Frozen Research Articles

Effect of dimethyl fumarate on the renal calcium oxalate stone formation in rats and possible mechanism

Objective To observe the effect of dimethyl fumarate (DMF) on the renal calcium oxalate crystals formation in SD rats induced by glyoxylic acid monohydrate, and explore the possible mechanism. Methods Thirty male Sprague-Dawley rats were randomly divided into 3 groups: control group, model group and DMF group (n=10 each). The control group was free to drink purified water. Model group was induced by intraperitoneal injection of glyoxylic acid monohydrate to establish a kidney calcium oxalate stone model, and DMF group was treat with DMF by gastric administration on the basis of modeling. After 10 days of continuous treatment, the 24 h urine, serum and kidney of rats in each group were collected. Serum creatinine (SCr) value, calcium and oxalate (Ox) contents in urine were measured. Von Kossa staining method was used to detect the deposition of calcium oxalate crystals in kidney tissue. Western blotting was used to detect the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and HO-1 protein in renal tissue. The frozen section DHE staining was used to detect the ROS level in the kidney, thiobarbituric acid method was used to test malondialdehyde (MDA) content, and the xanthine oxidase method was used to detect superoxide dismutase (SOD) activity. Results There was no visible calcium crystal in the kidney of the control group. Compared to the model group, the amounts of renal calcium crystal were significantly reduced in the DMF group (76.07±4.87) /HP vs. (37.94±4.63) /HP (t=17.940, P 0.05). There was no significant difference in 24-hour urinary calcium ion content between the three groups (F=1.670, P>0.05). Compared with the control group, renal ROS levels (t=20.920, P<0.01), Nrf2 (t=17.290, P<0.01) and HO-1 protein (t=38.030, P<0.01) expression levels were significantly increased in the model group. Compared with the model group, renal ROS levels were significantly reduced in the DMF group (t=16.000, P<0.01), while the expression levels of Nrf2 (t=25.580, P<0.01) and HO-1 protein (t=79.290, P<0.01) were significantly increased. Conclusion The formation of calcium oxalate kidney stones is related to oxalate-mediated oxidative stress. DMF may interfere with the pathogenesis of calcium oxalate kidney stones by activating Nrf2 to induce HO-1 to inhibit oxidative stress. Key words: Calcium oxalate stones; Oxidative stress; Nuclear factor erythroid 2-related factor 2; Dimethyl fumarate

No-reference artifacts measurements based video quality metric

In multimedia delivery, perceived quality of video signal has a significant role in overall users Quality of Experience (QoE). Therefore, multimedia service providers must constantly measure and monitor perceived video quality, which is usually performed using no-reference (NR) video quality metrics. In this paper, a novel NR objective video quality metric named Artifacts Measurements Based Video Quality Metric (AMB-VQM) is proposed. In addition to artifacts measures computed by blocking (BL), packet-loss (PL), and freezing (FZ) artifacts detection algorithms, the metric incorporates artifacts masking based on spatial and temporal video content complexity. Furthermore, a newly created FERIT-RTRK-2 video quality database, which contains 486 Full HD test video sequences impaired by video compression (MPEG-2, H.264/AVC, and H.265), packet-loss, frame freezing, and combinations of these procedures, is presented in this paper. FERIT-RTRK-2 database is publicly available for scientific community at http://www.rt-rk.com/other/VideoDBReadme.html. Additionally, newly created user-friendly subjective video quality assessment tool with graphical user interface, which can be used for conducting of subjective video quality experiments, is presented. In experimental part the performance of the proposed AMB-VQM is compared to this of 10 other objective video quality metrics (PSNR, SSIM, VSNR, PSNRHVS, PSNRHVSM, VIFP, ViS3, ST-MAD, BRISQUE, VIIDEO) using distorted video sequences from four different video quality databases: CSIQ, LIVE, FERIT-RTRK and FERIT-RTRK-2. The results show that AMB-VQM achieves high performance when predicting the video quality for videos distorted in different manners. AMB-VQM results outperform the results of most of the analyzed popular and very often used video quality metrics.

