[Diagnosis and treatment of 18 cases of Chiari malformation with hoarseness].

Objective: To investigate the diagnosis and treatment of Chiari malformation patients with hoarseness and other otorhinolaryngological symptoms. Methods: The clinical data of 18 patients of Chiari malformation with hoarseness were retrospectively collected, which was composed of 5 men and 13 women, aged 3-71 with median age of 52. All the patients were admitted to the Affiliated Hospital of Qingdao University from January 1989 to January 2020. All patients underwent brain MRI and laryngoscopy. The patient's symptoms and first diagnosis department, diagnosis time, total course of disease, hoarseness course, diagnosis and treatment, and postoperative recovery time were summarized. Follow-up time was 3-16 years, with median follow-up time of 6.5 years. Descriptive methods were used for analysis. Results: The first visit departments of 18 patients included neurology (9 cases), otorhinolaryngology head and neck surgery (5 cases), pediatrics (2 cases), orthopedics (1 case) and respiratory department (1 case). Except for the 7 cases in neurology department, the other 11 patients were not diagnosed in time. The disease duration of 18 patients with Chiari malformation ranged from 2 months to 5 years, and hoarseness was present from 20 days to 5 years. After diagnosis, 9 patients underwent posterior fossa decompression surgery, and 1 of them underwent syrinx drainage at the same time. The symptoms of 8 cases improved significantly after operation, with the improvement time from 1 to 30 days. In addition, 9 patients chose conservative treatment, among whom 8 had no improvement in symptoms and 6 progressed. Conclusions: Posterior fossa decompression is an effective treatment for Chiari malformation, and the prognosis is good. Timely diagnosis and treatment can improve the prognosis of patients.

Effect of appetite-conditioned reflex stimulation on early enteral nutrition tolerance after surgery.

OBJECTIVE: This study aimed to discuss the effects of appetite-conditioned reflex stimulation on the early enteral nutrition (EEN) tolerance, complications, and postoperative hospital stay in patients who underwent surgery. METHODS: Seventy patients who underwent laparoscopic radical resection of colorectal cancer surgery in our hospital between February and December 2017 were randomly divided into a stimulated appetite group (experimental group, including visual stimulation, nasal stimulation, taste stimulation and hearing stimulation) and a control group (n = 35). Both groups received EEN. EEN tolerance, complications, and postoperative hospital stay were then compared between the groups. RESULTS: Sixty-six patients, including 34 in the experimental group and 32 in the control group, completed the relevant experiment. The experimental group had significantly lower incidence rates of nausea, vomiting, bloating, use of prokinetic drugs, and gastric tube replacement (P < 0.05), and shorter tolerable regular eating time (5.0 ± 1.0 d vs 6.4 ± 1.9 d, P < 0.05) and postoperative hospital stay (7.0 ± 2.0 d vs 8.0 ± 1.8 d, P < 0.05) than the control group. No significant difference in complication rate was detected (P > 0.05). CONCLUSION: Appetite-conditioned reflex stimulation can improve EEN tolerance, decrease the risk of complications, and shorten ordinary diet recovery time and hospital stay.

[Clinical features and prognostic factors of primary gastric neuroendocrine neoplasms].

Objective: To study the clinical characteristics and classification of gastric neuroendocrine neoplasm(NEN) and prognostic factors of mixed adenoneuroendocrine carcinoma (MANEC) and gastric neuroendocrine carcinoma(NEC). Methods: A total of 148 gastric NENs were divided into type Ⅰ, type Ⅱ and type Ⅲ based on the classification of European Neuroendocrine Tumor Society (ENETS). Kaplan-Meier test and Cox regression model were used in univariate and multivariate survival analysis in 108 cases with pathological G3 gastric NEN. Results: In this study, the percentages of type Ⅰ, type Ⅱ and type Ⅲ were 25.0%(37), 3.4%(5) and 71.6%(106) respectively. Among type Ⅰ patients, 28(75.7%) lesions were located in gastric fundus or body, 29(78.4%) had bumps. Lymph node involvement was found in 4 (10.8%) patients. Twenty-six (70.3%) patients received endoscopic treatment and 11 (29.7%) with surgery. All 5 type Ⅱ patients presented lesions in gastric fundus or body, including 4 with ulcers, who were all treated by endoscope. Three type Ⅱ patients had gastrinoma, and 2 combined with multiple endocrine neoplasmⅠ. In type Ⅲ patients, 56(52.8%) showed ulcerative lesions. The majority of patients (102, 96.2%) had a single lesion, 94(88.7%) with lymph node or other organ metastasis. In this study, no deaths were reported in gastric NEN with a pathological grade of G1 or G2. The mortality rate was 38.9%(42/108) in patients with G3 NEN. Survival analysis suggested that age, metastasis of tumor were associated with poor prognosis (P=0.041, 0.025). Conclusions: Patients with gastric NEN have heterogenous clinical presentations according to gender, age, endoscopic features, infiltration and metastasis, and pathological grade. Aging and metastasis are negative prognostic factors of G3 gastric NEN.

Dexmedetomidine enhances ropivacaine-induced sciatic nerve injury in diabetic rats.

BACKGROUND: Previous studies suggest that dexmedetomidine has a protective effect against local anaesthetic-induced nerve injury in regional nerve blocks. Whether this potentially protective effect exists in the context of diabetes mellitus is unknown. METHODS: A diabetic state was established in adult male Sprague-Dawley rats with intraperitoneal injection of streptozotocin. Injections of ropivacaine 0.5%, dexmedetomidine 20 µg kg-1 (alone and in combination), or normal saline (all in 0.2 ml) were made around the sciatic nerve in control and diabetic rats (n=8 per group). The duration of sensory and motor nerve block and the motor nerve conduction velocity (MNCV) were determined. Sciatic nerves were harvested at post-injection day 7 and assessed with light and electron microscopy or used for pro-inflammatory cytokine measurements. RESULTS: Ropivacaine and dexmedetomidine alone or in combination did not produce nerve fibre damage in control non-diabetic rats. In diabetic rats, ropivacaine induced significant nerve fibre damage, which was enhanced by dexmedetomidine. This manifested with slowed MNCV, decreased axon density, and decreased ratio of inner to outer diameter of the myelin sheath (G ratio). Demyelination, axon disappearance, and empty vacuoles were also found using electron microscopy. An associated increase in nerve interleukin-1ß and tumour necrosis factor-α was also seen. CONCLUSIONS: Ropivacaine 0.5% causes significant sciatic nerve injury in diabetic rats that is greatly potentiated by high-dose dexmedetomidine. Although the dose of dexmedetomidine used in this study is considerably higher than that used in clinical practice, our data suggest that further studies to assess ropivacaine (alone and in combination with dexmedetomidine) use for peripheral nerve blockade in diabetic patients are warranted.

Nickel oxide nanoparticles induced pulmonary fibrosis via TGF- ß1 activation in rats.

Nano nickel oxide (NiO), widely used in industry, has recently been discovered to have pulmonary toxicity. However, no subchronic exposure studies about nano NiO-induced pulmonary fibrosis have been reported. The objective of this study was to investigate pulmonary fibrosis induced by nano NiO and its potential mechanism in rats. Male Wistar rats ( n = 40, 200-240 g) were randomized into control group, nano NiO groups (0.015, 0.06, and 0.24 mg/kg), and micro NiO group (0.024 mg/kg). All rats were killed to collect lung tissue after intratracheal instillation of NiO particles twice a week for 6 weeks. To identify pulmonary fibrosis, Masson trichrome staining, hydroxyproline content, and collagen protein expression were performed. The results showed widespread lung fibrotic injury in histological examination and increased content of hydroxyproline, collagen types I and III in rat lung tissue exposed to nano NiO. To explore the potential pulmonary fibrosis mechanism, transforming growth factor beta 1 (TGF- ß1) content was measured by enzyme-linked immunosorbent assay, and the messenger RNA expression of key indicators was detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The TGF- ß1 content was increased in nano NiO exposure groups, as well as the upregulated gene expression of TGF- ß1, Smad2, Smad4, matrix metalloproteinase, and tissue inhibitor of metalloproteinase. The findings indicated that nano NiO could induce pulmonary fibrosis, which may be related to TGF- ß1 activation.

Identification of warm day and cool night conditions induced flowering-related genes in a Phalaenopsis orchid hybrid by suppression subtractive hybridization.

The influence of warm day and cool night conditions on induction of spikes in Phalaenopsis orchids has been studied with respect to photosynthetic efficiency, metabolic cycles and physiology. However, molecular events involved in spike emergence induced by warm day and cool night conditions are not clearly understood. We examined gene expression induced by warm day and cool night conditions in the Phalaenopsis hybrid Fortune Saltzman through suppression subtractive hybridization, which allowed identification of flowering-related genes in warm day and cool night conditions in spikes and leaves at vegetative phase grown under warm daily temperatures. In total, 450 presumably regulated expressed sequence tags (ESTs) were identified and classified into functional categories, including metabolism, development, transcription factor, signal transduction, transportation, cell defense, and stress. Furthermore, database comparisons revealed a notable number of Phalaenopsis hybrid Fortune Saltzman ESTs that matched genes with unknown function. The expression profiles of 24 genes (from different functional categories) have been confirmed by quantitative real-time PCR in induced spikes and juvenile apical leaves. The results of the real-time PCR showed that, compared to the vegetative apical leaves, the transcripts of genes encoding flowering locus T, AP1, AP2, KNOX1, knotted1-like homeobox protein, R2R3-like MYB, adenosine kinase 2, S-adenosylmethionine synthetase, dihydroflavonol 4-reductase, and naringenin 3-dioxygenase accumulated significantly higher levels, and genes encoding FCA, retrotransposon protein Ty3 and C3HC4-type RING finger protein accumulated remarkably lower levels in spikes of early developmental stages. These results suggested that the genes of two expression changing trends may play positive and negative roles in the early floral transition of Phalaenopsis orchids. In conclusion, spikes induced by warm day and cool night conditions were complex in Phalaenopsis orchids; nevertheless, several molecular flowering pathway-related genes were found. The acquired data form the basis for a molecular understanding of spike induction by warm day and cool night conditions in Phalaenopsis orchids.

The structural basis of the increase in isometric force production with temperature in frog skeletal muscle.

X-ray diffraction patterns were recorded from isolated single fibres of frog skeletal muscle during isometric contraction at temperatures between 0 and 17 degrees C. Isometric force was 43 +/- 2% (mean +/- S.E.M., n = 10) higher at 17 degrees C than 0 degrees C. The intensity of the first actin layer line increased by 57 +/- 18% (n = 5), and the ratio of the intensities of the equatorial 1,1 and 1,0 reflections by 20 +/- 7% (n = 10), signalling radial or azimuthal motions of the myosin head domains. The M3 X-ray reflection from the axial repeat of the heads along the filaments was 27 +/- 4% more intense at 17 degrees C, suggesting that the heads became more perpendicular to the filaments. The ratio of the intensities of the higher and lower angle peaks of the M3 reflection (R(M3)) was 0.93 +/- 0.02 (n = 5) at 0 degrees C and 0.77 +/- 0.02 at 17 degrees C. These peaks are due to interference between the two halves of each myosin filament, and the R(M3) decrease shows that heads move towards the midpoint of the myosin filament at the higher temperature. Calculations based on a crystallographic model of the heads indicated that the observed R(M3) change corresponds to tilting of their light-chain domains by 9 deg, producing an axial displacement of 1.4 nm, which is equal to that required to strain the actin and myosin filaments under the increased force. We conclude that the higher force generated by skeletal muscle at higher temperature can be accounted for by axial tilting of the myosin heads.

Effects of sarcomere length and temperature on the rate of ATP utilisation by rabbit psoas muscle fibres.

1. The steady state rate of ATP utilisation by single permeabilised fibres from rabbit psoas muscle immersed in silicone oil was measured using a linked enzyme assay that coupled ADP production to the oxidation of NADH.2. At sarcomere length 2.5 microm, at 10 degrees C, the rate of ATP utilisation in relaxing conditions was 6 +/- 1 microM s-1 (mean +/- S.E.M., n = 8 fibres); during isometric contraction it was 310 +/- 10 microM s-1 (mean +/- S.E.M., n = 11). Assuming a myosin active site concentration of 150 microM, these values correspond to rates of ATP utilisation per active site of about 0.04 and 2.1 s-1, respectively. 3. The rate of ATP utilisation in relaxing conditions was independent of sarcomere length in the range 2.5-4.0 microm. The rate of ATP utilisation during isometric contraction had a dependence on resting sarcomere length similar to that of isometric force in the range 2.5-4.0 microm, but was less strongly dependent on sarcomere length than was isometric force in the range 1.5-2.5 microm. 4. The rate of ATP utilisation in relaxing conditions had a Q10 of 2.5 in the temperature range 7-25 degrees C, but this increased to 9.7 in the range 25-35 degrees C, suggesting that some active force may have been generated in relaxing solution at temperatures above 25 degrees C. 5. The rate of ATP utilisation during isometric contraction had a Q10 of 3.6 throughout the temperature range 7-25 degrees C; this was similar to the Q10 for isometric force at low temperature (3.5 at 7-10 degrees C) but much larger than that for isometric force at higher temperature (1.3 at 20-25 degrees C). 6. Application of the NADH-linked assay to single muscle fibres in oil improves the effective sensitivity and time resolution of the method, and allows continuous measurements of the rate of ADP production during active contraction.

Effect of active shortening on the rate of ATP utilisation by rabbit psoas muscle fibres.

1. The rate of ATP utilisation during active shortening of single skinned fibres from rabbit psoas muscle at 10 degrees C was measured using an NADH-linked assay. Fibres were immersed in silicone oil and illuminated with 365 nm light. The amounts of NADH and carboxytetramethylrhodamine (CTMR) in the illuminated region of the fibre were measured simultaneously from fluorescence emission at 425-475 and 570-650 nm, respectively. The ratio of these two signals was used to determine the intracellular concentration of NADH, and thus the ATP utilisation, without interference from movements of the fibre with respect to the measuring light beam. 2. The total extra ATP utilisation due to shortening (ATP) was determined by extrapolation of the steady isometric rates before and after shortening to the mid-point of the shortening period. ATP had a roughly linear dependence on the extent of shortening in the range 1-15 % fibre length (L0) at a shortening velocity of 0.4 L0 s-1 from initial sarcomere length 2.7 microm. For shortening of 1 % L0, ATP was 21 +/- 1 M (mean +/- S.E.M., n = 3). 3. The mean rate of ATP utilisation during ramp shortening of 10 % L0 had a roughly linear dependence on shortening velocity in the range 0.05-1.2 L0 s-1. During unloaded shortening at 1.2 L0 s-1 the mean rate of ATP utilisation was 1.7 mM s-1, about 9 times the isometric rate. ATP was roughly independent of shortening velocity, and was 84 +/- 9 microM (mean +/- S.E.M., n = 6) for shortening of 10 % L0. 4. The implications of these results for mechanical-chemical coupling in muscle are discussed. The total ATP utilisation associated with shortening of 1 % L0 is only about 17 % of the concentration of the myosin heads in the fibre, suggesting that during isometric contraction either less than 17 % of the myosin heads are attached to actin, or that heads can detach without commitment to ATP splitting. The fraction of myosin heads attached to actin during unloaded shortening is estimated from the rate of ATP utilisation to be less than 7 %.

Conformation of the myosin motor during force generation in skeletal muscle.

Myosin motors drive muscle contraction, cytokinesis and cell locomotion, and members of the myosin superfamily have been implicated in an increasingly diverse range of cell functions. Myosin can displace a bound actin filament several nanometers in a single interaction. Crystallographic studies suggest that this 'working stroke' involves bending of the myosin head between its light chain and catalytic domains. Here we used X-ray fiber diffraction to test the crystallographic model and measure the interdomain bending during force generation in an intact single muscle fiber. The observed bending has two components: an elastic distortion and an active rotation that generates force. The average bend of the force-generating myosin heads in a muscle fiber is intermediate between those in crystal structures with different bound nucleotides, and the C-terminus of the head is displaced by 7 nm along the actin filament axis compared with the in vitro conformation seen in the absence of nucleotide.

Vasectomy and spermatic granuloma in hamsters.

Fifty-eight hamsters were bilaterally vasectomized either 1, 2, 3 or 6 months before experimentation. Fifty-five sham-vasectomized hamsters served as control. Cauda epididymal fluid was obtained by micropuncture. The effect of vasectomy on the incidence of spermatic granuloma was studied. The data were analyzed according to the presence or absence of granuloma after vasectomy and were compared with the data of their respective control. The incidence of granuloma increased with the duration of vasectomy and reached 92.8% at the end of 6 months after operation. Distension of the epididymis increased to a maximum at 1 month, but recovered to nearly normal irrespective of the existence of granuloma. The weight of the testis, spermatocrit and sperm density significantly decreased, and the percentage of abnormal sperm in the cauda and caput increased markedly in the absence of granuloma compared with their respective tract with granuloma or control. The testes in both the group with and without granuloma showed marked atrophy 6 months after vasectomy. The concentration of carnitine in the cauda epididymal plasma was significantly reduced from 2-6 months. The possible protective effect of a granuloma formation is discussed.

Effect of (D-Trp6, Pro9-NEt)-GnRH on the function and ultrastructure of pituitary and testis in male rats.

Groups of ten adult male Wistar rats were treated chronically with GnRH agonist for different durations. The responses of pituitary and testis to GnRH agonist were evaluated by serum and testicular testosterone, serum and pituitary LH, and testicular LH receptors. Testicular testosterone and LH receptors were decreased very significantly under our experimental regimen, irrespective of the duration of the treatment Serum testosterone levels were reduced after 10 and 15 injections, but only rats receiving 10 injections showed a significant increase in serum LH levels and decrease of pituitary LH content. The type II gonadotropes of the pars distalis of pituitary were increased in number but showed a higher degree of dilated smooth endoplasmic reticulum with few secretory granules. Many large lipid droplets appeared in the cytoplasms of the Leydig cells. Degenerative changes were observed in most seminiferous tubules following GnRH agonist treatment. Obvious abnormal acrosome and nuclear caps of some spermatids were also observed. The functional changes caused by GnRH agonist coincided with their ultrastructural appearance.

Antifertility effect of polyvinylpyrrolidone-gossypol and gossypol in male rats.

Thirty-nine adult male Wistar rats were administered 20 mg/kg or 24.3 mg/kg polyvinylpyrrolidone-gossypol (PVP-G) and 20 mg/kg gossypol acetic acid (G-A) 6 times a week for 6 weeks. Mating test was taken to evaluate the antifertility effect. Caudal sperm count, body weight, sex and accessory sex organ weights were recorded. At the end of 6 weeks treatment, the recovery period of 6 weeks was investigated. The results showed that the onset of antifertility action and recovery with PVP-G are faster than with G-A.