Effect of optimal timing of internal fixation on postoperative complications in multiple rib fracture patients / 第二军医大学学报

Objective To explore the effect of optimal timing of internal fixation on postoperative complications of multiple rib fractures. Methods A total of 31 cases of multiple rib fractures receiving internal fixation in our hospital from Mar. 2014 to Jul. 2016 were included in this study. According to the time from injury to internal fixation, the patients were divided into early operation group (≤72 h, n=17) and routine operation group (>72 h, n=14). The clinical data of the patients were compared between the two groups, including age, gender, body mass index (BMI), number of fractured ribs, incidence of comorbidity, incidence of postoperative complications and pain improvement rate. Results There were no significant differences in age, gender, BMI, number of fractured ribs, or incidence of comorbidity between the two groups (all P>0.05). The time from injury to internal fixation was significantly less in the early operation group than that in the routine operation group ([2.2±1.5] d vs [7.4±2.8] d, P0.05). Conclusio Early internal fixation surgery (≤72 h) may contribute to reducing incidence of postoperative pulmonary infection and atelectasis of the patients with multiple rib fracture.

Epidemiological features of 1 281 patients with head injuries arising from the 2008 Wenchuan earthquake / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To analyze the epidemiological features of patients with head injuries in the 2008 Wenchuan earthquake.</p><p><b>METHODS</b>Medical records of patients with head injuries who were admitted to 14 hospitals in Deyang, Mianyang and Chengdu cities after the earthquake were retrospectively analyzed. The patients'age, gender, cause of injury, diagnosis, and outcome were analyzed retrospectively.</p><p><b>RESULTS</b>A total of 1 281 patients with 807 males and 474 females were included. According to Glasgow Coma Scale score at admission, 1 029 patients presented with mild injury, 161 moderate injury and 91 severe injury. The major cause of injuries (83%) was bruise by collapsed buildings. Open head injuries accounted for 60.8%. A total of 720 patients underwent surgical treatment. Good recovery was achieved in 1 056 patients, moderate disability in 106, severe disability in 71, coma in 29 and death in 19.</p><p><b>CONCLUSIONS</b>In this series, male patients were more than female patients. The main cause of injury was hit by falling objects due to building collapse. Minor and open craniocerebral injuries were most common. The epidemiological features of head injuries in Wenchuan earthquake may be helpful to preparation for future rescue.</p>

Effects of qingyi II granules on intestinal bacterial translocation in rats with acute necrotizing pancreatitis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects and mechanism of Qingyi II Granules (QYG) on the bacterial translocation in rats with acute necrotizing pancreatitis (ANP).</p><p><b>METHODS</b>Eighteen Sprague-Dawley rats were randomized equally into 3 groups, the sham-operated group (A), the ANP model group (B) and the treated group (C). Rats in Group B and C were established into ANP model by retrograde injection of 30 g/L sodium taurocholate into pancreatobiliary duct. QYG was administered, beginning from 1 h after modeling, for three times (every 6 h) per day via intragastric infusion to Group C in dose of 10 mL/kg (250 g/L), while to the other two groups, equal volume of saline was infused instead. All animals were sacrificed 24 h after modeling. The contents in mesenteric lymph nodes and distant sites (liver, spleen, pancreas) were taken for bacterial culture and strain identification, the expression of high mobility group box 1 (Hmgb1) mRNA in ileal tissue was assayed by real-time PCR; the levels of nitric oxide (NO) and endothelin-1 (ET-1) were determined by ELISA; the wet/ dry ratio of ileum was measured; and the pathologic features of pancreas and ileum were examined respectively.</p><p><b>RESULTS</b>In Group B, evident pathological injury in pancreas and ileum was shown, expression of Hmgb1 mRNA up-regulated, levels of NO and ET-1 in ileum tissues increased to 1.67 +/- 0.21 micromol/L and 102.18 +/- 9.19 ng/L respectively, and the bacterial counts in the mesenteric lymph nodes and distant sites increased significantly. Compared with Group B, the level of NO and ET-1 reduced to 1.39 +/- 0.23 micromol/L and 83.15 +/- 5.39 ng/L, respectively in Group C, with all the above-mentioned abnormal changes alleviated significantly.</p><p><b>CONCLUSION</b>Levels of Hmgb1, NO and ET-1 might play important roles in the ANP model rats with intestinal bacterial translocation. QYG shows effects on preventing the intestinal bacterial translocation by way of down-regulate the Hmgb1 mRNA expression, lowering the concentration of NO and ET, and ameliorating the injury of pancreatic and ileum tissues.</p>