Establishment and verification of immortalized lymphoblastic cell lines derived from platelets CD36 deficient individuals

Objective To investigate the establishment and verification of immortal lymphoblastic cell lines from platelets CD36 deficient individuals. Methods From January 2012 to January 2018, eight individuals with platelet CD36 deficiency were selected as the study subjects. Among them, six cases were blood donors from Nanning Blood Center, one case was patient with platelet transfusion refractoriness (PTR) hospitalized in Guangxi 923 Hospital, and 1 case was mother of a child with fetal/neonatal alloimmune thrombocytopenia (FNAIT) hospitalized in Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. All the subjects′ ages ranged from 15 to 66 years. The subjects were identified as platelet CD36 deficiency by flow cytometry, monoclonal antibody immobilization of platelet (MAIPA) and CD36 genotyping. Among them, one case was a CD36 mutant heterozygote of 538T>C, three cases were mutant heterozygote of 380C>T, one case was mutant homozygous of 329-330del, and 3 cases were mutant heterozygote of 329-330del. Volume of 5 mL heparin anticoagulant blood was collected from participants and their lymphocytes were isolated. Epstein-Barr virus (EBV) and cyclosporine were used to treat peripheral blood lymphocytes of participants with platelet CD36 deficiency to obtain immortal lymphoblast cell lines, which were frozen after stable passages. Resuscitation activity and mycoplasma detection of these cell lines were performed, and the CD36 gene was sequenced for verification. The procedure of this study is accordance with the requirement of the revised World Medical Association Declaration of Helsinki in 2013. Informed consent was obtained from each participant. Results ① After EBV and cyclosporine treatment, the peripheral blood lymphocytes of the participants were cultured for 7 d, and blastoformation of the cells with prickly edges were observed, and some of the cells were agglutinated in clusters. After continuous replacement of the complete culture medium for about 1 month, a large number of cells proliferated and grew vigorously, and more clonal spheres could be seen to form by naked eyes, and immortalized lymphoblastic cell line was successfully obtained. ② CD36 deficient immortalized lymphoblastic cell lines were subcultured for 20 generations, then frozen in liquid nitrogen. All of them were successfully resuscitated, and the cell lines were observed growing well under inverted phase contrast microscope. ③ Mycoplasma test results of the CD36 deficient immortalized lymphoblastic cell lines showed negative. ④ DNA of CD36 deficient immortalized lymphoblastic cell lines were amplified and sequenced by PCR, and comparison results showed that the DNA of immortalized lymphoblastic cell lines were identical to those of individuals with CD36 deficiency, and no gene mutation occurred. The genotypes of CD36 deficient immortalized lymphoblastic cell lines established in this study included 1 case of CD36 gene 538T>C mutant heterozygote, three cases of 380C>T mutant heterozygotes, one case of 329-330del mutant homozygote and 3 cases of 329-330del mutant heterozygotes. Conclusions CD36 deficient immortalized lymphoblastic cell lines passaged stably, the genotypes of these platelets CD36 deficient individuals are permanently preserved and can be used as long-term experimental reliable materials for the study of CD36 related platelet immunology. Key words: Antigens, CD36; Platelets; Herpesvirus 4, human; Cell line; Lymphoblast cell lines

Comparison of ID-LC-MS/MS and two CLIAs in measuring plasma aldosterone

Objective Accurate measurement of aldosterone is critical in the diagnosis of primary aldosteronism. We compared the harmonization of three assays including isotope dilution liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) and two chemiluminescence immunoassays (CLIAs: system A and system B) for the aldosterone measurement. Methods A total of 45 plasma samples, 4 quality control materials, 5 lyophilized bovine serums, and 3 fresh frozen human serum pools were measured by three assays respectively. Based on CLSI EP15-A3 rule, the precision was assessed by coefficient of variance. Deming regression and Bland & Altman plots was performed for method comparison, and correlation coefficient was calculated for concordance (CCC). Results All three methods met the performance criteria based on desirable biological variation for precision (<7.35%). System A showed a relevantly good correlation and comparability with ID-LC/MS/MS (R2=0.985, CCC=0.967), while System B showed relevantly bad correlations and comparability with both System A (R2=0.538, CCC=0.605) and ID-LC/MS/MS (R2=0.547, CCC=0.528).. However, the average relevant bias of two CLIAs exceeded the bias requirement derived from biological variation (18.60%). Conclusion Significant differences were found in the measurement of plasma aldosterone using ID-LC-MS/MS and two CLIAs, which urges the establishment of traceability hierarchy and improvement of reagents' specificity for standardization of aldosterone measurement in clinical settings. Key words: Aldosterone; Luminescence; Immunoassay; Chromatography, liquid; Tandem mass spectrometry

