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BACKGROUND: Helicobacter pylori (H. pylori), according to a number of recent observational studies, is connected to atherosclerosis (AS). However, the link between H. pylori and AS is debatable. METHODS: In order to calculate the causal relationship between H. pylori and AS, we employed a two-sample Mendelian randomization (MR) analysis. The data for H. pylori were obtained from the IEU GWAS database ( https://gwas.mrcieu.ac.uk/datasets/ ) and the data for AS were obtained from the Finngen GWAS database ( https://r5.finngen.fi/ ). We selected single nucleotide polymorphisms with a threshold of 5 × 10-6 from earlier genome-wide association studies. MR was performed mainly using the inverse variance weighted (IVW) method. To ensure the reliability of the findings, We performed a leave-one-out sensitivity analysis to test for sensitivity. F-value was used to test weak instrument. RESULTS: A positive causal relationship between H. pylori OMP antibody levels and peripheral atherosclerosis was shown by our two-sample MR analysis (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.14-1.54, P = 0.26E-03) using IVW. Additionally, there was a causative link between coronary atherosclerosis and H. pylori VacA antibody levels (IVW OR = 1.06, 95% CI = 1.01-1.10, P = 0.016). All the F-values were above 10. CONCLUSIONS: This MR study discovered a causal link between H. pylori and AS. Different antibodies have different effects, so future researches are needed to figure out the exact mechanisms behind this link.
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Aterosclerosis , Helicobacter pylori , Humanos , Helicobacter pylori/genética , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Reproducibilidad de los Resultados , Aterosclerosis/diagnóstico , Aterosclerosis/genética , Anticuerpos AntibacterianosRESUMEN
BACKGROUND: Cardiovascular disease (CVD) remains the foremost cause of mortality globally. Taurine, an amino acid, holds promise for cardiovascular health through mechanisms such as calcium regulation, blood pressure reduction, and antioxidant and anti-inflammatory effects. Despite these potential benefits, previous studies have yielded inconsistent results. This meta-analysis of randomized controlled trials (RCTs) aims to evaluate the existing evidence on the quantitative effects of taurine on hemodynamic parameters and cardiac function grading, which are indicative of overall cardiovascular health and performance. METHODS: We conducted an electronic search across multiple databases, including Embase, PubMed, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov, from their inception to January 2, 2024. Our analysis focused on key cardiovascular outcomes, such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular ejection fraction (LVEF), and New York Heart Association (NYHA) Functional Classification. Meta-regression was applied to explore dose-dependent relationships based on the total taurine dose administered during the treatment period. A subgroup analysis, stratified according to the baseline disease status of patients, was also conducted. RESULTS: The analysis included a pooled sample of 808 participants from 20 randomized controlled trials. Taurine demonstrated a significant reduction in HR (weighted mean difference [WMD] = -3.579 bpm, 95% confidence interval [CI] = -6.044 to -1.114, p = 0.004), SBP (WMD = -3.999 mm Hg, 95% CI = -7.293 to -0.706, p = 0.017), DBP (WMD: -1.435 mm Hg, 95% CI: -2.484 to -0.386, p = 0.007), NYHA (WMD: -0.403, 95% CI: -0.522 to -0.283, p < 0.001), and a significant increase in LVEF (WMD: 4.981%, 95% CI: 1.556 to 8.407, p = 0.004). Meta-regression indicated a dose-dependent reduction in HR (coefficient = -0.0150 per g, p = 0.333), SBP (coefficient = -0.0239 per g, p = 0.113), DBP (coefficient = -0.0089 per g, p = 0.110), and NYHA (coefficient = -0.0016 per g, p = 0.111), and a positive correlation with LVEF (coefficient = 0.0285 per g, p = 0.308). No significant adverse effects were observed compared to controls. In subgroup analysis, taurine significantly improved HR in heart failure patients and healthy individuals. Taurine significantly reduced SBP in healthy individuals, heart failure patients, and those with other diseases, while significantly lowered DBP in hypertensive patients It notably increased LVEF in heart failure patients and improved NYHA functional class in both heart failure patients and those with other diseases. CONCLUSIONS: Taurine showed noteworthy effects in preventing hypertension and enhancing cardiac function. Individuals prone to CVDs may find it advantageous to include taurine in their daily regimen.
