Abstract Eosinophilic infiltration has been associated with severe myocarditis and depressed cardiac function; however, demonstrating a causal relationship between eosinophils and myocarditis and dilated cardiomyopathy (DCM) has long remained elusive. We show here that Interleukin-5 (IL-5) is dispensable for the recruitment of eosinophils into the inflamed heart, the development of myosin-induced myocarditis (EAM) and the progression of EAM to DCM. However, IL-5-overexpressing transgenic mice developed peripheral eosinophilia, severe eosinophilic myocarditis, increased myocardial fibrosis and accelerated progression to DCM. In addition, eosinophil-deficient (dblGATA1) mice developed attenuated EAM, decreased myocardial fibrosis and greatly improved left ventricular function. Treatment with resorcinol, a specific inhibitor of eosinophilic peroxidase, significantly decreased myocarditis and myosin-induced heart hypertrophy. We conclude that eosinophils are required for the development of EAM, and the progression to DCM, at least in part through their secretion of eosinophilic peroxidase.
The goal of management for bronchial asthma (referred to as asthma below) is to achieve overall control of the condition, including control of current symptoms and reduction on future risks. Asthma exacerbation as one of critical component of the future risks (1,2), may induce a variety of harms to the host, necessitate additional use of medical resources, impose serious socioeconomic burdens, and represent a significant cause of asthma-related disability and mortality (3). As such, prevention and reduction of the asthma exacerbation are of important relevance in improving the overall control of asthma (2-5).
Abstract Background: Dural and bony defects mostly occur in the same position in the cerebrospinal fluid (CSF) rhinorrhea of anterior cranial base fractures, and a few cases of delayed CSF leakage after repair are also reported. Case presentation: We report a case in which a pedicled temporoparietal fascial flap was used to repair the comminuted fracture of the anterior skull base with CSF leakage. Delayed CSF leakage occurred 45 days after the operation. A minimally invasive approach through an eyebrow incision was performed for reoperation, it was found that the bony defect was located in the right frontal sinus and the dural defect was located in the right ethmoid plate. Conclusions: This case suggests that delayed traumatic CSF rhinorrhea after reconstructive surgery is more complex than usual, and appropriate approach should be adopted to repair the dural and bony defects, the transeyebrow approach is a good choice.
Bronchial asthma (referred to as “asthma” hereinafter in this consensus document) is a chronic inflammatory airway disease with well-accepted heterogeneity and complex pathophysiological processes (1). Severe asthma is recognized as a poorly controlled condition that seriously affects quality of life, accounts for massive use of medical resources, and imposes huge socioeconomic burdens, representing a primary cause of asthma-related disability and death in the patients (2-5). In this regard, improving the diagnosis and treatment of severe asthma should be of paramount importance towards better outcomes in overall control and prognosis, as well as lower medical costs (5).
Objective To compare the effect of fentanyl and remifentanil on the haemodynamic response to laryn-goscopy and tracheal intubation and the changes of plasm concentration of blood sugar and cortisol during rapid sequence induction of anaesthesia. Methods 24 ASA Ⅰ - Ⅱ patients were randomly divided into two groups: remifentanil group (group RF, n= 12), fentanyl group(group F, n= 12). In group RF anaesthesia was induced vecuronium 0. 1 mg/kg and propofol 1. 5 mg/kg followed by remifentanil 1. 0 given as a bolus over 30s(diluted to 20ml saline) . Laryn-goscopy and tracheal intubation were performed 60s later. In group F anaesthesia was induced vecuronium 0. 1mg/kg and propofol 1. 5mg/kg and fentanyl 3. 0 μg/kg, Laryngoscopy and tracheal intubation were performed 3min later. Changes of haemodynamics and plasm concentration of blood sugar and cortisol were recorded continuously. Results BP in group RF after induction was significantly lower than baseline ( P 0.05 ), followed with lower HR. And no changes of haemodynamic response was found in group RF after intubation, compared those of pre - induction. In group F BP and HR were lower pre - intubation and there was no significance compared baseline. The BP and HR in group F increased significantly l,3min after intubation, compared those of pre- induction (P 0.05). And DBp,HR could last until 5min after intubation. The haemodynamic response parameters of two groups were similar in baseline. SBp,DBp in group RF after induction was significantly lower than those in group F (P0.05) . HR,SBp,DBp in group RF 1 min after intubation ; SBp,DBp 3min after intubation ; DBp 5min after intubation was significantly lower than those in group F ( P 0.05). Blood sugar level in group RF after intubation was not significantly different from those in group F butcor-tisol level decreased significantly ( P 0.05 ) . Conclusion Remifentanil could depress the stress response to laryngoscopy and tracheal intubation effectively and better than minidose fentanyl.
Objective To explore the correlation of the distance between anastomosis and dentate line in patients with severe circumferential prolapsed haemorrhoids treated by stapled haemorrhoidectomy with the patients' postoperative clinical manufestival score, and assess its value in the choice of anastomosis site in stapled haemorrhoidectomy. Methods One hundred and six patients with severe circumferential prolapsed haemorrhoids was treated by stapled haemorrhoidectomy. The distance between anastomosis and dentate line was documented during the operation, effect of the treatment and complications were also documented postoperatively. All above-mentioned data were analysed statisticaly by one-way ANOVA and ridit test.Results Four groups were established in 106 patients according to the distance between anastomosis and dentate line. Patients with distance less than 1.0cm were defined as group A, between 1.0 cm and 1.5 cm as group B, between 1.5 cm and 2.0 cm as group C, more than 2.0 cm as group D. Concerning the postoperative incontinence score, satisfaction index and complications such as haemorrhage,ederma of anal everage,residal skin-tags, there was no significant difference between all groups. But there was significant difference between four groups in score of pain. Conclusions Patients with severe circumferential prolapsed haemorrhoids treated by Stapled haemorrhoidectomy tend to have good clinical outcome. The appropriate distance between anastomosis and dentate line should be chosed by the status of prolapsed haemorrhoids.
Key words:
Stapled haemorrhoidectomy; Circumferential prolapsed haemorrhoids; Anastomosis; Dentate line
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