Effects of MCC950 on cognitive function in a mouse model of sepsis-associated encephalopathy

Objective To investigate the effects of Nod-like receptor protein 3 inhibitor MCC950 on cognitive function in a mouse model of sepsis-associated encephalopathy (SAE). Methods Ninety adult male C57BL/6 mice were randomly (random number) divided into three groups: the sham + saline group (n=20, sham group), CLP + saline group (n=35, CLP group), and CLP + MCC950 group (n=35, MCC950 group). SAE mouse model was established by cecal ligation and puncture (CLP) surgery. Saline (10 mL/kg) or MCC950 (10 mg/kg) was intraperitoneally injected 30 min before surgery and on day 1, 2, 4 and 6 after surgery according the grouping. Seven days after surgery, six mice were taken from each group. Western blot was used to detect the hippocampal content of NLRP3, apoptosis-associated speck-like protein (ASC), interleukin-1β (IL-1β) and IL-18. The number of NLRP3-positive cells in CA1 region were detected by immunohistochemical analysis. The remaining mice in each group were used for open field and fear conditioning tests 14 days after surgery. One-way analysis of variance was used for inter-group comparison, and SNK-q test was used for pairwise comparison. A P value <0.05 was considered statistically significant. Results Compared the MCC950 group with the CLP group, the freezing time of context test was significantly increased [(137±21) s vs (84±15) s, P=0.013 ], the hippocampal content of NLRP3, IL-1β and IL-18 were significantly reduced (P 0.05). Conclusions MCC950 administration can improve cognitive function in a mouse model of SAE, which is probably due to the inhibition of NLRP3 inflammasome and downstream inflammatory cytokines IL-1β and IL-18. Key words: Sepsis-associated encephalopathy; Cognitive function; Neuroinflammation; NLRP3 inflammasome; Interleukin-1β; Interleukin-18

Development of Numerical Simulation in Nickel-Based Superalloy Turbine Blade Directional Solidification

Development of Numerical Simulation in Nickel-Based Superalloy Turbine Blade Directional Solidification

Impact of diagnostic laparoscopy in the management of gastric cancer in Egyptian patients

Background Gastric cancer (GC) is one of the leading causes of cancer-related deaths. In Egypt, it is the 14th among cancers mortality. Preoperative imaging as Computed Tomography and Endoscopic Ultrasonography have limitations in predicting the advanced disease, leading to many unnecessary laparotomies with more morbidity and mortality. Therefore, diagnostic laparoscopy (DL) may play a vital role in preoperative staging. The aim of the work was to evaluate the role of diagnostic laparoscopy (DL) in detecting peritoneal, liver metastasis and malignant ascites. Methods 40 patients of GC were involved, preoperative abdomen CT scan was done. DL was done under general anesthesia through 3 ports, the liver and whole peritoneal surfaces were examined for any metastasis, also any ascites was aspirated if there was no ascites irrigation with saline was done and re-aspirated. Any metastasis was biopsied and examined by frozen section also any aspirate was underwent immediate cytological examination. Results DL was positive in 12 patients (30%), detected as the following; 6 patients with liver deposits, 4 patients with peritoneal deposits and 2 patients with positive cytology. Therefore these 12 patients avoided unnecessary laparotomy, while the remaining 28 patients underwent curative resection of the tumor. Conclusion About 30% of GC is advanced once diagnosed. DL may be very helpful in detecting metastatic tumor missed by CT scan. Liver metastasis is the commonest metastasis of GC. Patients with positive DL avoid unnecessary laparotomy, and this does not delay them of having palliative treatment.

