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Background: Studies on the influence of diabetes mellitus on the radiological presentation of pulmonary tuberculosis performed so far yielded inconsistent results. We aimed to summarize the relevant evidence on this topic systematically., Methods: We systematically searched PubMed/MEDLINE (1980-2016) and the references of related articles (English-language reports) for observational studies that compared the radiological presentation of pulmonary tuberculosis in diabetes and non-diabetes patients., Results: A total of fifteen studies that enrolled 2,020 diabetic patients and 5,280 controls were included in this systematic review. None of the included studies showed any significant difference in the upper lobe involvement and or in bilateral disease between diabetes and non-diabetes patients. However, lower lung field cavitary disease was found to be more frequent (relative risks ranging from 2.76, 95% CI 2.28-3.35 to 4.47, 95% CI 2.62-7.62) in patients with poor glycemic control (HbA1C >9%). Similarly, a significantly higher proportion of cavitary disease in diabetes patients was reported by 7 out of 15 studies, the meta-analysis of cavities of any size/site also showed the significantly higher risk of cavitary disease in diabetes patients (p-value = 0.0008). Three studies stratified the presence of cavities by diabetes control status, finding a higher proportion of cavities in uncontrolled diabetic patients (relative risks ranging from 1.85, 95%CI 1.34-2.55 to 3.59, 95%CI 2.53-5.11). One out of four studies found a significantly higher proportion of nodular infiltrations in diabetes versus non-diabetes patients., Conclusion: While there is no difference in localization of lung lesions between patients with diabetes and non-diabetes, our review found that the risk of cavitary disease is relatively higher in diabetes patients. It is essential for researchers to unify the criteria for diabetes diagnosis, patient selection, and radiographic severity and stratify the results by the potentially confounding factors., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aim: In the present study, we combined a nanofibrous polylactic acid (PLA) scaffold fabricated by electrospinning with a polypropylene (PP) material to generate a new type of mesh for hernia repair., Materials & Methods: The PLA/PP mesh was tested with tensile testing, in vitro cytocompatibility and degradation. A total of 90 rats were randomly allocated to PLA/PP, PP and polyester (PE) mesh groups for the in vivo study to evaluate the properties of PLA/PP mesh., Results: PLA/PP mesh had superior mechanical properties. It also resulted in less inflammation adhesion formation (p < 0.05), which was related to the TGF-β1/Smad pathway. The distribution of collagen I and III in PLA/PP mesh was also superior to those in the other two groups (p < 0.05)., Conclusion: The PLA/PP mesh would be suitable for ventral hernia repair in the future.

In terms of the clinical effect of peripheral nerve injury repair, the biological degradable conduit 2 mm small gap tubulization is far better than the traditional epineurial or perineurium neurorrhaphy. The assumption of the bi-directional induction between the central system and the terminal effector during peripheral nerve regeneration is purposed and proved in clinical by our group. The surgical approach of transferring a portion of or the whole contralateral C7 nerve to repair a part of or the whole ipsilateral brachial plexus injury is clinically promoted, in which the most important idea and practice is to use the cone conduit designed by the group to repair thick nerves with fine nerves. Some of the patients suffering from cerebral palsy or cerebral haemorrhage and those who got cerebral infarction yet have not reached recovery after 3-6 months could regain some functions of the ipsilateral upper limb and improve the life quality by transfer of a portion of or the whole contralateral C7 nerve and connection by cone conduit.

Local radiotherapy is the major therapeutic approach to control inoperable cervical cancer. In this study, we analyzed the local immune microenvironment of cervical cancer before and after clinical radiation therapy to investigate whether tumor response due to immunomodulation. A total of 59 patients with pathologically diagnosed cervical cancers classified according to the International Federation of Obstetrics and Gynecology (FIGO) criteria were recruited. The patients were treated according to their disease status with standard radiation regimens. For each patient, tumor biopsies were conducted before, during and after radiation treatment with the doses of 0, 10, 20 and 30 Gy, respectively. All of the tumor samples were then grouped according to the doses delivered and tumor infiltrating lymphocytes with the biomarkers of CD8, CD4, FOXP3 and OX40 were measured by in situ immunohistochemistry. We found that before radiation treatment both CD8(+) T cell and CD4(+) T cell infiltrates were more present in the tumor stroma than in the tumor nests, while OX40(+) and FOXP3(+) T cell infiltrates were present at similar levels in both the tumor nests and stroma. After radiation treatment, the levels of CD8(+) T cells and CD4(+) T cells in the tumor nests and stroma were decreased compared with the levels before irradiation. However, OX40(+) T cells and FOXP3(+) T cells did not show any difference before and after irradiation, which indicates that the FOXP3(+) T cells were more resistant to ionizing radiation than were the cytotoxic effector T cells and demonstrates a dynamic rebalance of infiltrating lymphocytes in the tumor milieu occurs after radiotherapy. This suggest that local antitumor immunity could be compromised due to decreased cytotoxic effector cells and the relatively stable status of FOXP3(+) T cells after irradiation. Therefore, regulation of these FOXP3(+) T cells may be a potentially effective approach to enhance the efficacy of cancer radiation therapy.

