BACKGROUND & AIMS: :The authors report an unconventional method of management in hematomas complicating tangentiel trauma. They use the application of liposuction within the first days, this procedure allow complete removal of the clots. It is associated with a biological glue sprayed all over the skin detachment. This simple operative technique is carried out under local anaesthesia and minimizes the recurrence of hematoma. The long term morphological result is satisfactory, avoiding the sequelae of conventional procedures.

背景与目标： : 作者报告了一种非常规的治疗方法，可治疗并发切缘创伤的血肿。他们在第一天使用吸脂术，这个程序允许完全去除血块。它与喷洒在皮肤上的生物胶有关。这种简单的手术技术是在局部麻醉下进行的，可最大程度地减少血肿的复发。长期的形态学结果令人满意，避免了常规手术的后遗症。

BACKGROUND & AIMS: A 53-year-old man was admitted to the hospital for management of pneumonia and a giant fluid-filled bulla. He appeared acutely ill and had persistent fever despite prolonged therapy with parenteral antibiotics and aggressive bronchial drainage. Percutaneous placement of an 8.5F catheter into the bulla enabled drainage of both fluid and air within the bulla and led to resolution of his symptoms within 24 h. This report demonstrates that drainage of giant fluid-filled bullae may lead to rapid resolution of symptoms and describes a novel management technique for this condition.

背景与目标： 一名53岁的男子因治疗肺炎和巨大的充满液体的bulla而入院。尽管长期使用肠胃外抗生素治疗和积极的支气管引流，但他似乎病情严重，并持续发热。将8.5F导管经皮放置到大疱中，可以在大疱中排出液体和空气，并在24小时内缓解症状。该报告表明，巨大的充满液体的大疱的引流可能会导致症状的快速解决，并描述了一种针对这种情况的新颖管理技术。

BACKGROUND & AIMS: OBJECTIVE:The aim of this study was to assess the potential contribution of HLA-class I MICA and HLA-B gene polymorphisms towards the pathogenesis of giant cell arteritis (GCA). METHODS:Ninety-eight biopsy-proven GCA patients and 225 ethnically matched controls from Lugo, Northwest Spain, were genotyped for the MICA-TM microsatellite polymorphism using a polymerase chain reaction (PCR)-based method. Genotyping of HLA-B was performed using PCR and detection with a reverse sequence-specific oligonucleotide (SSO) probes system. RESULTS:A significant difference in the distribution of the alleles of MICA between patient and control groups (P = 0.005) was found. This was due to an increased frequency of the MICA A5 allele in GCA patients compared with controls (26 vs 13.6%; P = 0.0001; P(C) = 0.0005; OR 2.2, 95% CI 1.4-3.4). In addition, the HLA-B*15 allele showed a higher frequency in GCA patients compared with controls (P = 0.004; P(C) = 0.04; OR 2.7, 95% CI 1.3-5.7). Interestingly, the association observed with the MICA A5 allele seems to be independent of linkage disequilibrium with HLA-B, as well as independent of that previously described with HLA-DRB1*04. Remarkably, simultaneous presence of MICA A5 and HLA-B*15 or HLA-DRB1*04 genetic markers leads to an increase in the OR obtained for each individual genetic marker (MICA A5 + B*15 OR 3.2; MICA A5 + DRB1*04 OR 5.8). CONCLUSIONS:Our results provide the first evidence that the MICA and HLA-B genes are independently associated with the genetic susceptibility to GCA, and suggest that several genes within the MHC might have independent effects in the susceptibility to this systemic vasculitis.

