Diagnosis and treatment of a case of hepatic mixed echinococcosis infection combined with distant organ metastasis.

Hydatidosis is a zoonotic parasitic disease caused by Echinococcus, which is highly prevalent in pastoral areas. In China, this disease is mainly caused by Echinococcus granulosus and Echinococcus multilocularis. Cystic echinococcosis, which is one of the most common types of echinococcosis, is described as swelling and growth of cystic lesions. Alveolar echinococcosis, which is less common, is invasive. Cases of mixed echinococcosis infection accompanied by extrahepatic organ metastasis are extremely rare. Treatment of these cases is complicated and the prognosis is extremely poor. We report a case of hepatic echinococcosis in a 40-year-old Tibetan man who was treated with the hepatic right tricuspidectomy + left hepatic duct jejunostomy (Roux-en-Y) surgical procedure. This procedure provides a reference for treatment of similar cases of echinococcosis. For patients with multiorgan metastasis, chemotherapy is the first choice. This should be followed by possible surgical treatment for life-threatening lesions of alveolar echinococcosis and subsequent chemotherapy. Individualized treatment accompanied by multidisciplinary treatment and damage control surgery could optimally benefit patients with advanced hepatic echinococcosis.

Application of Implantable Hearing Aids and Bone Conduction Implant System in patients with bilateral congenital deformation of the external and middle ear.

OBJECTIVE: To determine the efficacy of the application of the Implantable Hearing Aids and Bone Conduction Implant System in patients with bilateral congenital deformation of the external and middle ear. METHODS: twenty patients with bilateral congenital malformation of the external and middle ear were included in the study. Implantable Hearing Aids implantation was performed in ten patients, and Bone Conduction Implant System implantation was performed in ten patients. Audiometric tests, including pure-tone audiometry and speech discrimination in the free field were performed pre-operatively and post-operatively. RESULTS: Implantable Hearing Aids and Bone Conduction Implant System implantation were performed successfully in all patients. The mean pure-tone threshold improvement with Implantable Hearing Aids or Bone Conduction Implant System activation in the free filed pure tone audiometry was 25 dB and ranged from 0.25 to 4 kHz. Mean free field speech discrimination in quiet was 80% at 65 dB compared to 18% pre-operatively. The mean pure-tone threshold improvement with Bone Conduction Implant System was 25.5 dB better than 18.2 dB with Implantable Hearing Aids. The mean free filed speech discrimination in quite improvement with Bone Conduction Implant System was 66% better than 58% with Implantable Hearing Aids. CONCLUSION: Implantable Hearing Aids or Bone Conduction Implant System are effective options for improving hearing in patients with bilateral congenital deformation of the external and middle ear. The procedure is safe and effective, and its indications are wider than those of tympanoplasty for such cases. Furthermore, the Bone Conduction Implant System is better than Implantable Hearing Aids, tympanoplasty and hearing aids.

TGF-ß3 reduces apoptosis in ischemia-induced adipose-derived stem cells by enhancing DNA repair.

Adipose-derived stem cells (ADSCs) possess good proliferative and differentiative abilities, making then a promising candidate for the treatment of cartilage defects. However, local ischemia often causes apoptosis in ADSCs. Transforming growth factor-ß3 (TGF-ß3) is often used as a chondrogenic differentiation cytokine whose function in apoptosis is unclear. The aim of the present study was to investigate the role of TGF-ß3 in ischemia-induced ADSC apoptosis. In the present study, the phenotypes and multipotent differentiation properties of human ADSCs at passage 3 were analyzed using flow cytometry and cytochemical staining. ADSCs were cultured in a serum- and glucose-free medium under hypoxic conditions with or without exogenous TGF-ß3 treatment. The apoptosis rate was measured using a TUNEL array and Annexin V/propidium iodide staining. The expression of apoptosis-associated proteins was measured using western blotting. The results revealed ADSCs cultured in normal condition have multi-lineage differentiation potential and high levels of cluster of differentiation (CD)29, CD44 and CD105 expression. Furthermore, ADSCs weakly express CD14, CD34 and CD45, with strong clone formation and migration abilities. Serum deprivation under hypoxic conditions resulted in mitochondria-mediated apoptosis in ADSCs, which was attenuated by exogenous TGF-ß3 treatment via upregulation of poly ADP-ribose polymerase (PARP). The results of the present study indicate that TGF-ß3 is able to protect ADSCs from ischemia-induced apoptosis via PARP-associated DNA damage repair.