AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated...AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.展开更多
AIM： To observe the therapeutic efficacy of Baicalin in rats with severe acute pancreatitis （SAP） and explore its therapeutic mechanisms. METHODS： The SAP rat models were randomly divided into the model control gr...AIM： To observe the therapeutic efficacy of Baicalin in rats with severe acute pancreatitis （SAP） and explore its therapeutic mechanisms. METHODS： The SAP rat models were randomly divided into the model control group, Baicalin treatment group, octreotide treatment group and sham operation group. All groups were randomly subdivided into 3 h, 6 h and 12 h groups with 15 rats in each group. The survival, ascites volume and pathological changes of pancreas in all rats were observed at different time points after operation. The plasma amylase content and serum TNF-α, IL-6, malonaldehyde （MDA） and PLA2 contents were also determined. RESULTS： The survival was not obviously different between the treated groups, and was significantly higher in treated groups at 12 h compared to the model control group （P 〈 0.05, 15 vs 10）. The ascites/body weight ratio at 3 h and 6 h was significantly lower in Baicalin treatment group compared to the model control group and octreotide treatment group （P 〈 0.05, 1.00 vs 2.02 and 1.43 and P 〈 0.001, 2.29 （1.21） vs 2.70 （0.80） and 2.08 （2.21）, respectively）. The contents of amylase, TNF-α, IL-6, MDA and PLA2 were significantly lower in the treated groups than in the model control group （P 〈 0.05, 4342 vs 5303, 5058 vs 6272 in amylase, P 〈 0.01, 21.90 vs 36.30, 23.80 vs 39.70, 36 vs 54.35 in MDA and 56.25 vs 76.10 in PIA2, or P 〈 0.001, 65.10 and 47.60 vs 92.15 in TNF-α, 3.03 vs 5.44, 2.88 vs 6.82, 2.83 vs 5.36 in IL-6, respectively）. The pathological scores of pancreas in the treated groups were significantly lower than that in the model control group （P 〈 0.05, 9.00 vs 10.05, 6.00 vs 9.00, 8.00 vs 10.05）, but no marked difference was found between the treated groups. CONCLUSION： The Baicalin injection has significant therapeutic effects on SAP rats, its effects are similar to those of octreotide. The Baicalin injection is also cheap and has a big application range, quite hopefully to be used in clinical treatment of SAP.展开更多
Objective: To study the clinical features of chronic hepatitis B (CHB) patients with tyrosine-methionine-aspartateaspartate (YMDD) mutation after lamivudine therapy. Methods: This investigation was a retrospective stu...Objective: To study the clinical features of chronic hepatitis B (CHB) patients with tyrosine-methionine-aspartateaspartate (YMDD) mutation after lamivudine therapy. Methods: This investigation was a retrospective study of 63 CHB patients with YMDD mutation during lamivudine therapy. Clinical data, including period and types of YMDD mutation; hepatitis B virus (HBV) DNA levels and alanine aminotransferase (ALT) levels before and after YMDD mutation were measured. YMDD mutation in the HBV DNA polymerase gene was determined using polymerase chain reaction (PCR) and direct sequencing. HBV DNA quantification was determined using real-time PCR. Relevant serum markers of HBV were measured. The follow-up period was 12 months after YMDD mutation. Results: YMDD mutation occurred 7～44 months (median, 21.5 months) after the start of lamivudine therapy. The majority of the cases (42/63, 66.6%) had YMDD mutants detected between 12 and 24 months. Four types of YMDD mutation were observed in this study, rtL180M/M204V mutation was the predominant type (26/63, 41.3%). A proportion of patients (16/63, 25.4%; 12/63, 19.1%) had higher HBV DNA levels and ALT levels (after mutation vs before mutation),respectively. Conclusion: The majority of patients with YMDD mutants had similar or lower HBV DNA levels and ALT levels compared with baseline values. This subset of patients might have benefited from the continued lamivudine therapy. The patients with increased ALT and HBV DNA levels (breakthrough hepatitis) should benefit from the addition of a newer nucleotide analogue (e.g. adefovir).展开更多
