RESUMO
Objective: To explore the clinical efficacy of a modified no-touch technique (MNTT) in establishing autogenous arteriovenous fistulas (AVF) in hemodialysis patients. Methods: A total of 63 patients with AVF which was first established by MNTT in the Department of Nephrology, Suzhou Science and Technology Town Hospital from January 2021 to August 2022 were retrospectively included. The clinical data, ultrasound evaluation data of AVF, AVF maturity rate and AVF patency rate were collected. Subsequently, the AVF rate of patients in the MNTT group was compared with the patency rate of patients in the conventional operation group in the same hospital from January 2019 to December 2020. The Kaplan-Meier method was used to draw the survival curve, and the log-rank test was used to compare the difference in postoperative patency rate between the two groups. Results: There were 63 cases in the MNTT group, with 39 males and 24 females, and aged (60±17) years. Meanwhile, there were 40 cases in the conventional operation group, including 23 males and 17 females, and aged (60±13) years. In the MNTT group, the immediate patency rate was 100% (63/63) after surgery, and the AVF maturation rate at 2, 4 and 8 weeks postoperatively were 54.0% (34/63), 85.7% (54/63), and 90.5% (57/63), respectively. The primary patency rate was 90.0% (45/50), 85.0% (34/40), 82.9% (29/35), and 81.0% (17/21) at 3, 6, 9 months, and 1 year after the operation, respectively, and the assisted patency rates were all 100.0%. The one-year primary patency rate in the MNTT group was higher than that in the conventional surgery group (81.0% versus 63.5%, log-rank χ2=5.12, P=0.023). Ultrasound results showed that in the MNTT group, AVF veins were evenly dilated, the vascular wall gradually thickened, the brachial artery blood flow gradually increased, and spiral laminar flow occurred in the cephalic vein and radial artery. Conclusion: AVF established by MNTT features with fast maturity and a high patency rate, which is worthy of clinical promotion.
Assuntos
Fístula Arteriovenosa , Derivação Arteriovenosa Cirúrgica , Masculino , Feminino , Humanos , Derivação Arteriovenosa Cirúrgica/métodos , Estudos Retrospectivos , Grau de Desobstrução Vascular , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Diálise RenalRESUMO
Objective: To investigate the efficacy and safety of transbronchial cryobiopsy (TBCB) after lung transplantation. Methods: The clinical characteristics, TBCB procedure, diagnosis and treatment, and outcomes of lung transplant recipients of 6 patients (all male, aged 33-67 years) with TBCB in China-Japan Friendship Hospital from May to November 2021 were retrospectively analyzed. Results: Among the 6 patients diagnosed by TBCB, there were 2 cases of organizing pneumonia, 1 acute cellular rejection, 1 antibody-mediated rejection, and 1 bronchiolitis obliterans, and 1 diffuse alveolar damage. After the clinical diagnosis was confirmed, the condition improved after adjustment of the treatments followed. There were no serious complications related to the TBCB procedure. Conclusion: TBCB is valuable and relatively safe in the diagnosis of complications after lung transplantation, but the indications need to be strictly controlled.
Assuntos
Doenças Pulmonares Intersticiais , Transplante de Pulmão , Humanos , Masculino , Biópsia/métodos , Broncoscopia/efeitos adversos , Broncoscopia/métodos , Pulmão/patologia , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/complicações , Transplante de Pulmão/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , IdosoRESUMO
Emamectin·chlorfenapyr is insecticide compounded by emamectin benzoate and chlorfenapyr. There is no special antidote after poisoning, and the mortality rate of patients is very high. We admitted a case of toxic encephalopathy caused by oral administration of emamectin·chlorfenapyr. The clinical manifestations of patient were gastrointestinal symptoms, profuse sweating, high fever, changes in consciousness. After admitted to the hospital, despite active comprehensive treatment, the patient died of ineffective rescue eventually.