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Presión Sanguínea , Enfermedades Cardiovasculares , Ensayos Clínicos Controlados Aleatorios como Asunto , Taurina , Taurina/farmacología , Taurina/administración & dosificación , Humanos , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Volumen Sistólico/efectos de los fármacos , Función Ventricular Izquierda/efectos de los fármacosRESUMEN
This publication has been retracted by the Editor due to the identification of non-original figure images and manuscript content that raise concerns regarding the credibility and originality of the study. Reference: Jin-Cheng Zheng, Ke-Jie Chang, Yu-Xiang Jin, Xue-Wei Zhao, Bing Li, Meng-Hang Yang. Arsenic Trioxide Inhibits the Metastasis of Small Cell Lung Cancer by Blocking Calcineurin-Nuclear Factor of Activated T Cells (NFAT) Signaling. Med Sci Monit 2019; 25:2228-2237. DOI: 10.12659/MSM.913091.
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Insertional Achilles tendinopathy is an umbrella medical term referring to pain and swelling on the posterior aspect of the calcaneus. High-resolution ultrasound imaging is commonly used in daily practice to assess the pathological changes of the Achilles tendon, cortical bone of the calcaneus, and soft tissues located inside the retrocalcaneal space to optimize the management of relevant patients. To the best of our knowledge, a standardized ultrasound protocol to evaluate the retrocalcaneal bursal complex is lacking in the pertinent literature. In this sense, our step-by-step sonographic approach is intended to be an easy and ready-to-use guide for sonographers/physicians in daily practice to assess this anatomical complex in patients with Achilles tendinopathy. Needless to say, the peculiar histological features of this V-shaped synovial/fibrocartilaginous bursa surrounding the posteroinferior wedge of the Kager's fat pad and the retrocalcaneal space make the examination challenging.
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Objective: To analyze the manifestations of infectious mononucleosis and its impact on liver function in children. Methods: This retrospective study analyzed clinical data from 695 children with infectious mononucleosis (IM) who were hospitalized at the Department of Pediatrics, Chengdu First People's Hospital between January 1, 2017, and December 31, 2022. They were analyzed into two groups according to whether their ALT was greater than 40 U/L. Demographic variables, clinical features, and laboratory findings were collected from medical records. Statistical analyses were performed using the Statistic Package for Social Science (SPSS) 26. Results: A total of 695 children with infectious mononucleosis (IM)(409 males and 286 females) were included in the study. The age distribution was 161 infants (<3 years), 357 preschoolers (3-7 years), and 177 school-aged children (≥7 years). After clinical recovery, 61 cases had elevated liver enzymes. Asynchronous changes in AST and ALT were present in 18 children. The highest proportion of fever onset (75.2%) occurred in infancy (P = .00). Elevated AST, lymphocyte percentage and WBCs, age in school age, uncomplicated myocardial injury these were the risk factors for the development of liver injury in children with infectious mononucleosis. P values were .00, .048, .021, .000 and .002, respectively. 95% CIs were 65., 2-315.52, 1.01-3.48, 1.18- 7.37, 2.57-13.52 and 1.79-13.35, respectively. Conclusions: The clinical features vary with sex and age. Children with IM who are school-aged, without myocardial injury, and have elevated WBC, lymphocyte percentage, and AST should be monitored for potential liver damage. Careful evaluation is necessary following clinical recovery to determine if vaccination is appropriate.
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The pertinent literature widely describes ultrasound-guided procedures targeting the retrocalcaneal bursa and the tendon tissue to manage insertional Achilles tendinopathy. Synovial bursae and cutaneous nerves of the superficial retrocalcaneal pad are often overlooked pain generators and are poorly considered by clinicians and surgeons. A layer-by-layer dissection of the superficial soft tissues in the retrocalcaneal region of two fresh frozen cadavers was matched with historical anatomical tables of the textbook Traite d'Anatomie Topographique Avec Applications Médico-Chirurgicales (1909 by Testut and Jacob). An accurate and detailed description of the superficial retrocalcaneal pad with its synovial bursae and cutaneous nerves was provided. Cadaveric dissections confirmed the compartmentalized architecture of the superficial retrocalcaneal fat pad and its histological continuum with the superficial lamina of the crural fascia. Superficial synovial tissue islands have been demonstrated on the posterior aspect of the Achilles tendon in one cadaver and on the posterolateral surface of the tendon in the other one. Digitalization of the original anatomical tables of the textbook Traite d'Anatomie Topographique Avec Applications Médico-Chirurgicales (1909 by Testut and Jacob) showed five potential locations of the superficial calcaneal bursa and a superficial retrocalcaneal nerve plexus within the Achilles tendon-fat pad interface. In clinical practice, in addition to the previously described interventions regarding the retrocalcaneal bursa and the tendon tissue, ultrasound-guided procedures targeting the synovial and neural tissues of the superficial retrocalcaneal pad should be considered to optimize the management of insertional Achilles tendinopathy.