Dear Editor,Herein,we present an interesting case of a recurrent,large macular hole(MH)treated with phacovitrectomy and auto-transplantation of the anterior lens capsule and blood.It is well known that pars plana vitr...Dear Editor,Herein,we present an interesting case of a recurrent,large macular hole(MH)treated with phacovitrectomy and auto-transplantation of the anterior lens capsule and blood.It is well known that pars plana vitrectomy(PPV)surgery has a high success rate in the treatment of MHs.Unfortunately,MHs can persist if they remain open or reopen after surgery.These are not only a barrier to vision recovery,but also confer the risk of retinal detachment.Recurrent or persistent MH treatment remains a challenge for vitreoretinal surgcons.Herein,we report a case of a recurrent,large MH in which the anterior lens capsule and blood were auto-transplanted to close the hole.展开更多
Dear Editor,I’m Dr.Dan Li from the Department of Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu Province,China.I’m writing to present an interesting case.It is well known tha...Dear Editor,I’m Dr.Dan Li from the Department of Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu Province,China.I’m writing to present an interesting case.It is well known that retained subretinal perfluorocarbon droplets are a possible surgical complication after intravitreal injection of perfluorocarbon liquid(PFCL).The retinal neuroepithelial layer and retinal pigment epithelial layer cannot be bonded where it located.The retina is in a state of detachment.When the patient is lying on the bed,due to the action of gravity,the subretinal PFCL will gradually shift to the posterior pole,especially the macular region.Subfoveal PFCL droplet may seriously affect the visual function.Clinicians are committed to finding a method of removing subfoveal PFCL with less damage.We recently encountered a case of this complication,reported here.展开更多
The development of novel theranostic agents with outstanding diagnostic and therapeutic performances is still strongly desired in the treatment of hepatocellular carcinoma(HCC).Here,a fucoidan-modified mesoporous poly...The development of novel theranostic agents with outstanding diagnostic and therapeutic performances is still strongly desired in the treatment of hepatocellular carcinoma(HCC).Here,a fucoidan-modified mesoporous polydopamine nanoparticle dual-loaded with gadolinium iron and doxorubicin(FMPDA/Gd^(3+)/DOX)was prepared as an effective theranostic agent for magnetic resonance imaging(MRI)-guided chemo-photothermal therapy of HCC.It was found that FMPDA/Gd^(3+)/DOX had a high photothermal conversion efficiency of 33.4%and excellent T1-MRI performance with a longitudinal relaxivity(r1)value of 14.966 m M^(-1)·s^(-1).Moreover,the results suggested that FMPDA/Gd^(3+)/DOX could effectively accumulate into the tumor foci by dual-targeting the tumor-infiltrated platelets and HCC cells,which resulted from the specific interaction between fucoidan and overexpressed p-selectin receptors.The excellent tumor-homing ability and MRI-guided chemo-photothermal therapy therefore endowed FMPDA/Gd^(3+)/DOX with a strongest ability to inhibit tumor growth than the respective single treatment modality.Overall,our study demonstrated that FMPDA/Gd^(3+)/DOX could be applied as a potential nanoplatform for safe and effective cancer theranostics.展开更多
Objective To discuss the application of semi-precision attachment in restoring a midfacial defect, including a nasal, upper lip, and anterior maxillary defect. Methods A splinted metal-ceramic crowns （from the upper ...Objective To discuss the application of semi-precision attachment in restoring a midfacial defect, including a nasal, upper lip, and anterior maxillary defect. Methods A splinted metal-ceramic crowns （from the upper right first molar to left molar） and a bar with stud attachments was done. A removable partial denture （RPD） containing the patrix portion of the attachment was then designed to restore the missing maxillary anterior teeth and alveolar ridge. Finally,, The facial prosthesis was joined to the denture utilizing two retentive metal posts on the superior aspect of the removable partial. Results A splinted metal-ceramic crowns （from the upper right frst molar to left molar） and a bar with stud attachments was done. A RPD containing the patrix portion of the attachment was then designed to restore the missing maxillary anterior teeth and alveolar ridge. Finally, The facial prosthesis was joined to the denture utilizing two retentive metal posts on the superior aspect of the removable partial. The prosthesis markedly improved the appearance of the patient and demonstrated good retention. Conclusion Using attachment in restoring rnaxillofacial defect may provide adequate retetion which lead to a sucessful treatment outcome.展开更多
BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The ...BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.展开更多
We report a case of primary sclerosing cholangitis (PSC) with benign lyphadenopathy which was diagnosed with endosonography guided fine needle aspiration (EUS-FNA). A 65-year-old woman was admitted to Jikei University...We report a case of primary sclerosing cholangitis (PSC) with benign lyphadenopathy which was diagnosed with endosonography guided fine needle aspiration (EUS-FNA). A 65-year-old woman was admitted to Jikei University Hospital with severe jaundice. Although endoscopic retrograde cholangiography and liver biopsy revealed the findings consistent with PSC, abdominal computed tomography revealed numerous large perihepatic lymph nodes with a maximum diameter of more than 3 cm. Therefore, EUS-FNA was done in order to exclude malignant lymphadenopathy, and adequate specimens obtained by EUS-FNA showed reactive hyperplasia of lymphnode. The patients were scheduled to undergo liver transplantation.展开更多
Oridonin, a diterpenoid isolated from Rabdosia rubescens, has been proven to possess various pharmacological and physiological effects such as anti-inflammation, anti-bacterial, and anti-neoplastic, although in recent...Oridonin, a diterpenoid isolated from Rabdosia rubescens, has been proven to possess various pharmacological and physiological effects such as anti-inflammation, anti-bacterial, and anti-neoplastic, although in recent years, more attention has been paid to its anti-neoplastic effects. For example, oridonin can trigger cell cycle arrest, apoptosis, and autophagy in different neoplastic cell lines. This review summarizes the considerable knowledge about the action mechanisms of oridonin that has been studied in recent years. The present observations reveal the novel anti-neoplastic effects of oridonin, suggesting that it may be effective as a potent alternative or adjunct drug to conventional chemotherapy.展开更多
Background Central venous stenosis and obstruction （CVD） is a serious and prevalent challenge to both resolve the venous hypertension symptoms and maintain the pantency of the ipsilateral hemodialysis access in hemo...Background Central venous stenosis and obstruction （CVD） is a serious and prevalent challenge to both resolve the venous hypertension symptoms and maintain the pantency of the ipsilateral hemodialysis access in hemodialysis patients. This study aimed to summarize our experience of the endovascular management of the central venous stenosis or obstruction in hemodialysis patients. Methods Twenty-four haemodialysis cases of central vein stenosis or obstruction with ipsilateral functional vascular access in our hospital between July 2006 and February 2012 were treated by interventional therapy and the data were analyzed retrospectively. Results Eighteen males and six females with mean age of （66.4±13.8） years and manifesting with arm swelling and venous hypertension were enrolled; 62.5% of them had a history of catheterization. Venography showed stenotic lesion in 10 cases including eight cases of brachiocephalic vein stenosis and two cases of subclavian vein stenosis and 14 cases of obstruction lesions including seven cases of short brachiocephalic obstruction and seven cases of long segment obstruction. Interventional therapy was performed and the technique success rate was 83.3%. Percutaneous transluminal angioplasty （PTA） was performed in nine cases and stent was performed in 11 cases firstly. The symptoms of venous hypertension were resolved after intervention in all the cases. There was no major complication and death perioperatively. During follow-up, reintervention was done, the primary patency rates were （88.9±10.5）%, （64.8±10.5）% and （48.6±18.7）% at 3 months, 6 months and 1 year after treatment in the PTA group; （90.0±9.5）% and （77.1±14.4）% at 6 months and 1 year after treatment in the stent group, respectively. The secondary patency rates were （48.6±18.7）% in the PTA group and （83.3±15.2）% in the stent group 1 year after treatment, respectively. There was no significant difference between the two groups （primary patency, P=0.20; secondary patency, P=0.10）. Conclusions The endovascular intervention is a safe and effective method for CVD in short term; enhanced follow-up and repeated interventions are required to maintain patency for long term. The prevention is most important. Avoiding and minimizing the placement of the central venous catheter may be the key point for the prevention.展开更多