Assuntos
Inseticidas , Síndromes Neurotóxicas , Humanos , DissacarídeosRESUMO
OBJECTIVE: To analyze the factors related to the need for revision surgery due to nonunion or internal fixation failure after the treatment of distal femoral fracture with lateral locking plate (LLP). METHODS: Retrospective analysis was made of the clinical data of 130 cases with distal femoral fracture treated in our hospital from March 2005 to March 2019. SPSS 17.0 software (univariate analysis and Logistic regression analysis) was used to analyze the general condition [gender, age, body mass index (BMI), comorbidities, smoking history], injury related factors (energy of injury, open or closed injury, AO/OTA classification of fracture, fracture area distribution), operation related factors (operation time, reduction quality, postoperative infection) and construct characteristics of internal fixation. RESULTS: Twelve of 130 patients who were included in the study underwent revisional surgery, with a revision rate 9.2%. Univariate analysis showed that there were significant differences in age, BMI, AO/OTA classification, fracture area distribution, operation time, reduction quality, length of plate/fracture area, length of plate/fracture area above condylar between the two groups (P < 0.05). Logistic regression analysis showed that AO/OTA classification (A3), supracondylar involved fracture, operation time, reduction quality and the length of the plate/fracture area above the condylar were the possible related factors (P < 0.05). Destruction of the medial support ability of the femur in comminuted type A3 fracture, supra-condylar cortex area fracture involvement, increase of the bending stress of the LLP due to poor fracture reduction quality, damage of the blood supply of fracture end due to long-time operation, and stress concentration caused by insufficient length of plate might be risk factors of revisional operation after the treatment of distal femoral fracture with LLP. For the patients who needed revision after LLP treatment, additional use of medial minimally invasive plate fixation and autologous bone transplantation, change to intramedullary nail fixation were commonly used clinical treatment strategies. CONCLUSION: AO/OTA classification (A3), supracondylar involved fracture, long operation time, poor reduction quality and the length of the plate/fracture area above the condylar were the possible predictive factors of the revision in distal femoral fractures treated with lateral locking plate. The appropriate application of the locking plate and operation strategy are the key to reduce the revision rate in distal femoral fractures.
Assuntos
Fraturas Femorais Distais , Fraturas do Fêmur , Humanos , Fraturas do Fêmur/cirurgia , Fraturas do Fêmur/etiologia , Estudos Retrospectivos , Placas Ósseas/efeitos adversos , Fixação Interna de Fraturas/efeitos adversos , Resultado do TratamentoRESUMO
OBJECTIVE: To retrospectively analyze the risk factors of avascular necrosis of femoral head (ANFH) after internal fixation in young and mid-aged adults. METHODS: From January 2007 to December 2017, femoral neck fracture patients (18-60 years old) treated by reduction and internal fixation were retrospectively studied in Peking University Third Hospital. We recorded their gender, age, body mass index (BMI), American Society of Anesthesiology (ASA) grade, reason of injury, fracture side, interval between injury and surgery, location of fracture line, Garden classification, Pauwels classification, reduction method (open or closed), internal fixation and reduction quality. The diagnosis of ANFH was confirmed based on X-ray and MRI images during the follow-up. The internal fixation method included cannulated compression screw (CCS) or dynamic hip screw (DHS, with or without anti-rotation screw). χ2 test and Logistic regression analysis were used to analyze the relationship between the various factors and postoperative ANFH. RESULTS: A total of 113 patients were included in this study, including 63 males and 50 females with an average age of (43.17 ± 12.34) years. They were followed up by (25.08 ± 16.17) months. ASA grade included grade I (21 cases), grade II (55 cases) and grade III (37 cases). The reasons of injury included low-energy trauma (76 cases) and high-energy (37 cases). The fracture line included subcapital type (37 cases), transverse type (74 cases) and basal type (2 cases). Garden classification included type I (3 cases), type II (46 cases), type III (39 cases) and type IV (25 cases). Pauwels classification included type I (21 cases), type II (55 cases) and type III (37 cases). Interval between injury and surgery was (3.88 ± 3.66) days, 108 patients and 5 patients performed closed and open reduction respectively. 63 patients performed CCS, and 50 patients performed DHS. The reduction quality included grade A (91 cases), grade B (18 cases) and grade C (4 cases). 18 patients developed ANFH after surgery, the incidence rate was 15.93% (18/113). The result of χ2 test showed the reason of injury (OR=0.19, P < 0.01), Garden classification (OR=0.13, P < 0.01), Pauwels classification (OR=0.12, P = 0.02), internal fixation method (OR=3.29, P = 0.04) and reduction quality (OR=0.33, P < 0.01) were significantly associated with ANFH. These five factors were further included into the Logistic regression analysis, and its results showed that the reason of injury (OR=4.11, P = 0.03) and Garden classification (OR=4.85, P = 0.04) were statistically significant. CONCLUSION: The reason of injury, Garden classification, Pauwels classification, internal fixation and reduction quality may increase the risk of ANFH after surgery, and the reason of injury and Garden classification were much more significant.