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Controlling resistance by external fields provides fascinating opportunities for the development of novel devices and circuits, such as temperature-field-induced superconductors, magnetic-field-triggered giant magnetoresistance devices, and electric-field-operated flash memories. In this work, we demonstrate a light-triggered nonvolatile resistive switching behavior in oxygen-doped MoS2. The two-terminal devices exhibit stable light-modulated resistive switching characteristics and optically tunable synaptic properties with an on/off ratio of up to 104. The integrated device with crossbar architecture enables simultaneous image sensing, preprocessing, and storage in a single device, thereby increasing the training efficiency and recognition rate of image recognition tasks. This work presents a novel pathway to develop the next generation of light-controlled memory and artificial vision systems for neuromorphic computing.
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BACKGROUND: V-Y advancement flap (VYAF) is a commonly used flap for facial reconstruction, but it is not popular in Asian society with limited aesthetic outcome evaluation. OBJECTIVE: To demonstrate our experience of facial VYAF with the quantitative aesthetic outcome assessment. METHODS AND MATERIALS: From January 2013 to December 2022, patients who underwent facial VYAF reconstruction were reviewed. Postoperative photographs were collected and independently graded by three plastic surgeons, three nurses, and six non-medical personnel using Manchester scar scale (MSS). The representative preoperative images were selected for surgeons' reconstruction preferences survey. RESULTS: Forty-eight patients (27 females and 21 males), with a mean age of 66.8 (23-97) years, were included in this study. All flaps survived with no flap necrosis. Only six patients (12.5%) developed minor postoperative complications, and they were treated conservatively and resolved uneventfully. The total MSS score was 7.8 ± 1.9 (scale of 4 [best scar] to 24 [worst scar]) and the overall scar VAS rating was 1.9 ± 1.1 (0 [best scar] to 10 [worst scar]), indicating satisfactory postoperative scar condition. From the survey of 22 plastic surgeons and 11 scenarios, VYAF was rarely chosen among other local flaps which only accounted for 8.7%. CONCLUSION: VYAF is an easy and safe method for facial reconstruction with low morbidity, but its usefulness is underappreciated. With a proper design and cautious dissection, we believe that good aesthetic and functional outcomes can be achieved with VYAF. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Pueblo Asiatico , Estética , Procedimientos de Cirugía Plástica , Colgajos Quirúrgicos , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Procedimientos de Cirugía Plástica/métodos , Anciano , Colgajos Quirúrgicos/trasplante , Estudios Retrospectivos , Adulto Joven , Anciano de 80 o más Años , Resultado del Tratamiento , Traumatismos Faciales/cirugía , Estudios de Cohortes , Medición de Riesgo , Supervivencia de Injerto , Cicatrización de Heridas/fisiología , CicatrizRESUMEN
OBJECTIVE: Injection of the tibiotalar (TT) joint is commonly performed in clinical practice under ultrasound (US) guidance using an anteromedial approach. However, in some patients, this approach may be technically challenging due to post-traumatic and/or degenerative bony changes. Therefore, the aim of this cadaveric investigation was to demonstrate the feasibility of the ultrasound-guided (USG) injection of the ankle joint via the anterolateral sulcus (ALS) by confirming the dye placement/distribution inside the articular space. Likewise, the safety of the procedure has also been evaluated by measuring the distance between the needle and the intermediate dorsal cutaneous nerve of the foot. DESIGN: A descriptive laboratory study with eight embalmed cadaveric ankles using the Fix for Life (F4L) method was performed at the setting of an academic institution. The interventional technique and the related anatomical findings were illustrated. During the injection, the needle was advanced into the TT joint through the ALS under US guidance, i.e., in-plane anterior-to-posterior approach. With the objective to confirm its correct placement, the needle was kept in situ and-to demonstrate the location of the dye inside the articular space-all eight ankles were injected with 3 mL of green color dye. Thereafter, a layer-by-layer anatomical dissection was performed on all four cadavers. RESULTS: The position of the needle's tip within the ALS was confirmed in all specimens. Accurate placement of the dye inside the articular space of the ankle was confirmed in seven of the eight cadaveric ankles, with 87.5% of accuracy. Herewith, unintentional spilling of the dye within the superficial soft tissues was reported in two of the eight ankles (25.0%). The mean distance between the needle and the intermediate dorsal cutaneous nerve of the foot, measured in all eight procedures, was 3 cm. CONCLUSION: USG injection of the ALS using the in-plane, anterior-to-posterior approach can accurately place the injectate inside the articular space. CLINICAL RELEVANCE: This cadaveric investigation described the accuracy and potential pitfalls of USG injection of the ankle via the anterolateral approach which represents an alternative technique in patients with reduced accessibility of the anteromedial recess due to degenerative and/or post-traumatic bony changes.