After peripheral nerve injury, axons often project sprouts from the node of Ranvier proximal to the damage site. It is well known that one parent axon can sprout and maintain several regenerating axons. If enough endoneurial tubes in the distal stump are present for the regenerating axons to grow along, then the number of mature myelinated nerve fibers in the distal stump will be greater than the number in the proximal stump. "Multiple regeneration" is used to describe this phenomenon in the peripheral nerve. According to previous studies, a prominent nerve containing many axons can be repaired by the multiple regenerating axons sprouting from another nerve that contains fewer axons. Most peripheral nerves contain a mixture of myelinated motor and sensory axons as well as unmyelinated sensory and autonomic axons. In this study, a multiple regeneration animal model was developed by bridging the proximal common peroneal nerve with the distal common peroneal nerve and the tibial nerve. Differences in the multiple regeneration ratio of motor and sensory nerves were evaluated using histomorphometry one month after ablating the dorsal root ganglion (DRGs) and ventral roots, respectively. The results suggest that the motor nerves have a significantly larger multiple regeneration ratio than the sensory nerves at two different time points.

Geniposide, a main iridoid glucoside component of gardenia fruit, has been shown to possess anti-inflammatory activity. However, its potential use for acute lung injury (ALI) has not yet been studied. The aim of this study was to evaluate the anti-inflammatory properties of geniposide using a mouse ALI model. ALI was induced by intranasal injection of lipopolysaccharide (LPS). Pretreatment of mice with geniposide (20, 40, or 80 mg/kg) resulted in a marked reduction in inflammatory cells and total protein concentration in the bronchoalveolar lavage fluid (BALF) of mice. Levels of inflammatory mediators, including tumour necrosis factor- α (TNF- α), interleukin-6 (IL-6), and interleukin-10 (IL-10), were significantly altered after treatment with geniposide. Histological studies using hematoxylin and eosin (H&E) staining demonstrate that geniposide substantially inhibited LPS-induced alveolar wall changes, alveolar haemorrhage, and neutrophil infiltration in lung tissue, with evidence of reduced myeloperoxidase (MPO) activity. In addition, we investigated potential signal transduction mechanisms that could be implicated in geniposide activity. Our results suggest that geniposide may provide protective effects against LPS-induced ALI by mitigating inflammatory responses and that the compound's mechanism of action may involve blocking nuclear factor-kappaB (NF- κB) and mitogen-activated protein kinases (MAPK) signalling pathway activation., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Traumatic carotid cavernous fistula (TCCF) is a rare vascular complication of traumatic brain and facial injury. The purpose of this study was to analyze the incidence of this disorder in different types of basilar skull fracture, determine whether particular clinical factors impacted outcomes, and discuss ways of improving prognosis., Method: We performed a retrospective analysis of cases with basilar skull fracture or angiography-confirmed TCCF in inpatients between 1999 and 2005, as well as an analysis of the incidence rate of TCCF in each type of basilar skull fracture. For patients diagnosed with TCCF, cases were divided into "disability" and "no disability" groups, and related clinical factors with potential impact on prognosis were analyzed., Results: In 312 inpatients with basilar skull fractures, an overall incidence of 3.8% for TCCF was observed, and the incidence of this disorder with anterior fossa fracture, middle fossa fracture, and posterior fossa fracture was 2.4%, 8.3%, and 1.7%, respectively. In this retrospective analysis, factors such as patients' age, gender, number of embolization procedures performed, and time from injury to first symptom onset did not significantly affect outcome (p > 0.05). However, the time from first symptom onset to endovascular embolization differed significantly between the disability and no disability groups (p < 0.05)., Conclusions: A relatively high incidence of TCCF occurred in patients with middle fossa fractures, especially those with transverse or oblique fractures. Prompt diagnosis and intervention should be emphasized in the management of patients with TCCF, and noninvasive techniques for early detection of TCCF should be considered in cases of middle fossa fractures under certain conditions after brain or facial trauma to ensure positive outcomes.

Large cranial defects resulting from decompressive craniectomy performed for refractory intracranial hypertension after head trauma is one of the indications for cranioplasty, and this procedure is commonly performed 3 months after craniectomy. However, the large cranial defect would lead to the kinds of complications early during the phase of these patients' recovery, which would go against rehabilitation. This study retrospectively reviewed 23 patients undergoing early cranioplasty (5-8 weeks after craniectomy) in the last 4 years with a detailed choice of patients, outcome of complications after head trauma and large craniectomy, as well as assessment of prognosis. The early outcome (1 month later) revealed most of the patients who had conscious disturbance before the cranioplasty recovered their consciousness and presented an improved neurologic function. The long-dated prognosis (18 months later) revealed that 17 patients were good (independent patients) in this series (74%), whereas four patients survived with a severe disability (17%) and two remained in a vegetative state (9%). No dead patients or intracranial infection after the procedure were found in this study. Most patients' complications were relieved after the cranioplasty with improvements of symptoms or image of computed tomography scan. In conclusion, we consider that with the appropriate choice of patients and materials, early cranioplasty for large cranial defects after decompressive craniectomy would be safe and helpful for the improvement of patients' neurologic function and prognosis. To our knowledge, this series may be the first detailed report in English about early cranioplasty after decompressive craniectomy. We are going to perform prospective and retrospective contrastive studies to further confirm the effects of this procedure on the patients with large cranial defects after decompressive craniectomy.

Bilateral traumatic carotid cavernous fistula is very rare after traumatic brain and facial injury. We present a 68-year-old woman with bilateral traumatic carotid cavernous fistula, who was treated with transarterial embolization by detachable balloon on both fistulas and recovered completely. We also reviewed the presentations, treatment and the complications after the transarterial embolization of this disorder.