Assuntos
Fraturas do Colo Femoral , Necrose da Cabeça do Fêmur , Adolescente , Adulto , Feminino , Fixação Interna de Fraturas , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: To analyze the risk factors of recurrent kyphosis after removal of short segmental pedicle screw fixation in patients with thoracolumbar burst fractures. METHODS: Retrospective analysis was conducted of 144 cases of thoracolumbar burst fractures without neurological impairment treated in Peking University Third Hospital from January 2010 to December 2017. There were 74 males and 70 females, with an average age of (39.1±13.2) years. The distribution of the injured vertebrae was T12: 42, L1: 72 and L2: 30, with fracture types of A3: 90, B1: 25 and B2: 29. The patients were divided into two groups: Recurrent kyphosis group (n=92) and non-recurrent kyphosis group (n=52). SPSS 26.0 software was used for univariate analysis and Logistic regression analysis. RESULTS: The average follow-up time was 28 (20-113) months. The imaging indexes of pre-operation, 3 days post-operation, 12 months post-operation and the last follow-up were measured and compared. Anterior vertebral body height, segmental kyphosis, vertebral wadge angle and Gardner deformity were significantly improved after operation (P < 0.05), and there were some degrees of loss in the 1-year follow-up; anterior vertebral body height and vertebral wadge angle were no longer changed after the removal of the screws; however, segmental kyphosis and Gardner deformity were still aggravated after the removal of the screws (P < 0.05). There were some degrees of collapse of the height of the upper and lower discs during the follow-up. Univariate analysis showed that there were statistically significant differences (P < 0.05) between the two groups in gender, age (36.9 years vs. 43.0 years), upper disc injury, CT value (174 vs. 160), segmental kyphosis (16.6° vs. 13.3°), vertebral wadge angle (16.7° vs. 13.6°), Gardner deformity (19.1° vs. 15.2°) and ratio of anterior vertebral body height (0.65 vs. 0.71). Logistic regression analysis showed that male (OR: 2.88, 95%CI: 1.196-6.933), upper disc injury (OR: 2.962, 95%CI: 1.062-8.258) and injured vertebral wedge angle were risk factors of recurrent kyphosis after removal of internal fixation for thoracolumbar burst fracture (P < 0.05). CONCLUSION: The patients with thoracolumbar burst fracture can obtain satisfactory effect immediately after posterior short segmental pedicle screw fixation, however, there may be some degree of loss during the follow-up. Male, upper disc injury and injured vertebral wedge angle are the risk factors of recurrent kyphosis after removal of internal fixation for thoracolumbar burst fracture.
Assuntos
Cifose , Parafusos Pediculares , Fraturas da Coluna Vertebral , Adulto , Feminino , Fixação Interna de Fraturas , Humanos , Cifose/epidemiologia , Cifose/etiologia , Cifose/cirurgia , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia , Resultado do TratamentoRESUMO
Tissue-resident memory T cells (TRM cells) are a novel population of tissue-restricted antigen-specific T cells. TRM cells are induced by pathogens and promote host defense against secondary infections. Although TRM cells cannot be detected in circulation, they are the major memory CD4+ and CD8+ T-cell population in tissues in mice and humans. Murine models of CD8+ TRM cells have shown that CD8+ TRM cells maintain tissue residency via CD69 and though tumor growth factor ß-dependent induction of CD103. In contrast to CD8+ TRM cells, there are few models of CD4+ TRM cells. Thus, much less is known about the factors regulating the induction, maintenance, and host defense functions of CD4+ TRM cells. Citrobacter rodentium is known to induce IL-17+ and IL-22+ CD4+ T cells (Th17 and Th22 cells, respectively). Moreover, data from IL-22 reporter mice show that most IL-22+ cells in the colon 3 months after C. rodentium infection are CD4+ T cells. This collectively suggests that C. rodentium may induce CD4+ TRM cells. Here, we demonstrate that C. rodentium induces a population of IL-17A+ CD4+ T cells that are tissue restricted and antigen specific, thus meeting the criteria of CD4+ TRM cells. These cells expand and are a major source of IL-22 during secondary C. rodentium infection, even before the T-cell phase of the host response in primary infection. Finally, using FTY 720, which depletes circulating naive and effector T cells but not tissue-restricted T cells, we show that these CD4+ TRM cells can promote host defense.