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Articulación del Tobillo , Humanos , Articulación del Tobillo/diagnóstico por imagen , Cadáver , Inyecciones Intraarticulares/métodos , Ultrasonografía Intervencional/métodosRESUMEN
BACKGROUND: Injections around the Achilles tendon (AT) are commonly performed in clinical practice to manage non-insertional Achilles tendinopathy, but the presence/distribution of the injectate with relation to its sheath has not been assessed specifically. Accordingly, the aim of this cadaveric investigation was to demonstrate the feasibility of Achilles paratenon injection under ultrasound guidance - by confirming the exact needle positioning as well as the dye distribution inside the paratenon lumen. METHODS: A descriptive laboratory study with three human cadaveric specimens (one fresh cadaver and two cadavers embalmed using the Fix for Life (F4L) method) was performed in a tertiary-care academic institution. The interventional technique and the related anatomical findings were illustrated. During the injection, the needle was advanced inside the Achilles paratenon under ultrasound guidance i.e. in-plane medial-to-lateral approach. With the objective to confirm its correct placement, the needle was kept in situ on the right AT of the fresh cadaver. Likewise, to demonstrate the location of the dye inside the lumen of Achilles paratenon, the other five ATs - four on the embalmed cadavers and one on the fresh cadaver - were injected with 5 mL of green color dye. After removal of the needle, a layer-by-layer anatomical dissection was performed on all three cadavers. RESULTS: On the right AT of the fresh cadaver, the position of the needle's tip within the Achilles paratenon was confirmed. Accurate placement of the dye inside the paratenon lumen was confirmed in four (80%) ATs, one of the fresh and three of the embalmed cadavers. No spread inside the crural fascia compartment or between the AT and the Kager's fat pad was observed. Herewith, unintentional spilling of the dye within the superficial soft tissues of the posterior leg was reported in the left AT of one of the two embalmed cadavers (20%). CONCLUSIONS: Ultrasound-guided injection using the in-plane, medial-to-lateral approach can accurately target the lumen of Achilles paratenon.
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Tendón Calcáneo , Cadáver , Ultrasonografía Intervencional , Humanos , Tendón Calcáneo/diagnóstico por imagen , Tendón Calcáneo/anatomía & histología , Tendinopatía/diagnóstico por imagen , Inyecciones , Masculino , Estudios de Factibilidad , AncianoRESUMEN
We present, what we believe to be, a novel microlens array (MLA) scheme for laser light shaping in laser scanning smart headlight. The laser spot has a Gaussian distribution that may reach a high peak power density in the central part, which is called hot spot. When the laser beam is applied to a phosphor plate for luminous conversion, the hot spot of Gaussian beam causes thermal quench and decreases luminous efficacy. To avoid this effect, an MLA is used, so as to achieve a uniform energy distribution. In this study, we propose a laser scanning smart headlight fabricated by a new MLA structure, with an arrangement providing both light uniformity and shaping. The novel MLA is designed by two-dimensional micro-concave lens array yielding a flat-top beam. The flexible fabrication process employs laser drilling to shape the micro-hole array on the glass substrate surface and then etch it to form MLA without requiring any mask lithography process. The full-width half maximum (FWHM) of light output distribution can be adjusted by the glass etching parameters, and the light distribution could be controlled by the arranged layout of the array. Thus, beams with FWHM divergence ranging from 5° to 34° has been fabricated and characterized. The typical pixel shape is a rectangle with two different FWHMs in two orthogonal directions, and the fabrication method achieves this goal as well. This novel design and unique maskless process of the MLAs is a promising tool for development the next generation laser scanning smart headlight.
