Huge Bartholin’s cyst managed by primary marsupialization:A case report

BACKGROUND We report on the case of a 21-year-old female who could not walk due to a huge Bartholin's cyst occupying the right vulvar region.The patient was treated by marsupialization of the Bartholin’s cyst and postoperative antibiotic therapy.CASE SUMMARY A 21-year-old female without a medical history of sexually transmitted diseases presented to our outpatient clinic with complaints of a painful vulvar lump and a green-yellowish discharge for 4 d.A large Bartholin’s cyst,10 cm in diameter,was suspected over the right side of the vulva.She was advised to be admitted to the ward for intravenous antibiotic treatment and to perform marsupialization several days later.However,the patient requested immediate surgery because of time limitations.The patient underwent marsupialization under local anesthesia.The procedure was well-tolerated.After making the incision,a significant amount of malodorous pus(approximately 30 mL)was removed from the abscess.The patient was followed up for 1 wk postoperatively.The Bartholin’s cyst regressed,and the surgical wound healed well.CONCLUSION Our case shows that an initial marsupialization followed by oral antibiotic therapy can be an appropriate treatment option for a large Bartholin’s cyst.However,depending on the patient’s condition,a suitable treatment,either cystectomy or marsupialization,can be considered.

Delayed diagnosis in inflammatory bowel disease:Time to consider solutions

In this editorial,we discuss a recently published manuscript by Blüthner et al in the World Journal of Gastroenterology,with a specific focus on the delayed diagnosis of inflammatory bowel disease(IBD).IBD,which includes Crohn's disease and ulcerative colitis,is a chronic intestinal disorder.A time lag may exist between the onset of inflammation and the appearance of signs and symptoms,potentially leading to an incorrect or delayed diagnosis,a situation referred to as the delayed diagnosis of IBD.Early diagnosis is crucial for effective patient treatment and prognosis,yet delayed diagnosis remains common.The reasons for delayed diagnosis of IBD are numerous and not yet fully understood.One key factor is the nonspecific nature of IBD symptoms,which can easily be mistaken for other conditions.Additionally,the lack of specific diagnostic methods for IBD contributes to these delays.Delayed diagnosis of IBD can result in numerous adverse consequences,including increased intestinal damage,fibrosis,a higher risk of colorectal cancer,and a decrease in the quality of life of the patient.Therefore,it is essential to diagnose IBD promptly by raising physician awareness,enhancing patient education,and developing new diagnostic methods.

Subconjunctival trypsin injection for anterior chamber fibrin exudates in eyes with globe rupture following vitrectomy

AIM:To compare the safety and clinical outcomes of subconjunctival trypsin and dexamethasone(DEX)injections in the treatment of anterior chamber fibrin exudates in eyes with globe rupture following primary wound repair and vitrectomy.METHODS:A retrospective analysis included 42 males and 10 females(mean age 46.0±6.0y,range 34 to 58y)who underwent primary wound sutures and vitrectomy for globe rupture.Patients with pupil-covered fibrinous exudate or/and membrane in the anterior chamber were treated.On the first postoperative day,subconjunctival injections of either 5000 units(0.4 mL)of trypsin solution(n=25)or 0.5 mL(1 mg)DEX(n=27)were administered to accelerate exudate absorption.Efficacy was assessed by observing break time and partial absorption of the fibrin exudate membrane.Safety and comfort were evaluated by monitoring intraocular pressure(IOP),allergy,pain,and foreign body sensation.RESULTS:Both groups achieved 1/3 absorption of the anterior chamber fibrin exudate membrane,but the trypsin group exhibited shorter break time and partial absorption time compared to the DEX group(P<0.05).Trypsin treatment was also less irritating to patients.No adverse reactions were reported,and IOP remained stable.Visual acuity improved in both groups without statistical difference.CONCLUSION:Compared to DEX,trypsin demonstrates a shorter absorption time for the fibrin exudate membrane with a more comfortable process in treating pupil-covered fibrinous exudate or/and membrane after vitrectomy for globe rupture.