Assuntos
Linfócitos T CD4-Positivos/imunologia , Citrobacter rodentium/imunologia , Infecções por Enterobacteriaceae/imunologia , Animais , Citrobacter rodentium/genética , Infecções por Enterobacteriaceae/genética , Infecções por Enterobacteriaceae/microbiologia , Humanos , Memória Imunológica , Interleucina-17/genética , Interleucina-17/imunologia , Interleucinas/genética , Interleucinas/imunologia , Camundongos , Camundongos Endogâmicos C57BL , Células Th17/imunologia , Interleucina 22RESUMO
Objective: To investigate the blood lipid levels and prevalence of dyslipidemia in people with hypertension and diabetes in Henan province. Methods: From April 2016 to April 2017, multi-stage cluster sampling was adopted to investigate 71 285 local residents aged between 35 and 75 from 6 districts and counties in Henan province including Zhongmu county of Zhengzhou city, Huojia county of Xinxiang city, Hualong district of Puyang city, Qi county of Hebi city, Xigong district of Luoyang city, and Wugang city of Pingdingshan city. Blood samples were collected. According to the diagnostic criteria of hypertension and diabetes, the study population was divided into control group (n=29 427), hypertension group (n=21 965), diabetes group (n=8 009) and hypertension-diabetes group (n=11 884). Comparisons on blood lipid levels and dyslipidemia between 4 groups were performed. Results: The total cholesterol (TC) level of all subjects was 4.37 (3.78, 5.05) mmol/L. The triglyceride (TG) level was 1.27 (0.97, 1.80) mmol/L, the low-density lipoprotein cholesterol (LDL-C) level was 2.34 (1.88, 2.88) mmol/L and the high-density lipoprotein cholesterol (HDL-C) level was 1.31 (1.08, 1.59) mmol/L. Except for the TC level in women aged 65-75 years and LDL-C levels in women aged 55-64 and 65-75 years, there were significant differences in TC, TG, LDL-C and HDL-C levels between subjects of control group, hypertension group, diabetes group, and hypertension-diabetes group in different age ranges (including 35-44, 45-54, 55-64,and 65-75 years) and genders(all P<0.01).Except for the LDL-C and HDL-C in men aged 35-44 years and LDL-C in women aged 65-75 years, there were significant differences in the dyslipidemia rates of TC, TG, LDL-C and HDL-C between subjects of control group, hypertension group, diabetes group and hypertension-diabetes group in different age ranges and genders(P<0.01 or <0.05). After adjusting for age, gender, smoking, drinking, snoring, region, and body mass index, multivariate logistic regression analysis showed that hypertension (OR=1.221, 95%CI 1.113-1.339, P<0.01), diabetes (OR=1.636, 95%CI 1.461-1.833, P<0.01) and hypertension-diabetes (OR=1.832, 95%CI 1.658-2.023, P<0.01) were independent risk factors for TC abnormality. Hypertension (OR=1.566, 95%CI 1.478-1.659, P<0.01), diabetes (OR=2.182, 95%CI 2.031-2.342, P<0.01) and hypertension-diabetes (OR=2.655, 95%CI 2.492-2.829, P<0.01) were also independent risk factors for TG abnormality. Diabetes (OR=1.510, 95%CI 1.309-1.742, P<0.01) and hypertension-diabetes (OR=1.461, 95%CI 1.285-1.661, P<0.01) were independent risk factors for LDL-C abnormality. Diabetes (OR=1.261, 95%CI 1.180-1.346, P<0.01) and hypertension-diabetes (OR=1.195, 95%CI 1.126-1.268, P<0.01) were independent risk factors for HDL-C abnormality. Conclusion: The prevalence of dyslipidemia in patients with hypertension and diabetes is high in Henan province, so adequate blood lipid education and control should be applied to people with risk factors as soon as possible.
Assuntos
Diabetes Mellitus , Dislipidemias , Hipertensão , Lipídeos , Adulto , Idoso , China/epidemiologia , HDL-Colesterol , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Triglicerídeos/sangueRESUMO
Esophageal squamous cell carcinoma (ESCC) is one of the most frequently diagnosed cancers in China, but the etiology and mode of carcinogenesis of this disease remain poorly understood. Phosphatase and tensin homolog deleted on chromosome 10 (PTEN), as a negative regulator of Akt/mTOR pathway, frequently mutates or is inactive in many cancers. Although mTOR has been thought a promising cancer therapeutic target, the sensitivity of tumor cells to rapamycin was still to be revaluated. In this study, we measured the effects of rapamycin on cell proliferation and phosphorylation of Akt in ESCC cells with varying degrees of differentiation. And then, the relationship between PTEN status and the sensitivity of cells to rapamycin was investigated in EC9706 cells with or without wild-type PTENâ in vitro and in vivo. The results demonstrated ESCC cells with poor differentiation were insensitive to rapamycin of high concentration and rapamycin obviously promoted the phosphorylation of Akt in these cells, but it had no obvious effects on p-Akt in cells with well differentiation. Also, we showed that wild-type PTEN improved the sensitivity of poor differentiation cells to rapamycin through inhibiting phosphorylation of Akt in vitro and in vivo. This study explored the possible molecular mechanism of some ESCC cells insensitive to rapamycin and provided a measure for treating ESCC patients with PTEN inactivation using mTOR inhibitors.