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OBJECTIVES: To explore the subacromial motion metrics in patients with and without subacromial impingement syndrome (SIS) and to investigate whether the abnormality was associated with rotator cuff pathologies. DESIGN: This cross-sectional observational study used dynamic quantitative ultrasonography imaging for shoulder joint assessment. SETTING: Outpatient rehabilitation clinic. PARTICIPANTS: Individuals with SIS on at least 1 shoulder (n=32) and asymptomatic controls (n=32) (N=64). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Frame-by-frame, the humeral greater tuberosity against the lateral edge of the acromion was traced to obtain the minimal vertical acromiohumeral distance (AHD). The rotation angle and radius of the humerus were computed using the least-squares curve fitting method. RESULTS: Approximately two-thirds of the shoulders with SIS did not have any sonographically identifiable rotator cuff pathologies. There was a consistent trend of nonsignificantly increased humeral rotation angles in painful shoulders. The generalized estimating equation demonstrated that the decreased minimal vertical AHD was associated with painful subacromial impingement (ß coefficient: -0.123cm, 95% confidence interval [CI], -0.199 to -0.047). The area under the curve for the minimal vertical AHD to discriminate painful or impinged shoulders ranged from 0.624-0.676. The increased rotation angle (ß coefficient: 10.516°; 95% CI, 3.103-17.929) and decreased rotation radius (ß coefficient: -2.903cm; 95% CI, -5.693 to -0.111) were shown to be significantly related to the presence of supraspinatus tendinopathy. CONCLUSIONS: Shoulders with SIS were characterized by a decreased minimal vertical AHD during dynamic examination. Abnormal subacromial metrics can develop in patients with mild (or no) rotator cuff pathologies. More prospective cohort studies are warranted to investigate the changes in subacromial motion metrics in populations at risk for painful or impinged shoulders.
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Síndrome de Abducción Dolorosa del Hombro , Articulación del Hombro , Humanos , Síndrome de Abducción Dolorosa del Hombro/diagnóstico por imagen , Estudios Transversales , Estudios Prospectivos , Hombro , Dolor , Ultrasonografía , Rango del Movimiento ArticularRESUMEN
OBJECTIVE: To investigate the efficacy of hydrodilatation with 40 mg triamcinolone acetonide (TA) compared with the same procedure with 10 mg TA in patients with adhesive capsulitis (AC) of the shoulders. DESIGN: Prospective, double-blind, randomized controlled trial with 12 weeks of follow-up. SETTING: Tertiary care rehabilitation center. PARTICIPANTS: Eighty-four patients diagnosed with AC (N=84). INTERVENTIONS: Ultrasound guidance using (A) hydrodilatation with 4 mL of TA (40 mg)+4 mL 2% lidocaine hydrochloride+12 mL normal saline or (B) hydrodilatation with 1 mL of TA (10 mg)+4 mL 2% lidocaine hydrochloride+15 mL normal saline through the posterior glenohumeral recess. MAIN OUTCOME MEASURES: Shoulder Pain and Disability Index (SPADI), visual analog scale (VAS) for pain, and range of motion (ROM) at baseline and at 6 and 12 weeks after injection. RESULTS: Both groups experienced improvements in the SPADI score, VAS scores for pain, and ROM throughout the study period. However, group-by-time interactions were not significant for any outcome measurement at any follow-up time point. No adverse events were reported in either group. CONCLUSION: Ultrasound-guided hydrodilatation with 40 and 10 mg TA yielded similar improvements in SPADI, VAS score, and ROM at the 12-week follow-up. Considering the potential detrimental effects of corticosteroids on the adjacent cartilage and tendons, a low dose of TA would be preferable for ultrasound-guided hydrodilatation for AC.
