Mucous cyst of the distal interphalangeal joint (DMC) or interphalangeal connection of the thumb is common in middle-aged and elderly people, and it often occurs in the fingers of people with osteoarthritis (OA). Although there are many conservative treatments, DMC is usually treated by surgery. The common complications of surgical treatment are recurrence of DMC and skin necrosis. This article introduces the method and clinical effect of osteophyte excision and joint debridement in the treatment of DMC of the distal interphalangeal (DIP) joint.In total, 19 cases of affected fingers made an 'S' incision in the DIP joint under local anesthesia to remove the osteophyte of the DIP joint, clean the dorsal joint capsule, wash the joint, and retain only the bilateral collateral ligament and extensor tendon device. It is suspected that the injured finger of the extensor tendon should be protected by external fixation.Out of 15 patients, 1 patient presented with partial skin necrosis that healed after dressing changes while the other patients recovered well. The visual analog scale (VAS) scores of all affected fingers after surgery were lower than those before the surgery (VAS score: 4.93 ± 0.88 vs. 4.07 ± 1.03, p < 0.05). The range of motion (ROM) of the affected finger decreased in one patient, and the post-operative activity of the other fingers increased in varying degrees (ROM: 67.60 ± 5.40 vs. 71.27 ± 7.06, p > 0.05).Using osteophyte excision and joint debridement to treat DMC can avoid skin necrosis caused by cyst removal and can avoid the recurrence of DMC to the greatest extent, so it is a safe and effective way of treatment.
Objective To analyze the clinicopathological features of acute monocytic leukemia cutis.Methods A retrospective study was performed on four patients with acute monocytic leukemia with skin lesions as the initial presentation.Results All the patients were elderly people with the age being 68,70,74 and 82 years respectively.Typical cutaneous lesions were multiple,reddish or purple,tenacious papules,plaques,or nodules involving the trunk and extremities.There was no obvious subjective symptom.Histopathologically,there was a dense and diffuse infiltration of numerous monomorphous tumor cells in the dermis,which were medium-sized,kidney-or oval-shaped with obvious atypia and arranged concentrically around blood vessels or appendages or linearly between collagen fibers.An uninvolved zone of papillary dermis that separated the normal epidermis from the underlying dermal infiltrate was observed.Immunohistochemical analysis showed that the tumor cells were positive for CD68,CD4,CD45RO,CD56,leukocyte common antigen (LCA),but negative for CD3,CD20,CD30,CD34,CD117 and CD123.Conclusions Acute monocytic leukemia cutis mainly occurs in elderly people,which is pathologically characterized by a dense monomorphous infiltration of tumor cells between collagen fibers throughout the dermis as well as an uninvolved zone between the dermis and epidermis.
Key words:
Leukemia, myelomonocytic, acute; Pathological processes; Skin manifestations
Bufalin, which is isolated from toad venom, exerts positive effects on hearts under pathological circumstance. We aimed to investigate the effects and mechanisms of bufalin on myocardial I/R injury. In vivo, bufalin ameliorated myocardial I/R injury, which characteristics with better ejection function, decreased infarct size and less apoptosis. The levels of pyroptotic proteins were increased in I/R-treated macrophages and inflammatory cytokines expressed more in I/R-induced mouse, which could be attenuated by bufalin. Bufalin also reduced H/R-treated macrophage pyroptosis in vitro. Autophagic flux blockage and ROS accumulation were reduced by bufalin in impaired macrophages. Overexpression of p62 abrogated the anti-proptosis and anti-oxidative effects of bufalin. The levels of apoptosis related proteins were changed and TUNEL-positive ratio was raised in cardiomyocytes that received conditioned medium treatment with H/R-treated macrophages, while bufalin pretreatment could reduce apoptosis. These findings indicate that bufalin may attenuate myocardial I/R injury by suppressing macrophage pyroptosis via P62 pathway.
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