Ovarian aging is characterized by a progressive decline in oocyte quality and quantity with age.Icariin(ICA),a flavonoid compound derived from Epimedium species,has demonstrated potential as an agent for ovarian resto...Ovarian aging is characterized by a progressive decline in oocyte quality and quantity with age.Icariin(ICA),a flavonoid compound derived from Epimedium species,has demonstrated potential as an agent for ovarian restoration.In this study,a subcutaneous implantation system using gelatin methacryloyl(GelMA)hydrogel embedded with ICA was developed to restore ovarian function in aged female mice.Mice were assigned to receive subcutaneous implantation of GelMA alone(GelMA group),GelMA containing ICA(GelMA/ICA group),or a sham operation.Ovarian morphology,serum hormone levels,follicle counts across developmental stages,and reproductive outcomes were evaluated.In vitro fertilization(IVF)and embryo culture assays were performed to assess oocyte developmental potential,while a 10 day natural mating trial was conducted to determine fertility restoration.RNA sequencing(RNA-seq)and RT-qPCR were performed to elucidate the underlying molecular mechanisms.Results showed that GelMA/ICA treatment significantly increased ovarian index(0.19±0.01 vs.0.13±0.01,P<0.0001)and follicle numbers at all developmental stages,including primordial(383.33±151.65 vs.107.14±32.26,P<0.0001),primary(203.33±83.22 vs.91.43±27.04,P=0.003),and secondary follicles(154.17±52.00 vs.59.28±20.50,P=0.029)compared to the sham controls.Hormonal analyses revealed a significant reduction in serum follicle-stimulating hormone(FSH,11.97±3.53 vs.53.10±17.89 ng/mL,P=0.0008),accompanied by elevated anti-Müllerian hormone(AMH,22.97±2.26 vs.5.54±1.56 ng/mL,P<0.0001)and estradiol(E2,315.30±37.62 vs.168.5±14.78 pg/mL,P<0.0001).Oocyte yield and developmental potential improved significantly,as reflected by the increased number of superovulated MII oocytes(17.83±5.15 vs.4.83±4.79,P=0.0002),and higher proportions of two-cell(85.90%±6.16%vs.50.00%±10.00%,P=0.0009),four-cell(81.67%±9.76%vs.50.00%±10.00%,P=0.0061),and blastocyst stage embryos(64.25%±10.55%vs.23.33%±15.28%,P=0.0067).Live birth numbers were significantly increased following GelMA/ICA treatment(6.90±3.21 vs.1.72±2.05,P=0.0001).Transcriptomic analysis revealed up-regulation of genes associated with cytoskeletal organization(Vil1,Tubb3),lipid storage(Soat2,Plin4),oocyte maturation(Oosp2),and cytokine secretion(Cxcl12).Collectively,these findings suggest that GelMA/ICA hydrogels effectively reverse key hallmarks of ovarian aging and restore reproductive function in aged mice,offering a promising platform for fertility preservation and a novel therapeutic for future investigations into ovarian aging.展开更多
Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients.In order to achieve ...Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients.In order to achieve a good cosmetic result,reconstruction must be performed simultaneously with radical surgical treatment.Currently,there are a large number of methods for performing breast reconstruction.One of the most commonly used is radical subcutaneous/skin-sparing mastectomy with simultaneous reconstruction with a silicone endoprosthesis.Grand W Carlson type technique is used,with skin incisions in the form of an inverted T is usually performed in patients with large mammary gland with severe grade III ptosis,as the patients usually require reduction of excess skin.However,the most vulnerable aspects of this type of reconstruction is the impossibility of preserving the nipple-areolar complex(NAC),which is associated with a high risk of developing such complications as partial/complete necrosis of the NAC.The current study provides an overview of an original method to decrease the risk of necrosis of NAC with evaluation of blood supply of the nipple and inferior deepithelialized flap using real-time intraoperative Doppler ultrasonography and indocyanine green fluorescence system.展开更多
BACKGROUND Subcutaneous implantable cardioverter-defibrillator(S-ICD)implantation requires effective anesthesia.General anesthesia(GA)carries risks like hemodynamic instability,while ultrasound-guided intercostal nerv...BACKGROUND Subcutaneous implantable cardioverter-defibrillator(S-ICD)implantation requires effective anesthesia.General anesthesia(GA)carries risks like hemodynamic instability,while ultrasound-guided intercostal nerve block(US-ICNB)may offer better pain control.This study hypothesized US-ICNB is superior in perioperative safety and pain management.AIM To compare perioperative outcomes of GA and US-ICNB in S-ICD implantation.METHODS This retrospective single-center study included 64 patients who received S-ICD implantation between February 2021 and December 2024.They were divided into GA and US-ICNB groups based on anesthesia type.Demographic data,perioperative parameters(operation time,pain scores,analgesic usage),and postoperative outcomes(complications,defibrillation events)were collected and analyzed.Statistical tests were used to compare the two groups.RESULTS This study included 64 patients(20 in the GA group and 44 in the US-ICNB group).Baseline left ventricular ejection fraction was significantly lower in the US-ICNB group(39.20%±12.00%vs 56.20%±11.50%in GA,P<0.001),while American Society of Anesthesiologists scores and comorbidities were comparable.US-ICNB showed superior pain control,with significantly lower numeric rating scale scores at 6-48 hours(P<0.001)and fewer patients requiring analgesics(P=0.02).The US-ICNB group had shorter operation times(P<0.001),total hospital stays(P<0.001),and later first analgesia times(P<0.001).No anesthesia-related complications occurred in either group.CONCLUSION Both anesthetic methods were safe in the short term.However,US-ICNB was superior in reducing operation and hospital stay times and alleviating peri-operative pain.It has high safety in S-ICD implantation and deserves further clinical promotion,though large-scale,multi-center,randomized controlled trials are needed to confirm these findings.展开更多
