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To explore the molecular pathogenesis of primary hyperparathyroidism (PHPT), we investigated the proliferation and apoptosis of parathyroid cells in a rabbit model of diet-induced PHPT. A total of 120 adult Chinese rabbits were randomly divided into normal diet (Ca:P, 1:0.7) group (control group) or a high-phosphate diet (Ca:P, 1:7) group (experimental group). The thyroid and parathyroid complexes were harvested for 1-month interval from month 1 to month 6. The expression of proliferation markers, including proliferating cell nuclear antigen (PCNA) and cyclin-D1, and B cell lymphoma-2 (Bcl-2), were evaluated by immunohistochemistry in thyroid and parathyroid tissues. Apoptosis was quantified by DNA-fragment terminal labeling. Our results demonstrated that parathyroid cells in the experimental group started proliferating from the end of the 2nd month, the expression of PCNA, Bcl-2, and cyclin-D1 were significantly higher in the PHPT group than those of the control group (p<0.05). Furthermore, the apoptosis index (AI) was positively correlated with the glandular cell count and expression of PCNA in the 6th month in the PHPT group. Overall, our results suggested that excessive proliferation and apoptosis of parathyroid cells may contribute to the pathogenesis of PHPT through PCNA-related, Bcl-2-related, and cyclin-D1-related pathways.

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BACKGROUND: There are discrepancies in the understanding of the structure of the capsuloligamentous complex of the first metatarsophalangeal joint (MTPJ); this study aims to investigate the differences with previous anatomical reports of high-resolution 3T magnetic resonance imaging (MRI) and histological analysis in illustrating the structure of the capsuloligamentous complex of the first MTPJ. METHODS: Nine fresh frozen cadaveric feet specimens (from two women and three men; aged 32 to 58 years) were used in this study. All specimens underwent MR examination with T1-weighted imaging and T2-weighted spectral attenuated inversion recovery in three planes. Subsequently, all cadaveric feet specimens were sliced into 2-mm-thick sections. The MRI features of the capsuloligamentous complex of the first MTPJ were analyzed in these specimens. Hematoxylin-eosin and Masson's trichrome staining methods were used to explore the histologic features of the capsuloligamentous complex of the first MTPJ. RESULTS: Different from most previous studies, our results showed that the plantar plate could be divided into four portions including the central portion of the plantar plate, the intersesamoid, the sesamoid phalangeal and the metatarsosesamoid ligaments. The normal central portion of the plantar plate could be clearly visualized in the sagittal and coronal plane MR images. The intersesamoid ligament is a continuation of the central portion of the plantar plate on the sagittal plane on the gross specimen, the MR imaging, and the histological examination. On the coronal plane of the gross specimen and MR imaging, the sesamoid phalangeal ligaments and the central portion of the plantar plate can be seen as separate ligaments, but they appeared interwoven with the same continuous collagenous fibers on the histological analysis. CONCLUSION: High-resolution 3T MRI allows accurate demonstration of the different anatomical details of the capsuloligamentous complex of the first MTPJ from previous anatomical reports. The histological analysis provides further understanding of the structures of the capsuloligamentous complex of the first MTPJ from previous studies.

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BACKGROUND: Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities. METHODS: Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed. RESULTS: The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons. CONCLUSIONS: Sports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.

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BACKGROUND: The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese. METHODS: Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study. All cadavers and volunteers had magnetic resonance (MR) examination of the wrist with coronal T1-weighted and proton density-weighted imaging with fat suppression in three planes, respectively. MR arthrography (MRAr) was performed on one of the cadaveric wrists. Subsequently, all 14 cadaveric wrists were sliced into 2 mm thick slab with band saw (six in coronal plane, four in sagittal plane, and four in axial plane). The MRI features of normal TFCC were analyzed in these specimens and forty healthy wrists. RESULTS: Triangular fibrocartilage, the ulnar collateral ligament, and the meniscal homolog could be best observed on images in coronal plane. The palmar and dorsal radioulnar ligaments were best evaluated in transverse plane. The ulnotriquetral and ulnolunate ligaments were best visualized in sagittal plane. The latter two structures and the volar and dorsal capsules were better demonstrated on MRAr. CONCLUSION: High-resolution 3T MRI is capable to show the detailed complex anatomy of the TFCC and can provide valuable information for the clinical diagnosis in Chinese.

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Objective To continuously monitor the glucose level during the early phase of acute ischemic stroke (AIS) in patients without diabetes mellitus history, so as to provide evidences for detailed blood glucose information and prognostic evaluation. Methods Ninety-one consecutive non-diabetic AIS patients received continuous glucose monitoring and were divided into normoglycemia (n=20), transient hyperglycemia (n=31), and persistent hyperglycemia (n=40) groups. The general data, blood glucose fluctuation parameters and biochemical indices were compared between the three groups. The National Institutes of Health (NIH) Stroke Scale (NIHSS) scores were also compared between the three groups at 24 h, 7 d, and 14 d after treatment. Results The ratio of male patients and the ratio of cerebral infarction history and hypertension history in the persistent hyperglycemia group were significantly lower than those in the other two groups (P<0.05). Compared with the other two groups, the persistent hyperglycemia group had significantly higher mean blood glucose, standard deviation of blood glucose, largest amplitude of glycemia excursion, mean amplitude of glycemia excursion, and absolute mean of daily differences (all P<0.01). The levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol, HbA1c, C reactive protein, and homocysteine in the persistent hyperglycemia group were significantly higher than those in the other two groups (P<0.01). The NIHSS scores of the persistent hyperglycemia group were significantly higher than those of other groups at 7 d and 14 d after treatment (P<0.05,P<0.01). Conclusion Continuous glucose monitoring can accurately reveal the blood glucose metabolism during the early phase of AIS, contributing the following treatment and prognosis prediction.

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[Objective]To explore an individualized treatment measure enjoying more practical,effective and safe characteristics through evaluating the efficacy and safety of combined medications of low-dose urokinase,low-molecular weight heparin nadroparin calcium and ozagrel sodium in treating patients with acute cerebral infarction.[Methods]One-hunderd patients with acute cerebral infarction patients were recruited in this trail,and grouped according to different treatment times:Group A (n=40,from January 2005 to February 2008,being selected into the group in accordance with standards of China Guideline for Cerebrovascular Disease Prevention and Treatment) and Group B (n=60,from March 2008 to June 2011,being selected into the group in accordance with indications for onset time within 24 h and allowing age more than 75 years).Standard thrombolytic therapy (high dose urokinase) was performed on Group A and combined medications of low-dose urokinase,low-molecular weight heparin nadroparin calcium and ozagrel sodium (triple antithrombotic therapy) were performed on group B.National Institute of Health Neurological Deficit Scale (NIHSS) and Evaluation Standard of Clinical Efficacy were used to evaluate the recovery of neurological function before treatment and 24 h,7 and 14 d after treatment.[Results] NIHSS scores after therapy rapidly decreased in both groups as compared with those before treatment (P＜0.05).The NIHSS scores of Group B at 24 h,and 7 and 14 d after treatment were significantly decreased as compared with those of Group A (P＜0.05).The efficacy rate of Group B was significantly higher than that of Group A (P＜0.05).Intraparenchymal hemorrhage rate was 10.0％ (4/40) in Group A and 3.3％ (2/60) in Group B.[Conclusion] Triple antithrombotic therapy is more effective and relatively safer than standard thrombolytic therapy in treatment of patients with acute cerebral infarction.