Objective:To explore the clinical effect on reconstruction of the soft tissue defects after resection of mucous cysts of distal interphalangeal joint (DIP) with transfer of the flap of dorsal branch of proper palmar digital artery.Methods:From September 2021 to September 2023, 8 patients (8 digits) with mucous cysts on DIP were treated in the Department of Hand and Microsurgery, the Affiliated Hospital of Binzhou Medical University. All 8 cases were females, aged 55-65 years old, with an average age of 60 years old. The cyst was located in the thumb in 1 case, in the index finger in 3 cases, in the middle finger in 3 cases, and in the ring finger in 1 case. After extensive resection of the mucous cysts, the size of soft tissue defects was at 0.8 cm×0.6 cm-1.7 cm×0.9 cm. Pedicled with the dorsal branch of proper palmar digital artery, the flaps adjacent to the defects were designed to cover the wounds. The size of the flaps was 1.2 cm×1.0 cm-2.0 cm×1.2 cm. Donor sites of the flap were covered by the full thickness skin grafts of medial upper arm. The postoperative follow-up was conducted by the combination of outpatient revisits and telephone reviews to observe the survival of the flap, and the functional recovery was evaluated according to the Evaluation Standard of Upper Limb Functional of Hand Surgery of Chinese Medical Association.Results:All flaps survived well after surgery. Postoperative follow-up ranged from 4 to 12 months, with a mean of 10 months. At the final follow-up, there was no recurrence of mucous cyst and all symptoms disappeared. All flaps healed well, with good appearance, soft texture and without obvious difference in colour from the surrounding skin. All skin grafts healed in one stage. The range of motion of the affected DIP was 0°-70°, and the TPD was at 7-8 mm, both caused no impact on daily life. The outcomes were excellent according to the evaluation criteria set by the Evaluation Standard of Upper Limb Functional of Hand Surgery of Chinese Medical Association.Conclusion:The flap pedicled with dorsal branch of proper palmar digital artery has obvious advantages with less damage and simple operation in the treatment of a mucous cyst of DIP. It is an ideal surgical procedure.

【Objective】 To study the expressions of BMAL1 and CerbB-2 genes in nasopharyngeal carcinoma (NPC) and their related mechanisms. 【Methods】 Plasmid transfection, MTT, RT-PCR and Western blotting were used to detect the proliferation of NPC cells, the expressions of BMAL1 and CerbB-2 genes and proteins, and the expression of NF-κB signaling pathway. 【Results】 The MTT results showed that BMAL1 and CerbB-2 could affect the proliferation of NPC cells. RT-PCR results showed that BMAL1 gene was significantly down-regulated in NPC (CK: 2.24±0.22, NPC: 0.63±0.11, P<0.01), while CerbB-2 gene expression was significantly up-regulated (CK: 0.89±0.13, NPC: 2.65±0.25, P<0.01). The p50 and p65 genes in the NF-κB signaling pathway were up-regulated in NPC cells (p50, CK: 0.48±0.12, NPC: 1.45±0.25; p65, CK: 0.52±0.12, NPC: 2.33±0.35, P<0.01). The results of Western blotting were consistent with gene expression, which further confirmed the reliability of the results. 【Conclusion】 This study reveals that BMAL1 and CerbB-2 regulate the invasion and metastasis of NPC cells through the inflammatory pathway NF-κB, providing further theoretical support for the treatment and prevention of NPC.

