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Objective:To seek any correlation between cortical activity and the swallowing of dysphagia patients with infratentorial stroke, and to observe any effect of three-needle acupuncture of the tongue on such activity.Methods:Thirty infratentorial stroke survivors with dysphagia were randomly divided into a tongue three-needle group and a sham acupuncture group, each of 15. Functional near-infrared spectroscopy was used to monitor changes in the concentration of oxygenated hemoglobin (ΔHbO 2) at rest, during acupuncture (or sham acupuncture), during real or sham electro-acupuncture, and at rest after the acupuncture or sham acupuncture treatment. The Modified Rankin Scale, a Penetration-Aspiration Scale (PAS), and the Functional Oral Intake Scale were employed to assess overall functional disability and the swallowing of both groups. Results:At rest the average ΔHbO 2 concentrations recorded in the left primary motor cortex, the left dorsolateral prefrontal cortex and the left premotor cortex in both groups were positively correlated with the PAS scores. During the acupuncture ΔHbO 2 concentration in the right inferior frontal gyrus and the left middle temporal gyrus increased significantly in the tongue three-needle group. It decreased significantly in the left somatosensory cortex and the left primary motor cortex. Conclusion:Three-needle acupuncture of the tongue induces changes in cortical activity in infratentorial stroke survivors with dysphagia, suggesting a potential technique for improving disordered swallowing.
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OBJECTIVE@#To preliminarily verify the effectiveness of self-designed artificial condyle-mandibular distraction (AC-MD) complex in the treatment of Pruzansky type ⅡB and Ⅲ hemifacial microsomia (HFM) through model test.@*METHODS@#Five children with Pruzansky type ⅡB and Ⅲ HFM who were treated with mandibular distraction osteogenesis (MDO) between December 2016 and December 2021 were selected as the subjects. There were 3 boys and 2 girls wih an average age of 8.4 years (range, 6-10 years). Virtual surgery and model test of AC-MD complex were performed according to preoperative skull CT of children. The model was obtained by three-dimensional (3D) printing according to the children's CT data at a ratio of 1∶1. The occlusal guide plate was designed and 3D printed according to the children's toothpaste model. The results of the model test and the virtual surgery were matched in three dimensions to calculate the error of the residual condyle on the affected side, and the model test was matched with the actual skull CT after MDO to measure and compare the inclination rotation of the mandible, the distance between the condylar of the healthy side and the residual condyle of the affected side, and the lengthening length of the mandible.@*RESULTS@#The error of residual condyle was (1.07±0.78) mm. The inclination rotation of the mandible, the distance between the condylar of the healthy side and the residual condyle of the affected side, and the lengthening length of the mandible after 3D printing model test were significantly larger than those after MDO ( P<0.05).@*CONCLUSION@#In the model test, the implantation of AC-MD complex can immediately rotate the mandible to the horizontal position and improve facial symmetry, and the residual condyle segment can be guided close to the articular fossa or the preset pseudoarticular position of the skull base after operation.
الموضوعات
Male , Child , Female , Humans , Goldenhar Syndrome/surgery , Mandible/surgery , Osteogenesis, Distraction/methods , Printing, Three-Dimensional , Facial Asymmetry/surgeryالملخص
On the basis of establishing the prescription of Xinjianqu and clarifying the increase of the lipid-lowering active ingredients of Xinjianqu by fermentation, this paper further compared the differences in the lipid-lowering effects of Xinjianqu before and after fermentation, and studied the mechanism of Xinjianqu in the treatment of hyperlipidemia. Seventy SD rats were randomly divided into seven groups, including normal group, model group, positive drug simvastatin group(0.02 g·kg~(-1)), and low-dose and high-dose Xinjianqu groups before and after fermentation(1.6 g·kg~(-1) and 8 g·kg~(-1)), with ten rats in each group. Rats in each group were given high-fat diet continuously for six weeks to establish the model of hyperlipidemia(HLP). After successful modeling, the rats were given high-fat diet and gavaged by the corresponding drugs for six weeks, once a day, to compare the effects of Xinjianqu on the body mass, liver coefficient, and small intestine propulsion rate of rats with HLP before and after fermentation. The effects of Xinjianqu before and after fermentation on total cholesterol(TC), triacylglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood urea nitrogen(BUN), creatinine(Cr), motilin(MTL), gastrin(GAS), and the Na~+-K~+-ATPase levels were determined by enzyme-linked immunosorbent assay(ELISA). The effects of Xinjianqu on liver morphology of rats with HLP were investigated by hematoxylin-eosin(HE) staining