Abstract:Objective To report our experience on robot-assisted pedicle screw insertion for scoliosis surgery and to verify the insertion accuracy. Methods A total of 14 patients with scoliosis were treated with robot-assisted pedicle screw insertion surgery (6 males and 8 females), including 12 suffering from idiopathic scoliosis and 2 suffering from congenital scoliosis. The time used by the robotic operation, times of X-ray used, and time for the robotic registration were recorded. CT images were used for evaluating the position of screws after the surgery. Results A total of 148 screws were inserted by the robot-guided machine. Averagely it took (1.7±0.9) times to set the platform for registration, (11.2±7.7) times for using X-ray per operation, and (19.3±6.2) min for each registration(time needed for setting the platform plus X-ray). After finishing the registration, it took an average of (2.4±0.9) min to insert a screw. The coronal Cobb angle was corrected from 50.1° (40°-63°) before operation to 12.8° (2°-28°) after operation, with a correction rate of 74.9% on average. CT images showed that the accuracy of robot-assisted pedicle screw insertion was 95.3% (141/148). Conclusion Mazor robot-guided pedicle screw placement is accurate and safe for scoliosis, and it may be a promising trend in spine surgery.

Abstract:Objective To investigate the absorption behaviors of three kinds of sophora alkaloids(matrine, oxymatrine and sophocarpine)in Caco-2 cells and their metabolic rates in rat liver microsomes. Methods Caco-2 cell absorption model was used to analyze the absorption behaviors of three sophora alkaloids and rat liver microsomal model in vitro was used to investigate the metabolic rates of three sophora alkaloids. The contents of three kinds of sophora alkaloids were determined by HPLC-MS and the permeation rates and metabolic rates were calculated. The analytical conditions were as follows: chromatographic column: Agilent Zorbax SB-C₁₈(3.0 mm×100 mm, 3.5 μm); mobile phase: acetonitrile/water(60:40, V/V)with isocratic elution; injection volume: 5 μL; flow rate: 0.8 mL/min; temperature of column: 30℃; and running time: 9 min. The selective ion monitoring(SIM)in positive ion mode was used in mass spectrometry, with drying gas temperature: 350℃; capillary voltage: 4 000 V; drying gas flow rate: 9.0 L/min; and fragmentor voltage: 90 eV. Results In the Caco-2 cell absorption model, matrine, oxymatrine and sophocarpine were separated with good linearity(r> 0.999 5)between 0.050 5-10.01 μmol/L, with the permeation rates being: matrine 1.251, oxymatrine 0.937 5, and sophocarpine 1.424. In rat liver microsomal model, matrine, oxymatrine and sophocarpine were separated with good linearity(r> 0.999 8)between 0.050 1-1.001 μmol/L, with the half-life period being: matrine 4.331 h,oxymatrine 1.084 h,and sophocarpine 2.478 h. The intra-day and inter-day precisions were <5%, the matrix effect was >80%, and the extraction recovery rate was >88%. Conclusion The three kinds of sophora alkaloids can easily pass the Caco-2 cell absorption model, with active transport being the main way, and it is difficult for them to be metabolized in rat liver microsomes.

Abstract:Objective To analyze the effects of injecting glial fibrillary acidic protein promoter (pGFAP)-containing lentivirus into mouse hippocampus on electroencephalogram(EEG)activity, and to explore the feasibility of applying the lentivirus in epilepsy study. Methods Astrocytes-specific infection of pGFAP lentivirus was identified in both cultured hippocampal cells and hippocampal slices from mice by immunofluorescence techniques. The mice were divided into two groups: artificial cerebrospinal fluid(ACSF)injection group and pGFAP lentivirus injection group. Changes in mice body weight were analyzed before and after brain injection. Changes of power spectrum and high-frequency oscillations(HFOs)of EEG were analyzed by Spike 2 software 3 to 4 weeks after pGFAP lentivirus injection. Results It was found that:(1)non-neuron cells were selectively infected by pGFAP lentivirus in cultured hippocampal cells;(2)pGFAP lentivirus specifically infected GFAP⁺cells in dentate gyrus(DG)area of mouse hippocampus;(3)compared with ACSF injection group, mouse body weight had no significant changes 3 to 4 weeks after the virus injection in pGFAP lentivirus injection group; and(4)pGFAP lentivirus injected into DG area of hippocampus had no significant effect on power spectrum, or the number and mean duration of HFOs of EEG. Conclusion It is a feasible strategy to study the function of astrocytes in epilepsy by brain injection of pGFAP lentivirus.