Machine perfusion for liver transplantation:A concise review of clinical trials

Background: With the increased use of extended-criteria donors, static cold storage has failed to provide optimal preservation of liver grafts, resulting in early allograft dysfunction and long-term complications Machine perfusion(MP) is a beneficial alternative preservation strategy for donor livers, particularly fo those considered to be of suboptimal quality, and could expand the limited donor pool. Data sources: A comprehensive search in Pub Med, EMBASE, Ovid databases and Clinical Trials.gov website was conducted using the medical subject heading terms "machine perfusion", "machine preservation""liver transplantation", combined with free text terms such as "hypothermic", "normothermic" and "sub normothermic". The deadline for the search was September 30, 2017. Results: MP can be classified as hypothermic, subnormothermic, and normothermic with the tempera ture maintained at 0–12 °C, 25–34 °C and 35–38 °C, respectively. Twelve clinical trials of MP have been reported in recent years. MP effectively decreased AST/ALT level and the incidence of early allograft dys function. However, the graft and patient survival rate after MP were similar to static cold storage. The detailed clinical characteristics such as liver function, graft survival, patient survival and early allograf dysfunction were reviewed.Conclusions: Clinical trial results showed that MP improves delayed graft function, primary non-function and biliary strictures. However, MP still requires validation in large clinical trials and the key parameters during MP still require optimization.

Microstructure and high temperature tensile properties of Al-Si-Cu-Mn-Fe alloys prepared by semi-solid thixoforming

The differences in the microstructure and elevated temperature tensile properties of gravity die cast,squeeze cast,and semi-solid thixoformed Al-Si-Cu-Mn-Fe alloys after thermal exposure at 300℃were discussed.The results demonstrate that the elevated temperature tensile properties of semi-solid thixoformed alloys were significantly higher than those of gravity die cast and squeeze cast alloys,especially after thermal exposure for 100 h.The ultimate tensile strength(UTS)of semi-solid thixoformed alloys after thermal exposure at 300℃for 0.5,10 and 100 h were 181,122 and 110 MPa,respectively.The UTS values of semi-solid thixoformed alloys were higher than those of heat resistant aluminum alloys used in commercial applications.The enhanced elevated temperature tensile properties of semi-solid thixoformed experimental alloys after thermal exposure can be attributed to the combined reinforcement of precipitation strengthening and grain boundary strengthening due to thermally stable intermetallic phases as well as suitable grain size.

Clinical outcomes and complications between FLACS and conventional phacoemulsification cataract surgery: a PRISMA-compliant Meta-analysis of 25 randomized controlled trials

AIM: To update and investigate the clinical outcomes and complications between femtosecond laser-assisted cataract surgery(FLACS) and conventional phacoemulsification cataract surgery(CPCS). METHODS: A Meta-analysis was performed using databases, including Pubmed, Embase, and the Cochrane library. At least one of the clinical outcomes and/or complications data in each included randomized controlled trials(RCT) was reported. The quality of the RCT was assessed with the Cochrane risk assessments tool.RESULTS: Overall, 25 RCTs including 3781 eyes were included. No statistically significant difference detected between FLACS and CPCS in terms of corrected distant visual acuity(CDVA), uncorrected distant visual acuity(UDVA), and central corneal thickness(CCT) at the longterm follow up, although FLACS showed better CDVA at 1 wk postoperatively, and less increase in CCT at 1 d and 1 wk. FLACS had better postoperative endothelial cell count(ECC) at 1 and 4-6 wk, while there was no significantly difference between FLACS and CPCS at 1 d, 3 and 6 mo [weighted mean difference(WMD): 51.54, 95% confidence interval(CI):-5.46 to 108.54, P=0.08;WMD: 48.52, 95%CI:-17.54 to 114.58, P=0.15;WMD: 12.17, 95%CI:-48.61 to 72.94, P=0.69, respectively]. Postoperative endothelial cell loss(ECL) of the FLACS was significantly lower than that of the CPCS at 1, 4-6 wk, and 3 mo(P=0.02, 0.008, 0.03, respectively). However, there was no significant difference between two groups at 6 mo(WMD:-30.36, 95%CI:-78.84 to 18.12, P=0.22). No significant difference was discovered with respect to the macular edema [odds ratio(OR): 0.93, 95%CI: 0.42 to 2.05, P=0.85], capsular complication excluding posterior capsular tears(OR: 0.79, 95%CI: 0.42 to 1.50, P=0.47) and intraocular pressure change(OR: 0.82, 95%CI: 0.39 to 1.72, P=0.60). However, posterior capsular tears were more common in CPCS group(OR: 0.12, 95%CI: 0.01 to 0.98, P=0.05). The effective phacoemulsification times were significantly lower in the FLACS group compared to the CPCS group(WMD:-0.78, 95%CI:-1.23 to-0.34, P=0.0006).CONCLUSION: No statistically significant difference is discovered between FLACS and CPCS in clinical outcomes at the long-term follow up. However, higher rate of posterior capsular tears is detected in patients receiving CPCS.