Assuntos
Antibióticos Antineoplásicos/farmacologia , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias Esofágicas/tratamento farmacológico , PTEN Fosfo-Hidrolase/genética , Proteínas Proto-Oncogênicas c-akt/efeitos dos fármacos , Sirolimo/farmacologia , Animais , Carcinoma de Células Escamosas/genética , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/genética , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos , Neoplasias Esofágicas/genética , Carcinoma de Células Escamosas do Esôfago , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , PTEN Fosfo-Hidrolase/efeitos dos fármacos , Farmacogenética , Fosforilação/efeitos dos fármacos , Fosforilação/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Distribuição Aleatória , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética , Serina-Treonina Quinases TOR/efeitos dos fármacosRESUMO
The biological properties of Piper sarmentosum render it a potential substitute for antibiotics in livestock feed. This study evaluated the effects of P. sarmentosum extract (PSE) on the growth performance, antioxidant capability and immune response of weaned piglets. Eighty 21-d-old weaned piglets were selected and randomly allocated to one of four dietary treatments with five replicates of four pigs each. The dietary treatments consisted of a basal diet supplemented with 0 (T0), 50 (T50), 100 (T100) or 200 (T200) mg/kg PSE. The feeding trial lasted 4 weeks. The results revealed that the T50 group had the highest average daily gain (ADG) and average daily feed intake (ADFI) throughout the feeding trial (p < 0.05). Additionally, the T50 group had higher (p < 0.05) serum glutathione peroxidase activity (GSH-Px) and lower (p < 0.05) serum malondialdehyde (MDA) levels than the T0 group at 4 weeks post-weaning (p < 0.05). Serum levels of interleukin-1ß (IL-1ß) and tumour necrosis factor-α (TNF-α) decreased, while serum levels of interleukin-4 (IL-4), interleukin-10 (IL-10) and transforming growth factor-ß (TGF-ß) increased by PSE supplementation at 4 weeks post-weaning (p < 0.05). PSE supplementation upregulated the mRNA expression of IL-4, IL-10 and TGF-ß and downregulated the mRNA expression of TNF-α, IL-1ß and interleukin-6 (IL-6) in the ileal mucosal layer of piglets (p < 0.05). In summary, our study findings revealed that PSE supplementation improved the antioxidant capability, and reduced inflammation, which may be beneficial to weaned piglet health.
Assuntos
Antioxidantes/metabolismo , Piper/química , Extratos Vegetais/farmacologia , Suínos/fisiologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Citocinas , Dieta/veterinária , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Glutationa Peroxidase/genética , Glutationa Peroxidase/metabolismo , Malondialdeído/metabolismo , Extratos Vegetais/química , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Superóxido Dismutase/genética , Superóxido Dismutase/metabolismo , Suínos/imunologia , Aumento de PesoRESUMO
OBJECTIVE: To evaluate the rate of basicervical fractures and document their diagnosis and treatment. METHODS: From January 2005 to May 2016, 28 basicervical fractures of the 832 trochanteric fractures were collected and evaluated. The patients were treated with multiple screws, dynamic hip screw (DHS), intramedullary nail. Via the operation time, postoperative hospitalization, loss of blood duration the operation, hidden blood loss, total blood loss, mean union time and the final follow-up Harris hip score, the characteristics of different internal fixations were compared and analyzed. RESULTS: The incidence of basicervical fractures was 3.37% (28/832) in our study. In the intramedullary nail group (16 patients), the operation time was 55 (20,120) min, the postoperative hospitalization was 3(2, 7) d, the intraoperative blood loss was 50 (5,100) mL, the hidden blood loss was 533.37 (376.19, 987.15) mL, and the total blood loss 627.35 (406.19, 1037.16) mL. The union time and final follow-up Harris score were 6 (3, 9) months and 90.25 (74,100) min. In the DHS group (8 patients), the operation time was 87.5 (65,115) min, the postoperative hospitalization was 5.5 (2, 17) d, the intraoperative blood loss was 100 (50,300) mL, the hidden blood loss was 278.11 (202.43, 849.97) mL, and the total blood loss 580.19 (368.55, 899.97) mL . The union time and final follow-up Harris score were 5.5 (4, 12) months and 85.5 (84, 87) min. In the multiple screws group (4 