High-precision freezing in cryotherapy by using customized and predesigned templates

High-precision freezing in cryotherapy by using customized and predesigned templates

Research and Development of Equiaxed Grain Solidification and Forming Technology for Nickel-Based Cast Superalloys

Research and Development of Equiaxed Grain Solidification and Forming Technology for Nickel-Based Cast Superalloys

Comparison between the triglycerides determination by HPLC in China and reference procedure used in the isotope dilution mass spectrometry CDC CRMLN

Objective To evaluate the comparability and consistency of two kinds of triglycerides reference methods, one of which is the isotope dilution liquid chromatography-mass spectrometry (LC/MS) in the Cholesterol Reference Method Laboratory Network (CRMLN), the other isthehigh-performance liquid chromatography (HPLC) method for triglyceride detection in China. Methods 52 fresh frozen sera with triglycerides levels among 0.45-4.52 mmol/L were determined by LC/MS and HPLC. After evaluation the precision and accuracy of the two methods, a series of analyses were conducted including plotting to scatter plots and deviation graphs, testing outliers, selecting the best fitting regression models and calculating the regression equations and parameters, and so on. The expected deviation at the level of medical decision of triglycerides and the 95% confidence range were statistically analyzed. Results For HPLC method, the CV of instrument measurement was 0.29%(0%-1.16%), the total CV of samples measurement was 0.54%(0.04%-1.28%), and the average bias of the reference materials was 0.22% (-0.43%-0.68%). ForLC/MSmethod,the CV of instrument measurement was 0.55%(0%-1.68%), the total CV of samples measurement was 0.79%(0%-1.93%), and the average bias of the NIST reference materials was 0.09%(-0.73%-1.29%). No outlier was found from the scatter plots and the statistical analysis and the linear regression was fitted to analyze the results of the two methods. The linear regression parameters of two methods for 52 fresh frozen human sera were as follows: the slope was 0.998 8, the standard error of slope was 0.003 5, the intercept was 0.003 7mmol/L, the standard error of intercept was 0.003 0 mmol/L, the standard error of Y-estimate was 0.023 6 mmol/L, and the correlation coefficient was 0.999 7. Compared with the LC/MS method, the absolute deviation of fresh sera by HPLC method was -0.001 mmol/L (-0.070-0.056 mmol/L), with a relative deviation of 0.13% (-2.01-2.83%). T-test showed no statistically significant difference between the two methods. The expected deviations at the triglycerides medicine decision level were within the 95% confidence range, and the expected deviations were far less than the allowable error. Conclusions The HPLC method of triglyceridesdetetion has good consistency and comparability with LC/MS method as one of the reference methods of CRMLN. Because of the advantages of HPLC method such as low cost, simplicity, less technical need, and better precision, HPLC method is expected to play an important role in the process of standardization and traceability of serum triglycerides. Key words: Triglycerides; Chromatography, high pressure liquid; Chromatography, liquid; Tandem mass spectrometry; Isotopes

The effect of tanshinone on meibomian gland cell proliferation, differentiation and lipid synthesis

Objective To investigate the effects of cryptotanshinone and tanshinone ⅡA, two major monomer components of tanshinone, on the proliferation, differentiation and lipid synthesis of rat meibomian gland epithelial cells in vitro. Methods The eyelid meibomian gland tissue was isolated from 2-month-old SD rats and co-cultured with 3T3 trophoblasts for 5 days.Cryptotanshinone and tanshinone ⅡA were prepared with DMSO into different concentrations.The cells were grouped to 0.125 μmol/L, 0.250 μmol/L, 0.500 μmol/L, 1.250 μmol/L and 2.500 μmol/L drug groups and treated for 48 hours, respectively.Only dimethyl sulfoxide (DMSO) was added in medium in the DMSO control group.The expressions of keratin 14 (K14) and p63 in frozen sections of meibomian gland tissue and clones of meibomian gland cells were detected by immunofluorescence.Real-time fluorescence quantitative PCR was used to assay the relative expression of K16, cell proliferation related antigen 67 (Ki67) and CCAAT enhancer binding protein α (C/EBPα) in meibomian gland cell clones.Crystal violet staining and oil red staining were used to evaluate the colony formation rate and lipid synthesis of meibomian gland epithelial cells. Results Primary cultured meibomian gland cells were cloned on day 4-5 in vivo, and the cloning area was increased on day 7 after culture, p63 and K14 were positively expressed in clones.Compared with the DMSO control group, the relative expression levels of Ki67 mRNA were significantly elevated in the 0.500 μmol/L, 1.250 μmol/L and 2.500 μmol/L cryptotanshinone groups (all at P 0.05). No lipid drop was found in the tarsal gland cell clones; however, the accumulation of lipid was seen in the cell clusters at the margin of the clones by oil red O staining.The average clone formation rate of tarsal gland cells in the 1.250 μmol/L cryptotanshinone group was (2.55±0.20)%, which was significantly higher than (2.05±0.13)% in the DMSO control group (t=4.379, P 0.05). Conclusions Cryptotanshinone and tanshinone ⅡA promote the proliferation of meibomian gland epithelia cells, but play less impacts to lipid synthesis of meibomian gland epithelia cells in vitro.cryptotanshinone promote the clone tormation of meibomian gland epithelia cells. Key words: Tanshinone; Meibomian gland epithelial cells; Proliferation; Differentiation; Lipid metabolism/drug effects; Cell culture