Fu's subcutaneous needling(FSN)represents a non-pharmacological therapy that employs disposable needles for subcutaneous application,primarily targeting the relaxation of tightened muscles,invigoration of blood ci...Fu's subcutaneous needling(FSN)represents a non-pharmacological therapy that employs disposable needles for subcutaneous application,primarily targeting the relaxation of tightened muscles,invigoration of blood circulation,and alleviation of local tissue ischemia.Originating from traditional acupuncture and modern techniques,FSN effectively treats muscle-related conditions,including soft tissue injuries,neck-shoulder-back pain,visceral pain,and non-painful diseases.Its unique features encompass shallow needling,the swaying movement technique,and an emphasis on governing the spirit.FSN is characterized by rapid therapeutic responses,high repeatability,and minimal side effects,adhering to the keep it simple,stupid(KISS)principle in research by emphasizing simplicity and efficacy.By mechanically releasing chronic muscle tension,FSN improves arterial blood flow,halts pathological leakage of intracellular adenosine triphosphate(ATP),and consequently resolves pain.This therapy offers a promising and safe approach for pain management and muscular health,deserving vigorous promotion and further scientific investigation.展开更多
BACKGROUND Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion(CSII)require a lower dose of insulin than those treated with multiple daily injections(MDIs).Howeve...BACKGROUND Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion(CSII)require a lower dose of insulin than those treated with multiple daily injections(MDIs).However,it is unclear whether this is also the case for patients with type 2 diabetes mellitus(T2DM).AIM To compare insulin dosage requirements between CSII and MDI in T2DM,iden-tifying influencing factors associated with both therapeutic modalities.METHODS A total of 954 patients with T2DM were divided into two groups:CSII and MDI groups.The total daily insulin dose(TDD),TDD per kilogram per day(TDD/kg),and ratio of total basal insulin dose to TDD(%TBa)required to achieve the target blood glucose levels were compared between the two groups.In addition,factors affecting insulin dosage were analyzed in both groups of patients.RESULTS Compared to the CSII group,the MDI group required a higher TDD[median(interquartile)]:30.00(24.00,38.00)U/day vs 26.40(21.60,32.40)U/day;P<0.01,TDD/kg and%TBa.In the MDI group and CSII groups,an increase in TDD was independently associated with an increase in body mass index(BMI),waist circumference(WC),fasting plasma glucose(FPG),and glycated hemoglobin(HbA1c).The pathophysiology of type 2 diabetes mellitus(T2DM)mainly involves insulin resistance and progressiveβ-cell failure,which leads to increased blood glucose levels(hyperglycemia)[1-3].Treatment for T2DM includes antidiabetic medications and insulin therapy[4,5].Patients with T2DM withβ-cell failure usually require insulin therapy[6-8].Continuous subcutaneous insulin infusion(CSII)and multiple daily injections(MDIs)are two major insulin therapies for controlling hyperglycemia in these patients.However,excessive insulin therapies may cause problems such as hypoglycemia,weight gain,and iatrogenic hyperinsulinemia[9].Therefore,attention should be paid to the dosage of insulin used.The establishment of insulin regimens for CSII and MDI therapies is primarily guided by physicians’empirical judgment.To date,there have been few clear guidelines or recommendations on the appropriate insulin dose during CSII and MDI treatment for T2DM[10].Yang et al[11]studied insulin doses and related factors in the CSII treatment of patients with T2DM[12].However,these studies did not cover the dose setting and related factors in MDI treatment.Previous studies have shown that patients with type 1 diabetes mellitus treated with CSII require less insulin than those treated with MDIs[13-15].However,it is unclear whether patients with T2DM on CSII also require less insulin than patients on MDI.Therefore,the present study determined the difference in insulin dosages between CSII and MDI therapies and evaluated the related factors in patients with T2DM.It also systematically analyzed the insulin dose characteristics of MDI and CSII in 954 hospitalized patients with T2DM,aiming to optimize the insulin dosage regimen and provide clinical references for guiding the application of CSII and MDI in patients with T2DM.展开更多
To introduce the experience of professor JIA Chun-sheng in rapid analgesia and motor function rehabilitation by subcutaneous penetration needling of auricular acupuncture.Subcutaneous penetration needling of auricular...To introduce the experience of professor JIA Chun-sheng in rapid analgesia and motor function rehabilitation by subcutaneous penetration needling of auricular acupuncture.Subcutaneous penetration needling of auricular acupuncture plays a role in rapid analgesia and motor function rehabilitation in treatment of pain in limbs and trunk and/or limb dysfunction caused by migraine,cervical spondylosis,acute lumbar sprain,soft tissue injury,scapulohumeral periarthritis,lumbar disc herniation,sciatica,stroke or cerebral trauma,and it is worthy of being widely promoted and applied clinically.展开更多
Objective To observe the efficacy of combining therapy in treatment of 90 patients with scapulohumeral periarthritis in different phases. Method Ninety patients with scapulohumeral periarthritis were treated with Fu＇...Objective To observe the efficacy of combining therapy in treatment of 90 patients with scapulohumeral periarthritis in different phases. Method Ninety patients with scapulohumeral periarthritis were treated with Fu＇s subcutaneous needling（FSN） combined with physiotherapy in painful phase, acupotomology and massage in adhesion phase, and appropriate functional exercise in rehabilitation phase. Seven days were considered as one course of treatment, and efficacy evaluation was performed after three courses. Function evaluation of shoulder joint was made. Result The total effective rate was 100%（38/38） in acute phase, 93.5%（29/31） in adhesion phase, and 100%（21/21） in rehabilitation phase. After treatment, the range of motion（ROM） of shoulder joint, pain, muscle force, activities of daily living（ADL） and joint local morphology of the patient have been improved obviously. Conclusion Better clinical efficacy is achieved in treatment of scapulohumeral periarthritis in different phases by combining therapy centering on FSN.展开更多
AIM: To investigate the feasibility, efficacy and safety of laparoscopic hepaticoplasty using gallbladder as subcutaneous tunnel and sphincter-of-Oddi preservation for hepatolithiasis.
