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Objective@#To establish a method for repairing extremities with extensively deep burn using large piece of fresh allogeneic scalp spliced by Meek glue combined with autologous microskin and observe its effect.@*Methods@#Medical records of two male patients with extremely extensive deep burn admitted to our hospital from May to November in 2018 were retrospectively analyzed. Two patients aged 44 and 25 years respectively, with total burn area of 90% and 97% total body surface area (TBSA) and full-thickness burn area of 85% and 70% TBSA, respectively. Preoperatively, the surgical area on the extremities was calculated to estimate the necessary amount of allogeneic scalp and Meek miniature skin. The large piece of fresh allogeneic scalp spliced by Meek glue combined with autologous microskin was prepared according to the methods described as follows. Thin medium-thickness fresh scalps with 3% TBSA and 0.30-0.35 mm in depth were harvested from each donor and spliced into a large piece with epidermis upward by spraying Meek glue. Then the spliced scalp was punched after covered with a single-layer gauze. Autologous microskin was transported onto the dermis of fresh large piece of allogeneic scalp by traditional floating method. Bilateral extremities with full-thickness burn of two patients were selected for self-control. The left upper extremity was denoted as treatment group while the right upper extremity was denoted as control group in Patient 1. The right lower extremity was denoted as treatment group while the left lower extremity was denoted as control group in Patient 2. Wounds in the treatment group were treated with fresh large piece of allogeneic scalp spliced by Meek glue and autologous microskin with expansion ratio of 1∶15 after escharectomy, while wounds in control group received grafting of Meek miniature skin with expansion ratio of 1∶6 and or 1∶9 after escharectomy. The donors of allogeneic scalp were 32 males who were the relatives or friends of the patients, aged 21-50 years, with scalp area of (548±48) cm2. The healing conditions of donor sites of scalp were observed on post operation day 10, and were followed up within 3 months after operation to observe whether forming alopecia and hypertrophic scar or not. Wound healing condition was evaluated during follow-up in post operation week (POW) 2-5 and 4 months after operation. Wound coverage rates were calculated in both treatment and control groups in POW 2, 3, 4, and 5.@*Results@#The donor sites of all allogeneic scalp of donors healed completely on post operation day 10. There was no alopecia or hypertrophic scar within 3 months after operation for follow-up. In POW 2, allogeneic scalp grafts basically survived in treatment group without obvious exudation, and most of the Meek miniature skin survived in control group with obvious exudation. Part of allogeneic scalp grafts dissolved and detached in treatment group in POW 3, and the surviving grafts scabbed. The eschar detached and new epithelium was observed in treatment group in POW 4 and 5. In POW 3-5, surviving Meek miniature skin in control group creeped and was incorporated, and the wounds shrank. Hypertrophic scar was observed in both treatment and control groups 4 months after operation, without obvious difference in scar as a whole. The wound coverage rates were respectively 84%-98% and 76%-92% in treatment group of two patients in POW 2-5, close to or higher than those of control group (35%-97% and 28%-81%, respectively).@*Conclusions@#The study establishes a novel method for splicing fresh allogeneic scalps into a large piece as the covering of microskin, which has good effect for repairing extensively deep burn wounds. Considering that allogeneic skin is scarce, this method may be a new option in clinical treatment for extensively deep burn patients.