Anatomy study and clinical significance about the spatial distribution of the recurrent branch of median nerve

Objective To provide anatomical data for avoiding the injury of the recurrent branch of median nerve (RBMN) through the proximal operative incision of the carpal thenar region. Methods Thirty adult upper limb specimens (16 formaldehyde fixed specimens and 14 fresh frozen specimens) were dissected. The origin of the RBMN, the angle between the RBMN and the longitudinal axis of the median nerve main trunk, the location of the first bifurcation point of the RBMN, the distribution of the superficial branch and the deep branch of the RBMN were measured, and the relationship between the RBMN and the proximal, middle and distal regions of the thenar was observed. Results The origin of the trunk of the RBMN located in the proximal and middle third of the thenar area account for 46.7% and 52.3%, respectively. After the RBMN originated from the main trunk of the median nerve, it moved towards the radial side at an average angle of 48.6° (range, 20° to 70°). The first bifurcation point of RBMN located in the proximal and middle third of the thenar area account for 56.7% and 43.3%, respectively. 96.7% deep branch and 56.7% superficial branch were located in the proximal third of the thenar area. Conclusion The RBMN and its terminal branches were mostly located in the proximal third of the thenar area, and any operation in this area should pay attention to avoiding injury. Key words: Median nerve; Anatomy; Recurrent branch; Clinical significance

In Vitro Degradation of Gelatin/carboxymethylcellulose Scaffolds for Skin Tissue Regeneration

The field of tissue engineering has grown in response to many medical needs for tissue replacement. For the skin replacement, there have to develop the different types of tissue engineered skin substitutes. The artificial scaffold have to be a biodegradable material with appropriate degradation rate for skin regeneration. In this study, gelatin blended with carboxymethylcellulose (CMC) scaffold was fabricated via freeze drying method. The various gelatin and CMC ratios were 100/0, 90/10, 80/20, 70/30 and 60/40, respectively. In vitro degradation of the scaffold was done by degradation in lysozyme in PBS buffer within desired time. The swelling ratio of the scaffolds was done by immersing in PBS buffer for 2 h at 37oC. The results revealed that the gelatin/CMC (80:20) scaffold showed the highest value of swelling ratio and have an appropriate degradation rate with completely degraded after 36 h.

Suprachoroidal injection of sodium hyaluronate in the treatment of 12 patients with rhegmatogenous retinal detachment

Objective To observe the retinal reattachment of suprachoroidal injection with sodium hyaluronate in the treatment of rhegmatogenous retinal detachment (RRD). Methods Twelve eyes of 12 patients with RRD diagnosed by the examinations of B-mode ultrasound, binocular indirect ophthalmoscope, OCT and scanning laser ophthalmoscope in West China Hospital of Sichuan University from October 2018 to February 2019 were included in this study. There were 7 males and 5 females, aged from 15 to 66 years, with the mean age of 32.40±14.81 years. There were 4 eyes with BCVA 0.4. The extent of retinal detachment involves 1 to 4 quadrants. All eyes were injected with sodium hyaluronate via suprachoroidal space under non-contact wide-angle system. Surgery was performed by the same ophthalmologist with extensive surgical experience. During the operation, the retinal hole was handled with scleral freezing and laser photocoagulation. The follow-up was 2 months. The retinal reattachment was observed. Results Of the 12 eyes, 6 eyes (50.00%) were anatomically reattached, 4 eyes (33.33%) ere partly anatomically reattached with subretinal fluid, 2 eyes (16.67%) were not reattached. The holes in 4 eyes of partly anatomically reattached with subretinal fluid were located on the choroidal pad and the holes were closed, in addition, the subretinal fluid gradually absorbed over time. Two eyes failed in retinal reattachment received vitrectomy with silicone oil tamponade or sclera buckling surgery. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits. Conclusion Suprachoroidal injection of sodium hyaluronate is an effective and safe treatment for RRD, which can promote retinal reattachment. Key words: Retinal detachment; Sodium hyaluronate; Suprachoroidal injection

