Anti-melanoma differentiation-associated gene 5 and anti-Ro52 antibody-dual positive dermatomyositis accompanied by rapidly lung disease:Three case reports

BACKGROUND Clinically amyopathic deramatomyositis was manifested as the various cutaneous dermatomyositis(DM)manifestations without muscle weakness.Anti-melanoma differentiation-associated gene 5(anti-MDA5)and anti-Ro52 antibody-dual positive clinically amyopathic DM patients are at a high risk of developing rapidly progressive interstitial lung disease,and they exhibit an immensely high half-year mortality.CASE SUMMARY We presented three patients with anti-MDA5 and anti-Ro52 antibody-dual positive DM patients and we reviewed the previous studies on the link between anti-MDA5 and anti-Ro52 antibody-dual positive DM.Although we aggressively treated these patients similarly,but they all exhibited different prognoses.We reviewed the importance of clinical cutaneous rashes as well as the pathogenesis and treatment in the dual positive anti-MDA5 and anti-Ro52 associated DM.CONCLUSION Patients with anti-MDA5 anti-Ro52 antibody-dual positive DM should be accurately diagnosed at an early stage and should be treated aggressively,thus,the patient’s prognosis can be significantly modified.

Research Progress of Heat Shock Protein 90 and Hepatocellular Carcinoma

Heat shock protein (HSP) is a kind of protein that mainly acts as a molecular chaperone to participate in the synthesis and folding of proteins, maintain the spatial conformation of proteins and protect cells from damage and other important biological functions. HSP90 plays an important role in maintaining molecular chaperone structure, regulating cell cycle and apoptosis, coordinating hormone signal transduction and promoting wound healing. And HSP90 also plays an important role in the occurrence and progression of tumors. In recent years, HSP90 inhibitors have made some achievements in molecular targeted therapy for malignant tumors, but further research is needed in clinical application. In this paper, the research status of the relationship between hepatocellular carcinoma targeted by heat shock protein 90 was reviewed.

Correlation of peripheral blood regulatory T cell content with inflammatory stress response and immune response in children with both pneumonia and sepsis

Objective: To investigate the correlation of peripheral blood regulatory T cell content with inflammatory stress response and immune response in children with both pneumonia and sepsis. Methods: A total of 90 child patient with both pneumonia and sepsis who were treated in our hospital between September 2014 and April 2017 were selected as sepsis group and 100 healthy children who received vaccination in our hospital during the same period were selected as normal control group. The differences in peripheral blood regulatory T cell (Treg) expression as well as serum inflammatory mediator, oxidative stress index and immunoglobulin contents were compared between the two groups of children. Pearson test was used to evaluate the correlation between Treg expression and disease in patients with both pneumonia and sepsis. Results: Peripheral blood Treg expression of sepsis group was significantly higher than that of control group;serum inflammatory mediators PCT, hs-CRP, TNF-α and IL-6 contents were higher than those of control group;serum oxidative stress indexes―nitric oxide and malondialdehyde contents were higher than those of control group whereas superoxide dismutase content was lower than that of control group;immunoglobulin IgA, IgM and IgG contents were lower than those of normal control group. Pearson test showed that peripheral blood Treg expression of children with both pneumonia and sepsis was directly correlated with the inflammatory stress response and immune response. Conclusion: Peripheral blood Treg expression significantly increases in children with both pneumonia and sepsis, which could directly affect the inflammatory stress response extent and humoral immune function.

Correlation of serum sTREM-1 content with inflammatory factors and immune function in neonatal infectious pneumonia

Objective: To investigate the correlation of serum soluble triggering receptors expressed on myeloid cells 1 (sTREM-1) content with inflammatory factors and immune function in neonatal infectious pneumonia. Methods: A total of 62 neonates with infectious pneumonia who were treated in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology between July 2016 and September 2017 were selected as pneumonia group, and 50 healthy neonates who were born in this hospital during the same period were selected as normal control group. The differences in serum levels of sTREM-1, inflammatory factors and immunoglobulins were compared between the two groups. Results: Serum sTREM-1 content of pneumonia group was higher than that of normal control group;serum cytokines IL-10, IL-17, PCT and CRP contents were higher than those of normal control group;serum immunoglobulins IgA, IgG and IgM contents were higher than those of normal control group;serum IL-10, IL-17, PCT, CRP, IgA, IgG and IgG contents of pneumonia group of neonates with high serum sTREM-1 content were higher than those of neonates with low serum sTREM-1 content. Conclusion: Serum sTREM-1 content is higher in neonates with infectious pneumonia, which is directly correlated with the inflammatory response and humoral immune function.