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Objective@#To explore the effects of scar excision combined with negative-pressure on repair of hypertrophic scar in burn children.@*Methods@#From October 2010 to August 2016, 25 children with hypertrophic scar after deep burn were hospitalized, with scar course ranging from 3 months to 11 years and scar area ranging from 35 to 427 [83(51, 98)]cm2. A total of 35 scars of 25 children were located in trunk (11 scars), upper limb (11 scars), and lower limb (13 scars). All children received scar excision operation and negative-pressure treatment (negative-pressure value ranged from -40 to -20 kPa), among which 6 cases received scar excision operation and negative-pressure treatment for two times for further removal of scars. After scar excision, electronic spring scale was used to measure the tension of the incision. The tension value of children ranged from 3.43 to 23.84 [7.16 (5.59, 9.12)] N, and then the incision was closed with appropriate suture according to the value of the tension. The incision with smaller tension was firstly opened on post operation day (POD) 8. After removing the suture, negative-pressure was conducted to POD 14. The incision with larger tension was firstly opened on POD 12. After removing the suture, biological semi-membrane was used to reduce tension to POD 16. All healed incisions were performed with anti-scar treatment for 1 year and relaxation and fixation for 3 months. General condition of the incision was observed after operation. The reduction percentage of scar area was calculated half-year after operation. The Patient and Observer Scar Assessment Scale was used to record the overall score of scar and scar score of trunk, upper limb, and lower limb before operation and half-year after operation. Data were processed with paired t test and Wilcoxon rank sum test.@*Results@#After removing the suture, all incisions of children healed well without redness, effusion, and rupture. Half-year after operation, the appearance and deformity of incision were obviously improved, and the symptoms including pruritus and pain were basically relieved. Half-year after operation, the scar area of children ranged from 0 to 174 [21(9, 47)]cm2, which was significantly decreased as compared with that before operation (Z=-5.16, P<0.05). The reduction percentage of scar area ranged from 36% to 100% [(73±19)%]. Half-year after operation, the overall score of scar and scar score of trunk, upper limb, and lower limb of children were obviously decreased as compared with those before operation (with t values from 6.42 to 17.37, P values below 0.05).@*Conclusions@#Scar excision combined with negative-pressure treatment has a good clinical effect on repair of hypertrophic scar in burn children, which is suitable for clinical application.
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OBJECTIVE:To explore the effect of comprehensive intervention mode on the rational use of Ribonucleic acid Ⅱ for injection,and to provide reference for the management of adjuvant drugs for cancer therapy.METHODS:The rational use of ribonucleic acid Ⅱ was interfered by establishing evaluation criteria,reviewing medical record,establishing tumor therapy adjuvant management work group,classifying drug prescription right,examining and approving off-label drug use,strengthening the assessment and training,clinical pharmacists intervention.The utilization of ribonucleic acid Ⅱ was analyzed statistically in our hospital during Apr.-Jun.2015 (before intervention),Jul.-Sept.2015 (after the first intervention),Oct.-Dec.2015 (after the second intervention) and Jan.-Mar.2016 (after the third intervention).RESULTS:The reasonable rate of Ribonucleic acid Ⅱ for injection was 77.34％ before intervention,and 83.25％,83.64％,95.12％ after the first,second and third intervention respectively;the difference was statistically significant compared to before intervention (P＜0.05).The irrational types included inappropriate indications,unsuitable treatment course,inappropriate usage and dosage,and unsuitable drug combination,etc.The percentage of these irrational types decreased from 2.96％,4.93％,13.79％ and 0.99％ before intervention to 1.63％,0,3.25％ and 0 after the third intervention,respectively.The utilization rate of Ribonucleic acid Ⅱ for injection was reduced from 8.81％ before intervention to 3.93％ after the third intervention,the differences were statically significant (P＜0.05).CONCLUSIONS:The comprehensive intervention model combined with multiple intervention methods can promote the rational use of Ribonucleic acid Ⅱ for injection.It is suggested to further study and evaluate the intervention effect of this model on other adjuvant drugs for cancer therapy.
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OBJECTIVE:To study the effect of catalpol on the activity and apoptosis of osteoclasts (OC) in the osteoblasts (OB)-OC co-culture system and its mechanism. METHODS:OB and OC were isolated respectively from the SD rats of 1-3 days and 5-7 days old to establish OB-OC co-culture system. After treated with 0(blank control),0.05,0.5,5,50 and 100 mg/L catal-pol for 48,72 and 96 h,the number of bone absorption lacuna for OC was observed by inverted microscope to reflect OC activity. After treated with 0(blank control)and 0.05 mg/L catalpol for 48,72 and 96 h,the activity of tartrate resistant acid phosphatase (TRACP)in OC was detected,and the apoptosis rate of OC was calculated. After treated with 0(blank control)and 0.05 mg/L ca-talpol,mRNA expression of osteoprotegerin(OPG)in OB was detected. RESULTS:In OB-OC co-culture system,the number of bone absorption lacuna in 0.05-50 mg/L catalpol groups was significantly lower than blank control group(P<0.01),indicating ca-talpol could inhibit OC activity,especially 0.05 mg/L catapol. Compared with blank control,0.05 mg/L catapol lowered the activity of TRACP but increased the apoptosis rate of OC(P<0.05);mRNA expression of OPG was up-regulated in OB(P<0.01). CON-CLUSIONS:In OB-OC co-culture system,catalpol can inhibit the activity of OC and induce the apoptosis of OC,and its mecha-nism may be associated with the mRNA expression up-regulation of OPG in OB.