背景与目标：

BACKGROUND & AIMS: :Burkholderia pseudomallei is a facultative intracellular pathogen and the causative agent of melioidosis, a spectrum of potentially fatal diseases endemic in Northern Australia and South-East Asia. We demonstrate that B. pseudomallei rapidly modifies infected macrophage-like cells in a manner analagous to osteoclastogenesis. These alterations include multinucleation and the expression by infected cells of mRNA for factors required for osteoclastogenesis: the chemokines monocyte chemotactic protein 1 (MCP-1), macrophage inflammatory protein 1 gamma (MIP-1gamma), 'regulated on activation normal T cell expressed and secreted' (RANTES) and the transcription factor 'nuclear factor of activated T-cells cytoplasmic 1' (NFATc1). An increase in expression of these factors was also observed after infection with Burkholderia thailandensis. Expression of genes for the osteoclast markers calcitonin receptor (CTR), cathepsin K (CTSK) and tartrate-resistant acid phosphatase (TRAP) was also increased by B. pseudomallei-infected, but not by B. thailandensis-infected cells. The expression by B. pseudomallei-infected cells of these chemokine and osteoclast marker genes was remarkably similar to cells treated with RANKL, a stimulator of osteoclastogenesis. Analysis of dentine resorption by B. pseudomallei-induced osteoclast-like cells revealed that demineralization may occur but that authentic excavation does not take place under the tested conditions. Furthermore, we identified and characterized lfpA (for lactonase family protein A) in B. pseudomallei, which shares significant sequence similarity with the eukaryotic protein 'regucalcin', also known as 'senescence marker protein-30' (SMP-30). LfpA orthologues are widespread in prokaryotes and are well conserved, but are phylogenetically distinct from eukaryotic regucalcin orthologues. We demonstrate that lfpA mRNA expression is dramatically increased in association with macrophage-like cells. Mutation of lfpA significantly reduced expression of the tested host genes, relative to the response to wild-type B. pseudomallei. We also show that lfpA is required for optimal virulence in vivo.

背景与目标： : pseudomalei伯克霍尔德菌是一种兼性细胞内病原体，也是类鼻疽病的病原体，类鼻疽是澳大利亚北部和东南亚流行的一系列潜在致命疾病。我们证明假单胞菌以类似于破骨细胞发生的方式快速修饰感染的巨噬细胞样细胞。这些改变包括破骨细胞形成所需的因子的多核和感染细胞的mRNA表达: 趋化因子单核细胞趋化蛋白1 (MCP-1)，巨噬细胞炎性蛋白1 γ (MIP-1gamma)，“调节活化正常T细胞表达和分泌” (RANTES) 和转录因子 “活化T细胞胞质核因子1” (NFATc1)。感染泰国伯克霍尔德菌后，还观察到这些因子的表达增加。破骨细胞标记物降钙素受体 (CTR)，组织蛋白酶K (CTSK) 和耐酒石酸酸性磷酸酶 (TRAP) 的基因表达也被假假性芽孢杆菌感染的细胞增加，但未被泰国芽孢杆菌感染的细胞增加。这些趋化因子和破骨细胞标记基因的假假单胞菌感染细胞的表达与用破骨细胞生成刺激物RANKL处理的细胞非常相似。假单胞菌诱导的破骨细胞样细胞对牙本质的吸收分析表明，可能会发生脱矿质，但在测试条件下不会发生真正的挖掘。此外，我们在假单胞菌中鉴定并鉴定了lfpA (用于内酯酶家族蛋白A)，该蛋白与真核蛋白 “regucalin” (也称为 “衰老标记蛋白-30” (SMP-30)) 具有显着的序列相似性。LfpA直系同源物在原核生物中广泛存在，并且保存良好，但在系统发育上与真核生物regucalcin直系同源物不同。我们证明lfpA mRNA表达与巨噬细胞样细胞相关显着增加。相对于对野生型B.Pseudomalei的反应，lfpA的突变显着降低了所测试宿主基因的表达。我们还表明，lfpA是体内最佳毒力所必需的。

BACKGROUND & AIMS: :A 64-year-old man was referred to our hospital with progressive loss of function in his right upper and lower extremities. Unenhanced computed tomographic showed a high-density nodular lesion in the left basal ganglion with surrounding hypoattenuation. Brain magnetic resonance imaging demonstrated a predominantly cystic mass with multiple internal septa and an eccentric solid component showing enhancement. Histological examination revealed organizing blood clot and piloid gliosis. This unusual appearance of a mass-like organizing blood clot should be considered in the differential diagnosis when an encapsulated cystic mass with nodular component following the signal characteristics of old blood on MRI is encountered.