Abstract:Objective To investigate the protective effects of flurbiprofen axetil(FA) on inhalation lung injury induced by lipopolysaccharides(LPS)inhalation in rats, so as to provide evidence for applying FA in treating inhalation lung injury in clinic. Methods A total of 96 adult male Sprague-Dawley rats were evenly randomized into four groups(n=24): saline negative control group(NS group), model group(LPS group), lipid emulsion preconditioning control group(Lip+LPS group), and FA preconditioning group(FA+LPS group). The model of inhalation lung injury was established with endotracheal instillation of LPS(1 mL/kg)in all experimental groups. NS group was identical to the other three groups except that saline(1 mL/kg)was administered instead of LPS. Lipid emulsion(20%,1 mL/kg)or FA injection(1 mL/kg,10 mg/mL)was intravenously injected via vena caudalis 1 hour before LPS in Lip+LPS and FA+LPS groups, respectively. Rats were sacrificed at 1 h, 6 h, 12 h and 24 h after LPS injection and assigned to 1 h, 6 h, 12 h and 24 h subgroups(n＝6). The arterial blood gas was analyzed and the lungs were removed for determination of the wet/dry mass(W/D)ratio and evaluation of histological injury in all groups. Real-time PCR was used to detect the mRNA levels of PPAR-α and PPAR-γ in rats lung homogenates. The concentration of tumor necrosis factor-alpha(TNF-α)in rat serum was determined by ELISA. Results The rats in LPS and Lip+LPS groups showed damaged structure of lung tissue and inflammation. The mRNA levels of PPAR-α and PPAR-γ in the lung tissues of LPS group were significantly lower than those of NS group(P< 0.05). The serum concentration of TNF-α of LPS group was significantly higher than that of NS group (P<0.05). The pulmonary lesions in FA+LPS group were ameliorated compared with those in LPS and Lip+LPS groups. Pressure of oxygen in arterial blood(PaO₂)was signficantly higher and semi-quantitative pathological score of lung was signficanlty lower in FA+LPS group than those in LPS and Lip+LPS group at 6 h, 12 h and 24 h after injection(P< 0.05). The mRNA levels of PPAR-α and PPAR-γ in rat lung tissues of FA+LPS group were signficanlty higher than those of LPS and Lip+LPS groups at all times, especially, at 6 h after the intravenous injection of LPS(P< 0.05). The serum concentration of TNF-α of FA+LPS group was significantly lower than that of LPS and Lip+LPS groups at all times, expecially, at 1 h after the intravenous injection of LPS (P<0.05). Conclusion FA preconditioning can alleviate the inflammation and protect inhalation injury to lung tissues induced by LPS in rats, which may involve the up-regulation of PPAR-α and PPAR-γ mRNA levels in rat lung tissues and the down-regulation of serum TNF-α.

Abstract:Objective To investigate the diffusion tensor tracking (DTT) imaging character of patients with cervical intraspinal tumors, and to study its association with spinal cord function and prognosis. Methods A total of 24 cervical intraspinal tumors were surgically removed from Feb. 2014 to Jan. 2015. Cervical diffusion tensor imaging (DTI) scan was performed in all patients three days preoperatively and one month postoperatively. The white matter fiber bundle was reconstructed by DTT to observe its traveling routes and integrity, and the spinal cord function was assessed by McCormick grading. Results DTT was able to distinctly display whether the tractography of white matter fiber bundle was full or sparse, intact or interrupted. The technique could also display the spacial relationship(displacement or encasement) between the tumor and fiber bundle. The preoperative tractography was found to be correlated with McCormick grading and prognosis of spinal cord function. Preoperative spinal cord function and prognosis one month postoperatively were significantly better in patients with intact fiber bundle than those with interrupted one (P<0.05). Conclusion DTT can directly display the morphology of white matter fiber bundle, and may also help to predict the prognosis of cervical intraspinal tumors.