To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four el...To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.展开更多
Objective:To observe and compare the clinical effect on knee osteoarthritis(KOA)between Fu’s subcutaneous needling therapy(FSN)and convention acupuncture.Methods:A total of 80 outpatients with KOA were divided into a...Objective:To observe and compare the clinical effect on knee osteoarthritis(KOA)between Fu’s subcutaneous needling therapy(FSN)and convention acupuncture.Methods:A total of 80 outpatients with KOA were divided into a FSN group(40 cases)and a conventional acupuncture group(40 cases)according to random number table.Within 1 week of treatment,FSN was used once every two days in the FSN group.The needle tip of Fu’s subcutaneous needle was inserted toward the affected muscle,about 5 mm in depth,at the angle of 15 to 25°.After the needle body lifted slightly,the needle went forward subcutaneously for 25 to 35 mm in depth and was swiped side to side horizontally with even exertion for about 1 min.According to the distribution of affected muscle,the reperfusion approach was repeated for 3 times consecutively.In the conventional acupuncture group conventional acupuncture was given,once a day,for 6 times totally.The scores of Western Ontario and McMaster universities osteoarthritis index(WOMAC)and Lysholm knee scoring scale(Lysholm)were compared between the two groups before and after 1-week treatment.The clinical effect of the two groups was analyzed statistically and evaluated.Results:After 1-week treatment with FSN,in the FSN group,the score of WOMACpain was reduced to be7.7±1.9 from 18.5±3.2,the score of WOMACstiffnessto be 1.5±0.7 from 4.5±1.8,WOMACfunction to be22.7±3.9 from 45.7±2.7 and the score of WOMACoverall to be 31.9±5.3 from 69.7±6.5.The differences were significant in comparison before and after treatment(all P<0.05).In the conventional acupuncture group,after 1-week treatment with conventional acupuncture,the score of WOMACpain was reduced to be11.3±2.8 from 18.2±3.0,the score of WOMACstiffness to be 3.0±1.6 from 5.6±1.7,WOMACfunction to be29.8±5.1 from 44.3±2.9 and the score of WOMACoverall to be 44.1±7.8 from 69.1±7.3.The differences were significant in comparison before and after treatment(all P<0.05).WOMAC score of every item in the FSN group was lower obviously than that in the conventional acupuncture group(P<0.01).After 1-week treatment,Lysholm score was increased to be 78.52±18.4 from 59.64±18.3 in the FSN group and it was to be 69.27±11.9 from 58.17±12.5 in the conventional acupuncture group.The differences were significant in comparison before and after treatment in either group(both P<0.05).Lysholm score in the FSN group was higher than that in the conventional acupuncture group(P<0.05).The total effective rate was 92.5%in the FSN group,higher than 77.5%in the conventional acupuncture group(P<0.05).Conclusion:Fu’s subcutaneous needling therapy effectively relieves the clinical symptoms of KOA and improves knee joint function.The therapeutic effect is better than that of the regular acupuncture.展开更多
This case report describes a 69-year-old man presen-ting with an extensive subcutaneous emphysema in his neck and generalized peritonitis caused by a lower gastrointestinal tract perforation. This case emphasizes that...This case report describes a 69-year-old man presen-ting with an extensive subcutaneous emphysema in his neck and generalized peritonitis caused by a lower gastrointestinal tract perforation. This case emphasizes that subcutaneous emphysema patients with negative thoracic findings should be scrutinized for signs of retroperitoneal hollow viscus perforation.展开更多
Subcutaneous fat deposition has many important roles in dairy cattle,including immunological defense and mechanical protection.The main objectives of this study are to identify key candidate genes regulating subcutane...Subcutaneous fat deposition has many important roles in dairy cattle,including immunological defense and mechanical protection.The main objectives of this study are to identify key candidate genes regulating subcutaneous fat deposition in high-producing dairy cows by integrating genomic and transcriptomic datasets.A total of 1654 genotyped Holstein cows are used to perform a genome-wide association study(GWAS)aiming to identify genes associated with subcutaneous fat deposition.Subsequently,weighted gene co-expression network analyses(WGCNA)are conducted based on RNA-sequencing data of 34 cows and cow yield deviations of subcutaneous fat deposition.Lastly,differentially expressed(DE)m RNA,lnc RNA,and differentially alternative splicing genes are obtained for 12 Holstein cows with extreme and divergent phenotypes for subcutaneous fat deposition.Forty-six protein-coding genes are identified as candidate genes regulating subcutaneous fat deposition in Holstein cattle based on GWAS.Eleven overlapping genes are identified based on the analyses of DE genes and WGCNA.Furthermore,the candidate genes identified based on GWAS,WGCNA,and analyses of DE genes are significantly enriched for pathways involved in metabolism,oxidative phosphorylation,thermogenesis,fatty acid degradation,and glycolysis/gluconeogenesis pathways.Integrating all findings,the NID2,STARD3,UFC1,DEDD,PPP1R1B,and USP21 genes are considered to be the most important candidate genes influencing subcutaneous fat deposition traits in Holstein cows.This study provides novel insights into the regulation mechanism underlying fat deposition in high-producing dairy cows,which will be useful when designing management and breeding strategies.展开更多
BACKGROUND Gastric cancer is the third most lethal malignant tumor worldwide.Metastasis has always been a major cause of poor prognosis.Epidemiological evidence shows that the most common sites for metastasis of gastr...BACKGROUND Gastric cancer is the third most lethal malignant tumor worldwide.Metastasis has always been a major cause of poor prognosis.Epidemiological evidence shows that the most common sites for metastasis of gastric carcinoma are the liver(48%),peritoneum(32%),lung(15%),and bone(12%);however,subcutaneous metastasis is are and occurs in approximately 0.8%of cases.We report a rare case of armpit subcutaneous metastasis of gastric cancer.The best surgical window was missed,as a result of lacking attention of the mass.CASE SUMMARY A 69-year-old man who had previously undergone radical gastrectomy and received eight cycles of oral chemotherapy for gastric cancer showed a rapidly growing mass in his the left armpit;within just 3 mo,the mass grew to a size of 6.9 cm×4.4 cm×5.7 cm.Color Doppler ultrasonography and Positron emission tomography/computed tomography prompted the possibility of metastasis of the malignancy.Fine needle aspiration biopsy guided by color Doppler ultrasound showed the presence of cancer cells in the mass.Immunohistochemical examination showed CDX-2(+),PCK(+),CK20(+),CK7(-),and TTF(-),which supported the metastasis of gastric cancer.Considering the risk of resection,the patient did not undergo surgical treatment.CONCLUSION The case indicates that unidentified subcutaneous masses in patients with a history of gastric cancer should be carefully evaluated.展开更多
Background:Meat quality is largely driven by fat deposition,which is regulated by several genes and signaling pathways.The cyclic adenosine monophosphate(cAMP)-regulated transcriptional coactivator 3(CRTC3)is a coacti...Background:Meat quality is largely driven by fat deposition,which is regulated by several genes and signaling pathways.The cyclic adenosine monophosphate(cAMP)-regulated transcriptional coactivator 3(CRTC3)is a coactivator of cAMP response element binding protein(CREB)that mediates the function of protein kinase A(PKA)signaling pathway and is involved in various biological processes including lipid and energy metabolism.However,the effects of CRTC3 on the metabolome and transcriptome of porcine subcutaneous adipocytes have not been studied yet.Here,we tested whether porcine CRTC3 expression would be related to fat deposition in Heigai pigs(a local fatty breed in China)and Duroc×Landrace×Yorkshire(DLY,a lean breed)pigs in vivo.The effects of adenovirus-induced CRTC3 overexpression on the metabolomic and transcriptomic profiles of subcutaneous adipocytes were also determined in vitro by performing mass spectrometry-based metabolomics combined with RNA sequencing(RNA-seq).Results:Porcine CRTC3 expression is associated with fat deposition in vivo.In addition,CRTC3 overexpression increased lipid accumulation and the expression of mature adipocyte-related genes in cultured porcine subcutaneous adipocytes.According to the metabolomic analysis,CRTC3 overexpression induced significant changes in adipocyte lipid,amino acid and nucleotide metabolites in vitro.The RNA-seq analysis suggested that CRTC3 overexpression alters the expression of genes and pathways involved in adipogenesis,fatty acid metabolism and glycerophospholipid metabolism in vitro.Conclusions:We identified significant alterations in the metabolite composition and the expression of genes and pathways involved in lipid metabolism in CRTC3-overexpressing adipocytes.Our results suggest that CRTC3 might play an important regulatory role in lipid metabolism and thus affects lipid accumulation in porcine subcutaneous adipocytes.展开更多
· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved ...· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.展开更多
Objective:To observe and compare the therapeutic effect on shoulder periarthritis between Fu’s subcutaneous needling(FSN)and electroacupuncture(EA).Methods:A total of 68 patients with periarthritis of shoulder were d...Objective:To observe and compare the therapeutic effect on shoulder periarthritis between Fu’s subcutaneous needling(FSN)and electroacupuncture(EA).Methods:A total of 68 patients with periarthritis of shoulder were divided into a FSN group and an EA group according to the random number table,34 cases in each one.In the FSN group,FSN was adopted,once every two days,totally for 10 times.In the EA group,EA was used once daily,consecutively for 20 times.Shoulder pain score and shoulder function score(Constant-Murley score)before and after treatment were compared between the two groups.The clinical therapeutic effect was analyzed and evaluated statistically.Results:After 20-day treatment,shoulder pain score was reduced obviously as compared with that before treatment in the patients of either group(both P<0.01).After treatment,shoulder pain score in the FSN group was lower significantly than that in the EA group(P<0.01).In 20 days of treatment,CMS was improved obviously as compared with that before treatment in the patients of both groups(both P<0.01)and CMS in the FSN group was higher significantly than that in the EA group after treatment(P<0.01).The effective rate was 94.11%in the FSN group and was 91.17%in the EA group.The remarkably effective rate was 73.52%in the FSN group,significantly higher than 20.58%in the EA group(P<0.01).Conclusion:Both FSN and EA are effective in treatment of periarthritis of shoulder,but FSN obtains a much higher remarkably effective rate in treatment of periarthritis of shoulder and its effects for relieving shoulder pain and improving shoulder function are superior to EA.Because of its effective treatment and simple operation,FSN deserves to be promoted in clinical practice for periarthritis of shoulder.展开更多
Pneumorrhachis(PR), or epidural emphysema, denotes the presence of air in the spinal epidural space. It can be associated with a variety of etiologies, including trauma; recent iatrogenic manipulations during surgical...Pneumorrhachis(PR), or epidural emphysema, denotes the presence of air in the spinal epidural space. It can be associated with a variety of etiologies, including trauma; recent iatrogenic manipulations during surgical, anesthesiological and diagnostic interventions;malignancy and its associated therapy. It usually represents an asymptomatic epiphenomenon but also can be symptomatic by itself, as well as by its underlying pathology, and rarely can be fatal. The pathogenesis and etiology of PR are varied and can sometimes be a diagnostic challenge. As such, there are no standard guidelines for the management of symptomatic PR and its treatment is often individualized. Here, we present a case of a 14-year-old boy treated for leukemia who developed this complication and whether chemotherapy related or not, it proved to be fatal for him. To our knowledge, this is the first case in the literature of this complication with acute lymphoblastic leukemia.展开更多
It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy. This study aimed to examine the clinical effica...It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy. This study aimed to examine the clinical efficacy of single-allergen sublingual immunotherapy(SLIT) versus multi-allergen subcutaneous immunotherapy(SCIT) and to discover the change of the biomarker IL-4 after 1-year immunotherapy in polysensitized children aged 6–13 years with allergic rhinitis(AR) induced by house dust mites(HDMs). The AR polysensitized children(n=78) were randomly divided into two groups: SLIT group and SCIT group. Patients in the SLIT group sublingually received a single HDM extract and those in the SCIT group were subcutaneously given multiple-allergen extracts(HDM in combination with other clinically relevant allergen extracts). Before and 1 year after the allergen-specific immunotherapy(ASIT), the total nasal symptom scores(TNSS), total medication scores(TMS) and IL-4 levels in peripheral blood mononuclear cells(PBMCs) were compared respectively between the two groups. The results showed that the TNSS were greatly improved, and the TMS and IL-4 levels were significantly decreased after 1-year ASIT in both groups(SLIT group: P<0.001; SCIT group: P<0.001). There were no significant differences in any outcome measures between the two groups(for TNSS: P>0.05; for TMS: P>0.05; for IL-4 levels: P>0.05). It was concluded that the clinical efficacy of single-allergen SLIT is comparable with that of multi-allergen SCIT in 6–13-year-old children with HDM-induced AR.展开更多
Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed.We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneou...Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed.We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneous metastasis of a borderline ovarian tumor.The patient received a laparoscopic unilateral adnexectomy for a solid-cystic tumor of the right ovary.Histopathological workup showed a papillary borderline tumor of mucinous type.Nine days later she underwent a hysterectomy,left adnexectomy,appendectomy and omentectomy.Exploration of the peritoneum revealed no intraperitoneal implants.Further exploration showed a non-invasive implant of a borderline tumor in the subcutaneous tissue above the fascia that had no contact to the peritoneum.It is hypothesized that tumor cells may have been implanted during a previous laparoscopy,the most recent of which had been fourteen years prior to her current presentation.Various risk factors for port-site malignancies have been identified.Tumor manipulation and extraction of tumor tissue without a protective bag may contribute to development of trocarsite metastasis.展开更多
Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A ...Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A convenient sample of 105 adult patients,who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI,were recruited over a period of six months.Patients were randomly allocated into three groups:A Control group who received the routine hospital care(G1,n=35)and two intervention group who received cryotherapy for 5-min(G2:cryotherapy applied before SCAI,n=35;G3:cryotherapy applied after SCAI,n=35).Demographic and medical history data sheet,Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.Results:The pain intensity among the patients in the two intervention groups(G2:Median=1.0;G3:Median=0)was significantly lower than in the control group(G1,Median=3.0).No significant difference was found between G2 and G3(P=0.728).Applying cryotherapy after SCAI(G3)decreased the frequency of hematoma formation(48hrs=31.4%&72hrs=28.5%)compared to applying it before injection(G2,100%)or not applying it(G1,100%).The size of hematoma in G3 was smaller than that in G2(P<0.01).Conclusion:Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size.Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.展开更多
基金supported by the National Natural Science Foundation of China(82271671)Nanjing Drum Tower Hospital Academic Innovation Peak Fund(2024-DF-02)+4 种基金Clinical Trials from Nanjing Drum Tower Hospital(2023-LCYJ-MS-05)Nanjing International Science and Technology Cooperation Program(202201027)to L.D.Research Project of State Key Laboratory of Reproductive Medicine and Offspring Health(SKLRM-2022D2)Changzhou Medical Center of Nanjing Medical University(CMCM202203)Clinical Trials from Nanjing Drum Tower Hospital(2022-LCYJ-ZD-02)to H.S.