Tea Polyphenols Reduce Inflammation of Orbital Fibroblasts in Graves’Ophthalmopathy via the NF-κB/NLRP3 Pathway

Objective:This study aimed to explore the effects of tea polyphenols(TP)on inflammation of orbital fibroblasts in Graves’ophthalmopathy(GO)and to provide new ideas for GO treatment.Methods:Primary orbital fibroblasts were extracted from orbital adipose/connective tissues of patients with and without GO.Real-time quantitative PCR(RT-qPCR)was used to detect the expression of interleukin(IL)-6,IL-1β,and monocyte chemotactic protein(MCP)-1 in non-GO and GO orbital fibroblasts.The CCK-8 assay was used to determine the appropriate concentration of TP for subsequent experiments.RT-qPCR and enzyme-linked immunosorbent assay(ELISA)were performed to investigate the effects of TP on lipopolysaccharide(LPS)-induced production of inflammatory cytokines.Nuclear factor-κB(NF-κB)expression was measured using Western blotting analysis.NOD-like receptor 3(NLRP3)expression was detected using both Western blotting analysis and immunofluorescence staining.Results:The mRNA levels of IL-6,IL-1β,and MCP-1 in GO orbital fibroblasts were significantly higher than those in non-GO cells.TP treatment significantly inhibited LPS-induced production of inflammatory factors,including IL-6,IL-1β,and MCP-1.TP also inhibited the expression levels of NF-κB and NLRP3.Inflammation in the GO orbital fibroblasts was higher than that in non-GO cells.TP inhibited the production of inflammatory cytokines in GO orbital fibroblasts in vitro through the NF-κB/NLRP3 pathway.Conclusion:These findings suggest that TP may have a potential role in GO treatment.

脂肪组织异常增殖在甲状腺相关眼病中的作用

甲状腺相关眼病(TAO)是最常见的眼眶疾病,公认是一种自身免疫性疾病,其发病机制至今尚未完全阐明。TAO可影响患者的外貌及视功能,严重者可导致失明。脂肪组织增殖导致眼眶组织体积增加是TAO的关键病理特征之一。眼眶脂肪组织的增多能够直接导致眶压增高,眼球突出。此外,脂肪组织可作为一种新的内分泌器官,分泌多种脂肪细胞因子、生长因子及蛋白分子等,其中部分因子可能参与了TAO的发病过程。本文旨在从脂肪分化关键蛋白的表达、自噬、眼眶压力、缺氧等方面,综述脂肪组织异常增殖分化在TAO发病过程中的作用。

International Organ Protection Symposium: The fusion of engineering and medicine

The International Organ Protection Symposium was held in Toronto,Canada on May 15–16,2019.This symposium focused on the fusion of engineering and medicine,bringing together experts in organ transplantation,organ repair,artificial organs,precision medicine,automation,micro and nanotechnologies.This letter highlights some of the innovative and impactful presentations in this symposium.Dr.Mitesh Badiwala,Director of Heart Transplantation Program at University Health Network,gave a speech of“Cardiac transplant advances in donation after circulatory death”.Dr.Badiwala introduced the history of heart transplantation and the donor organ shortage crisis.He pointed out that ex-situ heart perfusion allows the resuscitation of donation after circulatory death and expand organ pool.He reviewed the contemporary heart transplant research after circulatory death and shared his experience.At the end of his speech he showed the current challenges and future directions in heart donation after circulatory death.