Abstract:Objective To investigate the efficacy of ciclopirox olamine vaginal cream for treatment of vulvovaginal candidiasis(VVC). Methods According to the inclusion and exclusion criteria, 605 patients were enrolled in the present study from Jan. 2012 to Oct. 2013. The patients were randomly assigned to experimental group and the control group. Patients in the experimental group were given ciclopirox olamine ointment 5 g/d (ciclopirox olamine 0.05 g/d) for 7 days by vaginal delivery, and those in the control group were given miconazole nitrate suppositories 200 mg/d for 7 days in the same manner. The clinical efficacies of the two groups were compared. Results A total of 586 patients completed the study and the two groups had a good balance. The symptom remission rates 24 h after medication in the experimental group and the control group were 78.25% (223/285) and 41.86% (126/301), respectively, showing significant difference (P<0.01); and the total effective rates one week after treatment were 91.93% (262/285) and 85.05% (256/301), respectively, also showing significant difference between the two groups (P<0.01). The recurrence rates in 204 patients of the experimental group at 3 and 6 months after discontinuation were 0.49% (1/204) and 3.92% (8/204), while in 205 patients of the control group were 7.32% (15/205) and 14.15% (29/205), respectively, showing significant differences between the two groups at both time points(P<0.01). Conclusion Ciclopirox olamine vaginal cream is more effective than miconazole nitrate in treating VVC, and it can significantly reduce the recurrence rate.

Abstract:Objective To investigate the mechanism by which methyl pyropheophorbide-a-mediated photodynamic therapy (Mppa-PDT) inhibit cell viability and induce apoptosis in human ovarian cancer cell line SKOV3. Methods Human ovarian cancer cells SKOV3 at the logarithmic growth phase were divided into Mppa-PDT treated group (both Mppa and PDT treated group) and control groups (the blank group, the only Mppa treated group and only PDT treated group). After Mppa-PDT treatment, the cell viability was examined with CCK-8 assay; cell apoptosis was detected by flow cytometry with Annexin Ⅴ-FITC/PI; and nuclear morphological changes during cell apoptosis was detected by DAPI staning. Moreover, the celluar reactive oxygen species (ROS) were detected by DCFH-DA staining; DNA damage was observed by single cell gel electrophoresis; and the protein expression of p53, Caspase-3, Bax, and Bcl-2 were assessed by Western blotting analysis. Results (1) Mppa-PDT could greatly suppress the cell viability of human ovarian cancer cells SKOV3 in a dose-dependent manner. (2) The cell apoptosis rate of Mppa-PDT treated group was significanlty higher than those of three control groups (blank group, Mppa group and PDT group) (P<0.05), and there was no difference among the three control groups (P>0.05). (3) After treating with Mppa-PDT, DAPI staining showed strongly stained nuclei of the apoptotic cells; DCFH-DA staining displayed higher level of ROS than those of the three control groups; single cell gel electrophoresis showed greater DNA damage than those of the three control groups; and Western blotting analysis showed that the expression of p53, Caspase-3 and Bax protein was increased and Bcl-2 protein was decreased (P<0.05). Conclusion Mppa-PDT can significantly suppress cell viability and induce apoptosis in human ovarian cancer cell SKOV3, accompanied by DNA damage and the activation of mitochondrial apoptosis pathway.