背景与目标： : 一名64岁的男子因右上下肢功能逐渐丧失而被转诊至我们医院。未增强的计算机断层扫描显示左基底神经节有高密度结节病变，周围有衰减。脑磁共振成像显示主要是囊性肿块，多个内部间隔和偏心固体成分显示增强。组织学检查显示有组织的血块和纤毛样胶质增生。在鉴别诊断疾病中，当遇到带有结节成分的包囊性囊性肿块时，应考虑这种不寻常的肿块样组织血块的外观，该囊性肿块遵循MRI上旧血液的信号特征。

BACKGROUND & AIMS: :The aim of this study was to determine the metabolic response in giant pandas (Ailuropoda melanoleuca) to the consumption of certain parts of bamboo above ground growth. Giant pandas were provisioned with three species of bamboo: Phyllostachys bissetii, of which they only consume the culm (culm group); Bashania fargesii, of which they only consume the leaves (leaf group); and Qiongzhuea opienensis, of which they only consume the shoots (shoot group). The "culm" group absorbed the highest amount of calories and fiber, but was in short energy supply (depressed tricarboxylic acid cycle activity), and high fiber level diet might reduce the digestibility of protein. The "culm" and "leaf" groups absorbed less protein, and had a lower rate of body mass growth than the "shoot" group. Digestion of fiber requires energy input and yields low caloric extraction from the culm and leaf, and protein intake is important for increasing body mass. However, long-term consumption of shoots may have a potentially negative effect on the health because of high protein composition. Therefore, a balanced diet consisting of diverse plant parts of bamboo is important for the overall metabolic function and health of captive giant pandas.

背景与目标： : 这项研究的目的是确定大熊猫 (Ailuropoda melanoleuca) 对地面上某些竹子生长的消耗的代谢反应。大熊猫被提供了三种竹子: Phyllostachys bissetii，它们只消耗茎秆 (茎秆组); Bashania fargesii，它们只消耗叶子 (叶组); 和琼珠opienenensis，它们只消耗芽 (芽组)。“茎” 组吸收的卡路里和纤维量最高，但能量供应不足 (三羧酸循环活动降低)，高纤维水平的饮食可能会降低蛋白质的消化率。与 “芽” 组相比，“茎” 组和 “叶” 组吸收的蛋白质较少，并且体重增长率较低。纤维的消化需要能量输入，并且从茎和叶片中提取的热量低，蛋白质的摄入对于增加体重很重要。但是，由于高蛋白成分，长期食用芽可能会对健康产生潜在的负面影响。因此，由竹子的不同植物部分组成的均衡饮食对于圈养大熊猫的整体代谢功能和健康至关重要。

BACKGROUND & AIMS: :When K562 cells were infected with Newcastle disease virus (NDV) or human parainfluenza type 2 virus (hPIV-2), polykaryocyte formation could not be detected. Failure of multinucleated giant cell formation in K562 cells infected with either NDV or hPIV-2 is due to disturbance of the viral envelope-cell fusion step or to defect in the cell-cell fusion step, respectively. Especially, NDV completely replicated in K562 cells, and the hemagglutinin-neuraminidase and fusion proteins expressed on the cell surface of NDV-infected K562 cell were fully functional for fusion inducing activity. Therefore, the cell membranes of K562 cells are considered to be resistant to virus-induced cell fusion. Membrane fusion is regulated by many host factors including membrane fluidity, cytoskeletal systems, and fusion regulatory proteins system. An unknown regulatory mechanism of virus-induced cell fusion may function on the cell surface of K562 cells.

背景与目标： : 当K562细胞感染新城疫病毒 (NDV) 或人副流感2型病毒 (hPIV-2) 时，无法检测到多核细胞形成。感染NDV或hPIV-2的K562细胞中多核巨细胞形成的失败分别是由于病毒包膜-细胞融合步骤的紊乱或细胞-细胞融合步骤的缺陷。特别是NDV在K562细胞中完全复制，并且在NDV感染的K562细胞的细胞表面表达的血凝素-神经氨酸酶和融合蛋白具有完全的融合诱导活性。因此，K562细胞的细胞膜被认为对病毒诱导的细胞融合具有抗性。膜融合受许多宿主因素的调节，包括膜流动性，细胞骨架系统和融合调节蛋白系统。病毒诱导的细胞融合的未知调节机制可能在K562细胞的细胞表面起作用。

BACKGROUND & AIMS: :An undecapeptide which potentiates the beat of the ventricle in the African giant snail, Achatina fulica Ferussac, was purified from the atria of the snail. Its primary structure was determined to be H-Ser-Gly-Gln-Ser-Trp-Arg-Pro-Gln-Gly-Arg-Phe-NH2. This peptide was found to have excitatory actions not only on the ventricle but also on the penis retractor muscle, the buccal muscle and the identified neurons controlling the buccal muscle movement of Achatina.

