Objective To investigate the effect of subretinal fluid (SRF) with different grades of proliferative vitreoretinopathy (PVR) on bcl-2 oncoprotein expression in retinal pigment epithelium (RPE) cells and fib roblast (FB)． Methods Using immunohistological staining technique and Western-blotting method to detect the expression of bcl-2 protein in RPE cells and FB under the stimulation of SRF． Results The expression levels of bcl-2 increased in both types of cells to a certain extent compared with those of the control group 4 hours after the cells subjected to SRF； 36 hours later, the expression levels of bcl-2 of experimental groups decreased more quickly than those of the control group， and the control group showed relatively higher bcl-2 protein levels at the end of observation． Conclusions SRF may stimulate the e xpression of bcl-2 in RPE cells and FB under culture at early stage, but accel arate the declining of bcl-2 protein levels a certain time after subjected to SRF． (Chin J Ocul Fundus Dis, 2001,17:58-60)
Objective To evaluate whether to defer abdomen surgery in patients having poorly controlled or untreated hypertension before operation. MethodsThe perioperative clinical data of 531 patients with hypertension in our hospital from January 1997 to December 1998 was retrospectively analyzed. ResultsThe modility of perioperative hypertensive events was not significantly different, between controlled and uncontrolled patients with grade one and grade two（Pgt;0.05）. In grade three and systolic hypertension, certain complications in patients with poorly controlled hypertension were higher than in those with wellcontrolled hypertension（P＜0.05）. Conclusion The patients with grade one and grade two hypertension are not at increased operative risk. In patients with grade three and systolic hypertension, perioperative complications are increased and elective surgery should be postponed until their blood pressure is brought under 24/14.7 kPa （180/110 mm Hg） over 1 to 2 weeks.
Breast cancer is one of the most common malignant tumors among women. Typically, the operation of breast cancer should include breast surgery and axillary lymph node surgery since breast cancer first metastasizes to regional axillary lymph nodes. However, postoperative breast cancer-related lymphedema (BCRL) in upper limb is the most common long-term complication. The injury to upper limb lymphatic system contributes to causing the postoperative BCRL. Therefore, precision medicine in the extent of axillary lymph node surgery plays an important role in preventing BCRL which can improve the quality of life in breast cancer patients.
Objective To discuss the safety and effectiveness of removing esophageal foreign bodies in children by using Foley catheter. Method Retrospective analysis on the effect, operation method, complication and the types of foreign bodies of 138 cases of removing esophageal foreign bodies in children by using Foley catheter, which happened from January 1998 to January 2008 in Department of Otorhinolaryngology, the Third People’s Hospital of Chengdu. Result Among these 138 cases with esophageal foreign bodies, 126 cases (91.3%) were successfully taken out by using Foley catheter without anaesthesia, 7 cases were applied esophagoscopy under general anaesthesia, and 5 cases were cured owing to the slipping of foreign body into stomach. The operating time for Foley catheter was 5.1 minutes in average, and there’s no complicating disease in any case. The hard esophagoscope operation lasted for 15 minutes in average and one case was accompanied by dyspnea. The foreign bodies in 138 cases were coin (98 cases), button (14 cases), chess and I-go piece (13 cases), key-ring (4 cases), plastic bottle cap (3 cases), oblate battery (3 cases) and ring (3 cases), respectively. Conclusion Foley catheter is safe and effective for removing esophageal obtuse-rounded foreign bodies in children.
Objective To extract and identify primary culture rat pulmonary arterial smooth cells ( PASMCs) , and investigate the effects of hypoxia on the proliferation of PASMCs. Methods Rat PASMCs were separated by the method of tissue block anchorage, and the cellular morphology was observed under light microscope. The cells were identified by projection electron microscopy, and α-smooth muscle actin ( α-SMactin)in the cells was identified by immunohistochemistry and immunofluorescence. The primary cultured PASMCs were exposed to normoxic and/ or hypoxia condition for 2, 6, 12, 24, 48 hours respectively, thenMTT assay and PCNA ( proliferating cell nuclear antigen) immunohistochemistry were used to detect the proliferation of PASMCs. Results The cells tended to be long spindle and grew in the “peak-valley”mode under light microscope. Immunology results showed that endochylema was stained in brownish yellow, and the positive rate was beyond 96% . There were dense patch, dense body and many filaments in endochylema under projection electron microscopy. MTT assay demonstrated that the A values of PASMCs expose to hypoxia were higher than that of nomoxia. Comparing with normoxia, the A values of PASMCs exposed to hypoxia increased after 12 hours ( P lt;0. 05) , significantly increased after 24 hours ( P lt;0. 01) . Compared with 2 hours’exposure to hypoxia, the A values increased after 12 hours( P lt; 0. 05) , markedly increased after 24 hours ( P lt; 0. 01 ) , which after 48 hours was similar with 24 hours. The result of PCNA immunohistochemistry was consistent with that of MTT. Conclusions The tissue explants adherent method is simple and convenient, and can easily obtain rat PASMCs with high purity and stability. Hypoxia canpromote the proliferation of PASMCs.