Abstract:Objective To explore the effect of morphine hydrochloride on growth accumulated degree hour(ADH)and cephalopharyngeal skeleton of larvae of Parasarcophaga crassipalpis under natural condition, and to prove the feasibility of predicting the postmortem interval(PMI)using ADH and the shape indexes of cephalopharyngeal skeleton. Methods The larvae of Parasarcophaga crassipalpis were fed under natural condition with rabbit meat injected with morphine hydrochloride before death. The larvae were collected at 12 h intervals until the end of the stage(the larvae did not eat any more). The larvae were fixed in boiling water and were stored as specimen. The average daily temperature during the experiment was calculated for ADH. Then the cephalopharyngeal skeletons were isolated, observed, and then photographed under light mircoscope. Finally the morphology of the cephalopharyngeal skeleton was analyzed by digital image processing system. Results (1)Under natural conditions, the ADH was changed by morphine hydrochloride to a certain degree.(2)The area of the cephalopharyngeal skeleton maintained at a certain level when entered the third instar. The sclerotized area and the average optical density of the cephalopharyngeal skeleton were increased with the increase of ADH till the end of the third instar. The ADH that the sclerotized area and the average optical density reached the maximum was obviously higher than the one that the area of the cephalopharyngeal skeleton reached the maximum. Conclusion Morphine hydrochloride can obviously change the growth ADH of larvae of Parasarcophaga crassipalpis under natural conditions. The sclerotized areas and the average optical densities of the pharyngeal sclerite of the larvae show a good linearity with ADH till the end of the third instar, which can deduce PMI when combined together.

Abstract:Objective To evaluate the biocompatibility of orthodontic brackets coated with TiO_2-xN_x film, and to explore the effects of nitrogen-content and thickness of the film on the film biocompatibility. Methods We successfully prepared the TiO _2-xN_x film brackets samples. L929 cells were divided into film brackets group and control group. The film brackets group was further divided into the nitrogen content groups (argon/nitrogen gas flow ratio of 30: 1, 30:1.5, and 30: 2) and thickness groups (sputtering time were 30, 60, and 90 min). L929 cells were used to evaluate the biocompatibility of TiO_2-xN_x film of orthodontic brackets by the methods of cell adhesion, MTT assay and the lactate dehydrogenase LDH release assay. The experimental data were analyzed by SPSS 19.0 software, and the results were analyzed by one-way ANOVA. Results The L929 cells adhered and spread well on the surface of the brackets both in the film brackets group and the control group. Although the cell proliferation rates of the nitrogen content groups at 24, 48, and 72 h, and of the thickness group at 24 and 72 h were significantly different from that of the control group (P<0.05), the relative proliferation rates were higher than 80% in all the groups. The cell proliferation rate decreased with the increase of nitrogen content, and increased with the increase of film thickness. According to the LDH assay, LDH activity increased with the increase of nitrogen content, and decreased with the increase of film thickness, but there was no significant difference among all the groups (P>0.05). Conclusion The cytotoxicity of TiO_2-xN_x film is at grade 0 level, and nitrogen content and film thickness are relevant factors of the biocompatibility of L929 cells.

Abstract:Objective To investigate the pain burden and pain-related health seeking behaviors in adult patients during hospitalization in the First Affiliated Hospital of Chongqing Medical University, so as to improve the diagnosis and treatment of pain and improve patient satisfaction. Methods A short-term cross-sectional questionnaire survey (72 h) was carried out to investigate the adult patients during hospitalization from July 22^nd to July 24^th, 2013 in our hospital. Results The effective questionnaire response rate was 84%(2 106/2 515). The incidence of pain was 46.96% (989/2 106) in this research. It was found that 68.24%(651/954) of surgical patients having a pain duration less than 1 month. The incidences of moderate-severe pain of surgical patients was 34.80%(332/954) at rest pre-operatively and 28.83%(275/954) post-operatively. We found that 79.91% (1 683/2 106) of patients thought the pain was caused by disease, and 81.10% (764/942) of the patients thought the treatment for pain by the doctors was effective. Age and education level were found to be the factors influencing the pain burden of patients(P<0.05). Conclusion Pain burden is common among adult patients during hospitalization. The incidence of surgical pain is high, with acute and mild pain being the most. The patients have a high degree of awareness of pain and a high satisfactory rate with pain control; however, some pain is still not well controlled. Medical staffs should receive systematic and scientific training and give individual analgesic measures, so as to reduce the prevalence of pain and further improve patient satisfaction.