背景与目标： : 从蜗牛的心房中纯化了一种增强非洲巨型蜗牛Achatina fulica Ferussac心室搏动的十一肽。它的一级结构被确定为H-Ser-Gly-Gln-Ser-Trp-Arg-Pro-Gln-Gly-Arg-Phe-NH2。发现该肽不仅对心室具有兴奋作用，而且对阴茎牵开器肌肉，颊肌和控制Achatina颊肌运动的已识别神经元具有兴奋作用。

BACKGROUND & AIMS: BACKGROUND AND PURPOSE:Intracerebral hemorrhage (ICH) is a particularly devastating form of stroke with high mortality and morbidity. Hematomas are the primary cause of neurologic deficits associated with ICH. The products of hematoma are recognized as neurotoxins and the main contributors to edema formation and tissue damage after ICH. Finding a means to efficiently promote absorption of hematoma is a novel clinical challenge for ICH. Peroxisome proliferator-activated receptor gamma (PPARγ) and nuclear factor erythroid 2-related factor 2 (Nrf2), had been shown that, can take potential roles in the endogenous hematoma clearance. However, monascin, a novel natural Nrf2 activator with PPARγ agonist, has not been reported to play a role in ICH. This study was designed to evaluate the effect of monascin on neurological deficits, hematoma clearance and edema extinction in a model of ICH in rats. METHODS:164 adult male Sprague-Dawley (SD) rats were randomly divided into sham; vehicle; monascin groups with low dosages (1mg/kg/day), middle dosages (5mg/kg/day) and high dosages (10mg/kg/day) respectively. Animals were euthanized at 1, 3 and 7days following neurological evaluation after surgery. We examined the effect of monascin on the brain water contents, blood brain barrier (BBB) permeability and hemoglobin levels, meanwhile reassessed the volume of hematoma and edema around the hematoma by Magnetic Resonance Imaging (MRI) in each group. RESULTS:The high dosage of monascin significantly improved neurological deficits, reduced the volume of hematoma in 1-7days after ICH, decreased BBB permeability and edema formation in 1-3days following ICH. CONCLUSION:Our study demonstrated that the high dosage of monascin played a neuroprotective role in ICH through reducing BBB permeability, edema and hematoma volume.

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BACKGROUND & AIMS: :Coronary artery fistula with giant coronary artery ectasia is a rare abnormal CHD. Multidetector CT is useful for the diagnosis. Early diagnosis and surgery are recommended.

背景与目标： 冠状动脉瘘合并巨大冠状动脉扩张是一种罕见的异常冠心病。多探测器CT可用于诊断。建议早期诊断和手术。

BACKGROUND & AIMS: PURPOSE:Giant cell reparative granulomas are rare bone tumors. Although benign, these tumors are locally destructive and can be highly vascular. They seldom occur in the cranial vault. We describe a multidisciplinary approach to a case of giant cell reparative granuloma of the cranium in a 3-year-old patient. CASE REPORT:A 3-year-old girl female referred to the pediatric neurosurgery department for evaluation of a retro-auricular mass. She had a history of recurrent otitis media with two subsequent courses of antibiotics without resolution. CT imaging revealed an expansive lesion located in the right mastoid region. Open surgical biopsy revealed a hemorrhagic tumor consistent with a giant cell reparative granuloma. Angiography identified a hypervascular tumor blush that was supplied by the occipital artery. Preoperative transcatheter embolization was performed followed by a multidisciplinary surgical resection and reconstruction. Blood loss was minimal, and the patient recovered well after surgery. CONCLUSION:Preoperative endovascular embolization and a multidisciplinary intraoperative approach with primary resection and cranial vault reconstruction is an effective approach to hypervascular giant cell reparative granulomas.

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BACKGROUND & AIMS: :We present an unusual case of spinal cord ischemia from an acute type B intramural hematoma that was successfully treated with blood pressure elevation and drainage of cerebral spinal fluid.

背景与目标： : 我们介绍了急性b型壁内血肿引起的不寻常的脊髓缺血病例，该病例已成功通过血压升高和脑脊液引流治疗。

BACKGROUND & AIMS: :Recent clinical studies have suggested that denosumab is associated with beneficial tumour response, surgical down-staging, and reduced surgical morbidity in patients with giant cell tumour of bone. However, these studies reported results of patients still on denosumab treatment, or patients after denosumab treatment but with a short follow-up. Other studies reported that the new osseous tumour matrix and thickened cortical bone that develop with denosumab treatment does not allow the surgeon to delineate the true extent of the tumour, and probably increases the risk for local recurrence. A study showed that cell proliferation is only diminished by denosumab; the cells continue to proliferate in vitro, albeit at a slower rate. More importantly, nine cases of malignant transformation of GCT during denosumab therapy without previous radiation exposure have been reported; inhibition of RANKL may increase the risk of new malignancies due to immunosuppression. With these concerns in mind, this article is an attempt to put essential information in one place, creating a comprehensive review that the curious reader would find interesting and informative.