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BACKGROUND:The construction of tissue engineered skin needs a long time and high price, and the repair effects are poor. Moreover, the problems such as antigen elimination and disease propagation are not thoroughly solved. How to solve the tough problem of wound surface repair in patients lacking of autologous skin using current mature technology before the occurrence of ideal tissue engineered skin. OBJECTIVE:To investigate the effects of autologous composite skin constructed around expanders on the repair of the wound surface. METHODS:A total of 10 rabbits were selected. Two globular silica gel expanders were embedded subcutaneously in the symmetrical sites on the back of rabbits. After the expanders were covered by fiber kystis, cellsuspension of primary cultured skin epithelial cells (experimental group) or physiological saline (control group) were infused into lacuna between the expander. Four weeks later, the expanders were obtained. Experimental group presented epithelization, i.e., autologous composite skin. The skin and some fiber members on the top of the expanders were resected around the encystations. The fiber kystis on the bottom and surrounding the expanders was left to form the wound surface covered by autologous composite skin. However, the wound surface was covered by non-epithelization fiber kystis in the control group. The healing of wound surface was observed until recovered. RESULTS AND CONCLUSION:In the experimental group, the wound surface was ruddy and pure, with less secretion;the average healing time was (14.0±0.4) days;the microscopic appearance indicated that epithelial layer was thick and regular. In the control group, there was more secretion on wound surface;the average healing time was (27.0±0.7) days;the microscopic appearance indicated that epithelial layer was thin and irregular. These results suggested that the construction of autologous composite skin around the expanders could noticeably promote the healing of wound surface.
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Objective To evaluate the efficacy and drug resistance profiles of nucleosides (NA) retreatment in NA experienced chronic hepatitis B (CHB) patients. Methods Totally 104 NA experienced CHB subjects were enrolled in this study.All these subjects had received at least 3 months NA monotherapy and stopped the treatment,and then received NA retreatment for at least one year.The subjects were divided into three groups according to the following criteria:reached the therapy endpoint of China guideline when they stopped NA-naive treatment (group A,n =39); did not reach the therapy endpoint when they stopped NA-naive treatment but hepatitis B virus (HBV) DNA＜1.0× 103 copy/mL (group B,n=33); and with HBV DNA＞1.0× 103 copy/mL (group C,n=32).The efficacy and drug resistance profiles of retreatment were compared among three groups. The effects of baseline alanine aminotransferase (ALT) levels,HBV DNA levels and HBeAg titers on the retreatment efficacies were analyzed. The mutations of HBV P gene were detected by nested polymerase chain reaction (PCR) and direct sequencing.The data were analyzd by Wilcoxon test and x2 test.Results The time to ALT normalization in patients with baseline ALT＜ 1.3 × upper limit normal (ULN) was shorter than that in patients with ALT≥1.3×ULN (2 months vs 4 months; Z=2.281,P=0.023).The time to virological response in patients with baseline HBV DNA＜5 lg copy/mL was shorter than that in patients with HBV DNA≥5 lg copy/mL (1 month vs 2 months; Z=2.054,P =0.040). The time to virological response and ALT normalization in baseline HBeAg negative were both shorter than those in patients with baseline HBeAg positive patents ( 1 month vs 3 months and 2 months vs 4.5 months,respectively; Z=2.580 and 2.304,respectively; both P＜0.05). The subjects in group A achieved virological response and HBeAg seroconversion after retreatment earlier compared to previous NA-naive therapy ([1.61 ± 1.76] months vs [3.48±4.066]months and [3.38 ± 3.34] months vs [9.92-11.22] months,respectively; Z=-2.854 and-1.094,respectively; both P＜0.05).The cumulative HBeAg seroconversion rate in group A was higher compared to those in group B and group C (80.0％ vs 36.8％ and 37.5％,respectively; x2 =4.368 and 5.100,respectively; both P＜0.05).Thirteen patients developed clinical resistance and four of them developed genotypic resistance proved by PCR direct sequencing.Among the patients retreated with the same regimen as previous in the C group,the cumulative resistance rate was highest compared to group A and B (44％ vs 9％ and 0,respectively; x2 =5.019 and 6.588,respectively;both P＜0.05).No resistance was detected in the 14 patients retreated with combined NA treatment without cross resistance.Conclusions For NA experienced CHB patients who fulfill the indication of antiviral therapy,the retreatment should be started as earlier as possible. Retreatment with NA combination without cross resistance can prevent (reduce) the risk of developing drug resistance.