and oil red O fat staining. The effects of Xinjianqu on the protein expression of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK), phosphorylated AMPK(p-AMPK), liver kinase B1(LKB1), and 3-hydroxy-3-methylglutarate monoacyl coenzyme A reductase(HMGCR) in liver tissues were investigated by immunohistochemistry. The effects of Xinjianqu on the regulation of intestinal flora structure of rats with HLP were studied based on 16S rDNA high-throughput sequencing technology. The results showed that compared with those in the normal group, rats in the model group had significantly higher body mass and liver coefficient(P<0.01), significantly lower small intestine propulsion rate(P<0.01), significantly higher serum levels of TC, TG, LDL-C, ALT, AST, BUN, Cr, and AQP2(P<0.01), and significantly lower serum levels of HDL-C, MTL, GAS, Na~+-K~+-ATP levels(P<0.01). The protein expression of AMPK, p-AMPK, and LKB1 in the livers of rats in the model group was significantly decreased(P<0.01), and that of HMGCR was significantly increased(P<0.01). In addition, the observed_otus, Shannon, and Chao1 indices were significantly decreased(P<0.05 or P<0.01) in rat fecal flora in the model group. Besides, in the model group, the relative abundance of Firmicutes was reduced, while that of Verrucomicrobia and Proteobacteria was increased, and the relative abundance of beneficial genera such as Ligilactobacillus and Lachnospiraceae_NK4A136_group was reduced. Compared with the model group, all Xinjianqu groups regulated the body mass, liver coefficient, and small intestine index of rats with HLP(P<0.05 or P<0.01), reduced the serum levels of TC, TG, LDL-C, ALT, AST, BUN, Cr, and AQP2, increased the serum levels of HDL-C, MTL, GAS, and Na~+-K~+-ATP, improved the liver morphology, and increased the protein expression gray value of AMPK, p-AMPK, and LKB1 in the liver of rats with HLP and decreased that of LKB1. Xinjianqu groups could regulate the intestinal flora structure of rats with HLP, increased observed_otus, Shannon, Chao1 indices, and increased the relative abundance of Firmicutes, Ligilactobacillus(genus), Lachnospiraceae_NK4A136_group(genus). Besides, the high-dose Xinjianqu-fermented group had significant effects on body mass, liver coefficient, small intestine propulsion rate, and serum index levels of rats with HLP(P<0.01), and the effects were better than those of Xinjianqu groups before fermentation. The above results show that Xinjianqu can improve the blood lipid level, liver and kidney function, and gastrointestinal motility of rats with HLP, and the improvement effect of Xinjianqu on hyperlipidemia is significantly enhanced by fermentation. The mechanism may be related to AMPK, p-AMPK, LKB1, and HMGCR protein in the LKB1-AMPK pathway and the regulation of intestinal flora structure.
الموضوعات
Rats , Animals , AMP-Activated Protein Kinases/metabolism , Rats, Sprague-Dawley , Cholesterol, LDL , Fermentation , Aquaporin 2/metabolism , Lipid Metabolism , Liver , Lipids , Hyperlipidemias/genetics , Adenosine Triphosphate/pharmacology , Diet, High-Fat/adverse effectsالملخص
Objective@#To discuss the efficacy of computer aided design (CAD) and computer aided manufacturing (CAM) in the treatment of microgenia by osseous genioplasty.@*Methods@#From July 2015 to January 2018, 17 cases (Male, n=5, Female, n=12), aged from 17 to 32 years, with the meanage of 24 years, were enrolled. All patients had microgenia, and underwent osseous genioplasty. Computed tomography (CT) was performed preoperatively and 7-10 days postoperatively for all cases. Based on preoperative CT data, CAD was applied to make individualized surgical plan, surgery simulation, todetermine the movement of mentum. CAM was used to prefabricate the individualized surgical templates and transfer the CAD into intraoperative guidance. The registration of CAD and postoperative CT were performed to evaluate the surgical accuracy.@*Results@#All patients were satisfied with the surgical outcomes. The deformity of microgenia was significantly corrected. The Pg error was (0.24±0.08) mm, and the Me error was (0.15±0.17) mm.@*Conclusions@#The application of CAD increases the accuracy of surgical planning, and CAM provides areliable guidance with individualized template. Anoptimal surgical outcome can be achieved.
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Intraoral facial contour surgery is one of the most popular craniofacial cosmetic surgeries in China, in spite of its challenging surgical technique and serious complication, such as fracture and bleeding. In addition, the key point, such as inadequate tissue exposure and high soft tissue tension cannot be simulated using traditional three-dimensional model. Consequently, craniomaxillofacial surgery requires a long learning curve for young surgeons. This article describes the establishment and application of a new model for intraoral facial contour surgery. Compared to young surgeons trained using traditional three-dimensional model, the authors confirmed this new surgical model is more reliable and effective. Therefore, it is worthy of being popularized.