Abstract:Objective To explore the relationship among high homocysteine hypertension(H-type hypertension), early enlargement of hypertensive intracerebral hematoma and its clinical outcome and death within 3 months. Methods A total of 298 cases with primary cerebral hemorrhage were selected in this study. The data including general information,brain CT scan results within 6 and 24 h, the values of homocysteine(Hcy), blood glucose,cholesterol and fibrinogen, and the scores of National Institute of Health Stroke Scale(NIHSS)were collected. After 3 months follow-up, modified Bathel(MBI)scores and the death tolls were collected as well. Results The increase of plasma Hcy level(odds ratio[OR]=0.356, 95% confidence interval [CI]: 0.131-0.826;P＝0.021)and the elevation of systolic pressure(OR=1.021,95% CI: 1.002-1.028;P＝0.045)were independent risk factors of enlargement hematoma of primary cerebral hemorrhage. The increase of plasma Hcy level(OR=1.031, 95% CI: 1.021-1.278;P＝0.035)and the elevation of systolic pressure(OR=1.141, 95% CI: 1.011-1.072;P＝0.034)were the independent risk factors of clinical poor outcome. Besides,the elevation of systolic pressure(OR=1.023,95% CI: 1.007-1.051;P＝0.021), higher blood glucose(OR=1.382,95% CI: 1.221-1.673;P＝0.004), and the increase of Hcy level(OR=1.521, 95% CI: 1.025-8.096;P＝0.023) were the independent risk factors of death within 3 months. Conclusion H-type hypertension is the independent predictor of early enlargement of hematoma and clinical outcome and death of primary cerebral hemorrhage.

Abstract:Objective To compare the pharmacokinetics of deme-thoxycurcumin hydroxypropyl-β-cyclodextrin phospholipid complex, deme-thoxycurcumin hydroxypropyl-β-cyclodextrin, deme-thoxycurcumin phospholipid complex and deme-thoxycurcumin in rats in vivo, so as to discuss the advantages of hydroxypropyl-β-cyclodextrin phospholipid complex as drug carrier. Methods SD rats were gavaged with the preparations and free drug at 50 mg/mL (dose according to deme-thoxycurcumin). Then, blood samples were drawn from rat retinal venous plexus at 5 min, 10 min, 15 min, 30 min, 45 min, 1 h, 1.5 h, 2 h, 3 h, 4 h, 6 h, 8 h, 10 h, 12 h, 1 d, 2 d and 3 d. And the deme-thoxycurcumin concentrations in blood were determined by HPLC. Results The AUC_0-∞ of deme-thoxycurcumin hydroxypropyl-β-cyclodextrin phospholipid complex was (1 424.87±258.62) μg·L^-1·h, which was higher than that of deme-thoxycurcumin (370.58±2.76) μg·L^-1·h, deme-thoxycurcumin phospholipid complex (716.17±123.18) μg·L^-1·h and deme-thoxycurcumin hydroxypropyl-β-cyclodextrin (1 009.35±138.64) μg·L^-1·h, being 3.84, 1.98, and 1.41 folds of deme-thoxycurcumin, deme-thoxycurcumin phospholipid complex and deme-thoxycurcumin hydroxypropyl-β-cyclodextrin, respectively (P<0.01 or P<0.05). Conclusion The deme-thoxycurcumin hydroxypropyl-β-cyclodextrin phospholipid complex has a better absorption property than deme-thoxycurcumin phospholipid complex and deme-thoxycurcumin hydroxypropyl-β-cyclodextrin, which can help to improve the bioavailability.

Abstract:Tunneling nanotubes (TNT) is a newly discovered connection mode between animal cells, and its formation is of great importance in physiological and pathological processes of animals and humans. The forming conditions and the promoting mechanism of TNT are not fully understood yet. It has been known that the state of cells (such as inflammatory conditions and stress reaction), molecular level (Fas ligand, cell adhesion molecules and the ligand interactions, M-Sec/TNFaip2/B94 and lipid molecules), and pathogenic infection are important for the formation of TNT. In this paper we reviewed the promoting mechanisms for TNT formation.