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Bursitis , Articulación del Hombro , Humanos , Articulación del Hombro/diagnóstico por imagen , Estudios Prospectivos , Solución Salina/farmacología , Solución Salina/uso terapéutico , Triamcinolona Acetonida , Corticoesteroides/uso terapéutico , Lidocaína , Dolor de Hombro/tratamiento farmacológico , Dolor de Hombro/etiología , Ultrasonografía Intervencional , Bursitis/diagnóstico por imagen , Bursitis/tratamiento farmacológico , Rango del Movimiento Articular , Resultado del Tratamiento , Inyecciones Intraarticulares/métodosRESUMEN
Background: Radiation ulcers after percutaneous coronary intervention (PCI) are increasingly common. However, their diagnosis, treatment, and prevention strategies have not been well studied. Objectives: To present our experience in the diagnosis, treatment, and prevention of PCI-related radiation ulcers. Methods: Patients diagnosed with PCI-related radiation ulcers were collected. Radiation fields of PCI were simulated using the Pinnacle treatment planning system to confirm the diagnosis. Surgical methods and outcomes were reviewed, and a prevention protocol was developed and evaluated for its effectiveness. Results: Seven male patients with ten ulcers were included. Among the patients, the right coronary artery was the most common target vessel of PCI, and the left anterior oblique was the most commonly used PCI view. Nine ulcers had undergone radical debridement and reconstruction: four smaller ones with primary closure or local flaps, and five with thoracodorsal artery perforator flaps. No new cases were identified in a 3-year follow-up period after implementing the prevention protocol. Conclusions: PCI-related ulcer diagnosis is more evident with radiation field simulation. The thoracodorsal artery perforator flap is an ideal option for back or upper arm radiation ulcer reconstruction. The proposed prevention protocol for PCI procedures was effective in lowering the incidence of radiation ulcers.
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BACKGROUND: Small cell lung cancer (SCLC) is the most malignant type of lung cancer. We previously reported that arsenic trioxide (As2O3) inhibited tumor initiating cells (TICs) of SCLC in vitro. In the present study, we aimed to identify the above effect in vivo and shed light on its underlying mechanism. METHODS AND RESULTS: TICs were enriched by culturing human SCLC cell line as sphere cells in specified serum-free medium. The expression of stem cell markers, CD133 and CD44, and the in vivo tumorigenicity of both TICs and their parental cells were examined. To demonstrate the inhibitory effect of As2O3 on TICs, cell proliferation, clone formation and sphere formation assays were performed. CD133 and Notch pathway-related factors were also measured after As2O3 treatment. Xenograft models were established by injecting TICs into nude mice. Mice were treated with As2O3 for 14 days. Afterwards, the tumor volume and the expression of CD133 and Notch1 were evaluated. TICs obtained by the above-mentioned method showed elevated levels of stem cell markers and increased tumorigenicity compared with their parental cells. As2O3 treatment largely inhibited TICs proliferation, sphere formation and clonogenic capacity. As2O3 also reduced the expression of CD133 and down-regulated Notch pathway in TICs. Furthermore, As2O3 potently inhibited tumor growth, decreased the expression of CD133 and down-regulated Notch1 in tumors originating from TICs. CONCLUSIONS: Our data demonstrate that As2O3 has a remarkable inhibitory effect on TICs of SCLC both in vitro and in vivo, and the mechanism might involve the down-regulation of Notch pathway.
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Antineoplásicos , Arsenicales , Neoplasias Pulmonares , Carcinoma Pulmonar de Células Pequeñas , Animales , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Apoptosis , Trióxido de Arsénico/farmacología , Trióxido de Arsénico/uso terapéutico , Arsenicales/farmacología , Arsenicales/uso terapéutico , Línea Celular Tumoral , Humanos , Neoplasias Pulmonares/metabolismo , Ratones , Ratones Desnudos , Células Madre Neoplásicas/metabolismo , Carcinoma Pulmonar de Células Pequeñas/tratamiento farmacológicoRESUMEN
Nerve ultrasound has become an integral part of the diagnostic workup of peripheral neuropathies. Especially in the examination of small nerves, ultrasound provides superior image quality by using high frequency transducers. For a selection of small nerves, this article summarizes the local anatomy and common pathologies and offers simple instructions for determining their location with ultrasound including some cases with pathologies. This selection of nerves comprises the great auricular nerve, the supraclavicular nerves, the suprascapular nerve, the medial antebrachial cutaneous nerve, the lateral antebrachial cutaneous nerve, the palmar cutaneous branch of the median nerve, the long thoracic nerve, the intercostobrachial nerve, the posterior cutaneous nerve, the infrapatellar branch of the saphenous nerve, the medial calcaneal nerve, and the deep peroneal nerve at the ankle. Following our recommendations, these nerves can be swiftly located and tracked along their course to the site of the pathology.