【摘要】 目的 擬初步建立孕28~34周的雙胎胎兒生長參數超聲測量值的正常范圍，比較晚孕期單、雙胎妊娠胎兒的宮內生長發育模式。 方法 對2009年5月-2010年4月超聲診斷為正常宮內雙活胎、單活胎孕婦，采用超聲測量胎兒相關生長發育指標，包括雙頂徑、頭圍、腹圍、股骨長等，測量其中部分雙胎的小腦橫徑并應用虛擬器官計算機輔助分析技術測量其小腦容積，比較晚孕期單、雙胎胎兒生長發育的差異。 結果 ①自妊娠30周以后，雙胎胎兒的雙頂徑發育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約2.3、1.7 mm；②自妊娠32周以后， 雙胎胎兒的頭圍的發育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約6.7、5.8 mm；③自妊娠30周以后， 雙胎胎兒的腹圍的發育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約6.9、5.3 mm；④雙胎胎兒股骨長從孕28~34周發育速度均較單胎胎兒緩慢，單、雙胎胎兒平均每周增長分別約2.0、1.7 mm；⑤多元分析孕28~34周的雙胎胎兒雙頂徑、頭圍、腹圍和股骨長，相對于單胎胎兒而言，自28周起，雙胎妊娠胎兒的生長發育較延緩；⑥自孕28~34周，雙胎胎兒小腦橫徑、小腦容積與單胎胎兒無明顯差異。 結論 雙胎妊娠胎兒與單胎妊娠胎兒在晚孕期有著不同的生長發育規律。【Abstract】 Objective To initially establish the growth parameters of normal twin pregnancy in 28-34 gestational ages according to the ultrasound measurement, and to compare the intrauterine growth patterns between the singleton and twin pregnancy. Methods The relevant index of the twin pregnancy, including the biparietal diameter (BPD), femur length, head circumference (HC), abdominal circumference (AC), were measured. The transverse cerebellar diameter (TCD) was measured and the virtural organ computer-aided analysis was used to detect the fetal cerebellar volume (FCV). The intrauterine growth patterns between the singleton and twin pregnancy was compared. Results After the gestational age of 30 weeks, the mean values of BPD of the twins pregnancies (1.7 mm) were lower than those of the singleton pregnancies (2.3 mm). After the gestational age of 32 weeks, the mean value of HC of the twins pregnancies (5.8 mm) was lower than that of the singleton pregnancies (6.7 mm). After the gestational age of 30 weeks, the mean values of AC of the twins pregnancies (5.3 mm) were lower than those of the singleton pregnancies (6.9 mm). After the gestational age of 28 weeks, the mean value of FL of the twins pregnancies (1.7 mm) was lower than the singleton pregnancies (2.0 mm). After the gestational age of 28 weeks, the growth of twin pregnancy fetuses is more slowly. After the gestational age of 28-34 weeks, the differences in mean values of TCD and FCV between the twin pregnancy and singleton pregnancy was not significant. Conclusion The twin pregnancy and singleton pregnancy have different growth patterns in the third trimester pregnancy.
Mitral stenosis includes mitral stenosis due to rheumatic fever and non-rheumatic valve stenosis characterized by degenerative changes. Rheumatic mitral stenosis is common in developing countries and occurs in young adults, while degenerative mitral stenosis is common in developed countries and increases in incidence with aging. Mitral stenosis of different etiologies can lead to changes in heart structure and function, which affects the quality of life and prognosis of patients, so lifelong management of mitral stenosis is crucial. This article provides a comprehensive reference for clinicians in the management of mitral stenosis, with a detailed overview of the emerging prevalence features, imaging diagnosis, and treatment methods.
Objective To understand pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of metaplastic breast cancer (MBC), and to provide some new ideas for clinical diagnosis and treatment, and exploration of scientific research for it. Method The relevant literatures of the latest research on MBC were reviewed and analyzed. Results At present, the pathogenesis of the MBC was still uncertain. The incidence of the MBC was lower, and it’s clinical manifestations were not specific. Compared with the invasive breast cancer, the tumor diameter was larger, the growth was faster, the differentiation degree was lower, the risks of the local and distant metastases were higher, while the lymph node metastasis was rare. Because of the clinical manifestation, auxiliary examination, and imaging examinations were lack of specificity, the diagnosis was difficult. Although the preoperative puncture could provide a reliable diagnosis evidence, it was difficult for distinguishing and accurate diagnosis due to it’s more subtypings. Some of the specific molecular targets could provide a help for it. At present, the modified radical mastectomy was often performed, the axillary lymph node metastasis was relatively rare in the MBC, so the sentinel lymph node biopsy was more important in the treatment of the MBC. The therapeutic effect was limited by the endocrine therapy, targeted therapy, or neoadjuvant chemotherapy and was poor by the systemic chemotherapy. Although the radiotherapy and chemotherapy could improve the overall survival and prolong the disease-free survival and control the local recurrence, the difference of it’s therapeutic effect was great due to the complex MBC typing. Conclusions MBC is a highly malignant and strongly invasive tumor, and it has more subtypings. Clinical manifestation and preoperative examination are lack of specificity, hence it is easy for misdiagnosis or missed diagnosis. Unified treatment guideline is lack of, prognosis is poor. So, it needs to explore some new treatment methods and formulate standardized treatment guidelines in order to achieve a better therapeutic effect.