Microstructure evolution and mechanical properties of Al-6.5Cu-0.6Mn-0.5Fe alloys with different Si additions

The effect of Si content on the microstructures and mechanical properties of the heat-treated Al-6.5 Cu-0.6 Mn-0.5 Fe alloy was investigated using image analysis,scanning electron microscopy(SEM),transmission electron microscopy(TEM),and tensile testing.The results show that the mechanical properties of Al-6.5 Cu-0.6 Mn-0.5 Fe alloys decrease slightly when the Si content is below 1.0%.This can be attributed to the comprehensive effect of microstructure evolution,including the increase of nano-sized α-Fe,the coarsened grain size,and an increase in Al2 Cu content at the grain boundary.When the Si content is 1.5%,the mechanical properties of the Al-6.5 Cu-0.6 Mn-0.5 Fe alloys decrease significantly,and this can be attributed to the agglomerated second intermetallics,which is resulted from the formation of excess Si particles.

Use of glycated albumin for the identification of diabetes in subjects from northeast China

BACKGROUND Metabolic memory is important for the diagnosis and treatment of diabetes in the early stage,and in maintaining blood glucose concentrations within the normal range.The clinical diagnosis of diabetes mellitus is currently made using fasting plasma glucose,2 h-plasma glucose(2h-PG)during a 75 g oral glucose tolerance test,and hemoglobin A1c(HbA1c)level.However,the fasting plasma glucose test requires fasting,which is a barrier to screening,and reproducibility of the 2h-PG level is poor.HbA1c is affected by a shortened red blood cell lifespan.In patients with anemia and hemoglobinopathies,the measured HbA1c levels may be inaccurate.Compared with HbA1c,glycated albumin(GA)is characterized by more rapid and greater changes,and can be used to diagnose new-onset diabetes especially if urgent early treatment is required,for example in gestational diabetes.In this study,we provided cutoff values for GA and evaluated its utility as a screening and diagnostic tool for diabetes in a large high-risk group study.AIM To evaluate the utility of GA in identifying subjects with diabetes in northeast China,and to assess the diagnostic accuracy of the proposed GA cutoff in the diagnosis of diabetes mellitus.METHODS This cross-sectional study included 1935 subjects,with suspected diabetes or in high-risk groups,from 2014 to 2015 in the Second Affiliated Hospital of Harbin Medical University(Harbin,China).The use of GA to identify diabetes was investigated using the area under the receiver operating characteristic curve(AUC).The GA cutoffs were derived from different 2h-PG values with hemoglobin A1c cutoffs used as a calibration curve.RESULTS The GA cutoff for the diagnosis of diabetes mellitus was 15.15%from the receiver operating characteristic(ROC)curve.ROC analysis demonstrated that GA was an efficient marker for detecting diabetes,with an AUC of 90.3%.CONCLUSION Our study supports the use of GA as a biomarker for the diagnosis of diabetes.

年龄相关性黄斑变性小鼠模型的研究进展

年龄相关性黄斑变性(age-related macular degeneration,ARMD)是一种由遗传、年龄、环境、饮食、吸烟等多种危险因素相互作用导致的复杂疾病。干性ARMD首先损害Bruch膜,随后影响视网膜色素上皮(retinal pigmented epithelium,RPE)和光感受器等,血管内皮生长因子(vascular endothelial growth factor,VEGF)可介导病理性血管形成和血管渗透性增高,形成脉络膜新生血管。其中任何单一危险因素均不足以导致人类发病,仅模仿单一因素的动物模型无法复制出ARMD的所有表型,但是可以复制出ARMD的不同特征。这些动物模型为疾病机制研究和寻找药物作用靶点提供了切入点。具体造模方法有激光造模、基因造模、饲喂造模、氧化造模和利用其他模型等。本文总结了国内外此方面的经典文献并加以综述,旨在协助研究者选取符合研究目的的造模方法,并提供新的造模思路。

Chinese expert consensus on organ protection of transplantation(2022 edition)

Introduction Organ transplantation increases survival and improves qual-ity of life to many patients with end-stage organ failure.Or-gan shortage is a worldwide problem that restricts organ trans-plantation[1].Organ procurement and preservation as well as ischemia-reperfusion injury(IRI)after transplantation are the im-portant factors affecting prognosis of recipients.Since the de-velopment of organ transplantation technology in the 20th cen-tury,organ protection technology has been a most promising con-cept in this field.Organ preservation solutions such as the Collins solution,University of Wisconsin(UW)solution,and histidine-tryptophan-ketoglutarate(HTK)solution were developed sequen-tially[2],which developed rapidly in static cold storage(SCS)tech-niques.SCS remains the standard preservation technique for organ transplantation[2].