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OBJECTIVE@#To explore the effects of 5-Aza-2'-deoxycitydine(5-Aza-dC) and trichostatin A (TSA) on the expression and methylation of CHFR in human laryngeal carcinoma cell line.@*METHOD@#The mRNA expression and promoter hypermethylation and were detected by Realtime fluro-genetic quantitative PCR and methylation specific PCR in Hep-2 cell line, which were cultured in vitro and then treated with different concentrations of 5-Aza-dC and TSA.@*RESULT@#Compared with the control team, 5-Aza-dC alone reactivated expression of the CHFR in Hep-2 cell line (1.75 +/- 0.21). TSA had no effect on gene expression (1.05 +/- 0.13). The combined treatment with 5-Aza-dC and TSA increased gene expression (2.15 +/- 0.18). The cell lines showed a characteristic DNA methylation status. 5-Aza-dC and combined 5-Aza-dC and TSA resulted in demethylation of CHFR. In contrast, TSA alone did not affect the DNA methylation status of CHFR.@*CONCLUSION@#Hypermethylation of CHFR gene promoter is a common event in the occurrence and development of laryngeal carcinoma. The promoter aberrant methylation of CHFR is a main cause for down-expression of CHFR. After either treatment with 5-Aza-dC alone or in combination with TSA, the expression of CHFR is up-regulated duo to the reversal methylation. It can be a new idea to the therapy of laryngeal carcinoma.
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Humans , Azacitidine , Pharmacology , Cell Cycle Proteins , Genetics , Metabolism , DNA Methylation , Decitabine , Gene Expression , Hep G2 Cells , Hydroxamic Acids , Pharmacology , Laryngeal Neoplasms , Metabolism , Methylation , Neoplasm Proteins , Genetics , Metabolism , Poly-ADP-Ribose Binding Proteins , Promoter Regions, Genetic , Ubiquitin-Protein LigasesABSTRACT
OBJECTIVE@#To investigate the effect of 5-Aza-dC and TSA to tumor suppressor gene RASSF1A expression and methylation level in Hep-2 cell line.@*METHOD@#Hep-2 cell line were cultured in vitro and handled with 5-Aza-dC and TSA. Detected RASSF1A expression and methylation level were detected before and after drug intervention using Realtime PCR and MSP.@*RESULT@#(1) Before intervention with drug, tumor suppressor gene RASSF1A was weakly expressed and methylated in Hep-2 cell line. (2) With the effect of 5-Aza-dC and TSA, the methylation of RASSF1A gene was reversed. And the effect of combination of 5-Aza-dC and TSA was similar with 5-Aza-dC alone. There was no obvious effect using TSA alone. (3) With the effect of 5-Aza-dC and TSA, the expression of RASSF1A was improved. And the effect of 5-Aza-dC was stronger than TSA. Synergetic effect was found when using 5-Aza-dC and TSA simultaneously.@*CONCLUSION@#In Hep-2 cell line, Promoter methylation of tumor suppressor RASSF1A may play a very important role in loss of gene expression, but it is not the only cause. 5-Aza-dC and TSA can improve RASSF1A expression by reversing DNA methylation and histone deacetylation.
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Humans , Antimetabolites, Antineoplastic , Pharmacology , Azacitidine , Pharmacology , Cell Line, Tumor , DNA Methylation , Gene Expression , Gene Silencing , Genes, Tumor Suppressor , Hydroxamic Acids , Pharmacology , Promoter Regions, Genetic , Tumor Suppressor Proteins , GeneticsABSTRACT
Objective To investigate the clinical characteristics and management of congenital hypertrophic pyloric stenosis (CHPS) associated with intestinal malrotation (IM) in infants.Methods The clinical data of 6 cases with CHPS and IM admitted in our hospital from Jan 2003 to Dec 2009 were reviewed,including clinical presentation,symptoms and information of imageology.Results Through barium meal examination and sonography,4 cases were diagnosed CHPS and IM,pyloromyotomy and Ladd's procedure were performed;two cases were diagnosed CHPS,only pyloromyotomy was done,secondary operation was performed for recrudescence of vomiting.All the cases were followed up for 1 to 3 years with good prognosis.Conclusion The etiology of CHPS with IM isn't clear.The diagnosis of IM may be delayed because the symptoms of IM can be masked by that of CHPS.It is helpful for diagnosis of this disease to have barium meal and sonography examination.Good prognosis will be achieved if prompt preoperative diagnosis and operation can be done.
