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鼻咽部黏膜黑色素性嗜酸细胞化生（melanotic oncocytic metaplasia，MOM）属于罕见的良性病变，其临床表现不典型，易被误诊为血管瘤、痣或恶性黑素瘤等。本文通过回顾3例就诊于十堰市太和医院耳鼻咽喉头颈外科的鼻咽部MOM患者的诊疗过程，探讨该疾病的喉镜表现、病理特点、鉴别诊断及治疗。.

Regarding scarce capacities an early detection consultation (EDC) was established to discriminate patients in an outpatient setting with inflammatory from non-inflammatory rheumatic diseases. A total of 500 patients suspected of having a rheumatic disease received an appointment within 2 weeks. They were interviewed with the help of a digital questionnaire (RhePort), briefly physically examined followed by a determination of CRP. The questionnaire answers were scored using an algorithm within RhePort (from 0 = non-inflammatory to 4 = highly probably inflammatory). Likewise, after completion of the EDC, the rheumatologists scored the overall assessment. The RhePort score and EDC score were compared with the "true" diagnosis made in a detailed second examination after an average of 10 weeks. In 490 evaluable patients 133 inflammatory (27%) and 357 noninflammatory rheumatic diseases (73%) were diagnosed. A classification based solely on the RhePort questionnaire (score 1) identified 103 out of 129 as inflammatory (sens. 80%) and 125 out of 355 as non-inflammatory (spec. 35%) resulting in an AUC of 0.62 after ROC analysis. With a score 1, the rheumatological assessment after EDC classified 130 out of 133 patients as inflammatory (sensitivity 98%) and 261 out of 357 as non-inflammatory (specificity 73%). The combined EDC can decisively increase the sensitivity and specificity compared to an "automated" survey by means of a digital questionnaire alone. In addition to the early identification and treatment of inflammatory patients, rapid identification of patients who are not in need of rheumatological treatment can create capacities for care.Angesichts knapper rheumatologischer Ressourcen wurde eine digital unterstützte Früherkennungssprechstunde (FS) etabliert zur frühen und sicheren Unterscheidung von Patienten mit entzündlich rheumatischen vs. nichtentzündlichen Erkrankungen. Es erhielten 500 Patienten mit Verdacht auf eine rheumatische Erkrankung einen Termin innerhalb von 2 Wochen. Sie wurden mithilfe eines digitalen Fragebogens (RhePort) befragt, kurz symptomorientiert untersucht, rheumatologische Basislaborwerte wurden bestimmt. Die Antworten wurden mit einem in RhePort hinterlegten Algorithmus gescort (von 0 = nichtentzündlich bis 4 = hochwahrscheinlich entzündlich), ebenso die Gesamteinschätzung der Rheumatologen nach Abschluss der FS. RhePort-Score und FS-Score wurden verglichen mit der Referenzdiagnose, die bei einer ausführlichen Zweituntersuchung nach im Mittel 10 Wochen erfolgte. Bei 490 auswertbaren Patienten wurden 133 entzündlich rheumatische (27 %) und 357 nichtentzündliche Erkrankungen (73 %) diagnostiziert. Eine Klassifikation allein aufgrund des RhePort-Fragebogens (Score 1) erkannte 103 von 129 als entzündlich (Sens. 80 %) und 125 von 355 als nichtentzündlich (Spez. 35 %), was in einer AUC von 0,62 nach ROC-Analyse resultierte. Bei einem Score 1 klassifizierte die rheumatologische Einschätzung nach FS 130 von 133 Patienten als entzündlich (Sensitivität 98 %), 261 von 357 nichtentzündlich (Spezifität 73 %). Die kombinierte FS kann Sensitivität und Spezifität entscheidend steigern im Vergleich zu einer alleinigen „automatisierten“ Befragung mittels Fragebogen. Neben früher Identifikation und Behandlung von entzündlich rheumatischen Patienten können durch schnelle Identifikation nicht rheumatologisch behandlungsbedürftiger Patienten Kapazitäten für die Versorgung geschaffen werden.

Total mesorectal excision (TME) represents the gold standard for radical resection in rectal cancer. The development in radiology and laparoscopic surgical equipment and the advancement in technology have led to a deepened understanding of the mesorectum and its surrounding structures. Both the accuracy of preoperative staging and the preciseness of the planes of TME surgical dissection have been enhanced. The postoperative local recurrence rate is reduced and the long-term survival of rectal cancer patients is improved. The preservation of the pelvic autonomic nervous system maintains the patient's urinary and sexual functions to the greatest extent possible, which in turn improves the patient's postoperative quality of life. A thorough understanding of the anatomy of the mesorectum and its surrounding structures is a prerequisite for successful TME. Herein, we review the basic concepts and the anatomy of the mesorectum in the current literature. Some important clinical issues are also discussed systematically in terms of imaging, surgery, and pathology.全直肠系膜切除（TME）是直肠癌根治术的"金标准"。近年来，随着影像及腹腔镜外科器械设备和技术的进步，人们对直肠系膜及周围结构的认识逐步加深，术前分期更加准确，TME手术平面更加精准，明显降低了患者术后的局部复发率，改善了远期生存。同时，自主神经系统得到比较完好的保留，最大程度地保护了患者的排尿和性功能，改善了患者术后的生活质量。正确认识直肠系膜及盆腔的解剖结构，是成功施行TME手术治疗的前提。因此，本文结合既往文献，对直肠系膜的基本概念及解剖结构进行了深入探讨，并从影像、外科及病理多学科角度，对临床相关重要问题进行了系统阐述。.

