weight, fat mass and parameters of glucose and lipid metabolism in high fat diet (HFD)-induced obese rats and its mechanism.Methods pGL3-Enhancer-PPARγ2 (625 bp)-Luc plasmid, a luciferase reportergene expression plasmid containing PPARγ2 promoter was constructed and stably transfected 3T3-L1 preadipocytes were established.PPARγ2 promoter`s activities in these cells were detected after administration with different concentration (0.1 mg/L~1 000 mg/L) of RCAE or with 100 mg/L RCAE for different action time.PPARγ2 mRNA expression in human adipocytes were detected after administration with 100 mg/L RCAE.Meanwhile, HFD-induced obese rats were administrated with low or high dose RCAE to investigate the effects of RCAE on serum glucose, lipid and insulin levels, body weight, visceral fat mass and so on.Results 10 mg/L RCAE could increase luciferase expression in 3T3-L1 cells to 1.43 folds of that in control group (P<0.01) and it reached 3.24 folds of that in control group when the concentration of RCAE was 1000 mg/L (P<0.01).With the administration with 100 mg/L RCAE, the luciferase activity of 3T3-L1 cells peaked at 28 h where it was 2.72 folds of that in control group (P<0.01), and the expression of PPARγ2 mRNA in human adipocytes increased to 2.27 folds of that in control group (P<0.01).Compared with HFD group, low dose RCAE significantly reduced the fasting insulin level, HOMA-IR and visceral fat mass (P<0.05).Conclusions Low dose RCAE significantly reduces the visceral fat mass and ameliorates insulin resistance in HFD-induced obese rats.The potential mechanism may be explained by the stimulation of PPARγ2 promoter activities and the increased expression of PPARγ2 gene.