Abstract:Grainyhead-like 2 (GRHL2), an mammalian homolog of Drosophila grainyhead, is associated with age-related hearing impairment repair, neural tube closure, epidermal integrity, and wound healing; it also takes part in the initiation and progression of cancer. As the research going on, GRHL2 has been proven to be of great importance in different molecular mechanisms of different types of cancer. We herein reviewed the biological functions of GRHL2 family and the roles of GRHL2 proteins in digestive system neoplasms, hoping to lay a foundation for more advanced research of GRHL2.

Abstract:Acute aortic dissection(AAD) is a medical emergency caused by the destruction of the aortic tunica media and is always fatal. Genetic disorders are known to be responsible for AAD, but little is known about the etiology of other non-genetic cases. Tenascin-C(TnC) is a large extracellular matrix glycoprotein and mechanical stretching can up-regulate TnC expression. TnC knockout (TnC-KO) mice have higher blood pressure in the aortic artery and are liable to develop AAD; and mice with AAD have more inflammatory cells in the aortic tissue. TnC prevents aorta from AAD by regulating ECM structure, regulating vascular smooth muscle cell function and inhibiting inflammatory response in the aorta. In this paper we reviewed the role of TnC in the development and progression of AAD.

Abstract:Objective To investigate the association between head fat and metabolic parameters in Chinese obese patients. Methods The data of 99 obese patients were collected from the outpatient department, the Tenth People's Hospital of Shanghai from September, 2011 to December, 2014. The accumulated regional fat was measured by dual-energy X-ray absorptiometry (DEXA). The body weight, body mass index (BMI), neck circumference (NC), waist circumference (WC), hip circumference (HC), visceral index, basal metabolism (BM), liver function, fasting plasma glucose (FPG), fasting insulin, fasting C peptide, blood lipid, uric acid (UA) and C-reactive protein were also obtained for analysis. Results (1) The participants consisted of 35 men and 64 women, with a mean head fat of (1.67±0.34) kg. (2) The head fat was positively correlated with body weight, BMI, NC, WC, HC, visceral index, BM, head fat percentage, arm fat, arms and legs fat, trunk fat, total fat and total muscle in both male and female participants (male: r=0.620, 0.616, 0.670, 0.678, 0.663, 0.635, 0.518, 0.635, 0.488, 0.458, 0.588, 0.618, and 0.579; female: r=0.624, 0.593, 0.610, 0.672, 0.482, 0.657, 0.647, 0.616, 0.639, 0.336, 0.467, 0.544, and 0.762, repectively; all P<0.05). In the female participants the head fat was positively correlated with fasting insulin and UA (r=0.348, 0.349,all P<0.05). For all the participants, the head fat was positively correlated with body weight, BMI, NC, WC, HC, visceral index, BM, UA, head fat percentage, upper arm fat, arms and legs fat, trunk fat, total fat, total muscle, and trunk/peripheral fat (r=0.664, 0.598, 0.685, 0.716, 0.575, 0.703, 0.610, 0.288, 0.526, 0.542, 0.346, 0.527, 0.564, 0.688, and 0.207,respectively; all P<0.05). (3) NC and WC were predictors of head fat for all subjects (β=12.802 and 29.138, both P<0.05); WC was a predictor of head fat for males (β=21.108, P<0.001); and total muscle, upper arm fat, and BM were predictors of head fat for females (β=0.046, 0.116, and-0.914, all P<0.05). Conclusion Head fat accumulation is closely related to the content and distribution of total fat and UA. Head fat may be used as an indicator for metabolic disorder risk for Chinese obese patients.