Glaucoma is the leading irreversible blinding eye disease worldwide, and China has the largest amount of primary angle-closure glaucoma (PACG). To reduce blindness, the therapeutic evolution can play a role. With the technical development of minimally invasive glaucoma surgery (MIGS), the treatment of angle-closure glaucoma has been in a transformation. This article reviews the literatures related to the advances of MIGS in the combined treatment of PACG. The research findings show that MIGS may become one of the preferred surgical treatments for PACG in the future clinical management of glaucoma.青光眼是世界首位不可逆性致盲眼病，中国作为原发性闭角型青光眼发病率最高国家，重视和改进其治疗方法是降低致盲率的有效途径。随着微创青光眼手术（MIGS）技术的发展，原发性闭角型青光眼的治疗方法更新迭代。本文汇总目前国内外相关文献，总结MIGS在原发性闭角型青光眼联合手术治疗中的应用进展，提示MIGS可能成为未来治疗原发性闭角型青光眼的优选联合方法，为临床提高青光眼治疗水平提供参考。.

Based on the data from China Health and Nutrition Survey (CHNS), 840 girls aged 6-15 years who had information about menarche and participated in dietary survey at least once within 1-5 years before onset of menarche between 1989 and 2015 were included in the study. The median age at baseline of the 840 participants was 10 (9, 11) years. The median age at menarche of the participants was 13 (12, 14) years. After adjusting for the age of birth, place of residence, body mass index Z-score, physical activity level and annual household income per capita, the average age of menarche was advanced by 0.036 (95%利用中国居民健康与营养调查（CHNS）数据，选取1989—2015年间具有初潮信息且在初潮发生前1~5年内至少参与了一次膳食调查的840名6~15岁女童作为研究对象。840名研究对象的年龄

Introduction Lingual thyroglossal duct cysts (LTGDC) are a rare kind of thyroglossal duct cyst. However, Sistrunk surgery is not very suitable for this type of cyst. This study aimed to explore the efficacy of transoral excision of LTGDC by plasma coblation. Methods The present study reviewed 11 patients, comprising seven males and four females, who had been diagnosed with LTGDC preoperatively by computed tomography (CT) and fibre-optic electronic laryngoscopy. Of those patients, two had recurrence after surgery of epiglottic cysts. All these patients underwent transoral excision by plasma coblation. Then, we collected preoperative data of the patients, observed the effect of surgery, and analysed factors relevant to LTGDC, including the estimated bleeding amount, postoperative hospitalisation, complications and recurrence rates. Results The connection between LTGDC and hyoid was tapered on sagittal images of CT, which was vital evidence for the diagnosis of LTGDC. Surgery was performed successfully for all 11 patients, and all recovered without complication. There was no evidence of recurrence after surgery, during follow up for 3–43 months. Conclusions Transoral surgery for LTGDC can be performed successfully by plasma coblation, which is an effective and safe surgical treatment. Fibre-optic electronic laryngoscopy and CT are essential to the diagnosis of LTGDC in order to avoid missing detection and misdiagnosis.

近年来，急性胰腺炎局部并发症的治疗手段日趋成熟，微创阶梯引流模式已被人们广泛接受。本文将结合当前的实践证据，规范急性胰腺炎不同时期局部并发症的定义，并就其干预指征与时机作出具体阐述。.

Previous studies have shown that microRNA-765 (miR-765) is involved in certain biological behaviors of human cancers. However, abnormal expression and function of miR-765 have not been reported in osteosarcoma (OS).Changes in the expression of miR-765 and MTUS1 (Microtubule-associated tumor suppressor 1) were examined via Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot analysis. The function of miR-765 was investigated through Cell Counting Kit-8 (CCK-8) and transwell assays in OS. The target of miR-765 was identified using a Dual-Luciferase reporter assay.MiR-765 was upregulated in OS tissues. And upregulation of miR-765 promoted cell proliferation, migration and invasion in OS. In addition, MTUS1 was confirmed as a direct target gene of miR-765. Moreover, miR-765 promoted the progression of OS through targeting MTUS1. Furthermore, miR-765 was involved in tumorigenesis of OS through activating extracellular-signal-regulated kinase/ epithelial-mesenchymal transition (ERK/EMT) pathway.MiR-765 targets MTUS1 to promote the progression of OS via mediating the ERK/EMT pathway. Therefore, miR-765 may be used as a novel biomarker for the diagnosis of OS.