Objective To present and summarize the data concerning the diagnosis and treatment of popliteal aneurysm in our hospital. Methods The data of popliteal aneurysm in our hospital from 1975 to 2004 were reviewed and analyzed. Eleven patients with 11 diseased limbs were treated, including 8 males and 3 females, age from 21 years to 64 years 〔(48.54±13.66) years〕. The combined diseases include syphilis, rheumatic heart disease and chronic obstructire pulmonary disease etc. Ten patients received operations, including endoaneurysmorrhaphy (n=4) and graft bypass after aneurysmal resection (n=6), through posterior approach (n=7) or medial approach (n=3). One patient, combined with advanced syphilis and heart failure, received conservative treatment because of his poor general condition. Results The common clinical manifestations included popliteal pulsating mass, claudication, difficulty in extension of the knee, pain etc. Acute ischemia occurred in 3 limbs. The diameter of popliteal aneurysms varied from 4-13 cm 〔（6.73±2.69) cm〕. There were 3 (27.3%) cases of ruptured aneurysms whose diameters were 7 cm, 7 cm and 11 cm respectively. Special examinations included arteriography and Doppler sonography. Pathological results of these patients were pseudoaneurysm (n=3), syphilitic aneurysm (n=3) and atherosclerotic aneurysm (n=4). Two patients were not followed up, and postoperative follow up of the other 8 patients ranged from 18 months to 30 years. In the group of endoaneurysmorrhaphy, postoperative gangrene of the affected limb occurred in one patient, and above-knee amputation was performed. One patient suffered from intermittent claudication in the group of endoaneurysmorrhaphy and of graft bypass respectively. No manifestations of limb ischemia were found in the other 5 patients during the time of follow up. Conclusion General utilization of Doppler sonography in screening high risk patients might be helpful to detect popliteal aneurysm. For symptomatic popliteal aneurysm or asymptomatic popliteal aneurysm with diameter larger than 3 cm, operation is indicated. Asymptomatic popliteal aneurysms no more than 3 cm in diameter could be monitored with care.
Objective To investigate the effects of titanium modified by ultrasonic acid etching/anodic oxidation (UAT) loaded with endothelial progenitor cells-exosome (EPCs-exo) on proliferation and osteogenic and angiogenic differentiations of adipose-derived stem cells (ADSCs). Methods The adipose tissue and bone marrow of 10 Sprague Dawley rats were harvested. Then the ADSCs and EPCs were isolated and cultured by collagenase digestion method and density gradient centrifugation method, respectively, and identified by flow cytometry. Exo was extracted from the 3rd to 5th generation EPCs using extraction kit, and CD9 and CD81 were detected by Western blot for identification. The three-dimensional printed titanium was modified by ultrasonic acid etching and anodic oxidation to prepare the UAT. The surface characteristics of UAT before and after modification was observed by scanning electron microscopy; UAT was placed in EPCs-exo solutions of different concentrations (100, 200 ng/mL), and the in vitro absorption and release capacity of EPCs-exo was detected by BCA method. Then, UAT was placed in DMEM medium containing different concentrations of EPCs-exo (0, 100, 200 ng/mL), and co-cultured with the 3rd generation ADSCs to construct UAT-ADSCs-exo. Cell morphology by laser confocal microscopy, live/dead cell staining, and cell proliferation were observed to evaluate biocompatibility; alkaline phosphatase (ALP) staining and alizarin red staining, RT-PCR detection of osteogenesis-related genes [osteocalcin (OCN), RUNT-related transcription factor 2 (Runx2), ALP, collagen type 1 (COL-1)] and angiogenesis-related gene [vascular endothelial growth factor (VEGF)], immunofluorescence staining for osteogenesis (OCN)- and angiogenesis (VEGF)-related protein expression were detected to evaluate the effect on the osteogenic and angiogenic differentiation ability of ADSCs. Results Scanning electron microscopy showed that micro-nano multilevel composite structures were formed on the surface of UAT. About 77% EPCs-exo was absorbed by UAT within 48 hours, while EPCs-exo absorbed on the surface of UAT showed continuous and stable release within 8 days. The absorption and release amount of 200 ng/mL group were significantly higher than those of 100 ng/mL group (P<0.05). Biocompatibility test showed that the cells in all concentration groups grew well after culture, and the 200 ng/mL group was better than the other groups, with fully spread cells and abundant pseudopodia, and the cell count and cell activity were significantly higher than those in the other groups (P<0.05). Compared with the other groups, 200 ng/mL group showed enhanced ALP activity and mineralization ability, increased expressions of osteogenic and angiogenic genes (OCN, Runx2, COL-1, ALP, and VEGF), as well as increased expressions of OCN and VEGF proteins, with significant differences (P<0.05). Conclusion EPCs-exo can effectively promote the adhesion, proliferation, and osteogenic and angiogenic differentiation of ADSCs on UAT surface, the effect is the most significant when the concentration is 200 ng/mL.