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PURPOSE: Chronic lymphocytic leukemia (CLL) is one of the most frequent type of B-cell chronic lymphoproliferative disorders and chronic inflammation takes part in the development of CLL. However, there has been no valid immune biomarker to predict the prognosis of untreated CLL patients. MATERIALS AND METHODS: In this retrospective study, we analyzed the clinical correlations and prognostic value of albumin-to-fibrinogen ratio (AFR) detected at diagnosis in 191 CLL patients. RESULTS: The cut-off value of AFR was 9.7 calculated by X-tile. Patients who were more than 65 years old were often accompanied by low level of AFR (p < 0.001). Survival analysis showed that patients with low level of AFR had shorter overall survival (OS) than patients with high level of AFR (p < 0.001). Multivariate analysis illustrated that AFR had a negative impact on OS (p=0.003) and was independent of parameters involved in CLL international prognostic index and other prognostic markers such as CD38 and ZAP-70. CONCLUSION: These data provide a comprehensive view of AFR and shows that AFR at diagnosis is an adverse prognostic factor in untreated CLL patients.
الموضوعات
Humans , B-Lymphocytes , Diagnosis , Fibrinogen , Inflammation , Leukemia, Lymphocytic, Chronic, B-Cell , Lymphoproliferative Disorders , Multivariate Analysis , Prognosis , Retrospective Studies , Serum Albuminالملخص
Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in western countries which has a highly heterogeneous clinical course. The 59th American Society of Hematology (ASH) Annual Meeting focused on monotherapy or combination of new agents including bcl-2 inhibitor and BCR signal pathway transduction kinase inhibitors as well as clinical efficacy and safety of new drugs. This paper reviews the progress of CLL therapy combined with the meeting.
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Objective@#To validate the prognostic value of chronic lymphocytic leukemia-international prognostic index (CLL-IPI) for Chinese CLL patients.@*Methods@#Two hundred and fifteen CLL patients who were initially diagnosed and treated in Jiangsu Province Hospital from January 2002 to November 2017 were included in the retrospective analysis. Risk stratification and prognosis were evaluated by CLL-IPI scoring system.@*Results@#①Of the 215 patients, 143 were males and 72 were females, with a median age of 60 (16-85) years old. The median treatment-free survival (TFS) and overall survival (OS) was 16 months (4-24 months) and 180 months (145-215 months), respectively. ② The median TFS for low (n=60), intermediate (n=50), high (n=45) and very high risk group (n=60) according to the CLL-IPI scoring system was 56, 15, 12 and 5 months, respectively (P<0.001). ③ The median follow-up was 48 months (1-192 months). The median OS for low risk group was not reached and for intermediate, high, and very high risk group was 180, 89 and 74 months, respectively. The estimated 5-year OS rate was 97.6%, 83.7%, 67.8% and 55.2%, respectively (P<0.001). ④ Multivariate analysis indicated that unmutated immunoglobulin heavy chain variable region (IGHV) gene and β2-microglobulin>3.5 mg/L(P<0.001) were independent prognostic factors of TFS, while TP53 deletion and/or mutation(P=0.008), unmutated IGHV (P=0.017) and age>65 years(P=0.045) were independent prognostic factors of OS.@*Conclusion@#CLL-IPI is the powerful tool for risk stratification in Chinese CLL patients.
الملخص
Objective: To validate the prognostic value of chronic lymphocytic leukemia-international prognostic index (CLL-IPI) for Chinese CLL patients. Methods: Two hundred and fifteen CLL patients who were initially diagnosed and treated in Jiangsu Province Hospital from January 2002 to November 2017 were included in the retrospective analysis. Risk stratification and prognosis were evaluated by CLL-IPI scoring system. Results: ①Of the 215 patients, 143 were males and 72 were females, with a median age of 60 (16-85) years old. The median treatment-free survival (TFS) and overall survival (OS) was 16 months (4-24 months) and 180 months (145-215 months), respectively. ② The median TFS for low (n=60), intermediate (n=50), high (n=45) and very high risk group (n=60) according to the CLL-IPI scoring system was 56, 15, 12 and 5 months, respectively (P<0.001). ③ The median follow-up was 48 months (1-192 months). The median OS for low risk group was not reached and for intermediate, high, and very high risk group was 180, 89 and 74 months, respectively. The estimated 5-year OS rate was 97.6%, 83.7%, 67.8% and 55.2%, respectively (P<0.001). ④ Multivariate analysis indicated that unmutated immunoglobulin heavy chain variable region (IGHV) gene and β(2)-microglobulin>3.5 mg/L(P<0.001) were independent prognostic factors of TFS, while TP53 deletion and/or mutation(P=0.008), unmutated IGHV (P=0.017) and age>65 years(P=0.045) were independent prognostic factors of OS. Conclusion: CLL-IPI is the powerful tool for risk stratification in Chinese CLL patients.