Ischaemic stroke is a leading cause of long-term disability in the world,with limited effective treatments.Increasing evidence demonstrates that exosomes are involved in ischaemic pathology and exhibit restorative the...Ischaemic stroke is a leading cause of long-term disability in the world,with limited effective treatments.Increasing evidence demonstrates that exosomes are involved in ischaemic pathology and exhibit restorative therapeutic effects by mediating cell–cell communication.The potential of exosome therapy for ischaemic stroke has been actively investigated in the past decade.In this review,we mainly discuss the current knowledge of therapeutic applications of exosomes from different cell types,different exosomal administration routes,and current advances of exosome tracking and targeting in ischaemic stroke.We also briefly summarised the pathology of ischaemic stroke,exosome biogenesis,exosome profile changes after stroke as well as registered clinical trials of exosome-based therapy.展开更多
Background： This study characterized the cardiac telocyte （TC） population both in vivo and in vitro, and investigated its telomerase activity related to mitosis. Methods： Using transmission electron microscopy and...Background： This study characterized the cardiac telocyte （TC） population both in vivo and in vitro, and investigated its telomerase activity related to mitosis. Methods： Using transmission electron microscopy and a phase contrast microscope, the typical morphological features of cardiac TCs were observed; by targeting the cell surface proteins CD1 17 and CD34, CD 117^＋CD34^＋ cardiac TCs wcrc sorted via flow cytomctry and validated by immunofluorescence based on the primary cell culture. Then the optimized basal nutrient medium for selected population was examined with the cell counting kit 8. Under this conditioned medium, the process of cell division was captured, and the telomerase activity of CD117^＋ CD34^＋ cardiac TCs was detected in comparison with bone mesenchymal stem cells （BMSCs）, cardiac fibroblasts （CFBs）, cardiomyocytes （CMs）. Results： Cardiac TCs projected characteristic telopodes with thin segments （podomers） in alternation with dilation （podoms）. In addition, 64% of the primary cultured cardiac TCs were composed of CD117^＋CD34^＋ cardiac TCs： which was verified by immunofluorescence. In a live cell imaging system, CD117^＋CD34^＋ cardiac TCs were observed to enter into cell division in a short time. followed by an significant invagination forming across the middle of the cell body. Using a real-time quantitative telomeric-repeat amplification assay, the telomerase concentration in CD117^＋CD34^＋ cardiac TCs was obviously lower than in BMSCs and CFBs, and significantly higher than in CMs. Conclusions： Cardiac TCs represent a unique cell population and CD11 7^＋CD34^＋ cardiac TCs have relative low telomerase activity that differs from BMSCs, CFBs and CMs and thus they might play an important role in maintaining cardiac homeostasis.展开更多
Central neurocytoma （CN）, first described by Hassoun et al in 1982, is a rare neuronal tumor of the centralnervous system, and accounts for 0.25%-0.5% of all intracranial tumors. CN commonly occurs as an intraventri...Central neurocytoma （CN）, first described by Hassoun et al in 1982, is a rare neuronal tumor of the centralnervous system, and accounts for 0.25%-0.5% of all intracranial tumors. CN commonly occurs as an intraventricular mass but may also occur as a periventricular parenchymal mass or even in locations remote from the ventricles, in which case it is termed as an extraventricular neurocytoma （EVN） （cerebral）. EVNs show a wide variability with regard to morphologic features, cellularity, and proliferation rate and are more frequently associated with poorer clinical outcomes than CNs. 1 To our knowledge, little is known regarding the treatment of atypical neurocytomas.展开更多
基金Supported by Research Grants from the fund of Suzhou Kowloon Hospital(No.SZJL202106).