Objective To observe the effects of recombinant human B-type natriuretic peptide (rhBNP) on cardiac function and heart rate variability (HRV) in patients with heart failure after acute myocardial infarction (AMI). Methods One hundred and twenty patients with heart failure after AMI admitted to the Department of Cardiology of Cangzhou Central Hospital of Hebei Province from January 2015 to January 2018 were enrolled. The patients were divided into a conventional treatment group and an rhBNP treatment group according to random number table method, with 60 cases in each group. The two groups were treated according to the AMI guidelines, the conventional treatment group received west medicine anti-myocardial ischemia and anti-heart failure treatment; the rhBNP treatment group received rhBNP on the basis of routine treatment; the first load dose was 2 μg/kg intravenous injection impact treatment, followed by maintaining dose 8.5 ng·kg-1·min-1 intravenous drip for 7 days. The changes of hypersensitivity C-reactive protein (hs-CRP), N-terminal B-type natriuretic peptide precursor (NT-proBNP), left ventricular ejection fraction (LVEF) and HRV index were observed before and after treatment in the two groups [HRV indexes including the changes of average normal RR interval standard deviation (SDNN), the average value of the normal RR interval standard deviation (SDANN), the root mean square (RMSSD) of the adjacent RR interval difference, and the percentage of adjacent RR interval difference > 50 ms (PNN50)]; the incidences of adverse reactions in the two groups were observed. Results After treatment, the levels of hs-CRP and NT-proBNP in the two groups were significantly lower than those before treatment (all P < 0.05). LVEF, SDNN, SDANN, RMSSD and PNN50 were higher than those before treatment, and the changes of the above indicators in the rhBNP treatment group were more significant than those in the conventional treatment group [hs-CRP (mg/L): 6.2±3.3 vs. 11.8±5.5, NT-proBNP (ng/L): 2.5±2.0 vs. 6.4±4.3, LVEF: 0.49±0.02 vs. 0.44±0.04, SDNN (ms): 93.3±18.1 vs. 79.1±16.0, SDANN (ms): 87.3±17.8 vs. 70.9±14.9, RMSSD: 30.3±11.0 vs. 23.8±10.4, PNN50: (15.9±7.3)% vs. (9.6±5.5)%, all P < 0.05]; No significant adverse reactions occurred during the treatment of the two groups. Conclusion rhBNP can significantly improve the heart function of patients with heart failure after AMI, reduce the levels of inflammatory response indicators and improve HRV;since its clinical efficacy is good, and its application safe, it is worthy to promote its clinical use.

Objective To investigate the expressions of interleukin-33 (IL-33),soluble growth stimulation expressed gene 2 (sST2) and transforming growth factor β1 (TGF-β1) in the patients with systemic sclerosis (SSc) and their correlations.Methods Serum IL-33,sST2 and TGF-β1 levels from 25 SSc patients and 25 healthy controls were determined by an enzyme linked immunosorbent assay (ELISA).The expressions of IL-33 in the damaged skin tissue of SSc patients and normal skin tissue were detected with the immunohistochemical staining.Results Serum IL-33 and TGF-β1 levels in SSc patients were significantly higher than that in healthy controls (P ＜ 0.05),and serum IL-33 levels were positively correlated with TGF-β1 levels in SSc patients (P ＜ 0.05).Immunohistochemical staining results showed that the expression level of IL-33 in the damaged skin tissue of SSc patients were significantly higher than that in normal skin tissue (P ＜ 0.05).However,there was no significant difference in the expression level of sST2 between SSc patinets and healthy controls.Conclusion Serum IL-33 levels in SSc patients increase significantly,which is correlated with the expression of TGF-β1,indicating that IL-33 may play an important role in the process of inflammation and fibrosis of SSc via the regulation of TGF-β1.

OBJECTIVE: To investigate the expression of EBV-encoded latent membrane protein 2A (LMP2A) and epithelial-mesenchymal transformation(EMT) associated markers (E-cadherin and fibronectin) in nasopharyngeal carcinoma (NPC) and its clinical significance. METHOD: The expression of LMP2A, E-cad-herin and fibronectin proteins in 32 cases of chronic nasopharyngeal inflammation, 56 cases of NPC and 18 cases of NPC lymph node metastasis were examined byimmunohistochemical SP method. RESULT: (1)The positive rates of LMP2A in NPC and its lymph node metastasis were significantly higher than those of chronic nasopharyngeal inflammation (89. 3%vs 37. 5%o and 77. 8% vs 37. 5%) respectively (both P<0. 01); The normal expression rates of E-cadherin in NPC and its lymph node metastasis were significantly lower than those of chronic nasopharyngeal inflammation (33. 9% vs 90. 6% and 5. 6% vs 90. 6%) respectively (both P<0. 01); The positive rates of fibronectin in NPC and its lymph node metastasis were significantly higher than those of chronic nasopharyngeal inflammation (83. 9% vs 28. 1% and 72. 2% vs 28. 1%) respectively (both P<0. 01). (2) ZLMP2A expression were negatively correlated with normal expression of E-cadherin (r= -0. 387, P<0. 01), and were positively correlated with fibronectin (r= 0. 421, P<0. 01). (3)LMP2A, E-cadherin and fibronectin expression were significantly correlated with N stage and clinical stage (both P<0. 05), but the three proteins were not significantly correlated with M stage (both P> 0. 05). In addition, LMP2A and E-cadherin expression were significantly correlated with T stage (both P<0. 01). CONCLUSION LMP2A and fibronectin expressions were increased in NPC, but normal expression of E-cadherin were decreased. LMP2A may promote lymph node metastasis and malignant progression of NPC by induce EMT through downregulation of E-cadherin and upregulation of fibronectin.
Cadherins ; biosynthesis ; Carcinoma ; Epithelial-Mesenchymal Transition ; Fibronectins ; biosynthesis ; Humans ; Lymphatic Metastasis ; Membrane Proteins ; biosynthesis ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Nasopharynx