الموضوعات
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Leukemia, Lymphocytic, Chronic, B-Cell , Mutation , Prognosis , Retrospective Studies , Survival Rateالملخص
OBJECTIVE@#To explore the protective effect and mechanism of Tetramethy1Pyrazine (TMP) on the pancreas function of acute pancreatitis rats.@*METHODS@#A total of 75 SD rats were randomly divided into three groups (A, B, C) with 25 rats in each group. Group A served as sham operation group. In the groups B and C, AP model was prepared as by injecting taurocholic acid sodium. Group B was model group. After modeling, rats were administrated by intraperitoneal injection of normal saline. Group C was TMP treatment group, which was administrated by intraperitoneal injection of 0.6% TMP after modeling. The rat blood specimens in each group were collected with 1 mL/100 g solution after modeling of 2, 6, 12 and 24 h. Levels of amylase (AMS), blood urea nitrogen (BUN), creatinine (CR), TNF-α and IL-6 were detected, and 5 rats were sacrificed. Histopathological examination was performed in he pancreatic tissue specimens of each group to observe pancreatic tissue damage.@*RESULTS@#After modeling in each time point, AMS, BUN, CR, TNF-α and IL-6 in groups B and C were significantly higher than that of in group A (P < 0.05). After modeling of 2 h, AMS, BUN and CR in group B increased significantly and reached the peak value at 6 h. After modeling of 12 h, serum level of TNF-α and IL-6 were significantly lower than that of in control group, while after 24 h of modeling, serum level of AMS, BUN, CR, TNF-α and IL-6 were significantly lower than that of in control group (P < 0.05). The histological observation showed that pancreatic tissue in rats of group A was normal without damage lesions. Massive bleeding, necrosis and serious injury were visible in pancreatic tissue of group B. The rat pancreatic tissue was bleeding in group C with small pieces of necrotic lesions. The degree of inflammatory cell infiltration was lower than group B, and the degree of injury was significantly lower than group B.@*CONCLUSIONS@#TMP can significantly decrease the serum level of TNF-α and IL-6 in AP rats, inhibits inflammatory response of AP, and has significant protective effect on pancreatic tissue and function in AP rats.
الملخص
Objective: To explore the protective effect and mechanism of Tetramethy1Pyrazine (TMP) on the pancreas function of acute pancreatitis rats. Methods: A total of 75 SD rats were randomly divided into three groups (A, B, C) with 25 rats in each group. Group A served as sham operation group. In the groups B and C, AP model was prepared as by injecting taurocholic acid sodium. Group B was model group. After modeling, rats were administrated by intraperitoneal injection of normal saline. Group C was TMP treatment group, which was administrated by intraperitoneal injection of 0.6% TMP after modeling. The rat blood specimens in each group were collected with 1mL/100g solution after modeling of 2, 6, 12 and 24h. Levels of amylase (AMS), blood urea nitrogen (BUN), creatinine (CR), TNF-α and IL-6 were detected, and 5 rats were sacrificed. Histopathological examination was performed in he pancreatic tissue specimens of each group to observe pancreatic tissue damage. Results: After modeling in each time point, AMS, BUN, CR, TNF-α and IL-6 in groups B and C were significantly higher than that of in group A (P<0.05). After modeling of 2h, AMS, BUN and CR in group B increased significantly and reached the peak value at 6h. After modeling of 12h, serum level of TNF-α and IL-6 were significantly lower than that of in control group, while after 24h of modeling, serum level of AMS, BUN, CR, TNF-α and IL-6 were significantly lower than that of in control group (P<0.05). The histological observation showed that pancreatic tissue in rats of group A was normal without damage lesions. Massive bleeding, necrosis and serious injury were visible in pancreatic tissue of group B. The rat pancreatic tissue was bleeding in group C with small pieces of necrotic lesions. The degree of inflammatory cell infiltration was lower than group B, and the degree of injury was significantly lower than group B. Conclusions: TMP can significantly decrease the serum level of TNF-α and IL-6 in AP rats, inhibits inflammatory response of AP, and has significant protective effect on pancreatic tissue and function in AP rats.