文摘AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.
基金Supported by Technological Foundation Project of Traditional Chinese Medicine Science of Zhejiang Province, No. 2003C130 and No. 2004C142 Foundation Project for Medical Science and Technology of Zhejiang province, No. 2003B134+3 种基金 Grave Foundation Project for Technological and Development of Hangzhou, No. 2003123B19 Intensive Foundation Project for Technology of Hangzhou, No. 2004Z006 Foundation Project for Medical Science and Technology of Hangzhou, No. 2003A004 and Foundation Project for Technology of Hangzhou, No. 2005224
文摘AIM： To observe the therapeutic efficacy of Baicalin in rats with severe acute pancreatitis （SAP） and explore its therapeutic mechanisms. METHODS： The SAP rat models were randomly divided into the model control group, Baicalin treatment group, octreotide treatment group and sham operation group. All groups were randomly subdivided into 3 h, 6 h and 12 h groups with 15 rats in each group. The survival, ascites volume and pathological changes of pancreas in all rats were observed at different time points after operation. The plasma amylase content and serum TNF-α, IL-6, malonaldehyde （MDA） and PLA2 contents were also determined. RESULTS： The survival was not obviously different between the treated groups, and was significantly higher in treated groups at 12 h compared to the model control group （P 〈 0.05, 15 vs 10）. The ascites/body weight ratio at 3 h and 6 h was significantly lower in Baicalin treatment group compared to the model control group and octreotide treatment group （P 〈 0.05, 1.00 vs 2.02 and 1.43 and P 〈 0.001, 2.29 （1.21） vs 2.70 （0.80） and 2.08 （2.21）, respectively）. The contents of amylase, TNF-α, IL-6, MDA and PLA2 were significantly lower in the treated groups than in the model control group （P 〈 0.05, 4342 vs 5303, 5058 vs 6272 in amylase, P 〈 0.01, 21.90 vs 36.30, 23.80 vs 39.70, 36 vs 54.35 in MDA and 56.25 vs 76.10 in PIA2, or P 〈 0.001, 65.10 and 47.60 vs 92.15 in TNF-α, 3.03 vs 5.44, 2.88 vs 6.82, 2.83 vs 5.36 in IL-6, respectively）. The pathological scores of pancreas in the treated groups were significantly lower than that in the model control group （P 〈 0.05, 9.00 vs 10.05, 6.00 vs 9.00, 8.00 vs 10.05）, but no marked difference was found between the treated groups. CONCLUSION： The Baicalin injection has significant therapeutic effects on SAP rats, its effects are similar to those of octreotide. The Baicalin injection is also cheap and has a big application range, quite hopefully to be used in clinical treatment of SAP.
文摘Objective: To study the clinical features of chronic hepatitis B (CHB) patients with tyrosine-methionine-aspartateaspartate (YMDD) mutation after lamivudine therapy. Methods: This investigation was a retrospective study of 63 CHB patients with YMDD mutation during lamivudine therapy. Clinical data, including period and types of YMDD mutation; hepatitis B virus (HBV) DNA levels and alanine aminotransferase (ALT) levels before and after YMDD mutation were measured. YMDD mutation in the HBV DNA polymerase gene was determined using polymerase chain reaction (PCR) and direct sequencing. HBV DNA quantification was determined using real-time PCR. Relevant serum markers of HBV were measured. The follow-up period was 12 months after YMDD mutation. Results: YMDD mutation occurred 7～44 months (median, 21.5 months) after the start of lamivudine therapy. The majority of the cases (42/63, 66.6%) had YMDD mutants detected between 12 and 24 months. Four types of YMDD mutation were observed in this study, rtL180M/M204V mutation was the predominant type (26/63, 41.3%). A proportion of patients (16/63, 25.4%; 12/63, 19.1%) had higher HBV DNA levels and ALT levels (after mutation vs before mutation),respectively. Conclusion: The majority of patients with YMDD mutants had similar or lower HBV DNA levels and ALT levels compared with baseline values. This subset of patients might have benefited from the continued lamivudine therapy. The patients with increased ALT and HBV DNA levels (breakthrough hepatitis) should benefit from the addition of a newer nucleotide analogue (e.g. adefovir).