This study analyzed the temporal-spatial distribution characteristics, epidemiological characteristics and gene sequences of hemorrhagic fever with renal syndrome (HFRS) in Guangxi, with the intention of providing a theoretical and technical support for the prevention of HFRS. A map of the incidence of HFRS of different cities in Guangxi was drawn up using the Geographic Information System (GIS) to investigate the epidemiological characteristics and infection source of HFRS between 2013 and 2016. Guangxi has a low incidence of HFRS, and autumn and winter are the main high-incidence seasons. Cases of HFRS were reported in all regions in Guangxi except Laibin city between 2013 and 2016. The distribution of cases in the four years suggested that Guilin, Nanning, Hechi and Wuzhou were the main infected regions, especially the local areas in the north of Guilin. The nucleotide and amino acid of S fragment and M fragment of Hantaviruses (HV) detected were highly homologous, and no obvious variation was found. Through analyzing the space-time characteristics, epidemiological characteristics and gene sequence of HFRS in Guangxi, it was found that areas rich in water, grass and moisture, such as paddy fields, are the main active areas for the host of HFRS.

To retrospectively analyze the efficacy of interferon plus imatinib (IM) in patients with chronic-phase chronic myelogenous leukemia(CML-CP)and ABL kinase domain mutations. The mutation rates of ABL kinase region in patients with Sokal score low, medium and high risk CML-CP were statistically significant (6.25%, 9.42% and 47.06%

To evaluate the clinical efficacy of anterior debridement combined with posterior atlantoaxial fusion for atlantoaxial Tuberculosis.From February 2005 to February 2013, 7 patients, 3 males and 4 females, with atlantoaxial Tuberculosis underwent anterior debridement combined with posterior atlantoaxial fusion in Department of Orthopedics Zhengzhou University People's Hospital were selected.In the preoperative and final follow-up, Japanese Orthopaedic Association score (JOA), neck disability index (NDI) and Frankel Classification were used to evaluate neurological function and calculate improvement rate.At final follow-up, clinical efficacy was evaluated by Odom's grade.Situation of internal fixation, fusion of upper cervical were assessed by X-ray, CT scan and MRI scan.Bony fusion were achieved in 7 cases after operation in 12 months. Tuberculosis were reached clinical cure between 17 and 21 months. At follow The JOA score increased from (11.1±0.7) preoperatively to (15.3±0.5) in final follow-up(P0.05), and the NDI decreased from (34.0±4.6) preoperatively to (10.1±1.3) in final follow-up (P0.05). At last follow-up, according to Odom's standard, excellent were obtained in 5 cases, good 1 cases and ordinary 1 case. Frankel Classification of all cases improved from D class to E.The treatment of anterior retropharyngeal debridement combine with atlantoaxial fusion, and local anti-tuberculosis drug using intraoperative, not only could obtain reliable clinical efficacy, completly removal of lesions, but also obtain strong stability, which plays an important role in the treatment of atlantoaxial Tuberculosis.

Introduction To provide standard implemental cells for biomedical research, an immortalized mesenchymal stem cell (MSC) lineage was established from the bone marrow of Chinese Guizhou minipigs. We investigated the characteristics of the MSC transfected with hTERT. Methods MSCs isolated from bone marrow (BM) were steadily transfected using a plasmid containing human telomerase reverse transcriptase gene (pCI-neo-hTERT) at population doubling (PD) time of 3. The expression of hTERT was analyzed by reverse transcriptase polymerase chain reaction; the morphology of the cells, by phase contrast microscope; cell growth curve, by MTS assay, and phenotype, flow cytometry and immunofluorescence. Karyotype and osteogenic differentiation of transfected cells were compared with normal MSCs. Results After transfection with the hTERT gene, the MSCs showed vigorous proliferation activity undergoing more than 60 PDs. Expression of the hTERT gene was detected in these cells. Transfected MSCs showed a prolonged life span, maintaining similar morphology and karyotype compared with normal MSCs. The apoptotic rate of transfected MSCs at PD60 was far below that of the normal MSCs at PD15. More than 99% of transfected MSCs were positive for stem cell markers, including SH-2, SH-3, SB-21, and CD29, and negative for CD34, CD45, and SLA-II. Transfected MSCs possessed the ability to differentiate into osteogenic as same as that of normal MSCs. Conclusion The hTERT gene-induced immortalization prolonged the life span of MSCs, maintaining the overall properties identical to the original cells, findings that will be useful for basic research.