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Enfermedades del Sistema Nervioso Periférico , Antebrazo , Humanos , Nervio Mediano , Nervios Periféricos/diagnóstico por imagen , Transductores , UltrasonografíaRESUMEN
BACKGROUND: There is still a lack of consensus regarding whether suprascapular nerve decompression should be routinely performed with rotator cuff repair. Therefore, this meta-analysis aimed to evaluate whether additional suprascapular nerve release (SSNR) could improve shoulder functional outcomes and pain relief more than rotator cuff repair alone. MATERIALS AND METHODS: We performed a literature review of electronic databases for noncomparative and comparative studies investigating the effect of SSNR in patients undergoing rotator cuff repair. The primary outcome was the change in shoulder function scores from the preoperative status, and the secondary outcome was the change in the visual analog scale (VAS) score of pain after surgery. A subgroup analysis was conducted based on the study design (noncomparative studies vs. comparative studies). RESULTS: Nine studies comprising 279 participants were included. Our analysis demonstrated that the group that underwent SSNR had a better shoulder functional score after surgery than at preoperative assessment (standardized mean difference [SMD], 1.333, 95% confidence interval [CI], 0.708-1.959). No significant differences were identified in shoulder function improvement between those with and without SSNR, with an SMD of 0.163 (95% CI, -0.091 to 0.418). Likewise, the group with SSNR showed a decreased VAS score after surgery compared to their preoperative status (SMD, 0.910; 95% CI, 0.560-1.260). However, there was no significant difference in VAS change between those with and without SSNR, with an SMD of 0.431 (95% CI, -0.095 to 0.956). CONCLUSION: The present meta-analysis revealed that SSNR might not be routinely needed in rotator cuff tendon repair as no additional benefits in functional improvement or pain relief were identified compared to rotator cuff tendon repair alone.
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Lesiones del Manguito de los Rotadores , Manguito de los Rotadores , Humanos , Hombro , Artroscopía/efectos adversos , Resultado del Tratamiento , Dolor/etiologíaRESUMEN
BACKGROUND: Thymosin ß4 (Tß4) is the most abundant member of the ß-thymosins and plays an important role in the control of actin polymerization in eukaryotic cells. While its effects in multiple organs and diseases are being widely investigated, the safety profile has been established in animals and humans, currently, little is known about its influence on Alzheimer's disease (AD) and the possible mechanisms. Thus, we aimed to evaluate the effects and mechanisms of Tß4 on glial polarization and cognitive performance in APP/PS1 transgenic mice. METHODS: Behavior tests were conducted to assess the learning and memory, anxiety and depression in APP/PS1 mice. Thioflavin S staining, Nissl staining, immunohistochemistry/immunofluorescence, ELISA, qRT-PCR, and immunoblotting were performed to explore Aß accumulation, phenotypic polarization of glial cells, neuronal loss and function, and TLR4/NF-κB axis in APP/PS1 mice. RESULTS: We demonstrated that Tß4 protein level elevated in all APP/PS1 mice. Over-expression of Tß4 alone alleviated AD-like phenotypes of APP/PS1 mice, showed less brain Aß accumulation and more Insulin-degrading enzyme (IDE), reversed phenotypic polarization of microglia and astrocyte to a healthy state, improved neuronal function and cognitive behavior performance, and accidentally displayed antidepressant-like effect. Besides, Tß4 could downregulate both TLR4/MyD88/NF-κB p65 and p52-dependent inflammatory pathways in the APP/PS1 mice. While combination drug of TLR4 antagonist TAK242 or NF-κB p65 inhibitor PDTC exerted no further effects. CONCLUSIONS: These results suggest that Tß4 may exert its function by regulating both classical and non-canonical NF-κB signaling and is restoring its function as a potential therapeutic target against AD.