基金Supported by Research Grants from the Program of the Suzhou Industrial Park Cultivation Project of China(No.JL201809).
文摘Dear Editor,Herein,we present an interesting case of a recurrent,large macular hole(MH)treated with phacovitrectomy and auto-transplantation of the anterior lens capsule and blood.It is well known that pars plana vitrectomy(PPV)surgery has a high success rate in the treatment of MHs.Unfortunately,MHs can persist if they remain open or reopen after surgery.These are not only a barrier to vision recovery,but also confer the risk of retinal detachment.Recurrent or persistent MH treatment remains a challenge for vitreoretinal surgcons.Herein,we report a case of a recurrent,large MH in which the anterior lens capsule and blood were auto-transplanted to close the hole.
基金Supported by Research Grants from the Program of the Suzhou Industrial Park Cultivation Project of China(No.JL201809)。
文摘Dear Editor,I’m Dr.Dan Li from the Department of Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu Province,China.I’m writing to present an interesting case.It is well known that retained subretinal perfluorocarbon droplets are a possible surgical complication after intravitreal injection of perfluorocarbon liquid(PFCL).The retinal neuroepithelial layer and retinal pigment epithelial layer cannot be bonded where it located.The retina is in a state of detachment.When the patient is lying on the bed,due to the action of gravity,the subretinal PFCL will gradually shift to the posterior pole,especially the macular region.Subfoveal PFCL droplet may seriously affect the visual function.Clinicians are committed to finding a method of removing subfoveal PFCL with less damage.We recently encountered a case of this complication,reported here.
基金supported by the National Key Research and Development projects intergovernmental cooperation in science and technology of China(2018YFE0126900)National Natural Science Foundation of China(82072025 and82072026)+2 种基金Zhejiang Provincial Natural Science Foundation(LQ21H180003)Key R&D Program of Lishui City(2021ZDYF12)Medical Health Science and Technology Project of Zhejiang Provincial Health Commission(2022RC088)。
文摘The development of novel theranostic agents with outstanding diagnostic and therapeutic performances is still strongly desired in the treatment of hepatocellular carcinoma(HCC).Here,a fucoidan-modified mesoporous polydopamine nanoparticle dual-loaded with gadolinium iron and doxorubicin(FMPDA/Gd^(3+)/DOX)was prepared as an effective theranostic agent for magnetic resonance imaging(MRI)-guided chemo-photothermal therapy of HCC.It was found that FMPDA/Gd^(3+)/DOX had a high photothermal conversion efficiency of 33.4%and excellent T1-MRI performance with a longitudinal relaxivity(r1)value of 14.966 m M^(-1)·s^(-1).Moreover,the results suggested that FMPDA/Gd^(3+)/DOX could effectively accumulate into the tumor foci by dual-targeting the tumor-infiltrated platelets and HCC cells,which resulted from the specific interaction between fucoidan and overexpressed p-selectin receptors.The excellent tumor-homing ability and MRI-guided chemo-photothermal therapy therefore endowed FMPDA/Gd^(3+)/DOX with a strongest ability to inhibit tumor growth than the respective single treatment modality.Overall,our study demonstrated that FMPDA/Gd^(3+)/DOX could be applied as a potential nanoplatform for safe and effective cancer theranostics.