Abstract:Objective To study the relationship between anxiety and depression symptoms and the relationships of HIV related behaviors with anxiety, depression and their comorbidity among men who have sex with men(MSM), so as to provide evidence for HIV behavior intervention. Methods Nonrandom sampling was applied to recruit MSM. Self-Rating Anxiety Scale (SAS) and The Center for Epidemiological Studies Depression Scale (CES-D) were used to evaluate the anxiety and depression symptoms. The participants were divided into four groups according to the results: anxiety, depression, their comorbidity and negative groups. The differences in HIV related behaviors among the four groups were compared and the canonical correlation analysis was used to study the relationship between anxiety and depression symptoms. Results Totally 854 MSM were surveyed in the present study. The detection rate of anxiety was 31.97% (273/854) and that of depression was 45.55% (389/854). The positive rate of comorbid anxiety and depression was 27.28% (233/854). Variance analysis showed that anxiety, depression and their comorbidity were correlated with 4 demographic characteristics:registered residence, educational level, sexual orientation and history of sexually transmitted disease (STD) (P<0.05); three HIV related behaviors(number of female sexual partners, looking for partner via the internet in recent 6 months, and providing or getting commercial sex services in recent 6 months) were correlated with anxiety, depression and their comorbidity (P<0.05).The canonical correlation analysis showed that depressed affect(X1), somatic and retarded activity(X3) of depression had a positive impact on anxiety and panic(Y1), somatic control(Y3) and gastrointestinal sensations(Y4) of anxiety; positive affect (X2) had a positive impact on vestibular sensations(Y2), while education(X6) had a negative influence on it. Conclusion Anxiety and depression are common in MSM, and there is a close relation between anxiety and depression symptoms; comorbidity of anxiety and depression is common; and all of them are highly associated with HIV related behaviors.

Abstract:Objective To explore the role of Treg/Th17 cell ratio imbalance in the pathogenesis of idiopathic thrombocytopenic purpura (ITP) patients with different Traditional Chinese Medicine (TCM) syndrome differentiation classifications: bleeding due to blood-heat, Yin deficiency with fire hyperactivity and Qi deficiency-caused bleeding. Methods A total of 92 patients were divided into the bleeding due to blood-heat group (n=30), Yin deficiency with fire hyperactivity group (n=31) and Qi deficiency-caused bleeding group (n=31) according to the TCM syndrome differentiation classification. The peripheral blood samples were obtained from the patients and 30 volunteers served as healthy controls. The percentages of Treg cells and Th17 cells in the blood samples were analyzed by flow cytometry, and the mRNA levels of Foxp3 and ROR-γt were analyzed by RT-PCR. Results The percentages of Treg cells in the peripheral blood of 3 different TCM syndrome ITP groups were significantly lower than those of control group (P<0.05), that of the bleeding due to blood-heat group was significantly lower than that of Yin deficiency with fire hyperactivity group and Qi deficiency-caused bleeding group (P<0.05), and that of Qi deficiency-caused bleeding group was signficantly lower than that of Yin deficiency with fire hyperactivity group (P<0.05). The percentages of Th17 cells in peripheral blood of 3 different TCM syndrome ITP groups were significantly higher than that of control group(P<0.05), and that of Yin deficiency with fire hyperactivity group was signficanlty higher than that of Qi deficiency-caused bleeding group (P<0.05). The ratios of Treg/Th17 of the 3 different TCM syndrome ITP groups were significantly lower than that of control group (P<0.05), that of the bleeding due to blood-heat group was significantly lower than that of Qi deficiency-caused bleeding group and Yin deficiency with fire hyperactivity group (P<0.05), and that of Qi deficiency-caused bleeding group was significantly lower than that of Yin deficiency with fire hyperactivity group (P<0.05). The Foxp3 mRNA levels of 3 different TCM syndrome ITP groups were significantly lower than that of control group (P<0.05), and there were significant differences between each two groups by the pairwise comparison (P<0.05). While ROR-γ mRNA levels of the 3 different TCM syndrome ITP groups were significantly higher than that of the control group (P<0.01). Conclusion The decreased Treg cells in patients with ITP contributes to the development and progression of ITP. The imbalance of Treg/Th17 ratio may play a critical role in the pathogenesis of ITP. The distribution of the percentages of Treg cells, the ratio of Treg/Th17 and the mRNA level of Foxp3 in a increasing order is: bleeding due to blood-heat group < Qi deficiency-caused bleeding group < Yin deficiency with fire hyperactivity group.