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Enfermedad de Alzheimer/metabolismo , Encéfalo/metabolismo , Encéfalo/patología , Disfunción Cognitiva/metabolismo , FN-kappa B/metabolismo , Neuroglía/metabolismo , Timosina/genética , Timosina/metabolismo , Precursor de Proteína beta-Amiloide/genética , Animales , Astrocitos/metabolismo , Modelos Animales de Enfermedad , Femenino , Masculino , Memoria , Ratones , Ratones Transgénicos , Microglía/metabolismo , Neuronas/metabolismo , Fenotipo , Presenilina-1/genética , Transducción de SeñalRESUMEN
OBJECTIVES: The study aimed to investigate whether the shoulder tendons changed their elasticity after ultrasound-guided peritendinous or intrabursal corticosteroid injections. DESIGN: Post hoc secondary analysis of a double-blinded, randomized controlled study with 3 months of follow-up. SETTING: Outpatient rehabilitation clinic. PARTICIPANTS: Patients with subacromial impingement syndrome (N=60). INTERVENTIONS: Patients with unilateral shoulder pain were randomly assigned to receive standard ultrasound-guided subacromial or dual-target corticosteroid injections. The supraspinatus tendons were exposed to 40 mg triamcinolone acetonide in the formal group, whereas the long head of the biceps brachii tendons (LHBT) and supraspinatus tendons were individually infiltrated by 20 mg triamcinolone acetonide in the latter group. Patients' bilateral shoulders were divided into group 1 (n=30, receiving standard subacromial injections), group 2 (n=30, receiving dual-target injections), and group 3 (n=60, without injections). MAIN OUTCOME MEASURES: Strain ratio of LHBT and supraspinatus tendons using ultrasound elastography. RESULTS: The repeated-measures analysis of variance revealed no intragroup difference of the strain ratio of the LHBT (P=.412 for group 1, P=.936 for group 2, P=.131 for group 3) and supraspinatus tendon (P=.309 for group 1, P=.067 for group 2, P=.860 for group 3) across the 3 time points. Treating group 3 as the reference, the linear mixed model revealed no significant changes in tendon elasticity after either the standard subacromial injection (P=.205 for the LHBT and P=.529 for the supraspinatus tendon) or the dual-target injection (P=.961 for the LHBT and P=.831 for the supraspinatus tendon). CONCLUSIONS: Elasticity of the LHBT and supraspinatus tendons is unlikely to change after a single dose of peritendinous or intrabursal corticosteroid injections. Future studies with a shorter follow-up interval are needed to validate whether corticosteroid injections can cause transient changes of the tendon's elasticity.
Asunto(s)
Síndrome de Abducción Dolorosa del Hombro/tratamiento farmacológico , Dolor de Hombro/tratamiento farmacológico , Tendones/efectos de los fármacos , Triamcinolona Acetonida/uso terapéutico , Ultrasonografía Intervencional , Adulto , Método Doble Ciego , Diagnóstico por Imagen de Elasticidad , Femenino , Glucocorticoides/uso terapéutico , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Síndrome de Abducción Dolorosa del Hombro/diagnóstico por imagen , Síndrome de Abducción Dolorosa del Hombro/fisiopatología , Dolor de Hombro/diagnóstico por imagen , Dolor de Hombro/fisiopatología , Tendones/diagnóstico por imagen , Tendones/fisiopatologíaRESUMEN
INTRODUCTION: The reconstruction of soft tissue defects of fingers is a challenge due to the limitations of local tissue availability. The dorsal metacarpal artery perforator (DMAP) flap is a vascular island flap raised on the dorsum of the hand, and it is a good option for finger reconstruction by replacing similar-for-similar in a single operation. In this study, we would like to share our experience of using the DMAP flap in cases of various traumatic finger defects. MATERIALS AND METHODS: From November 2016 to May 2019, patients who had traumatic finger injuries and had undergone DMAP flap for soft tissue reconstruction were examined. The patients' demographic data, injury and flap characteristics, wound healing status, and complications were collected and studied. The functional and aesthetic outcomes were evaluated using the Michigan Hand Outcomes Questionnaire. RESULTS: There was a total of 10 patients included in this study, of which 9 were male and 1 was female. The average age was 43 years (17-66 years). Seven patients were administered general anesthesia, and 3 others wide-awake local anesthesia. The average flap size was 4.9 × 2.0 cm, and all the donor sites were primarily closed. Nearly half of the patients had temporary venous congestion, but most of the flaps survived well ultimately. Only 1 patient had a partial flap necrosis, which required an additional skin graft. CONCLUSIONS: The DMAP flap offers a thin and pliable skin to reconstruct finger defects within 1-stage surgery. It is easy to harvest with reliable and constant circulation. With adequate design, the DMAP flap can be used to resurface both volar and dorsal finger defects and also can reach the tip of the little finger. The DMAP flap is the ideal flap for reconstruction of traumatic finger defect with either local or general anesthesia.