基金grant of Shanghai Leading Academic Discipline Fund(T0202)
文摘Objective To discuss the application of semi-precision attachment in restoring a midfacial defect, including a nasal, upper lip, and anterior maxillary defect. Methods A splinted metal-ceramic crowns （from the upper right first molar to left molar） and a bar with stud attachments was done. A removable partial denture （RPD） containing the patrix portion of the attachment was then designed to restore the missing maxillary anterior teeth and alveolar ridge. Finally,, The facial prosthesis was joined to the denture utilizing two retentive metal posts on the superior aspect of the removable partial. Results A splinted metal-ceramic crowns （from the upper right frst molar to left molar） and a bar with stud attachments was done. A RPD containing the patrix portion of the attachment was then designed to restore the missing maxillary anterior teeth and alveolar ridge. Finally, The facial prosthesis was joined to the denture utilizing two retentive metal posts on the superior aspect of the removable partial. The prosthesis markedly improved the appearance of the patient and demonstrated good retention. Conclusion Using attachment in restoring rnaxillofacial defect may provide adequate retetion which lead to a sucessful treatment outcome.
基金Supported by the UNC UNAN FGID Epidemiology Study Project,No.54-1808958.
文摘BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.
文摘We report a case of primary sclerosing cholangitis (PSC) with benign lyphadenopathy which was diagnosed with endosonography guided fine needle aspiration (EUS-FNA). A 65-year-old woman was admitted to Jikei University Hospital with severe jaundice. Although endoscopic retrograde cholangiography and liver biopsy revealed the findings consistent with PSC, abdominal computed tomography revealed numerous large perihepatic lymph nodes with a maximum diameter of more than 3 cm. Therefore, EUS-FNA was done in order to exclude malignant lymphadenopathy, and adequate specimens obtained by EUS-FNA showed reactive hyperplasia of lymphnode. The patients were scheduled to undergo liver transplantation.
基金Supported by National Natural Science Foundation of China (No.81274142,No.30300139)Natural Science Foundation of Science and Technology Commission of Shanghai Municipality (No.11ZR1423400)Key Project of Shanghai Municipal Education Commission(No.07zz43)
文摘Oridonin, a diterpenoid isolated from Rabdosia rubescens, has been proven to possess various pharmacological and physiological effects such as anti-inflammation, anti-bacterial, and anti-neoplastic, although in recent years, more attention has been paid to its anti-neoplastic effects. For example, oridonin can trigger cell cycle arrest, apoptosis, and autophagy in different neoplastic cell lines. This review summarizes the considerable knowledge about the action mechanisms of oridonin that has been studied in recent years. The present observations reveal the novel anti-neoplastic effects of oridonin, suggesting that it may be effective as a potent alternative or adjunct drug to conventional chemotherapy.
文摘Background Central venous stenosis and obstruction （CVD） is a serious and prevalent challenge to both resolve the venous hypertension symptoms and maintain the pantency of the ipsilateral hemodialysis access in hemodialysis patients. This study aimed to summarize our experience of the endovascular management of the central venous stenosis or obstruction in hemodialysis patients. Methods Twenty-four haemodialysis cases of central vein stenosis or obstruction with ipsilateral functional vascular access in our hospital between July 2006 and February 2012 were treated by interventional therapy and the data were analyzed retrospectively. Results Eighteen males and six females with mean age of （66.4±13.8） years and manifesting with arm swelling and venous hypertension were enrolled; 62.5% of them had a history of catheterization. Venography showed stenotic lesion in 10 cases including eight cases of brachiocephalic vein stenosis and two cases of subclavian vein stenosis and 14 cases of obstruction lesions including seven cases of short brachiocephalic obstruction and seven cases of long segment obstruction. Interventional therapy was performed and the technique success rate was 83.3%. Percutaneous transluminal angioplasty （PTA） was performed in nine cases and stent was performed in 11 cases firstly. The symptoms of venous hypertension were resolved after intervention in all the cases. There was no major complication and death perioperatively. During follow-up, reintervention was done, the primary patency rates were （88.9±10.5）%, （64.8±10.5）% and （48.6±18.7）% at 3 months, 6 months and 1 year after treatment in the PTA group; （90.0±9.5）% and （77.1±14.4）% at 6 months and 1 year after treatment in the stent group, respectively. The secondary patency rates were （48.6±18.7）% in the PTA group and （83.3±15.2）% in the stent group 1 year after treatment, respectively. There was no significant difference between the two groups （primary patency, P=0.20; secondary patency, P=0.10）. Conclusions The endovascular intervention is a safe and effective method for CVD in short term; enhanced follow-up and repeated interventions are required to maintain patency for long term. The prevention is most important. Avoiding and minimizing the placement of the central venous catheter may be the key point for the prevention.