Introduction Our previous experiments indicated that bone marrow mesenchymal stem cells of rhesus monkey (RhBMSCs) have a low proliferative ability with a finite life span, which will hamper their application in biomedical research. Establishing an immortalized RhBMSC lineage might solve the problem. Methods RhBMSCs isolated from the bone marrow of rhesus monkeys using density gradient centrifugation were purified using adherence separation. Then, the cells were steadily transfected by plasmid containing human telomerase reverse transcriptase gene (pCI-neo-hTERT). We analyzed expression of hTERT, proliferation, phenotype (SH-2, SH-3, SB-10, CD29, CD34, CD45, and HLA-DR), differentiation toward osteogenic lineage, karyotype, and tumorigenesis of transfected cells. Results After transfection, the RhBMSCs proliferated vigorously, undergoing more than 50 population doublings (PDs). Apoptotic rate of transfected RhBMSCs at PD40 was only 4.5%, versus untransfected RhBMSCs at PD15, which was more than 33.5%. Compared with normal RhBMSC, the life span of transfected RhBMSCs was prolonged, retaining similar morphology, karyotype, and potential to differentiate into an osteogenic lineage. More than 99% of transfected RhBMSCs were positive for stem cell markers, including SH-2, SH-3, SB-10, and CD29, and negative for CD34, CD45, and HLA-DR. Furthermore, the transfected cell line was benign in nude mice tumor formation. Conclusion Our results demonstrated that hTERT gene had been transfected into RhBMSCs. The transfected RhBMSCs proliferated vigorously. Phenotype, differentiation, and karyotype of transfected RhBMSC showed no significant difference from untransfected cells. The transfected RhBMSCs are a potential cell source for transplantation as well as tissue engineering.

Background and Objectives Six patients died and one patient survived following infusion of a specific lot of intravenous immunoglobulin (IVIG) within half an hour in May 2008. This study elucidated the underlying pathogenesis. Materials and Methods A variety of protein fractionation and identification approaches were employed to determine the abnormal components in IVIG products obtained from the hospital where the patients were treated. Animal studies using mice and monkeys were conducted to elucidate the pathophysiological mechanisms. In animal experiments, the effect and distribution of immunoglobulin was investigated using HE staining and immunohistochemistry (IHC) separately, while platelets and fibrinogen depletion were utilized to determine a possible link between thromboembolism formation in animals and the lethal effect of the IVIG. The size and distribution of the protein aggregates were determined with Coulter Counter Multisizer-3 after the dilution of the IVIG with plasma, and the lethal effect of the protein aggregates was simulated with artificial microparticles. Results The IVIG retrieved from the hospital was found to have striking similarities to the heat-treated IVIG in terms of protein aggregation profiles and lethal effects. Post-mortem examination indicated that immunoglobulin aggregates were mainly found in the lung of the animals, while depletion of platelets and fibrinogen from the IVIG preparations failed to prevent the death of the animals. Similar amount of artificial microparticles caused animal death in similar fashion. Conclusions Our findings indicate that the retrieved IVIG exerted its lethal effects by blocking the pulmonary circulation without markedly altering the coagulation cascade or immunological events.

Objective: The purpose of this study was to investigate the plasma levels of tumor necrosis factor (TNF)-alpha, its soluble p55 and p75 receptors, ex vivo lipopolysaccharide (LPS)-stimulated TNF-alpha production, and plasma levels of interleukin 6, interleukin 1, and interleukin 10 during a 7-day oral administration of iloprost in patients with active rheumatoid arthritis. Methods: During oral 7-day administration of the prostacyclin analog iloprost, the plasma levels of TNF-alpha, soluble p55, and p75 TNF-alpha receptors, IL-1, IL-6, and IL-10 and C-reactive protein (CRP) in serum were determined on days –1, 1, 3, 4, 6, and 8 and after a treatment-free follow-up on day 15. In addition, the ex vivo TNF-alpha production in whole blood under LPS-stimulated and -unstimulated conditions were measured. Fifteen patients with active rheumatoid arthritis and baseline TNF-alpha plasma levels of ≥2 pg/ml were included in independent groups receiving 50 µg, 100 µg, or 150 µg iloprost per day in addition to their conventional antirheumatic therapy. The respective dose was given once daily from days 1 to 3 and doubled from days 4 to 7. The tender and swollen joint count (28 joints) and the patients' assessments of pain severity and general feeling (10-cm visual analog scale) were performed on days –1, 4, and 8 (end of treatment) and after a 7-day follow-up. Results: The patients showed decreased TNF-alpha levels during iloprost administration. The decrease in the ex vivo LPS-stimulated TNF-alpha production and plasma levels of the p75 TNF receptor were found to be associated with a decrease in the number of tender joints. Additionally, IL-6 was downregulated. Conclusion: A 7-day oral administration of iloprost resulted in a change of in vivo and ex vivo cellular cytokine production, with reductions in TNF-alpha and p75 TNF receptor plasma levels. These changes were associated with clinical improvements in active rheumatoid arthritis.