Effects of freeze−thaw cycle and dry−wet alternation on slope stability

Effects of freeze−thaw cycle and dry−wet alternation on slope stability

Effect of Boron Content on Microstructure Evolution During Solidification and Mechanical Properties of K417G Alloy

Effect of Boron Content on Microstructure Evolution During Solidification and Mechanical Properties of K417G Alloy

Anatomical study in exposed area and operating space of extended endonasal approach to the ventral region of cranio-cervical junction

Objective To explore the scope, feasibility and indications of extended neuroendoscopic endonasal approach to reveal the region of cranial-cervical junction. Methods Ten (20 sides) intact frozen adult cadaveric heads were used to simulate the extended neuroendoscopic endonasal approach to remove the anterior tubercle of atlas, part of the atlas anterior arch, odontoid and part of the slope. In the cranial-cervical junction area, we observed the exposed range and measured the distance from the nostril to the anterior tubercle of atlas, the height and width of the anterior arch of the atlas, the distance of bilateral medial margin of occipital condyle, the distance of bilateral medial margin of the foramen lacerum, the vertical distance from the occipital condyle to the homolateral foramen lacerum, and the height, anteroposterior diameter and transverse diameter of the odontoid. Results The exposed range of the extended neuroendoscopic endonasal approach was as follows: when the lesion was located at the foramen magnum, the medial margin of the occipital condyle was the boundary of both sides, the root of the odontoid was the lower boundary, and the lower edge of the occipital bone was the upper boundary. When the lesion was located at the region of cranial-cervical junction, the upper edge of the foramen lacerum on both sides was the upper boundary, and the foramen lacerum and the outer edge of the occipital condyle were the boundaries of both sides of the bone window. By measurement, the distance from the nostril to the anterior tubercle of atlas was 8.9-9.7 cm, with an average of 9.3±0.3 cm. The height of the anterior arch of the atlas was 2.3-3.0 cm, with an average of 2.7±0.3 cm; the width was 1.5-2.0 cm, with an average of 1.8±0.2 cm; the distance of bilateral medial margin of occipital condyle was 1.5-2.0 cm, with an average of 1.8±0.2 cm; the distance of bilateral medial margin of the foramen lacerum was 2.1-2.9 cm, with an average of 2.4 ±0.3 cm; the vertical distance from the occipital condyle to the homolateral foramen lacerum was 1.6-2.2 cm, with an average of 1.9±0.3 cm; the height of the odontoid was 0.9-1.3 cm, with an average of 1.1±0.2 cm, its length was 0.8-1.3 cm, with an average of 1.1±0.2 cm; the transverse diameter of the dentate was 0.9-1.2 cm, with an average of 1.0±0.1 cm.The maximum exposed area of cranio-cervical junction was 6.4-9.8 cm2, with an average of 8.6±1.6 cm2. Conclusion The extended neuroendoscopic endonasal approach with removal of the anterior tubercle of atlas and part of the atlas anterior arch could effectively reveal the cranial-cervical junction area which is suitable for the treatment of odontoid deformity, skull base depression and atlantoaxial joint dislocation as well as resection of epidural tumors in the cranial-cervical junction and ventral and ventral midline tumors. Key words: Natural orifice endoscopic surgery; Anatomy; Cranio-cervical junction; Extended endonasal approach