The mechanism of transforming growth factor beta1 in myofibroblast differentiation / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the mechanism underlying myofibroblast differentiation induced by transforming growth factor (TGF) beta1 in obliterative bronchiolitis following lung transplantation.</p><p><b>METHODS</b>Heterotopic tracheal transplantation was performed in Smad3 wild-type and knock-out mice to simulate the lung transplantation in human. Murine tracheal fibroblasts cultivated in primary culture were used for in vitro study. Immunohistochemistry, immunocytochemistry, Western Blotting, RT-PCR and DNA electrophoresis mobility gel shift assay were conducted to detect the expression of alpha-smooth muscle actin (alphaSMA), the marker of fibroblast-myofibroblast differentiation, and the activation of Smad3, p38 and ERK1/2.</p><p><b>RESULTS</b>In affected airways of experimental obliterative bronchiolitis, abundant expression of alphaSMA were found. In vitro study for tracheal fibroblasts, the activation of Smad3 by TGF-beta1 presents as three major forms, phosphorylation, nuclear translocation and DNA binding. In Smad3 wild-type fibroblasts, TGF-beta1 induces the increase of the myofibroblasts transformation, characterized by the elevation of alphaSMA, both at transcription and protein level. While in Smad3 knock-out fibroblasts, the transformation of myofibroblasts induced by TGF-beta1 is significantly decreased (t = 2.080, P = 0.027; t = 1.982, P = 0.032), but not completely abolished. Further study in Smad3-deficient fibroblasts demonstrates that p38 and ERK1/2 could be activated by TGF-beta1 and result in fibroblast differentiation.</p><p><b>CONCLUSIONS</b>TGF-beta1 could promote the transformation of fibroblasts into myofibroblasts in Smad3 dependent and independent signal pathways, especially the Smad3 dependent path, and result in the development of obliterative bronchiolitis.</p>

Inhibition effects of complement depletion with CVF on cardiac allografts rejection in inbred strain rats / 中华器官移植杂志

Objective To study the efficacy of complement depletion with CVF in preventing a-cute rejection after heart allotransplantation in inbred strain rats. Methods Inbred male Lewis rats were used as recipients and Brown-Norway rats as donors, and the heterotopic heart transplantation model was established. The allografts were divided into 2 groups (n=8 in each group). After infusing low-dose CVF 20?g/kg to the CVF-treated group, cardiac allograft survival time was observed on 4 rats of each group. The remaining 4 rats in each group were killed respectively at day 1,3,5 and 6, the pathological grade for acute rejection, the complement activity in serum, the deposition of C3 on tissue, and the extent of infiltration by CD3+ T cells were compared. Results The mean survival time of heart allograft was (11. 69?0. 72) days and (6. 65?0. 35) days in CVF-treated group and control group respectively (P

Construction of heart heterotopic transplantation model in inbred strain rat / 重庆医科大学学报

Objective: To establish the model of inbred strain rat heart heterotopic transplantation.Methods:Male Lewis rats were used as recipients and Brown-Norway rats as donors,and the heterotopic transplants were done using ono's method with some modifications.The ascending aorta and pulmonary artery of donor were anastomosed end-to-side to the recipient abdominal aorta and inferior vena cava respectively.Results:48 heart transplantations were performed.We summarized surgical technique after sixteen rats of preliminary experiment.The successful rate was improved to 96.88% in 32 rats of formal transplantation.Time of cold ischemia,hot ischemia and rebeat were shorten significantly and operational time reduced to 60 min.Conclusion:To strengthen the protection of donor heart and perioperative treatment is the key point in the heart heterotopic transplantation in inbred strain rat.