Toric intraocular collamer lens with anterior chamber maintainer for myopic astigmatism following penetrating keratoplasty:a case report

Dear Editor,I am Zong-Ming Zhuang,from the Department of Ophthalmology,the First Affiliated Hospital of Guangxi Medical University,Nanning,China.I am writing to present a case of toric intraocular collamer lens(TICL)implantation for myopic astigmatism after penetrating keratoplasty(PK)with anterior chamber maintainer(ACM)and without ophthalmic viscoelastic surgical device(OVD).The current study was conducted in accordance with the Declaration of Helsinki principles,the patient signed a written informed consent.

Significance of changes of serum ICAM-1 and LDH activity in different severity of vascular lesions of coronary heart disease

Objective:To analyze the relationship between serum ICAM-1,lactate dehydrogenase(LDH)and coronary heart disease(CHD)by clinical detection of serum ICAM-1 and LDH Objective to investigate the relationship between the severity of different types of coronary artery stenosis(CHD)and its role in the progression of CHD.Methods:180 patients with chest pain and coronary angiography were selected,including 145 patients with CHD diagnosed by coronary angiography and 35 patients without abnormal coronary angiography(control group).The 145 patients with CHD were further divided into mild partial stenosis group(a-chd,stenosis development≤49%),moderate partial stenosis group(b-chd,stenosis development 50%~74%)and severe partial stenosis group(c-chd,stenosis development≥75%).The levels of ICAM-1 and LDH in serum of patients were detected by ELISA,and the differences of ICAM-1 and LDH activities in different degrees of coronary artery disease and control group were statistically analyzed.Results:in the control group,HDL was higher than that in the c-chd group(P<0.05),neutrophils in the control group was lower than that in the c-chd group(P<0.05);ICAM-1,LDH and Gensini scores in the a-chd group,b-chd group and c-chd group were higher than those in the control group(P<0.05-P<0.01),and gradually increased with the aggravation of different coronary artery stenosis processes(P<0.05-P<0.01).The levels of serum ICAM-1 and LDH increased significantly with the increase of the number of CHD lesions(P<0.01).The levels of ICAM-1 and LDH were positively correlated with Gensini score(LDH r=0.409,P<0.01 and ICAM-1 r=0.463,P<0.01).The levels of ICAM-1 and neutrophils were positively correlated(r=0.208,P<0.01).The levels of LDH and ICAM-1 were negatively correlated with HDL(LDH r=-0.184,P<0.05 and ICAM-1)There was a negative correlation between LDH and total protein(r=-0.218,P<0.01),and a positive correlation between ICAM-1 and LDH(r=0.441,P<0.01).Conclusion:the levels of serum ICAM-1 and LDH gradually increase with the aggravation of different coronary artery stenosis,and there is a certain linear relationship between them.

Development of remaining life prediction of crankshaft remanufacturing core

This paper reviewed the main research work in the field of remaining life prediction of crankshaft remanufacturing core by Science and Technology on Remanu- facturing Laboratory. Based on the results of finite element analysis, the R angle zone of crankshaft was determined as a major measuring position. A special measuring probe is developed, and bending fatigue bench tests were carried out to collect electromagnetic damage information during fatigue process. A neural network model was established to identify damage degree of crankshaft core, and a damage evaluation equipment for crankshaft core was developed.

一种适用于模拟水力机械内部流动的水平集-浸入边界法研究

该文提出了一种适用于数值模拟复杂水力机械内部三维不可压缩流动的水平集-浸入边界法。采用有限差分法和投影法对流体域控制方程进行离散求解,时间推进采用二阶龙格-库塔格式。在浸入边界点上压力和速度进行强制重构,以满足相应的速度和压力边界条件,进而实现了考虑固体结构边界的三维流场数值模拟。基于非结构三角形网格离散固体区域的复杂边界,通过搜索圆计算流固交界面附近一定距离内网格点至交界面的距离和采用射线法区分流体域和固体域,实现了一种利用水平集函数准确且快速捕捉复杂流固交界面的方法。通过一系列标准测试算例验证了算法的精度与鲁棒性,并应用于轴流泵泵段的三维模拟。结果表明,该文基于水平集的浸入边界法可以有效模拟固体运动下的三维流场,并适用于水力机械三维复杂流动。