Desmoid Fibromatosis in the Brachial Plexus Mimicking an Ulnar Nerve Entrapment

Introduction: Ulnar nerve entrapment is a common cause of sensory disturbance and weakness in the upper extremity, especially in patients with diabetes mellitus. However, if the symptoms are atypical and the patient has severe pain other differential diagnoses should be considered. Case report: A 37-year-old man with type 1 diabetes mellitus was referred to the hand surgery unit due to increasing pain, numbness and weakness in his right arm developing over more than one year. An ulnar nerve neurography was inconclusive and the patient had a frozen shoulder on the right side. Due to the pain, the patient required high doses of opioids. At examination, the clinical presentation did not correspond to an ulnar nerve entrapment why other causes were considered. A chest X-ray revealed a lesion in the apical part of the right lung. Consequtive CT scan, MRI and fine and core needle biopsies led to the diagnosis of a desmoid tumor. Surgery was deemed to be too mutilating and treatment was initiated with doxorubicin. Due to tumor and symptom progression the therapy was changed to PegIntron, then antiestrogen and NSAID and finally tyrosine kinase inhibitor (sorafenib) resulting in tumor shrinkage. Conclusion: Although nerve entrapment is a common cause of discomfort and impaired function in the upper extremities different etiologies, including various tumors, have to be considered when the symptoms are atypical and if the patient has severe pain. For these patients, the diagnostic work-up has to be broadened.

Clinical trial of treatment of frozen shoulder by intensive moxibustion plus acupuncture

To compare the clinical therapeutic effect of intensive moxibustion plus acupuncture and simple acupuncture therapy in the treatment of frozen shoulder so as to provide a reference for clinical practice. A total of 60 patients with frozen shoulder were randomly divided into intensive moxibustion plus acupuncture group and simple acupuncture group (n＝30 per group). Acupoints Jianyu (LI15), Jianzhen (SI9), Jianliao (TE14), Tiaokou (ST38), Chengshan (BL57) and Ashi points (Extra) were punctured with filiform needles which were manipulated till the patients experienced feelings of soreness and distension in the local region, followed by retaining the needles for 40 min. For patients of the moxibustion plus acupuncture group, after acupuncture, an ignited moxa-stick segment was applied to the affected shoulder for 40－50 min. After the treatment, all patients were ordered to make a shoulder exercise (anteflexion, rear protraction, abduction and upthrow movements, etc.). The visual analogue scale (VAS) was used to assess the pain severity, and the Constant-Murley shoulder assessment scale (the total score is 100 points, including 15 points in pain severity and 20 points in daily living activities, 40 points in joint motion range, and 25 points in myodynamia) used to assess the functional state of the shoulder, and the "Standards for Diagnosis and Therapeutic Effect Evaluation of Diseases of Traditional Chinese Medicine"(1994) were employed to evaluate the therapeutic effect. Following the treatment, intra-group comparison showed that the VAS score was significantly reduced in both groups in comparison with their own pre-treatment (P<0.05), and the total scores of Constant-Murley scale, the scores of activities of daily living and active motion range, as well as the scores of pain integration and myodynamia, were all considerably increased in the two groups in comparison with their own pre-treatment (all P<0.05). The therapeutic effect of the moxibustion plus acupuncture was significantly superior to that of the simple acupuncture in reducing VAS score and increasing total score of Constant-Murley scale, and scores of activities of daily living and active motion range, as well as the scores of pain integration (P<0.05). Of the two 29 cases in the moxibustion plus acupuncture and simple acupuncture groups, 19 (65.52%) and 10 (34.48%) were cured, 8 (27.58%) and 12 (41.38%) experienced improvement, 2 (6.90%) and 7 (24.14%) were failed, with the effective rate being 93.10% and 75.86%, respectively. The therapeutic effective rate of the moxibustion plus acupuncture was evidently higher than that of the simple acupuncture (P<0.05)．. The therapeutic effect of intensive moxibustion plus acupuncture is superior to that of simple acupuncture in improving symptoms of frozen shoulder in patients.

Influence of Electromagnetic Swirling Flow in Nozzle on Solidification Structure and Macrosegregation of Continuous Casting Square Billet

Influence of Electromagnetic Swirling Flow in Nozzle on Solidification Structure and Macrosegregation of Continuous Casting Square Billet