patients), the operation time was 47.5 (35, 75) min, the postoperative hospitalization was 5 (2, 12) d, the intraoperative blood loss was 20 (2, 70) mL, the hidden blood loss was 150 (100.00, 412.01) mL, and the total blood loss 195.00 (120.00, 414.01) mL. The union time and final follow-up Harris score were 4 (4, 6) months and 80 (61, 97) min. The patients treated with multiple screws and intramedullary nail had a shorter operation time than the DNS group, but no obvious difference was found between the other two groups (P=0.367). Postoperative hospitalization had no significant difference among the three groups. The intraoperative bleeding was more in the DHS group, the other two groups had no significant difference (P=0.100). However, the hidden blood loss was more in the intramedullary nail group, the other two groups had no significant difference (P=0.134). The total blood loss in the intramedullary nail group was more than multiple screw group, similar to the DHS group (P=0.483). One patient treated with multiple screws underwent internal fixation failure three months after operation. The mean union time and final follow-up Harris scores had no significant difference among the three groups (P>0.05). CONCLUSION: Through this study, we found that the incidence of basicervical fractures is low. Fractures with no shift can be confirmed by preoperative X-ray. For displaced fractures, preoperative CT+3D reconstruction is recommended. Surgical treatment by closed reduction and internal fixation with DHS or intramedullary nail is shown to be very effective.
Assuntos
Parafusos Ósseos , Fixação Interna de Fraturas , Fraturas do Quadril , Perda Sanguínea Cirúrgica , Pinos Ortopédicos , Fêmur , Fixação Intramedular de Fraturas , Fraturas do Quadril/diagnóstico , Fraturas do Quadril/cirurgia , Humanos , Fixadores Internos , Duração da Cirurgia , Período Pós-Operatório , Radiografia , Resultado do TratamentoRESUMO
There exist controversies in the surgical treatment of maisonneuve injury with regard to reduction and fixation of syndesmosis and management of proximal fibular fracture. It is very important for the orthopaedic surgeons to learn more techniques and avoid pitfalls from clinical practice. We summarized the clinical data of 1 failed case, a 20-year-old girl with big body weight who underwent a primary surgery for the treatment of maisonneuve fracture with minimally invasive reduction and fixation of ankle syndesmosis and posterior malleolus and open reduction and internal fixation of medial malleolus, then a revision surgery for the treatment of iatrogenic syndesmotic malreduction with open reduction and re-stabilization of ankle syndesmosis supplemented with open reduction and internal fixation of proximal fibular facture. The malreduction of distal fibula was not found until finishing the postoperative computed tomography (CT) scan 2 weeks after the primary surgery, then the patient experienced an revision surgery including removal of the screws installed primarily for fixation of ankle syndesmosis, and open reduction and internal fixation of proximal fibular fracture, and limited open reduction and re-stabilization of ankle syndesmosis. Then the patient rehabilitated regularly under the direction of the surgeon who performed these two operations, and the postoperative recovery was smooth, then the hardwares for fixation of ankle syndesmosis and fracture of proximal fibula and medial malleolus were removed at different postoperative time. The patient experienced an excellent outcome at the end of the 3-year follow-up. The reasons for the failure in this case might include the overemphasized minimally invasive technique in the process of reduction, inaccurate assessment of intraoperative fluoroscopy and postoperative radiographs, and inappropriate utilization of the reduction clamp. Attention should be paid to the fact that an obliquely placed clamp for closed reduction of diastasis of ankle syndesmosis could result in syndesmotic malreduction. The worsened alignment of the fracture end of proximal fibula observed by intraoperative fluoroscopy may alert surgeons to syndesmotic malreduction. Partial exposure of syndesmosis and anatomical reduction and fixation of proximal fibular fracture may be useful measurres to avoid malreduction of ankle syndesmosis in the surgical treatment of maisonneuve injury in some patient, especially the patient with critically destabilized ankle.