Analysis of the Causes of Chronic Pain after Inguinal Hernia Repair without Tension and Its Prevention and Treatment

Purpose: Analyzing the causes of pain after tension-free repair in the inguinal hernia, and propose corresponding treatment strategies. Results: The patients in this group were followed up for 3 - 12 months. A total of 5 patients still had pain relief within 3 months after surgery. Further treatment was needed, and the incidence rate was 5%. Conclusion: Skilled surgical procedures are performed in patients with local anesthesia, and some of the absorbable repair materials can be used. The improved patch fixation and extra peritoneal repair can reduce the pain after inguinal hernia repair without tension.

The Clinical Effect of Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Low Lumbar Single Segment Disc Herniation

Objective: To observe the clinical effect percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of single lumbar disc herniation. Methods: From August 2017 to June 2019, 42 patients with low lumbar single segment lumbar disc herniation were treated with percutaneous transforaminal endoscopic discectomy surgery in our hospital. The operation time, incision size, bleeding volume and hospitalization time were recorded respectively. The patients were evaluated before operation, 1 month and 6 months after operation. Visual analogue scale (VAS) and assessment were used to evaluate the lumbocrural pain. The JOA score and the Oswestry disability index (ODI) were used to evaluate the lumbar function, and the modified macnab score was used to evaluate the clinical effect in the last follow-up. Results: All the 42 patients successfully completed the operation without any other operation. There were no severe complications such as dural injury and nerve root injury. The operation time was (76.98 ± 8.58) min, the incision size was (8.45 ± 1.2) mm, the bleeding volume was (20.14 ± 2.93) ml, and the hospitalization time was (4.55 ± 1.13) d. One month and six months after the operation, the visual analogue scale (VAS), the evaluation of lumbar function (Oswestry) and the disability index (ODI) were significantly improved compared with those before the operation (P Conclusion: The treatment of low lumbar but segmental lumbar disc herniation with percutaneous intervertebral foramen, with small incision, less bleeding and quick recovery, can improve the pain and dysfunction of patients.

Advances in Research on Immunological Checkpoint Inhibitors in Immunotherapy of Liver Cancer

The current treatments of liver cancer in China are mainly comprehensive treatment and systematic treatment, with poor therapeutic effect and high recurrence rate and metastasis rate. The existence of immunosuppressive microenvironment is an important reason for liver tumor cells to escape from the host immune system, and also an important basis for the occurrence and development of liver cancer. With the recent transformation of the target of tumor therapy from tumor cells to tumor cell immune microenvironment, immunotherapy has emerged quietly. It is a new strategy for the treatment of hepatocellular carcinoma to improve the immune attack on tumor cells by changing the immunosuppressive environment of hepatocellular carcinoma cells. Immune checkpoint is the main mechanism by which liver cancer cells escape the host immune system. PD-1/PDL-1 and CTLA-4 are targeted immunocheckpoint inhibitors, which have shown good therapeutic effects and application prospects in the clinical treatment of HCC. This article reviews the latest advances in immunocheckpoint inhibitors in the immunotherapy of hepatocellular carcinoma.

Comparison of effect of locking compression plate internal fixation and reconstruction plate fixation for treatment of mid-shaft clavicular fracture

Objective:To compare the effect of locking compression plate internal fixation and reconstruction plate fixation for the treatment of mid-shaft clavicular fracture.Methods: In this study, the medical records of 68 patients with mid-shaft clavicular fractures treated in our department from May 2014 to May 2017 were retrospectively analyzed. 32 patients in the control group received the reconstruction plate fixation, while 36 patients in the observation group received the locking compression plate internal fixation. Patients were followed up for 12 months, thereafter, various indicators including operative indexes, Constant-Murley (CM) score, disability of arm shoulder and hand (DASH) score, activities of daily living (ADL), and complications were compared between groups.Results: The incision length, intraoperative blood loss, operation time, and fracture healing time of the observation group were significantly lower than the control group (P<0.05). The postoperative CM scores of the two groups were significantly increased, moreover, the scores of muscle strength, daily life and activity were significantly in the observation group were higher than those of the control group (P<0.05), and no difference was found in the pain degree (P>0.05). There was a decrease trend in the DASH score and an increase trend in the ADL score in both groups, while both indexes were better in the observation group than in the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (8.33% vs 18.75%,P<0.05).Conclusion: Compared with the reconstruction plate fixation, locking compression plate internal fixation has the advantages of more mini invasive, better amelioration of shoulder joint function and less complication for patients with mid-shaft clavicular fractures.