文摘Ovarian aging is characterized by a progressive decline in oocyte quality and quantity with age.Icariin(ICA),a flavonoid compound derived from Epimedium species,has demonstrated potential as an agent for ovarian restoration.In this study,a subcutaneous implantation system using gelatin methacryloyl(GelMA)hydrogel embedded with ICA was developed to restore ovarian function in aged female mice.Mice were assigned to receive subcutaneous implantation of GelMA alone(GelMA group),GelMA containing ICA(GelMA/ICA group),or a sham operation.Ovarian morphology,serum hormone levels,follicle counts across developmental stages,and reproductive outcomes were evaluated.In vitro fertilization(IVF)and embryo culture assays were performed to assess oocyte developmental potential,while a 10 day natural mating trial was conducted to determine fertility restoration.RNA sequencing(RNA-seq)and RT-qPCR were performed to elucidate the underlying molecular mechanisms.Results showed that GelMA/ICA treatment significantly increased ovarian index(0.19±0.01 vs.0.13±0.01,P<0.0001)and follicle numbers at all developmental stages,including primordial(383.33±151.65 vs.107.14±32.26,P<0.0001),primary(203.33±83.22 vs.91.43±27.04,P=0.003),and secondary follicles(154.17±52.00 vs.59.28±20.50,P=0.029)compared to the sham controls.Hormonal analyses revealed a significant reduction in serum follicle-stimulating hormone(FSH,11.97±3.53 vs.53.10±17.89 ng/mL,P=0.0008),accompanied by elevated anti-Müllerian hormone(AMH,22.97±2.26 vs.5.54±1.56 ng/mL,P<0.0001)and estradiol(E2,315.30±37.62 vs.168.5±14.78 pg/mL,P<0.0001).Oocyte yield and developmental potential improved significantly,as reflected by the increased number of superovulated MII oocytes(17.83±5.15 vs.4.83±4.79,P=0.0002),and higher proportions of two-cell(85.90%±6.16%vs.50.00%±10.00%,P=0.0009),four-cell(81.67%±9.76%vs.50.00%±10.00%,P=0.0061),and blastocyst stage embryos(64.25%±10.55%vs.23.33%±15.28%,P=0.0067).Live birth numbers were significantly increased following GelMA/ICA treatment(6.90±3.21 vs.1.72±2.05,P=0.0001).Transcriptomic analysis revealed up-regulation of genes associated with cytoskeletal organization(Vil1,Tubb3),lipid storage(Soat2,Plin4),oocyte maturation(Oosp2),and cytokine secretion(Cxcl12).Collectively,these findings suggest that GelMA/ICA hydrogels effectively reverse key hallmarks of ovarian aging and restore reproductive function in aged mice,offering a promising platform for fertility preservation and a novel therapeutic for future investigations into ovarian aging.
文摘Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients.In order to achieve a good cosmetic result,reconstruction must be performed simultaneously with radical surgical treatment.Currently,there are a large number of methods for performing breast reconstruction.One of the most commonly used is radical subcutaneous/skin-sparing mastectomy with simultaneous reconstruction with a silicone endoprosthesis.Grand W Carlson type technique is used,with skin incisions in the form of an inverted T is usually performed in patients with large mammary gland with severe grade III ptosis,as the patients usually require reduction of excess skin.However,the most vulnerable aspects of this type of reconstruction is the impossibility of preserving the nipple-areolar complex(NAC),which is associated with a high risk of developing such complications as partial/complete necrosis of the NAC.The current study provides an overview of an original method to decrease the risk of necrosis of NAC with evaluation of blood supply of the nipple and inferior deepithelialized flap using real-time intraoperative Doppler ultrasonography and indocyanine green fluorescence system.
文摘BACKGROUND Subcutaneous implantable cardioverter-defibrillator(S-ICD)implantation requires effective anesthesia.General anesthesia(GA)carries risks like hemodynamic instability,while ultrasound-guided intercostal nerve block(US-ICNB)may offer better pain control.This study hypothesized US-ICNB is superior in perioperative safety and pain management.AIM To compare perioperative outcomes of GA and US-ICNB in S-ICD implantation.METHODS This retrospective single-center study included 64 patients who received S-ICD implantation between February 2021 and December 2024.They were divided into GA and US-ICNB groups based on anesthesia type.Demographic data,perioperative parameters(operation time,pain scores,analgesic usage),and postoperative outcomes(complications,defibrillation events)were collected and analyzed.Statistical tests were used to compare the two groups.RESULTS This study included 64 patients(20 in the GA group and 44 in the US-ICNB group).Baseline left ventricular ejection fraction was significantly lower in the US-ICNB group(39.20%±12.00%vs 56.20%±11.50%in GA,P<0.001),while American Society of Anesthesiologists scores and comorbidities were comparable.US-ICNB showed superior pain control,with significantly lower numeric rating scale scores at 6-48 hours(P<0.001)and fewer patients requiring analgesics(P=0.02).The US-ICNB group had shorter operation times(P<0.001),total hospital stays(P<0.001),and later first analgesia times(P<0.001).No anesthesia-related complications occurred in either group.CONCLUSION Both anesthetic methods were safe in the short term.However,US-ICNB was superior in reducing operation and hospital stay times and alleviating peri-operative pain.It has high safety in S-ICD implantation and deserves further clinical promotion,though large-scale,multi-center,randomized controlled trials are needed to confirm these findings.
基金supported by Guangdong Key Laboratory of Acupuncture and Moxibustion(202101).