BACKGROUND AND PURPOSE: Craniocervical artery dissection is the most common cause of ischemic stroke identified in young adults. For the diagnosis of craniocervical artery dissection, multisequence MR imaging is recommended but is time-consuming. Recently, investigators proposed a simultaneous noncontrast angiography and intraplaque hemorrhage imaging technique allowing simultaneous noncontrast MRA and vessel wall imaging in a single scan. This study sought to investigate the feasibility of 3D simultaneous noncontrast angiography and intraplaque hemorrhage MR imaging in the characterization of craniocervical artery dissection. MATERIALS AND METHODS: Twenty-four symptomatic patients (mean age, 45.0 ± 16.1 years; 21 men) with suspected craniocervical artery dissection were recruited. The 3D simultaneous noncontrast angiography and intraplaque hemorrhage 3D TOF MRA and black-blood imaging sequences were performed on a 3T MR imaging scanner. The agreement between simultaneous noncontrast angiography and intraplaque hemorrhage imaging and multisequence MR imaging in evaluating arterial dissection was determined. RESULTS: Dissection was found to involve 1 artery in 22 patients and 2 arteries in 2 patients. The intramural hematoma and luminal occlusion were detected in 19 (79.2%) and 11 (45.8%) patients, respectively. In measuring stenosis, the Cohen κ value between 3D TOF MRA and simultaneous noncontrast angiography and intraplaque hemorrhage imaging was 0.82 ( P < .001). All intramural hematomas on multisequence imaging were successfully identified by simultaneous noncontrast angiography and intraplaque hemorrhage imaging. CONCLUSIONS: 3D simultaneous noncontrast angiography and intraplaque hemorrhage imaging showed excellent agreement with multisequence MR imaging in evaluating luminal stenosis and intramural hematoma in patients with craniocervical artery dissection. The simultaneous noncontrast angiography and intraplaque hemorrhage imaging saved nearly 50% of scanning time compared with multisequence MR imaging. Our findings suggest that 3D simultaneous noncontrast angiography and intraplaque hemorrhage imaging might be an alternative, time-efficient diagnostic tool for craniocervical artery dissection. CCAD : craniocervical artery dissection IMH : intramural hematoma MERGE : Multi-Echo Recombined Gradient Echo SNAP : simultaneous noncontrast angiography and intraplaque hemorrhage

Several single-nucleotide polymorphisms (SNPs) in DNA repair gene have been shown to affect DNA repair and to modify susceptibility to cancer. In this study, to investigate the role of these SNPs in glioma, we examined the potential association of 14 SNPs in DNA repair genes with the glioma risk in a Chinese population. We included 326 glioma cases and 376 cancer-free controls. Genotyping of the 14 SNPs was performed on 384-well plates on the Sequenom MassARRAY platform. Of the 14 SNPs, rs1799782 and rs1799793 did not display the Hardy-Weinberg equilibrium in the control group. Moreover, the genotype distribution differed significantly between the two groups for the SNPs rs25487, rs3218536, and rs1799793. The rs25487 G/G genotype strongly and significantly increased the risk of glioma when compared with the rs25487 A/A genotype, indicated by an odds ratio (OR) = 2.23 [95% confidence interval (95%CI) = 1.36-3.87]. The rs25489 A/G genotype was also significantly associated with increased risk of glioma when compared with the A/A genotype (OR = 1.52; 95%CI = 1.03-2.35). In addition, rs1799782 increased the risk of glioma (OR = 1.89; 95%CI = 1.27-3.04), and a similar association was found for rs1800067 (OR = 1.89; 95%CI = 1.21-3.07). In conclusion, the results of our study suggest that the rs25487, rs25489, rs1799793, and rs13181 SNPs are associated with an increased risk of glioma. These findings may be useful for identifying the genetic factors involved in the development of glioma to help devise more efficient strategies to prevent this disease.

Laminin-α2 deficient congenital muscular dystrophy (CMD) is an autosomal recessive disorder characterized by severe muscular dystrophy, which is typically associated with abnormal white matter. In this study, we assessed 43 CMD patients with typical white matter abnormality and laminin-α2 deficiency (complete or partial) diagnosed by immunohistochemistry to determine the clinical and molecular genetic characteristics of laminin-α2 deficient CMD. LAMA2 gene mutation analysis was performed by direct sequencing of genomic DNAs. Exonic deletion or duplication was identified by multiplex ligation-dependent probe amplification (MLPA) and verified by high-density oligonucleotide-based CGH microarrays. Gene mutation analysis revealed 86 LAMA2 mutations (100%); 15 known and 37 novel. Among these mutations, 73.9% were nonsense, splice-site or frameshift and 18.8% were deletions of one or more exons. Genetic characterization of affected families will be valuable in prenatal diagnosis of CMD in the Chinese population.

In recent years, several researches have showed that Buyang Huanwu Decoction (BHD) possesses multiple target points in the intervention of diseases, and has same treatment effects on cerebrovascular diseases and cardiovascular diseases. But, there was no full report about the mechanistic and material basis in Brain-Heart concurrent treatment. The objective of the present study was to examine the pharmacological mechanism of traditional Chinese medicine in the intervention of coronary heart disease and stroke. We combined the HIT, PubChem, David Database resource and the networked pharmacology method to ultimately find out BHD’s thirty-five potential brain-heart concurrent treatment target points, and preliminarily reveal BHD’s material basis for treatment of cerebrovascular diseases and cardiovascular diseases. Finally, the study provided new information with the guidance meanings.Key words: Buyang Huanwu Decoction (BHD), Brain-Heart concurrent treatment, Pharmaceutical effect mechanism, Material basis.