Assuntos
Traumatismos do Tornozelo/cirurgia , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Redução Aberta , Adulto , Articulação do Tornozelo , Feminino , Fíbula , Fluoroscopia , Fraturas Expostas/cirurgia , Humanos , Masculino , Radiografia , Instrumentos Cirúrgicos , Tíbia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To investigate the diagnosis, treatment and prognosis of orbital solitary fibrous tumor. METHODS: Clinical data of 4 cases with orbital solitary fibrous tumor from January 2001 to June 2014 in the Second Affiliated Hospital of Xi'an Jiaotong University was retrospectively analyzed and the image, pathologic and immunohistochemical findings were reviewed. RESULTS: In the 4 cases, 3 were males and 1 was female, aged from 48 to 67 years. The main symptoms were unilateral progressive proptosis, orbital tumor and decreased vision. Two cases involved the left orbit and 2 in right. The locations of the tumor were in the lateral (2 cases) or inferior orbit (2 cases). Encapsulated smooth round shadow was shown in imaging examination and a homogeneous enhancement strengthening was seen by CT scanning. All cases underwent surgical resection and the removed tumors, appeared as round or irregular oval with fibrous capsule, were 1.5-5.0 cm in size. Three cases were pathological benign and 1 was malignant. Microscopically, the tumors were composed of a large number of spindle tumor cells and varying amounts of interstitial collagen deposition and angiogenesis. There was no atypia in benign tumor, while there was atypia in malignant tumor. Moreover, the tumor was invasive, capsuleless and shown hyperplasia area by light microscope in the case with malignant disease. CD34 and Vimentin were positive in 4 cases and Bcl-2 positive in 2 cases by immunohistochemistry staining. One patient with malignant pathology showed strong positive staining of Ki-67 (>70%) and died of tumor recurrence 10 months after he received the second operation. No metastasis or recurrence occurred by a follow-up of 2 months to 5 years in other 3 cases. CONCLUSIONS: Orbital SFT is characteristic of unilateral progressive proptosis in symptom. Imaging examination is an important diagnostic tool and a complete surgical resection of the tumor is the primary treatment method. Diagnosis depends on pathological and immunohistochemical staining. Malignant transformation may be occurred from benign lesion, hence postoperative follow-up is essential for confirmed patients.(Chin J Ophthalmol, 2016, 52: 268-272).
Assuntos
Biomarcadores Tumorais/análise , Órbita/fisiopatologia , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/cirurgia , Tumores Fibrosos Solitários/patologia , Tumores Fibrosos Solitários/cirurgia , Idoso , Antígenos CD34/análise , Colágeno , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/análise , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Órbita/diagnóstico por imagem , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vimentina/análiseRESUMO
BACKGROUND: In organ transplantation, increasing evidence, both in experimental and human studies, indicates that Toll-like receptor (TLR) activation is involved in the innate immune recognition of allograft. TLR5, the only protein recognition receptor of TLRs, is indicated potentially to be the immune regulation target. This study was designed to determine whether TLR5 could be a biomarker for in vivo allograft visualization, after immunosuppressant rapamycin treatment, using radiolabeled sodium iodide ((131) I)-anti-TLR5 monoclonal antibody (mAb). METHODS: BALB/c mice were transplanted with C57BL/6 skin, with/without rapamycin treatment (the rapamycin-treated group and the phosphate buffered saline [PBS]-rejection group, respectively). In vivo dynamic whole-body phosphor-autoradiography and ex vivo biodistribution studies were conducted after (131) I-anti-TLR5 mAb injection. RESULTS: Dynamic phosphor-autoradiography imaging showed clear graft localization from 12 h onward. At 72 h after injection, graft uptake quantified from images was higher for the rapamycin-treated group (26,448 ± 904 digital light units [DLU]/mm(2) ), compared with the PBS-treated allo-rejection group (9176 ± 576 DLU/mm(2) ). Treatment with anti-TLR5 mAb inhibited graft uptake. Organ biodistribution study reflected the same tendency, and (131) I-anti-TLR5 mAb uptake reached a maximum of 12.05 ± 1.86 %ID/g (percent injected dose per gram) at 1 h, and graft-to-native skin ratio reached 8.10 ± 0.10 %ID/g at 72 h after injection in rapamycin-treated grafts. CONCLUSION: Radiolabeled anti-TLR5 mAb showed higher uptake in allo-treated grafts compared with allo-rejection grafts, which was proved by non-invasive dynamic phosphor-autoradiography imaging, and invasive ex vivo biodistribution. Radiolabeled anti-TLR5 mAb is a new tracer for non-invasive in vivo imaging of TLR5 in rapamycin-treated allograft.