文摘Fu's subcutaneous needling(FSN)represents a non-pharmacological therapy that employs disposable needles for subcutaneous application,primarily targeting the relaxation of tightened muscles,invigoration of blood circulation,and alleviation of local tissue ischemia.Originating from traditional acupuncture and modern techniques,FSN effectively treats muscle-related conditions,including soft tissue injuries,neck-shoulder-back pain,visceral pain,and non-painful diseases.Its unique features encompass shallow needling,the swaying movement technique,and an emphasis on governing the spirit.FSN is characterized by rapid therapeutic responses,high repeatability,and minimal side effects,adhering to the keep it simple,stupid(KISS)principle in research by emphasizing simplicity and efficacy.By mechanically releasing chronic muscle tension,FSN improves arterial blood flow,halts pathological leakage of intracellular adenosine triphosphate(ATP),and consequently resolves pain.This therapy offers a promising and safe approach for pain management and muscular health,deserving vigorous promotion and further scientific investigation.
基金Supported by the National Key R and D Program of China,No.2021YFC2501700 and No.2021YFC2501705and the National Natural Science Foundation of China,No.82171580 and No.81672646.
文摘BACKGROUND Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion(CSII)require a lower dose of insulin than those treated with multiple daily injections(MDIs).However,it is unclear whether this is also the case for patients with type 2 diabetes mellitus(T2DM).AIM To compare insulin dosage requirements between CSII and MDI in T2DM,iden-tifying influencing factors associated with both therapeutic modalities.METHODS A total of 954 patients with T2DM were divided into two groups:CSII and MDI groups.The total daily insulin dose(TDD),TDD per kilogram per day(TDD/kg),and ratio of total basal insulin dose to TDD(%TBa)required to achieve the target blood glucose levels were compared between the two groups.In addition,factors affecting insulin dosage were analyzed in both groups of patients.RESULTS Compared to the CSII group,the MDI group required a higher TDD[median(interquartile)]:30.00(24.00,38.00)U/day vs 26.40(21.60,32.40)U/day;P<0.01,TDD/kg and%TBa.In the MDI group and CSII groups,an increase in TDD was independently associated with an increase in body mass index(BMI),waist circumference(WC),fasting plasma glucose(FPG),and glycated hemoglobin(HbA1c).The pathophysiology of type 2 diabetes mellitus(T2DM)mainly involves insulin resistance and progressiveβ-cell failure,which leads to increased blood glucose levels(hyperglycemia)[1-3].Treatment for T2DM includes antidiabetic medications and insulin therapy[4,5].Patients with T2DM withβ-cell failure usually require insulin therapy[6-8].Continuous subcutaneous insulin infusion(CSII)and multiple daily injections(MDIs)are two major insulin therapies for controlling hyperglycemia in these patients.However,excessive insulin therapies may cause problems such as hypoglycemia,weight gain,and iatrogenic hyperinsulinemia[9].Therefore,attention should be paid to the dosage of insulin used.The establishment of insulin regimens for CSII and MDI therapies is primarily guided by physicians’empirical judgment.To date,there have been few clear guidelines or recommendations on the appropriate insulin dose during CSII and MDI treatment for T2DM[10].Yang et al[11]studied insulin doses and related factors in the CSII treatment of patients with T2DM[12].However,these studies did not cover the dose setting and related factors in MDI treatment.Previous studies have shown that patients with type 1 diabetes mellitus treated with CSII require less insulin than those treated with MDIs[13-15].However,it is unclear whether patients with T2DM on CSII also require less insulin than patients on MDI.Therefore,the present study determined the difference in insulin dosages between CSII and MDI therapies and evaluated the related factors in patients with T2DM.It also systematically analyzed the insulin dose characteristics of MDI and CSII in 954 hospitalized patients with T2DM,aiming to optimize the insulin dosage regimen and provide clinical references for guiding the application of CSII and MDI in patients with T2DM.
文摘To introduce the experience of professor JIA Chun-sheng in rapid analgesia and motor function rehabilitation by subcutaneous penetration needling of auricular acupuncture.Subcutaneous penetration needling of auricular acupuncture plays a role in rapid analgesia and motor function rehabilitation in treatment of pain in limbs and trunk and/or limb dysfunction caused by migraine,cervical spondylosis,acute lumbar sprain,soft tissue injury,scapulohumeral periarthritis,lumbar disc herniation,sciatica,stroke or cerebral trauma,and it is worthy of being widely promoted and applied clinically.
文摘Objective To observe the efficacy of combining therapy in treatment of 90 patients with scapulohumeral periarthritis in different phases. Method Ninety patients with scapulohumeral periarthritis were treated with Fu＇s subcutaneous needling（FSN） combined with physiotherapy in painful phase, acupotomology and massage in adhesion phase, and appropriate functional exercise in rehabilitation phase. Seven days were considered as one course of treatment, and efficacy evaluation was performed after three courses. Function evaluation of shoulder joint was made. Result The total effective rate was 100%（38/38） in acute phase, 93.5%（29/31） in adhesion phase, and 100%（21/21） in rehabilitation phase. After treatment, the range of motion（ROM） of shoulder joint, pain, muscle force, activities of daily living（ADL） and joint local morphology of the patient have been improved obviously. Conclusion Better clinical efficacy is achieved in treatment of scapulohumeral periarthritis in different phases by combining therapy centering on FSN.
文摘AIM: To investigate the feasibility, efficacy and safety of laparoscopic hepaticoplasty using gallbladder as subcutaneous tunnel and sphincter-of-Oddi preservation for hepatolithiasis.
文摘To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.
基金Supported by Outstanding Innovation Talent Support Project of Heilongjiang University of Traditional Chinese Medicine:2018RCD10:the ForthTerm National Chinese Medicine(Clinical and Basic Research)Outstanding Talent Advanced Training Program,State Administration of Traditional Chinese Medicine:National TCM Education[2017]24.