Pulsed-dye laser (PDL)-mediated photothermolysis is the current standard treatment for port-wine stain (PWS) birthmarks. Vascular-targeted photodynamic therapy (PDT) might be an alternative for the treatment of PWS.To compare clinical outcomes of PDT and PDL treatment of PWS.Two adjacent flat areas of PWS lesions were selected from each of 15 patients (two male and 13 female; age 11-36 years) and randomly assigned to either single-session PDL or PDT. PDL was delivered using a 585-nm pulsed laser. PDT was carried out with a combination of haematoporphyrin monomethyl ether (HMME) and a low-power copper vapour laser (510.6 and 578.2 nm). Clinical outcomes were evaluated colorimetrically and visually during follow-up.A total of nine red PWS lesions and six purple PWS lesions were treated. For red PWS, colorimetric assessment showed that the blanching rates of PDL and PDT at 2 months ranged from -11% to 24% and 22% to 55%, respectively. For purple PWS, blanching rates of PDL and PDT ranged from 8% to 33% and 30% to 45%, respectively. Overall, there was a significant difference between the blanching effect of single-session PDL treatment and a single-session PDT treatment.This side-by-side comparison demonstrates that PDT is at least as effective as PDL and, in some cases, superior. The true value of PDT for the treatment of PWS deserves further investigation.

The objective of this study was to evaluate outcomes of patients who suffered complete brachial plexus avulsion before and after nerve transfers by assessing upper extremity function and pain using the DASH and NRS questionnaires. Patients who underwent nerve transfers improved their DASH and NRS scores compared with before surgery. Although individually there was no correlation with improved scores, the triple combination of rehabilitation exercises, electrical stimulation therapy and neurotrophic drugs postoperatively correlated positively with improved functional outcomes. This study suggested a positive effect of the passage of time and nerve transfers in total brachial plexus avulsions from patients’ self assessments.

TAp63 is a tumour-suppressor protein that is often underexpressed in various types of cancer. It has been shown to activate gene transcription depending on the transcription domain and to be closely related with metastasis. In this study, we demonstrate that TAp63 suppresses metastasis in colon cancer cells through microRNA-133b.We evaluated the correlation of TAp63 and miR-133b with HT-29 and SW-620 cells and investigated the roles of TAp63 in the expression of RhoA, E-cadherin and vimentin. We further investigated the roles of TAp63-mediated invasion and migration of colon cancer cells.TAp63 expression is downregulated in colon cancer, and microRNA-133b is a transcriptional target of TAp63. Furthermore, microRNA-133b is essential for the inhibitory effects of TAp63 on RhoA, E-cadherin and vimentin. Moreover, TAp63 inhibits cell migration and invasion through microRNA-133b. Correspondingly, the inhibitory effect of TAp63 on RhoA, E-cadherin, vimentin, migration and invasion can be blocked by the microRNA-133b inhibitor.TAp63 and microRNA-133b were able to suppress the metastasis of colon cancer. Both TAp63 and microRNA-133b may be potential biomarkers for diagnosis in colon cancer metastasis and may provide unique therapeutic targets for this common malignancy.

Cytogenetic study of 18 colorectal carcinomas confirmed the extensive heterogeneity and the complexity of the karyotypic picture in this type of tumor. Karyotypic analysis showed that chromosomes 17p and 5q, in both numerical and structural aspects, were the most frequently involved chromosomes and prone to losses. The most common structurally rearranged forms were translocations of 17p with other chromosomes, especially t(13q;17p), which constituted over 50% of all 17p rearrangements, and an interstitial deletion of 5q that made up as much as 73% of all structural abnormalities of 5q. According to the results, we conclude that chromosomes 17 and 5 may play important roles in the evolution of colorectal cancer and t(13q;17p) and del(5q) may be possibly specific to Chinese patients with colorectal cancer.

Background This study compared intake of specific nutrients based on the Dietary Approaches to Stop Hypertension (DASH) guidelines for hypertension management among multiethnic middle-aged and older adults. Methods We conducted quantitative analysis using baseline data of a prospective cohort study of 5972 adults aged 45 to 84 years recruited between July 2000 and August 2002 who participated in the Multi-Ethnic Study of Atherosclerosis (MESA). Diet information was collected using a 120-item food frequency questionnaire. Bivariate and multivariate methods were used to evaluate associations between DASH-accordant intake of each nutrient (fat, saturated fat, cholesterol, protein, fiber, calcium, magnesium, and potassium) with ethnicity and hypertension status. Results Less than 30% of MESA participants met any DASH nutrient target. DASH accordance was lowest in saturated fat intake and highest in cholesterol intake (5.3% and 29.5% of the participants, respectively). Multivariate analyses showed significant ethnic differences in DASH accordance in all nutrients but saturated fat. Compared with white participants, Chinese American participants had greater DASH accordance in cholesterol (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.13-1.67) and protein intake (2.32; 1.55-3.49) but less in total fat (0.47; 0.30-0.74), magnesium (0.58; 0.51-0.67), and potassium intake (0.40; 0.20-0.81); African Americans and Hispanics had greater DASH accordance in fiber intake (1.36; 1.13-1.62; and 2.23; 1.53-3.23, respectively) but less in calcium intake (0.44; 0.37-0.52; and 0.79; 0.68-0.91, respectively). Diagnosed and uncontrolled hypertension was associated with less DASH accordance in saturated fat (OR, 0.80; 95% CI, 0.70-0.91) and magnesium (0.80; 0.71-0.91). DASH accordance differed significantly with and without inclusion of dietary supplements in the analysis. Conclusions There is significant variation in DASH goal attainment among different ethnic groups. Assessments of nutrient intake that exclude dietary supplements may be underestimating DASH accordance.