背景与目标： : 最近的临床研究表明，denosumab与骨巨细胞瘤患者的有益肿瘤反应，手术分期降低和手术发病率降低有关。然而，这些研究报告了仍在接受denosumab治疗的患者或denosumab治疗后但随访时间短的患者的结果。其他研究报告说，denosumab治疗产生的新的骨性肿瘤基质和增厚的皮质骨无法使外科医生确定肿瘤的真实范围，并且可能增加了局部复发的风险。一项研究表明，denosumab仅能减少细胞增殖; 细胞在体外继续增殖，尽管速度较慢。更重要的是，据报道，在denosumab治疗期间没有先前的放射线照射的情况下发生了9例GCT恶性转化。抑制RANKL可能会由于免疫抑制而增加新恶性肿瘤的风险。考虑到这些问题，本文试图将基本信息放在一个地方，创建一个全面的评论，好奇的读者会发现有趣和信息丰富。

BACKGROUND & AIMS: UNLABELLED:Hematoma formation requiring operative treatment after shoulder arthroplasty may be associated with higher patient morbidity. We therefore determined whether there was an association of hematoma formation requiring operative treatment with deep infection after shoulder arthroplasty. Between 1978 and 2006, we performed 4147 shoulder arthroplasties in 3643 patients. Of these, 12 shoulders (0.3%) underwent reoperation for hematoma formation. The mean time interval from arthroplasty to surgery for the hematoma was 7 days (range, 0.5-31 days). Among nine cases in which cultures were taken, six had positive cultures; the organisms included Propionibacterium acnes in three, Staphylococcus epidermidis in one, Streptococcus species in one, and Staphylococcus epidermidis with Peptostreptococcus in one. The minimum followup was 12 months (mean, 68 months; range, 12 to 294 months). Two of the 12 patients eventually underwent resection arthroplasty for deep infection. The Neer score was excellent in one, satisfactory in six, and unsatisfactory in five patients. The data suggest hematoma formation after shoulder arthroplasty is often accompanied by positive intraoperative cultures. The surgeon should be aware of the high rate of unsatisfactory results associated with this complication as well as the possibility of developing a deep infection requiring additional surgery. LEVEL OF EVIDENCE:Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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BACKGROUND & AIMS: OBJECTIVES:Anti-phospholipid antibodies have been recognized to play a role in vascular thrombosis and pregnancy morbidity. They were first thought to be directed to phospholipids, but it is now known that the majority of pathogenic antibodies recognizes epitopes on phospholipid-binding plasma proteins such as beta2-glycoprotein I (beta2GPI) or possibly also annexin A5 (ANXA5). The mechanism of their prothrombotic action is still not completely understood. The aim of the present study was to observe the effect of antibodies against ANXA5 (aANXA5) and antibodies against beta2GPI (abeta2GPI) on the binding of ANXA5 to the negatively charged phospholipid membrane. METHODS:Giant phospholipid vesicles (GPVs) were used as a simple model of the membrane surface. GPVs composed of phosphatidylserine and phosphatidylcholine were produced in an aqueous medium. A single GPV was transferred to the solution containing ANXA5 conjugated with Alexa Fluor 488 (FANXA5) and (i) aANXA5 or abeta2GPI and (ii) different concentrations of abeta2GPI together with beta2GPI. The emission of the fluorescent light from the GPV surface, as the result of FANXA5 binding, was measured. RESULTS:Beta2GPI together with abeta2GPI reduced the binding of FANXA5 to GPVs. On the contrary, aANXA5 enhanced the binding of ANXA5 to the GPV surface. CONCLUSIONS:Our results point to the competition between FANXA5 and complexes of beta2GPI-abeta2GPI for the same binding sites and therefore support the hypothesis of the disruption of the ANXA5 protective shield on procoagulant phospholipid surface. The influence of increased cell surface ANXA5 concentration in the presence of aANXA5 on coagulation needs to be further studied.

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