文摘Objective:To observe and compare the clinical effect on knee osteoarthritis(KOA)between Fu’s subcutaneous needling therapy(FSN)and convention acupuncture.Methods:A total of 80 outpatients with KOA were divided into a FSN group(40 cases)and a conventional acupuncture group(40 cases)according to random number table.Within 1 week of treatment,FSN was used once every two days in the FSN group.The needle tip of Fu’s subcutaneous needle was inserted toward the affected muscle,about 5 mm in depth,at the angle of 15 to 25°.After the needle body lifted slightly,the needle went forward subcutaneously for 25 to 35 mm in depth and was swiped side to side horizontally with even exertion for about 1 min.According to the distribution of affected muscle,the reperfusion approach was repeated for 3 times consecutively.In the conventional acupuncture group conventional acupuncture was given,once a day,for 6 times totally.The scores of Western Ontario and McMaster universities osteoarthritis index(WOMAC)and Lysholm knee scoring scale(Lysholm)were compared between the two groups before and after 1-week treatment.The clinical effect of the two groups was analyzed statistically and evaluated.Results:After 1-week treatment with FSN,in the FSN group,the score of WOMACpain was reduced to be7.7±1.9 from 18.5±3.2,the score of WOMACstiffnessto be 1.5±0.7 from 4.5±1.8,WOMACfunction to be22.7±3.9 from 45.7±2.7 and the score of WOMACoverall to be 31.9±5.3 from 69.7±6.5.The differences were significant in comparison before and after treatment(all P<0.05).In the conventional acupuncture group,after 1-week treatment with conventional acupuncture,the score of WOMACpain was reduced to be11.3±2.8 from 18.2±3.0,the score of WOMACstiffness to be 3.0±1.6 from 5.6±1.7,WOMACfunction to be29.8±5.1 from 44.3±2.9 and the score of WOMACoverall to be 44.1±7.8 from 69.1±7.3.The differences were significant in comparison before and after treatment(all P<0.05).WOMAC score of every item in the FSN group was lower obviously than that in the conventional acupuncture group(P<0.01).After 1-week treatment,Lysholm score was increased to be 78.52±18.4 from 59.64±18.3 in the FSN group and it was to be 69.27±11.9 from 58.17±12.5 in the conventional acupuncture group.The differences were significant in comparison before and after treatment in either group(both P<0.05).Lysholm score in the FSN group was higher than that in the conventional acupuncture group(P<0.05).The total effective rate was 92.5%in the FSN group,higher than 77.5%in the conventional acupuncture group(P<0.05).Conclusion:Fu’s subcutaneous needling therapy effectively relieves the clinical symptoms of KOA and improves knee joint function.The therapeutic effect is better than that of the regular acupuncture.
文摘This case report describes a 69-year-old man presen-ting with an extensive subcutaneous emphysema in his neck and generalized peritonitis caused by a lower gastrointestinal tract perforation. This case emphasizes that subcutaneous emphysema patients with negative thoracic findings should be scrutinized for signs of retroperitoneal hollow viscus perforation.
基金the support of founding by the Key Research Project of Ningxia Hui Autonomous Region(2022BBF02017)the earmarked fund for CARS-36the Program for Changjiang Scholar and Innovation Research Team in University(IRT-15R62)。
文摘Subcutaneous fat deposition has many important roles in dairy cattle,including immunological defense and mechanical protection.The main objectives of this study are to identify key candidate genes regulating subcutaneous fat deposition in high-producing dairy cows by integrating genomic and transcriptomic datasets.A total of 1654 genotyped Holstein cows are used to perform a genome-wide association study(GWAS)aiming to identify genes associated with subcutaneous fat deposition.Subsequently,weighted gene co-expression network analyses(WGCNA)are conducted based on RNA-sequencing data of 34 cows and cow yield deviations of subcutaneous fat deposition.Lastly,differentially expressed(DE)m RNA,lnc RNA,and differentially alternative splicing genes are obtained for 12 Holstein cows with extreme and divergent phenotypes for subcutaneous fat deposition.Forty-six protein-coding genes are identified as candidate genes regulating subcutaneous fat deposition in Holstein cattle based on GWAS.Eleven overlapping genes are identified based on the analyses of DE genes and WGCNA.Furthermore,the candidate genes identified based on GWAS,WGCNA,and analyses of DE genes are significantly enriched for pathways involved in metabolism,oxidative phosphorylation,thermogenesis,fatty acid degradation,and glycolysis/gluconeogenesis pathways.Integrating all findings,the NID2,STARD3,UFC1,DEDD,PPP1R1B,and USP21 genes are considered to be the most important candidate genes influencing subcutaneous fat deposition traits in Holstein cows.This study provides novel insights into the regulation mechanism underlying fat deposition in high-producing dairy cows,which will be useful when designing management and breeding strategies.
文摘BACKGROUND Gastric cancer is the third most lethal malignant tumor worldwide.Metastasis has always been a major cause of poor prognosis.Epidemiological evidence shows that the most common sites for metastasis of gastric carcinoma are the liver(48%),peritoneum(32%),lung(15%),and bone(12%);however,subcutaneous metastasis is are and occurs in approximately 0.8%of cases.We report a rare case of armpit subcutaneous metastasis of gastric cancer.The best surgical window was missed,as a result of lacking attention of the mass.CASE SUMMARY A 69-year-old man who had previously undergone radical gastrectomy and received eight cycles of oral chemotherapy for gastric cancer showed a rapidly growing mass in his the left armpit;within just 3 mo,the mass grew to a size of 6.9 cm×4.4 cm×5.7 cm.Color Doppler ultrasonography and Positron emission tomography/computed tomography prompted the possibility of metastasis of the malignancy.Fine needle aspiration biopsy guided by color Doppler ultrasound showed the presence of cancer cells in the mass.Immunohistochemical examination showed CDX-2(+),PCK(+),CK20(+),CK7(-),and TTF(-),which supported the metastasis of gastric cancer.Considering the risk of resection,the patient did not undergo surgical treatment.CONCLUSION The case indicates that unidentified subcutaneous masses in patients with a history of gastric cancer should be carefully evaluated.
基金The project was partially supported by the National Natural Science Foundation of China(31722053,31672427)the Natural Science Foundation of Zhejiang Province(LR17C170001)the“Hundred Talents Program”funding from Zhejiang University awarded to TZS.
