Total pancreatic necrosis after organophosphate intoxication

Cases of acute pancreatitis induced by organophosphate intoxication are encountered occasionally in clinics, but very few of them develop into severe pancreas necrosis and irreversible pancreatic function impairment. Here, we report a 47-year-old female organophosphate poisoning case after ingestion of massive insecticides; she was considered to have total necrosis and function failure of the pancreas via serum amylase test, glucose level test, and CT imaging. The patient exhibited no relief under the regular medicine treatment, which included sandostatin, antibiotics, intravenous atropine, and pralidoxime methiodide. She received percutaneous catheterization and drainage of pancreatic zone to expel hazardous necrotic waste, also by which the pathogenic evidence was obtained and the antibiotics were adjusted subsequently. The patient recovered gradually, was discharged after 2 weeks, and was prescribed with oral pancreatin capsules before meals and hypodermic insulin at meals and bedtime to compensate the impaired pancreatic function.     

A retrospective study of 2228 cases with eyelid tumors

AIM: To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS: In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin: epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS: Most eyelid tumors were epidermal in origin (1080, 48.5%), followed by miscellaneous (885, 39.7%) and adnexal tumors (263, 11.8%). Among all the tumors, 292 (13.1%) were malignant lesions, 1910 (85.7%) benign and 26 (1.1%) premalignant lesions. Most malignant tumors originated from epidermal cells (60.0%), followed by adnexal cells (34.6%). The most common malignant tumors were basal cell carcinomas (56.5%) followed by sebaceous carcinoma (34.6%), squamous cell carcinomas (3.8%) and lymphoma/plasmocytoma (1.7%). The benign and premalignant eyelid lesions mostly originated from epidermal cells (46.4%) followed by miscellaneous cell sources (45.2%), including melanocytic nevus (33.8%), seborrheic keratosis (13.7%), squamous cell papilloma (13.0%) and epidermal cysts (11.5%). CONCLUSION: Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.     

基于SOCS-JAK/STAT负反馈调节的复方鱼腥草对糖尿病肾损伤的干预作用研究

目的：糖尿病肾病（diabetic nephropathy, DN）是糖尿病（Diabetic mellitus,DM）临床常见的慢性并发症之一,本实验旨在研究复方鱼腥草三种提取部位及其完整成分对db/db小鼠肾损害的保护作用,并通过探究各提取物对JAK2/STAT3通路及其下游蛋白的影响来探讨复方鱼腥草防治糖尿病肾病的可能机制.方法：1、提取复方鱼腥草水提物、醇提物、挥发油成分,并将三种成分按照所得质量比配制得到复方鱼腥草完整成分。2、选取8只db/m小鼠为正常组;56只db/db小鼠分为模型组、盐酸二甲双胍组、AG490组、复方鱼腥草水提物组、复方鱼腥草醇提物组、复方鱼腥草挥发油组以及复方鱼腥草完整成分组,每组8只,给药8周,记录小鼠体重以及血糖,8周后检测小鼠血糖、肾功能指标及肾脏指数,酶联免疫试剂盒法检测血浆胰岛素水平（FINS）、转化生长因子-β1（TGF-β1）、纤连蛋白（FN）、HE染色观察小鼠肾脏病理变化。3、RT-PCR法检测各组小鼠肾组织中的JAK2mRNA、STAT3mRNA,SOCS-1mRNA表达的变化情况; Western blot法检测肾组织中的JAK2、p-JAK2、STAT3、p-STAT3、SOCS-1、c-fos及c-jun蛋白表达变化,运用免疫荧光法检测肾组织c-fos、c-jun蛋白的表达。结果：1、给药八周后,与正常组比较,模型组db/db小鼠血浆转化生长因子-β1（TGF-β1）、纤连蛋白（FN）、治疗组小鼠血清胰岛素水平、胰岛素敏感指数较模型组升高,转化生长因子-β1（TGF-β1）,纤连蛋白（FN）,水平降低（P<0.05）,各治疗组小鼠肾脏组织病理改善明显。2、模型组小鼠肾组织p-JAK2,p-STAT3及JAK2 mRNA,STAT3mRNA的表达均对比正常组小鼠肾组织的表达明显增高(P<0.05);与模型组相比,各给药组小鼠肾组织p-JAK2,p-STAT3表达均有降低,挥发油组及完整成分组小鼠肾组织SOCS-1基因及蛋白明显升高（p<0.05）;各给药组的JAK2、STAT3基因表达及蛋白变化不显著。各治疗组的c-fos、c-jun在肾小管及肾间质的表达均有不同程度下降。结论：复方鱼腥草对糖尿病肾损伤具有改善作用,其保护肾脏的作用可能与降低尿蛋白排泄,调节血糖,维持肾脏结构、功能的完整性有关。其改善糖尿病肾损伤的分子机制可能通过SOCS 负反馈调节JAK/STAT信号转导通路相关基因及蛋白表达,从而抑制降低下游原癌基因c-fos、c-jun的表达,减少炎症因子的活化,降低FN的分泌,减少ECM聚积有关。     

The tendon width of lateral rectus muscle in predicting the effect of recession: is it just age-related artifact?

Purpose

The tendon width of the lateral rectus muscle is known to be a useful indicator for estimation of the effect of lateral rectus recession in intermittent exotropia. This study was conducted to investigate whether the tendon width of the lateral rectus would differ according to different age groups.