Abstract:Objective To summarize the experience of imaging misdiagnosis in patients with ductal adenocarcinoma of pancreas (DACP), to investigate the reasons of misdiagnosis and improve the imaging diagnosis of DACP. Methods The 51 patients who were misdiagnosed by imaging in this study included 13 men and 38 women, with ages ranging from 37-79 years old and the median being 54 years old. All patients underwent CT and MRI examination before they were confirmed as DACP by pathological examination after surgery. The imaging data and pathological results were reviewed and the reasons of misdiagnosis were analyzed. Results Twenty poorly differentiated DACP without cysts were misdiagnosed as "cystic tumor of pancreas" or "pancreatic cyst" due to no obvious enhancement in images; 16 cases of DACP associated with pseudocysts were misdiagnosed as "pancreatitis associated with pseudocyst" due to that the tumors were masked by pseudocysts; and 15 cases of DACP associated with obstructive pancreatitis were misdiagnosed as "focal pancreatitis" due to the tumors' small volume and pancreatitis mask. Indefinite-edge masses which documented no or slight enhancement were seen in all cases (100%); 43 cases (84%) documented the dilated main pancreatic duct were "interrupted"; and 100% of bile ducts were blocked by masses located in the pancreatic head. Conclusion Knowing the local anatomy of pancreas and histopathological features of DACP and understanding imaging characteristics of the secondary changes of DACP can help to avoid imaging misdiagnosis.

Abstract:Objective To analyze the prevalence of dental anxiety in jaw cyst patients treated by cyst plug after fenestration decompression and to discuss its possible correlative factors. Methods A questionnaire survey was conducted among a total of 198 adult outpatients treated by cyst plug after fenestration decompression in our department from Mar.2012 to Dec.2014. All patients completed the Modified Dental Anxiety Scale (MDAS) to evaluate the level of dental anxiety and the related factors. The data were analyzed by SPSS 22.0 software package. Results The prevalence rate of dental anxiety in the outpatients treated by cyst plug after fenestration decompression was 63.6% (126/198) in the present study; χ² test results showed significant differences in the prevalence rates of dental anxiety in regard to the factors of sex, age, marital status, Visual Analogue Scale (VAS) degree, and receiving initial treatment or not(P<0.05); Logistic regression analysis demonstrated that the risk factors of dental anxiety included sex, age, VAS degree, and initial treatment or not; and Spearman rank correlation analysis showed a weakly positive correlation between VAS degree and MDAS classification, and the correlation coefficient was statistically significant. Conclusion The prevalence rate of dental anxiety in jaw cyst patients treated by cyst plug after fenestration decompression is high. Dental anxiety is closely associated with sex, age, marital status, VAS degree, and being initial treatment or not; and a positive correlation is found between the cyst fenestration decompression pain degree and the MDAS anxiety level.

Abstract:Objective To compare the urine aquaporin 2 (AQP2) levels between asthmatic patients and healthy participants, explore the AQP2 levels in patients with asthma of different clinical control levels and its relationship with inflammatory factors. Methods Urine AQP2 levels were examined by ELISA in 60 patients with asthma and 21 healthy participants; plasma interleukin (IL)-4, IL-6, tumor necrosis factor (TNF)-α and interferon (IFN)-γ levels were determined by by CBA method. Results The levels of urine AQP2 in clinical uncontrolled asthma group (ACT below 19) and partially controlled asthma group (ACT 20~24) were significantly higher than that in the healthy control group(P<0.01), and the level in the uncontrolled group was (174.28±40.81)pg/mL. The plasma IL-4 level in uncontrolled group was (1.10±0.25)pg/mL, which was significantly higher than those in the other two groups (P<0.01). The plasma IL-6 level in uncontrolled asthma group was the highest but showing no significant difference when compared with the other two groups(P=0.058). The TNF-α level in asthma patients was significantly higher than that in healthy controls(P<0.05). Urine AQP2 was found significantly correlated with plasma IL-4 and IL-6 levels(P=0.049,P=0.010); plasma IL-4 level was significantly correlated with IFN-γ level(P=0.019); IL-6 was significantly correlated with TNF-α level(P=0.010); and IL-10 was significantly correlated with IFN-γ levle(P=0.005). Conclusion Urine AQP2 level of asthma patients is increased, and it is significantly correlated with plasma levels of inflammatory factors IL-4 and IL-6. The role of AQP2 in the pathogenesis of bronchial asthma is worth further studying.

Abstract: