Trans-Rotator Cuff Approach for Spinoglenoid Cysts: Tips and Traps.

In this study, we introduce an arthroscopic technique for posterior-superior capsular fenestration and spinoglenoid cyst resection completely via a trans-rotator cuff approach. This approach can provide a full field of view and allow evaluation of the scope of the cyst under direct vision, which reduces the risk of recurrence and injury to the suprascapular neurovascular bundle.

Collagenous colitis in a child induced by chronic respiratory allergy: A case report.

INTRODUCTION: Collagen colitis (CC) is a microscopic colitis diagnosed by mucosal biopsy and is extremely rare in children. PATIENT CONCERNS: We reported a child with severe persistent diarrhea that could not be relieved with traditional diarrheal treatment. No abnormalities were found after multiple colonoscopies. DIAGNOSES: A significant increase in total IgE levels was found in the patient's blood. He had a history of mild chronic allergic rhinitis and slightly intermittent wheezing. However, we found that the child had a hyperallergic reaction to multiple respiratory antigens and had mild pulmonary dysfunction. Finally, colonoscopy with biopsy identified the diagnosis of CC. INTERVENTION: Considering that a respiratory allergic reaction was one of the causes of diarrhea, anti-allergic treatment was given to the child, and his severe diarrhea was soon relieved. Corticosteroid treatment was suggested to the patient, but his parents firmly refused steroid therapy. According to the patient's specific allergic reaction to mites, desensitization treatment was finally chosen for him. OUTCOMES: After 1 year of desensitization for dust mites, the patient's respiratory symptoms improved, total IgE levels decreased, autoantibodies declined, and diarrhea did not reoccur. Colonoscopy with biopsy showed a significant improvement in pathology. CONCLUSION: CC in children is rare, and childhood CC induced by a respiratory allergic reaction has not been previously reported. Therefore, this is a special case of CC in a patient who was cured with anti-allergy treatments and desensitization instead of steroid therapy.

The risk factors of residual lesions and recurrence of the high-grade cervical intraepithelial lesions (HSIL) patients with positive-margin after conization.

The aim of this study was to illuminate risks factors of residual lesions, and recurrence of the high-grade cervical intraepithelial lesions (HSIL) patients with positive margin who underwent cervical conization.A retrospective cohort study of 218 patients with positive margin after conization, including cold knife conization (CKC) and loop electrosurgical excisional procedure (LEEP), and follow-up from 2013 through 2016. The diagnosis of residual disease and recurrence were established and confirmed by biopsy. We evaluate the correlations among residual rate, recurrence rate, and clinical parameters, such as age, menopausal status, gravity, parity, glandular involvement, thinprep cytologic test (TCT), and human papillomavirus (HPV) results. We also detect the difference between CKC and LEEP.There was statistical difference between the positive margin rate of CKC group and LEEP regarding the surgery methods (5.8% and 12.09% separately, P < .001). Residual disease was found in 53.66% cases where 41 patients received second surgery after conization. Besides, age (P = .027), menopausal status (P = .006), and HPV infection (P = 0.018) were significantly associated with residual lesion. Among 177 cases with histopathologic follow-up, 15.91% women relapsed from 4 to 27 months. As for recurrence we found it was more frequent with HPV infection and glandular involvement (P < .001). TCT was also an independent factor in patients with recurrence of lesion. No evidence shows difference between CKC and LEEP for recurrence rate (P = .918).The factors related to rate of residual lesion were age, menopausal status, and HPV infection. HPV infection, TCT, and glandular involvement were associated with HSIL recurrence. LEEP was as effective as CKC with regard to recurrence rate. Further large-scale studies are needed to confirm our findings.

[Clinical features of Enterococcus faecium meningitis in children].

OBJECTIVE: To summarize the clinical features of Enterococcus faecium meningitis in children. METHODS: The clinical data of nine children with Enterococcus faecium meningitis were analyzed. RESULTS: In all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age. In those patients, 56% had high-risk factors before onset, which included intestinal infection, resettlement of drainage tube after surgery for hydrocephalus, skull fracture, perinatal maternal infection history, and catheter-related infection. The main symptoms were fever and poor response. In those patients, 22% had seizures; no child had meningeal irritation sign or disturbance of consciousness. The white blood cell count and level of C-reactive protein were normal or increased; the nucleated cell count in cerebrospinal fluid was normal or mildly elevated; the protein level was substantially elevated; the glucose level was decreased. The drug sensitivity test showed that bacteria were all sensitive to vancomycin and the vancomycin treatment was effective. Only one child had the complication of hydrocephalus. CONCLUSIONS: Enterococcus faecium meningitis occurs mainly in neonates and infants. The patients have atypical clinical features. A high proportion of patients with Enterococcus faecium meningitis have high-risk factors. Enterococcus faecium is sensitive to vancomycin.

P2Y1 receptor antagonists mitigate oxygen and glucose deprivation­induced astrocyte injury.

The aim of the present study was to elucidate the effects of blocking the calcium signaling pathway of astrocytes (ASs) on oxygen and glucose deprivation (OGD)­induced AS injury. The association between the changes in the concentrations of AS­derived transmitter ATP and glutamic acid, and the changes in calcium signaling under the challenge of OGD were investigated. The cortical ASs of Sprague Dawley rats were cultured to establish the OGD models of ASs. The extracellular concentrations of ATP and glutamic acid in the normal group and the OGD group were detected, and the intracellular concentration of calcium ions (Ca2+) was detected. The effects of 2'­deoxy­N6­methyl adenosine 3', 5'­diphosphate diammonium salt (MRS2179), a P2Y1 receptor antagonist, on the release of calcium and glutamic acid of ASs under the condition of OGD were observed. The OGD challenge induced the release of glutamic acid and ATP by ASs in a time­dependent manner, whereas elevation in the concentration of glutamic acid lagged behind that of the ATP and Ca2+. The concentration of Ca2+ inside ASs peaked 16 h after OGD, following which the concentration of Ca2+ was decreased. The effects of elevated release of glutamic acid by ASs when challenged by OGD may be blocked by MRS2179, a P2Y1 receptor antagonist. Furthermore, MRS2179 may significantly mitigate OGD­induced AS injury and increase cell survival. The ASs of rats cultured in vitro expressed P2Y1 receptors, which may inhibit excessive elevation in the concentration of intracellular Ca2+. Avoidance of intracellular calcium overload and the excessive release of glutamic acid may be an important reason why MRS2179 mitigates OGD­induced AS injury.

Synthesis, DNA binding, photo-induced DNA cleavage and cell cytotoxicity studies of a family of light rare earth complexes.

A family of light rare earth complexes, [RE(acac)(3)(dpq)] (RE=La (1), Ce (2), Pr (3), Nd (4), Sm (5)) and [RE(acac)(3)(dppz)].CH(3)OH (RE=La (6), Ce (7), Pr (8), Nd (9), Sm (10) viz. acetylacetonate (acac), dipyrido[3,2-d:20,30-f]quinoxaline (dpq), dipyrido[3,2-a:20,30-c] phenazine (dppz)), have been synthesized and structurally characterized. Binding interactions of these complexes with CT-DNA and their photo-induced DNA cleavage activity with pBR 322 DNA are also investigated. These complexes have strong DNA binding interaction (K(b)≈10(5)M(-1) and K(app)≈10(5)M(-1))and the binding propensity to CT-DNA decrease with the order: dppz complexes>dpq complexes. Furthermore, DNA photocleavage experiments indicate that these complexes are efficient DNA cleaving agents in UV-A (365 nm) and ambient light in the absence of any external reagents. Hydroxyl radical (HO(•)) and singlet oxygen ((1)O(2)) are the major cleavage active species from the machanistic studies. Moreover, cell cytotoxicity studies of these complexes on HeLa, K562 and MDA-MB-231 cells indicate that they have the potential to act as effective metal-based anti-cancer drugs.

SEM study on filum terminale with tethered cord syndrome.

OBJECTIVE: To improve the understanding in pathology and provide steady proof for diagnosis and treatment of tethered cord syndrome (TCS), the ultrastructure of filum terminale (FT) with TCS will be researched, respectively. METHODS: Thirty-one fila were sectioned and divided into two groups according to diameter. Twenty-two fila thicker than 2 mm were placed into group 1; nine no thicker than 2 mm were placed into group 2. Their transverse and longitudinal sections were respectively submitted for scanning electron microscopy analysis. RESULTS: For the FTs with TCS, ultrastructural analysis confirmed the presence of abundant collagen bundles and adipocytes, sparse or invisible elastic and reticular fibers inside the FT, but the latter two fibers were still visible in the relative normal areas of FT; some abnormalities, such as thickening, distortion, adhesion or fusion to piece, relatively dense and disorderly arrangement at a different degree, were quite common for collagen fiber. Some areas looked blurry, and some crystallization appeared occasionally on their surface. For the FTs with TFTS, those changes as mentioned above were still exhibited, but slightly relatively. All the changes mentioned inside all the FTs may exist alone or concomitantly, rarely simultaneously. Moreover, they can be often seen focally or diffusely occasionally. CONCLUSIONS: Low elasticity resulting from the destruction of the three-dimensional structure of FT is involved in TCS. Early FT severing is a treatment of choice no matter whether its appearance looks normal.

[Study on the roles of the expression of bcl-2 and bax in experimental immunological liver injury in rats].

OBJECTIVE: To elucidate the roles of Bcl-2 and Bax in experimental immunological liver injury in rat and the effect of lowering serum levels on the expression and the injury. METHODS: 48 male Wistar rats were divided into six groups randomly. The animal model of iron low-load was created by intravenation of deferoxamine (DFO) or phlebotomy respectively, and immunological liver damage model was reproduced by injection of BCG (Bacilli Calmette Guein) and lipopolysaccharide (LPS). Then the following parameters were determined such as serum iron (SI) concentration, transferrin (TRF) concentration, total proteins (TP) volume, the serum activity of aspartate aminotransferase (AST), malondialdehyde (MDA) content, iron content (HIC), the expression of Bcl-2 and Bax proteins in liver tissue were assayed; the ratio of Bax to Bcl-2, apoptotic index (AI), and proliferative index (PI) were also calculated. RESULTS: (1) The amount of Bax expression in liver injury group was significantly higher than that of control one, but no change in Bcl-2 expression. The ratio of Bax to Bcl-2 and AI augmented significantly, along with increased serum activities of AST and level of MDA, reduced volume of TP in liver injury animals. (2) The serum activity of AST and TP volume in both of the control groups with DFO and phlebotomy pretreatment remained at control level. Although the expression of Bax and Bcl-2, Bax/Bcl-2 ratio and AI were all higher than those of blank controls, the increased magnitudes of Bax/Bcl-2 ratio and Al were significantly lower than those of the liver injury animals. (3) The expression amounts of Bcl-2 and Bax increased in the injury animals induced after injecting DFO or phlebotomy, thus Bax/Bcl-2 ratio and Al increased. However, Bax/Bcl-2 ratio and AI of them were less than those of the injuries without lowered SI, and the magnitude of increased serum activity of AST was lower than that of the injuries, but no change in TP volume in the rats with lowered SI. The MDA levels in the injuries with lower value of serum iron were lower than those of the animals without lower SI. CONCLUSION: The results show that the apoptotic process of hepatocyte accelerates in immunological liver injury, apoptosis may facilitate hepatocyte damage. Effect of iron on the expression of apoptosis regulating proteins have played an important role in apoptosis of immunological hepatic injury.