To investigate the characteristics of the cerebral magnetic resonance imaging (MRI) of compressed air divers in diving accidents, we conducted an observational case series study. MRI of brain were examined and analysed on seven cases compressed air divers complicated with cerebral arterial gas embolism CAGE. There were some characteristics of cerebral injury: (1) Multiple lesions; (2) larger size; (3) Susceptible to parietal and frontal lobe; (4) Both cortical grey matter and subcortical white matter can be affected; (5) Cerebellum is also the target of air embolism. The MRI of brain is an sensitive method for detecting cerebral lesions in compressed air divers in diving accidents. The MRI should be finished on divers in diving accidents within 5 days.

Interpretation of data from health-related quality of life (HRQoL) questionnaires can be enhanced with the availability of minimally important difference (MID) estimates. This information will aid clinicians in interpreting HRQoL differences within patients over time and between treatment groups. The Immune Thrombocytopenic Purpura (ITP)-Patient Assessment Questionnaire (PAQ) is the only comprehensive HRQoL questionnaire available for adults with ITP.Forty centers from within the US and Europe enrolled ITP patients into one of two multicenter, randomized, placebo-controlled, double-blind, 6-month, phase III clinical trials of romiplostim. Patients enrolled in these studies self-administered the ITP-PAQ and two items assessing global change (anchors) at baseline and weeks 4, 12, and 24. Using data from the ITP-PAQ and these two anchors, an anchor-based estimate was computed and combined with the standard error of measurement and standard deviation to compute a distribution-based estimate in order to provide an MID range for each of the 11 scales of the ITP-PAQ.A total of 125 patients participated in these clinical trials and provided data for use in these analyses. Combining results from anchor- and distribution-based approaches, MID values were computed for 9 of the 11 scales. MIDs ranged from 8 to 12 points for Symptoms, Bother, Psychological, Overall QOL, Social Activity, Menstrual Symptoms, and Fertility, while the range was 10 to 15 points for the Fatigue and Activity scales of the ITP-PAQ. These estimates, while slightly higher than other published MID estimates, were consistent with moderate effect sizes.These MID estimates will serve as a useful tool to researchers and clinicians using the ITP-PAQ, providing guidance for interpretation of baseline scores as well as changes in ITP-PAQ scores over time. Additional work should be done to finalize these initial estimates using more appropriate anchors that correlate more highly with the ITP-PAQ scales.

Although the DASH (Dietary Approaches to Stop Hypertension trial) diet is among the therapeutic lifestyle changes recommended for individuals with hypertension (HTN), accordance with the DASH diet is not known.Using data from the National Health and Nutrition Examination Survey (NHANES) from the 1988-1994 and 1999-2004 periods, DASH accordance among individuals with self-reported HTN was estimated based on 9 nutrient targets (fat, saturated fat, protein, cholesterol, fiber, magnesium, calcium, sodium, and potassium) (score range, 0-9). Using data from 1999-2004, we compared the DASH score among demographic groups in age- and energy-adjusted models and modeled the odds of a DASH-accordant dietary pattern (or=4.5) using multivariable logistic regression. The DASH score, DASH accordance, and percentage of participants achieving individual targets were compared with estimates from NHANES 1988-1994 data.Based on 4386 participants with known HTN in the recent survey period (1999-2004), the mean (SE) DASH score, after adjustment for age and energy intake, was 2.92 (0.05), with 19.4% (1.2%) classified as DASH accordant. In multivariable logistic regression models, DASH accordance was associated with older age, nonblack ethnicity, higher education, and known diabetes mellitus. Accordance with DASH was 7.3% lower in the recent survey period compared with NHANES 1988-1994 (26.7% [1.1%]) (P.001), reflecting fewer patients with HTN meeting nutrient targets for total fat, fiber, and magnesium.The dietary profile of adults with HTN in the United States has a low accordance with the DASH dietary pattern, and the dietary quality of adults with HTN has deteriorated since the introduction of the DASH diet, suggesting that secular trends have minimized the impact of the DASH message.