Objective To investigate the value of pathological examination in the diag-nosis of lethal cases due to acute poisoning.Methods The macroscopic and microscopic find-ings in 28 autopsy cases (10 cases of toxic gas,7 cases of pesticide,6 cases of drug,3 cases of alcohol and 2 cases of chinese herbal medicine) died of acute poisoning during the period from October,2001 to June,2012 were retrospectively reviewed.Results Gross Changes were found on gross examination in 22 of the 28 cases studied.Of them,7 cases died of acute carbon mono-xide poisoning had showed cherry red of Shiban,muscle,visceral organs and blood.In addition,11 and 8 cases had been found gastric mucosa hemorrhage and epicardium petechial hemorrhage respectively.Histologically,myocardial interstitial hemorrhage was observed in 9 cases,pulmonary hemorrhage in 18 cases,bronchospasm in 12 cases,cerebral hemorrhage in 4 cases,hepato-cyte necrosis in 11 cases,renal tubular necrosis in 7 cases and gastric mucosa hemorrhage in 11 cases.In 6 cases of oral pesticides poisoning,besides they had all gastric mucosa hemorrhage,the change of character of gastric contents was found in 3 cases and pesticide odor from stomach in 3 cases.In addition,acute inflammatory and necrosis of gastric wall in 6 cases of oral pesticides poisoning were observed under the light microscope.Drug addicts often suffered from chronic lesions in multiple organs,such as chronic liver disease,fatty infiltration of the myocardium with myocardial atrophy,interstitial lung disease and pulmonary foreign body granuloma.Conclusions Pathology examination is helpful in the diagnosis of some lethal cases due to acute ooisoning,and it can provide pathological basis to study on treatment of acute poisoning.

Objective To investigate the expression of Toll-like receptor 4 (TLR4),and explore its relationship with neurological function after fluid percussion brain injury in rats.Methods 56 adult rats were randomly divided into traumatic brain injury group(TBI group,n=48) and sham operation group(SO group,n=8).The experimental models were established.The water content of edematous brain and the expression of TLR4 were measured with dry-wet measure,immunohistochemistry and Western Blot at 1 h,6 h,12 h,24 h,3 d,7 d after shock respectively.Results Compared with SO group,neuronal function score decreased in TBI group from 6 h(3.86±0.42),reached to the lowest level at 24 h(2.65±0.32),and gradually rose at 3rd day (3.25±0.17).TLR4 immunoreactive expression increased from 6 h,reached its maxmum at 24 h,lasted to 3rd day,and then began to drop at 7th day.The linear regression analysis indicated that expression of TLR4 had negative correlation with change of neuronal function score (r 1 =-0.824,r w =-0.867,P＜0.05).Conclusion TLR4 expression is upregulated following fluid percussion injury in rats and involved in neurological function impairment by inducing secondary inflammatory brain injury.