Patients and methods

We studied 133 patients ranging from 0 to 51 years of age who had undergone bilateral lateral rectus (BLR) recession for the basic type of intermittent exotropia. A total of 133 patients were divided into four groups; 16 patients who were younger than 2 years old (group 1), 20 patients who were 2–5 years old (group 2), 75 patients who were 5–13 years old (group 3), and 22 patients who were older than 13 years (group 4). Under general anesthesia and before dissection of the muscle tendon from the sclera, the tendon width of the lateral rectus of both eyes near insertion was measured with calipers.

Results

The tendon width of each group was as follows: in group 1, 7.84±0.35 mm in the right eye and 7.66±0.44 mm in the left eye; in group 2, 7.70±0.50 mm and 7.65±0.52; in group 3 8.11±0.36, 7.95±0.48. In group 4, measurements were 8.14±0.49 mm and 8.05±0.38 mm, respectively. The difference of tendon width in both eyes was statistically significant in all four groups (P<0.01) and the tendon widths of group 1 and 2 were narrower than that of group 3 and 4.

Conclusion

Measurement of tendon width of the lateral rectus muscle for prediction of the effect in intermittent exotropia should be applied in patients ≥5 years of age.     

CT findings of plastic bronchitis in children after a Fontan operation

BACKGROUND: Plastic bronchitis is a rare cause of acute obstructive respiratory failure in children. Life-threatening events are much more frequent in patients with repaired cyanotic congenital heart disease, and most frequent following a Fontan operation. Commonly, the diagnosis is not made until bronchial casts are expectorated. Detailed CT findings in plastic bronchitis have not been described. OBJECTIVE: To describe the CT findings in plastic bronchitis in children after a Fontan operation. MATERIALS AND METHODS: Three children with plastic bronchitis after a Fontan operation were evaluated by chest CT. Bronchial casts were spontaneously expectorated and/or extracted by bronchoscopy. Airway and lung abnormalities seen on CT were analyzed in the three children. RESULTS: CT demonstrated bronchial casts in the central airways with associated atelectasis and consolidation in all children. The affected airways were completely or partially obstructed by the bronchial casts without associated bronchiectasis. The airway and lung abnormalities rapidly improved after removal of the bronchial casts. CONCLUSION: CT can identify airway and lung abnormalities in children with plastic bronchitis after a Fontan operation. In addition, CT can be used to guide bronchoscopy and to monitor treatment responses, and thereby may improve clinical outcomes.     

Increased Myogenic Reactivity of Uterine Arteries from Pregnant Rats with Reduced Uterine Perfusion Pressure

The etiology of preeclampsia remains unknown. However, a contributing factor to this hypertensive disease of pregnancy is a reduction in uterine perfusion pressure resulting in placental ischemia. Uterine arteries may be a major regulator of this process through changes in vascular reactivity and localized blood flow. The reduced uterine perfusion pressure (RUPP) pregnant rat is an established animal model of preeclampsia pathology. Pregnant Sprague Dawley rats were used for this investigation and subjected to RUPP or SHAM surgery on Day 14 of gestation. On Day 21 of gestation, animals were terminated and resistance-caliber uterine arteries were harvested and mounted on a pressurized arteriograph to examine myogenic reactivity, agonist induced vasodilation (methacholine and VEGF), and vasoconstriction (phenylephrine and U-46619). Resistance-caliber uterine arteries from RUPP animals exhibited increased myogenic reactivity and decreased vasodilation (methacholine and VEGF) compared to SHAM uterine arteries (p<0.05). Phenylephrine and U-46619 induced constriction was similar in uterine arteries between RUPP and SHAM rats. These results suggest that resistancecaliber uterine arteries from RUPP pregnant rats are altered to reflect a more constrictive phenotype which may play a role in the development of maternal hypertension demonstrated in these animals and thereby potentially in preeclampsia.     

Selective management of obstructive submandibular sialadenitis

We aimed to describe the effect of our surgical and sialoendoscopic technique for diagnosis and treatment of chronic obstructive submandibular sialadenitis. METHODS: Between January 2004 and June 2006, 68 patients presented with obstructive symptoms and were diagnosed and treated by interventional sialoendoscopy or excision. The patients all had radiographs and then, if the sialolith could not be found, diagnostic sialoendoscopy. The obstruction was treated by operation or interventional sialoendoscopy depending on the size, shape, site, and quality of the sialolith. RESULTS: Forty-nine patients had sialoliths shown radiographically, and the features of 19 were found endoscopically and were of three types: radiolucent (n=6), in the branch (n=3), mucus plug (n=3), and stenotic (n=7). Twenty-seven obstructions were successfully removed surgically, giving a success rate of 27/31 (87%). Twenty-seven patients were treated by interventional sialoendoscopy, and in 22 cases the sialoliths were removed directly by sialoendoscopy (22/27, 81%). Obstructive symptoms were relieved in 9 of 10 cases without stones. CONCLUSION: Operation or sialoendoscopy can be used to treat the obstruction in the submandibular gland.     

The health of trafficked women: a survey of women entering posttrafficking services in Europe

Trained counselors interviewed 192 women who had been trafficked and sexually exploited about abuse and evaluated their physical and mental health status within 14 days of entry into posttrafficking services. Most reported physical or sexual violence while trafficked (95%), pre-trafficking abuse (59%), and multiple posttrafficking physical and psychological problems. Newly identified trafficked women require immediate attention to address posttrauma symptoms and adequate recovery time before making decisions about participating in prosecutorial or immigration proceedings or returning home.