基金funded by 2019YFA0112000,NSFC 81801170,ZH2018QNA16,ZH2018ZDA04.
文摘Ischaemic stroke is a leading cause of long-term disability in the world,with limited effective treatments.Increasing evidence demonstrates that exosomes are involved in ischaemic pathology and exhibit restorative therapeutic effects by mediating cell–cell communication.The potential of exosome therapy for ischaemic stroke has been actively investigated in the past decade.In this review,we mainly discuss the current knowledge of therapeutic applications of exosomes from different cell types,different exosomal administration routes,and current advances of exosome tracking and targeting in ischaemic stroke.We also briefly summarised the pathology of ischaemic stroke,exosome biogenesis,exosome profile changes after stroke as well as registered clinical trials of exosome-based therapy.
基金Source of Support： This study was supported by a grant from the Young Scientists Fund of the National Natural Science Foundation of China （No, 81300232）. Conflict of Interest： None dec ared.
文摘Background： This study characterized the cardiac telocyte （TC） population both in vivo and in vitro, and investigated its telomerase activity related to mitosis. Methods： Using transmission electron microscopy and a phase contrast microscope, the typical morphological features of cardiac TCs were observed; by targeting the cell surface proteins CD1 17 and CD34, CD 117^＋CD34^＋ cardiac TCs wcrc sorted via flow cytomctry and validated by immunofluorescence based on the primary cell culture. Then the optimized basal nutrient medium for selected population was examined with the cell counting kit 8. Under this conditioned medium, the process of cell division was captured, and the telomerase activity of CD117^＋ CD34^＋ cardiac TCs was detected in comparison with bone mesenchymal stem cells （BMSCs）, cardiac fibroblasts （CFBs）, cardiomyocytes （CMs）. Results： Cardiac TCs projected characteristic telopodes with thin segments （podomers） in alternation with dilation （podoms）. In addition, 64% of the primary cultured cardiac TCs were composed of CD117^＋CD34^＋ cardiac TCs： which was verified by immunofluorescence. In a live cell imaging system, CD117^＋CD34^＋ cardiac TCs were observed to enter into cell division in a short time. followed by an significant invagination forming across the middle of the cell body. Using a real-time quantitative telomeric-repeat amplification assay, the telomerase concentration in CD117^＋CD34^＋ cardiac TCs was obviously lower than in BMSCs and CFBs, and significantly higher than in CMs. Conclusions： Cardiac TCs represent a unique cell population and CD11 7^＋CD34^＋ cardiac TCs have relative low telomerase activity that differs from BMSCs, CFBs and CMs and thus they might play an important role in maintaining cardiac homeostasis.
文摘Central neurocytoma （CN）, first described by Hassoun et al in 1982, is a rare neuronal tumor of the centralnervous system, and accounts for 0.25%-0.5% of all intracranial tumors. CN commonly occurs as an intraventricular mass but may also occur as a periventricular parenchymal mass or even in locations remote from the ventricles, in which case it is termed as an extraventricular neurocytoma （EVN） （cerebral）. EVNs show a wide variability with regard to morphologic features, cellularity, and proliferation rate and are more frequently associated with poorer clinical outcomes than CNs. 1 To our knowledge, little is known regarding the treatment of atypical neurocytomas.