Objective To compare clinicopathological characteristics of coronary artery disease (CAD) patients with or without sudden coronary death(SCD).Methods A total of 145 autopsy cases with CAD were divided into SCD group(38 cases)and non-SCD group (107 cases).The difference on age,number of diseased coronary vessel,coronary athemsclerotic stage (fatty streak stage,fibrous plaque stage and atheromatous plaque stage),composite lesions of coronary artery,grade of stenosis severity,acute myocardial infarction,old myocardial infarction,hypertensive cardiomyopathy,myocardial fatty infiltration and arteriosclerosis of the arteries on the base of the brain were compared between SCD group and non-SCD group.Results (1) Patients were older in SCD group than in non-SCD group [(55.3 ± 14.5) years vs.(48.5 ± 13.3) years,P ＜ 0.01].(2) There was a significant positive correlation between coronary atherosclerotic stage and grade of coronary stenosis severity (rs =0.79,P ＜ 0.01).(3) The rate of multiple vessel disease,coronary atherosclerotic stage,composite lesions of coronary artery,grade Ⅲ-Ⅳ coronary artery stenosis,old myocardial infarction and arteriosclerosis of the arteries on the base of the brain were 60.5％ (23/38),84.2％ (32/38),63.2％ (24/38),86.8％ (33/38),36.8％ (14/38) and 34.2％ (13/ 38),respectively in SCD group,which were significantly higher than those in non-SCD group [25.2％ (27/ 107),29.0％ (31/107),18.7％ (20/107),19.6％ (21/107),3.7％ (4/107) and 6.5％ (7/107),respectively,all P ＜ 0.01].Conclusion Coronary artery atherosclerotic lesion is severer and patients are older in SCD patients than in non-SCD patients in this coronary artery disease patient cohort.

Objective To investigate the expression of inflanmatory cytokines such as interlukin-1β (IL-1 β),interlukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and intercelluar adhesion molecule-1 (ICAM-1),and explore their relationships with neuronal function score after fluid percussion brain injury in rats.Methods The experimental models were established in 48 adult rats.The water content of edematous brain and the expression of IL-Iβ,IL-6,TNF-α and ICAM-1 were measured with dry-wet measure,immunohistochemistry at 6 h,12 h,24 h,3 d,7 d after operation respectively.Results Compared with animals of shame operation (SO) group,neuronal function score decreased in TBI group from 6h (3.78±0.84),reached to the lowest level at 24h (2.65±0.32),and gradually increased at 3d (4.75±0.71).IL-6,IL-1β,TNF-α and ICAM-limmunoreactive expression increased from 6h,reached its maxmum at 24h,lasted to 3th day,and began to decrease at 7d.The linear regression analysis indicated that expression of IL-1β,IL-6,TNF-α and ICAM-1 had negative correlations with change of neuronal function score(r=-0.912,r=-0.892,r=-0.794,r=-0.887 respectively,P＜0.05).Conclusion IL-6,IL-1β,TNF-α and ICAM-1 expression is upregulated following fluid percussion injury in rats,and shows negative correlations with neuronal function score.The possible mechanisms is that inflammatory cytokines are involved in nerve function impairment by inducing secondary brain injury.

Objective To study the application and significance of constructivism theory in pathological experiment teaching.Methods Six classes in total of 198 students majoring in clinical medicine were selected from grade 2009 of Guangdong medical college for research and were divided into experimental group (n=99) and control group (n=99) using random number table.Various teaching methods based on constructivism theory were used in experimental group while conventional teaching methods were applied in control group.The observing ability for specimen and slices,theoretical level and learning behavior of students were assessed with the same standard and anonymous homemade questionnaire survey was executed for students.SPSS 13.0 statistical software was used to analyze the results.The examination results of the two groups were compared using independent samples t-test.The questionnaire survey results of the two groups were compared using Wilcoxon rank-sum test.P＜0.05 represented the difference having statistical significance.Results The observing capability for specimen and slices,theoretical level and learning behavior of students in experimental group were significantly improved (P＜0.01)and the questionnaire survey results demonstrated that there were statistical difference in feedbacks between the two groups and the satisfaction rate was significantly improved in experiment group (P＜0.01).Conclusions Applying comprehensive teaching methods based on constructivism theory can stimulate students' interest and initiative in learning,improve students' learning behavior and learning strategies,and significantly improve the teaching quality.