Progress in Endoscopic Treatment of Upper Gastrointestinal Bleeding

Due to the increase in the incidence of upper gastrointestinal bleeding, the treatment methods are more and more diversified. With the popularization of endoscopic techniques and the wide range of endoscopic hemostasis methods, endoscopy has become an important method for the treatment of upper gastrointestinal bleeding, and greatly updated the treatment concept of upper gastrointestinal bleeding. In this paper, we reviewed the literature reports of endoscopic treatment of upper gastrointestinal bleeding in recent years.

NOV gene expression in osteosarcoma tissue and its correlation with cell proliferation and migration

Objective: To investigate the NOV gene expression in osteosarcoma tissue and its correlation with cell proliferation and migration. Methods: Osteosarcoma tissue and adjacent normal tissue from 97 patients with osteosarcoma who underwent surgical treatment in the Central Hospital of Xiaogan between May 2014 and August 2017 were selected as the osteosarcoma group and the normal control group respectively. Fluorescence quantitative PCR was used to detect the expression of NOV gene, proliferation-related genes and invasion-related genes in different tissue samples, and Pearson test was used to evaluate the NOV gene expression in osteosarcoma tissue and its correlation with cell proliferation and migration. Results:NOV mRNA expression in osteosarcoma group was significantly lower than that in normal control group;KISS-1 and TAp73 mRNA expresion in osteosarcoma group were lower than those in normal control group whereas VCP, FoxM1, RIPK4 and STIM1 mRNA expression were higher than those in normal control group;DLX1 and Sema6A mRNA expression inosteosarcoma group were lower than those in normal control group whereas EFEMP1, GPR56, SOX5 and CRYAB mRNA expression were higher than those in normal control group. Pearson test showed that the NOV gene expression in osteosarcoma was directly correlated with the expression of cell proliferation genes and invasion genes. Conclusions: NOV gene expression in osteosarcoma tissue is lower than that in adjacent normal tissue, and the specific expression is directly correlated to tumor cell proliferation and invasion activity, and can be as a reliable index to judge the malignant degree of osteosarcoma.

Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province

Background:The 2019 novel coronavirus(2019-nCoV)causing an outbreak of pneumonia in Wuhan,Hubei province of China was isolated in January 2020.This study aims to investigate its epidemiologic history,and analyze the clinical characteristics,treatment regimens,and prognosis of patients infected with 2019-nCoV during this outbreak.Methods:Clinical data from 1372019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30,2019 to January 24,2020 were retrospectively collected,including general status,clinical manifestations,laboratory test results,imaging characteristics,and treatment regimens.Results:None of the 137 patients(61 males,76 females,aged 20-83 years,median age 57 years)had a definite history of exposure to Huanan Seafood Wholesale Market.Major initial symptoms included fever(112/137,81.8%),coughing(66/137,48.2%),and muscle pain or fatigue(44/137,32.1%),with other,less typical initial symptoms observed at low frequency,including heart palpitations,diarrhea,and headache.Nearly 80%of the patients had normal or decreased white blood cell counts,and 72.3%(99/137)had lymphocytopenia.Lung involvement was present in all cases,with most chest computed tomography scans showing lesions in multiple lung lobes,some of which were dense;ground-glass opacity co-existed with consolidation shadows or cord-like shadows.Given the lack of effective drugs,treatment focused on symptomatic and respiratory support.Immunoglobulin G was delivered to some critically ill patients according to their conditions.Systemic corticosteroid treatment did not show significant benefits.Notably,early respiratory support facilitated disease recovery and improved prognosis.The risk of death was primarily associated with age,underlying chronic diseases,and median interval from the appearance of initial symptoms to dyspnea.Conclusions:The majority of patients with 2019-nCoV pneumonia present with fever as the first symptom,and most of them still showed typical manifestations of viral pneumonia on chest imaging.Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.