Assuntos
Anticorpos Monoclonais , Imunossupressores/farmacologia , Sirolimo/farmacologia , Transplante de Pele , Receptor 5 Toll-Like/imunologia , Animais , Autorradiografia/métodos , Feminino , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Modelos Animais , Distribuição Tecidual , Receptor 5 Toll-Like/metabolismo , Transplante HomólogoAssuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , COVID-19 , Feminino , Humanos , Estudos Prospectivos , SARS-CoV-2RESUMO
Thyroid hormones play an important role in regulating metabolism and can affect metabolism-related traits such as fat deposition. The thyroglobulin (TG) gene produces the precursor of thyroid hormones and has been proposed as a candidate gene for a quantitative trait locus with an effect on fat deposition. In this study, we identified 4 novel single nucleotide polymorphisms (SNPs) in the 5' flanking region of the TG gene using a DNA sequencing method. The SNP marker association analysis indicated that the T1355C SNPs were significantly associated with meat percentage (P < 0.05). A significant association between the G1356A polymorphism and live weight and loin muscle area was also detected (P < 0.05). However, no significant association was found between 4 SNPs and the other growth, carcass composition, and meat quality traits including intramuscular fat. The results of this study suggest that TG gene-specific SNPs may be a useful marker for growth traits in marker-assisted selection programs in beef cattle.
Assuntos
Estudos de Associação Genética , Polimorfismo de Nucleotídeo Único/genética , Locos de Características Quantitativas/genética , Tireoglobulina/genética , Animais , Composição Corporal/genética , Peso Corporal/genética , Bovinos , China , Genótipo , Carne VermelhaRESUMO
The myogenic regulatory factor (MRF) family includes Myf5, MyoD1, Myf4, and Mfy6 genes. This experiment assessed the variation of Myf5 and MyoD1 genes from birth to maturity (30, 210, and 360 days) in the back muscle tissue of Wuzhishan pigs (WZSP), and the expression of Myf5 and MyoD1 mRNA in the heart, liver, lung, spleen, kidney, muscle, stomach, and intestine tissues were also examined. The results indicate that the expression level of mRNA for Myf5 and MyoD1 genes in the back muscle tissue is directly proportional to age (P < 0.05). Furthermore, of the eight adult pig tissue types that were tested, the expression of Myf5 and MyoD1 was highest in the muscle tissue.
Assuntos
Expressão Gênica , Carne , Proteína MyoD/metabolismo , Fator Regulador Miogênico 5/metabolismo , Animais , Qualidade dos Alimentos , Músculo Esquelético/metabolismo , Proteína MyoD/genética , Fator Regulador Miogênico 5/genética , Especificidade de Órgãos , Sus scrofaRESUMO
Population growth and climate change pose challenges to the sustainability of poultry farming. The emphasis on high-yield traits in commercialized breeds has led to a decline in their adaptability. Chicken varieties adapted to the local environment, possessing traits that facilitate adaptation to climate change, such as disease resistance and tolerance to extreme weather conditions, can improve hybridization outcomes. In this study, we conducted an analysis of the population structure and genetic diversity of 110 chickens representing indigenous breeds from southern China and two different commercial breeds. Further, we performed comparative population genomics, utilizing nucleotide diversity and fixation statistics, to characterize genomic features of natural selection and to identify unique genetic traits and potential selection markers developed by indigenous breeds after adapting to the local environment. Results based on genetic diversity and population structure analyses showed that indigenous varieties exhibited high levels of genetic diversity. Commercial breeds that have been indigenously bred demonstrated higher levels of genetic diversity than those that have not, and breeds with different selection practices displayed significant differences in genetic structure. Additionally, we further searched for potential genomic regions in native chicken ecotypes, uncovering several candidate genes related to ecological adaptations affecting local breeds, such as IKBKB, S1PR1, TSHR, IL1RAPL1 and AMY2A, which are involved in disease resistance, heat tolerance, immune regulation and behavioral traits. This work provides important insights into the genomic characterization of ecotypes of native chicken in southern China. The identification of candidate genes associated with traits such as disease resistance, heat tolerance, immunomodulation, and behavioral traits is a significant outcome. These candidate genes may contribute to the understanding of the molecular basis of the adaptation of the southern native chicken to the local environment. It is recommended that these genes be integrated into chicken breeding programs to enhance sustainable agriculture and promote effective conservation and utilization strategies.