Increasing amounts of evidence strongly suggests that dysregulation of ubiquitin-proteasome system is closely associated with cancer pathogenesis. Speckle-type POZ protein (SPOP) is an adapter protein of the CUL3-based E3 ubiquitin ligase complexes. It selectively recruits substrates for their ubiquitination and subsequent degradation. Recently, several exome-sequencing studies of endometrial cancer revealed high frequency somatic mutations in SPOP (5.7–10%). However, how SPOP mutations contribute to endometrial cancer remains unknown. Here, we identified estrogen receptor-α (ERα), a major endometrial cancer promoter, as a substrate for the SPOP-CUL3-RBX1 E3 ubiquitin ligase complex. SPOP specifically recognizes multiple Ser/Thr (S/T)-rich degrons located in the AF2 domain of ERα, and triggers ERα degradation via the ubiquitin-proteasome pathway. SPOP depletion by siRNAs promotes endometrial cells growth. Strikingly, endometrial cancer-associated mutants of SPOP are defective in regulating ERα degradation and ubiquitination. Furthermore, we found that SPOP participates in estrogen-induced ERα degradation and transactivation. Our study revealed novel molecular mechanisms underlying the regulation of ERα protein homeostasis in physiological and pathological conditions, and provided insights in understanding the relationship between SPOP mutations and the development of endometrial cancer.

Objective: Rheumatoid arthritis is a chronic inflammatory autoimmune disease with proinflammatory cytokines involved in its pathogenesis. Recently in vitro as well as in vivo studies have shown that iloprost, a stable prostacyclin analogue, can reduce the release of these cytokines. This study was performed to further investigate the anti-inflammatory effects of iloprost by determining plasma adhesion molecules as markers of endothelial cell activation, and plasma thrombomodulin as a parameter of endothelial cell injury in patients with rheumatoid arthritis receiving oral iloprost therapy. Methods: Plasma thrombomodulin levels and the values of the plasma adhesion molecules VCAM-1 (vascular cell adhesion molecule 1), E-selectin (CD62E), and ICAM-1 (intercellular adhesion molecule 1, CD 54) were measured by ELISA during a 7-day period of treatment with orally-administered iloprost in 14 patients with active rheumatoid arthritis. Finally, the same parameters were determined at the end of the observation period (1 week after the end of therapy). In addition, the disease activity was measured using the DAS (disease activity score) as well as the patients’ self-assessed pain severity, and correlated with the changes of plasma adhesion molecule and thrombomodulin levels. Results The plasma levels of all three adhesion molecules as well as of thrombomodulin significantly decreased under therapy with oral iloprost. After 1 week (day 7 of therapy), the mean percent changes from day 0 were −20.1% for VCAM-1 (p=0.008), −21.2 for ICAM-1 (p=0.003), −24.6% for E-selectin (p=0.001), and −21.7% for thrombomodulin (p=0.003). This decrease lasted up to 1 week after the end of therapy in the case of VCAM-1 (p=0.023) and ICAM-1 (p=0.001). Further analysis of the results revealed additional significant correlations between different parameters of clinical disease activity, thrombomodulin and adhesion molecules. Conclusion This study showed hints towards clinical effects in patients with rheumatoid arthritis receiving oral iloprost therapy. Pathophysiologically, the decrease of adhesion molecules points at an immunomodulating effect of iloprost. The observed thrombomodulin-lowering effect of iloprost may indicate stabilisation of endothelial cell function by diminishing endothelial cell injury.

Our aim in this retrospective study was to evaluate the extent of control of metastatic disease in the neck and the survival of patients with T1 and T2 oral cancer.All 171 patients with T1 and T2 squamous cell carcinoma (SCC) in the mouth were identified from our computerised database. All had had primary tumours resected and 21 patients with palpable neck nodes had therapeutic neck dissections. Among 150 patients with no palpable nodes, 75 had elective neck dissections, and 75 were observed. The decision to do an elective neck dissection was based on clinical criteria and was not randomised.Cervical nodes contained metastases in 17 of 21 patients who had therapeutic, and 27 of 75 who had elective, neck dissections. Neck metastases developed subsequently in 15 of 75 patients in the observed group, and 9 of these were salvaged by therapeutic neck dissection. The 5-year disease free survival was 19/21 after therapeutic dissection, 72/75 after elective dissection, and 69/75 in the observed group. Patients with cervical nodal metastases had significantly reduced 5-year survival compared with those without (63% and 91%, P = 0.003).

Experiments show that the natural products phenyl propanoid glycosides (PPGs) extracted from the plant Pedicularis spicata are capable of repairing DNA damaged by oxygen radicals. Based on kinetic measurements and experiments on tumor cells, a theoretical study of the interaction between PPG molecule Cistanoside C and telomeric DNA fragment has been carried out. The docking calculations performed using JUMNA software showed that the Cistanoside C could be docked into the minor groove of telomeric DNA and form complexes with the geometry suitable for an electron transfer between guanine radical and the ligand. Such complexes can be formed without major distortions of DNA structure and are further stabilized by the interaction with the saccharide side-groups.