文摘Background:Meat quality is largely driven by fat deposition,which is regulated by several genes and signaling pathways.The cyclic adenosine monophosphate(cAMP)-regulated transcriptional coactivator 3(CRTC3)is a coactivator of cAMP response element binding protein(CREB)that mediates the function of protein kinase A(PKA)signaling pathway and is involved in various biological processes including lipid and energy metabolism.However,the effects of CRTC3 on the metabolome and transcriptome of porcine subcutaneous adipocytes have not been studied yet.Here,we tested whether porcine CRTC3 expression would be related to fat deposition in Heigai pigs(a local fatty breed in China)and Duroc×Landrace×Yorkshire(DLY,a lean breed)pigs in vivo.The effects of adenovirus-induced CRTC3 overexpression on the metabolomic and transcriptomic profiles of subcutaneous adipocytes were also determined in vitro by performing mass spectrometry-based metabolomics combined with RNA sequencing(RNA-seq).Results:Porcine CRTC3 expression is associated with fat deposition in vivo.In addition,CRTC3 overexpression increased lipid accumulation and the expression of mature adipocyte-related genes in cultured porcine subcutaneous adipocytes.According to the metabolomic analysis,CRTC3 overexpression induced significant changes in adipocyte lipid,amino acid and nucleotide metabolites in vitro.The RNA-seq analysis suggested that CRTC3 overexpression alters the expression of genes and pathways involved in adipogenesis,fatty acid metabolism and glycerophospholipid metabolism in vitro.Conclusions:We identified significant alterations in the metabolite composition and the expression of genes and pathways involved in lipid metabolism in CRTC3-overexpressing adipocytes.Our results suggest that CRTC3 might play an important regulatory role in lipid metabolism and thus affects lipid accumulation in porcine subcutaneous adipocytes.
基金Supported by Jilin Province Science and Techology Development Plan Project(No.20150414032GH)
文摘· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.
基金Scientific Research Project of New Technique of Hunan Provincial People’s Hospital:MNRT-2018022。
文摘Objective:To observe and compare the therapeutic effect on shoulder periarthritis between Fu’s subcutaneous needling(FSN)and electroacupuncture(EA).Methods:A total of 68 patients with periarthritis of shoulder were divided into a FSN group and an EA group according to the random number table,34 cases in each one.In the FSN group,FSN was adopted,once every two days,totally for 10 times.In the EA group,EA was used once daily,consecutively for 20 times.Shoulder pain score and shoulder function score(Constant-Murley score)before and after treatment were compared between the two groups.The clinical therapeutic effect was analyzed and evaluated statistically.Results:After 20-day treatment,shoulder pain score was reduced obviously as compared with that before treatment in the patients of either group(both P<0.01).After treatment,shoulder pain score in the FSN group was lower significantly than that in the EA group(P<0.01).In 20 days of treatment,CMS was improved obviously as compared with that before treatment in the patients of both groups(both P<0.01)and CMS in the FSN group was higher significantly than that in the EA group after treatment(P<0.01).The effective rate was 94.11%in the FSN group and was 91.17%in the EA group.The remarkably effective rate was 73.52%in the FSN group,significantly higher than 20.58%in the EA group(P<0.01).Conclusion:Both FSN and EA are effective in treatment of periarthritis of shoulder,but FSN obtains a much higher remarkably effective rate in treatment of periarthritis of shoulder and its effects for relieving shoulder pain and improving shoulder function are superior to EA.Because of its effective treatment and simple operation,FSN deserves to be promoted in clinical practice for periarthritis of shoulder.
文摘Pneumorrhachis(PR), or epidural emphysema, denotes the presence of air in the spinal epidural space. It can be associated with a variety of etiologies, including trauma; recent iatrogenic manipulations during surgical, anesthesiological and diagnostic interventions;malignancy and its associated therapy. It usually represents an asymptomatic epiphenomenon but also can be symptomatic by itself, as well as by its underlying pathology, and rarely can be fatal. The pathogenesis and etiology of PR are varied and can sometimes be a diagnostic challenge. As such, there are no standard guidelines for the management of symptomatic PR and its treatment is often individualized. Here, we present a case of a 14-year-old boy treated for leukemia who developed this complication and whether chemotherapy related or not, it proved to be fatal for him. To our knowledge, this is the first case in the literature of this complication with acute lymphoblastic leukemia.
文摘It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy. This study aimed to examine the clinical efficacy of single-allergen sublingual immunotherapy(SLIT) versus multi-allergen subcutaneous immunotherapy(SCIT) and to discover the change of the biomarker IL-4 after 1-year immunotherapy in polysensitized children aged 6–13 years with allergic rhinitis(AR) induced by house dust mites(HDMs). The AR polysensitized children(n=78) were randomly divided into two groups: SLIT group and SCIT group. Patients in the SLIT group sublingually received a single HDM extract and those in the SCIT group were subcutaneously given multiple-allergen extracts(HDM in combination with other clinically relevant allergen extracts). Before and 1 year after the allergen-specific immunotherapy(ASIT), the total nasal symptom scores(TNSS), total medication scores(TMS) and IL-4 levels in peripheral blood mononuclear cells(PBMCs) were compared respectively between the two groups. The results showed that the TNSS were greatly improved, and the TMS and IL-4 levels were significantly decreased after 1-year ASIT in both groups(SLIT group: P<0.001; SCIT group: P<0.001). There were no significant differences in any outcome measures between the two groups(for TNSS: P>0.05; for TMS: P>0.05; for IL-4 levels: P>0.05). It was concluded that the clinical efficacy of single-allergen SLIT is comparable with that of multi-allergen SCIT in 6–13-year-old children with HDM-induced AR.
文摘Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed.We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneous metastasis of a borderline ovarian tumor.The patient received a laparoscopic unilateral adnexectomy for a solid-cystic tumor of the right ovary.Histopathological workup showed a papillary borderline tumor of mucinous type.Nine days later she underwent a hysterectomy,left adnexectomy,appendectomy and omentectomy.Exploration of the peritoneum revealed no intraperitoneal implants.Further exploration showed a non-invasive implant of a borderline tumor in the subcutaneous tissue above the fascia that had no contact to the peritoneum.It is hypothesized that tumor cells may have been implanted during a previous laparoscopy,the most recent of which had been fourteen years prior to her current presentation.Various risk factors for port-site malignancies have been identified.Tumor manipulation and extraction of tumor tissue without a protective bag may contribute to development of trocarsite metastasis.
文摘Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A convenient sample of 105 adult patients,who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI,were recruited over a period of six months.Patients were randomly allocated into three groups:A Control group who received the routine hospital care(G1,n=35)and two intervention group who received cryotherapy for 5-min(G2:cryotherapy applied before SCAI,n=35;G3:cryotherapy applied after SCAI,n=35).Demographic and medical history data sheet,Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.Results:The pain intensity among the patients in the two intervention groups(G2:Median=1.0;G3:Median=0)was significantly lower than in the control group(G1,Median=3.0).No significant difference was found between G2 and G3(P=0.728).Applying cryotherapy after SCAI(G3)decreased the frequency of hematoma formation(48hrs=31.4%&72hrs=28.5%)compared to applying it before injection(G2,100%)or not applying it(G1,100%).The size of hematoma in G3 was smaller than that in G2(P<0.01).Conclusion:Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size.Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.