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OBJECTIVE@#To explore the relationship between the level of expression and hypermethylation of the CHFR gene and the occurrence and development of laryngeal squamous cell carcinoma (LSCC).@*METHOD@#The mRNA expression and promoter hypermethylation were detected by Realtime fluro-genetic quantitative PCR and methylation specific PCR in 50 LSCCs (LSCC group) and 15 normal laryngeal tissue (control group).@*RESULT@#1) CHFR mRNA was shown in the control group, while the mRNA was loss expression in the 2 LSCC (4%), and the level of mRNA expression was significantly lower in the LSCC group. The relative ratio was 0.50 +/- 0.12, which is 0.30 +/- 0.04 at the early stage of the LSCC and 0.70 +/- 0.21 at the advanced stage, respectively. The discrepancy had statistical significance (P<0.01). 2) The methylation rate of CHFR was 22% (11/50) in the LSCC tissues, which was not found in the normal tissues. The aberrant methylation of CHFR was observed in 10 of the patients at the stage I and stage II of LSCC , in 1 of the patients at the stage III, and was absent at the stage IV. There was significant difference between the aberrant methylation of CHFR and the stage of carcinoma (P<0.01). 3) The mRNA expression level of the aberrant methylation patients was 0.11 +/- 0.05, which was significantly lower than that of the unmethylation patients 0.75 +/- 0.13. Gene inactivation was observed in 2 of the 11 patients with the aberrant promoter methylation. The methylation was associated with the expression of mRNA, with the correlation coefficient 0.387 (P<0.05).@*CONCLUSION@#Hypermethylation of CHFR gene promoter is associated with loss or lower expression of CHFR mRNA in the LSCCs, and it may contribute to the occurrence and development of LSCC. The promoter aberrant methylation of CHFR may be one of the early diagnostic and therapeutic marker genes.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , Genetics , Pathology , Cell Cycle Proteins , Genetics , CpG Islands , DNA Methylation , Gene Silencing , Laryngeal Neoplasms , Genetics , Pathology , Neoplasm Proteins , Genetics , Neoplasm Staging , Poly-ADP-Ribose Binding Proteins , Promoter Regions, Genetic , RNA, Messenger , Genetics , Ubiquitin-Protein LigasesABSTRACT
Objective To investigate the significantly elevated incidence of hepatitis C and mortality of cirrhosis and hepatocellular carcinoma (HCC) in Jianping county, and to explore the epidemiological features. Methods The data from database of death registry and infectious disease surveillance in Jianping county, Liaoning Province were analyzed. The distributions of incidence of hepatitis B and hepatitis C, mortality of cirrhosis and HCC in 23 villages and towns were investigated.Spearman's correlation was used to explore the correlations between hepatitis, cirrhosis and HCC.Results The standardized mortality of HCC in males and females in Jianping county were 77. 6/10~5and 22. 0/10~5, respectively, which were 2. 0 and 1. 7 times, respectively of the average levels of Liaoning rural areas. The incidence of hepatitis C was 58. 0/10~5 , which was 9. 5 times of the averagelevel of Liaoning Province. There were positive correlations between incidence of hepatitis C and mortality of cirrhosis (r=0. 495, P = 0. 008), and mortality of cirrhosis and HCC (r=0. 646, P<0.01). Conclusions The incidence of hepatitis C and mortality of cirrhosis and HCC in Jianping county are significantly higher than the average levels of Liaoning Province. Further investigations of the suspected causes are needed.
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Objective To know the ability of rural health doctors, find out the scope of job satis-faction and desire of training and extending for chosen extending rural health doctors. Methods Various factors were analyzed, which affect the appropriate health technology extension in rural areas based on the study in Liaoning province with the method of the questionnaire and the categorical data statistics. Results The quality of medical human resources in rural area was low. The main influencing factors for training were practicality of the training, rescannable time and whether increasing income. Meanwhile, The appropriate health technology extension was affected by the rationality, validity, safety of techniques, acceptance degrees of patients as well as the individual professional basis. Conclusion It was necessary to focus on continued medical education to improve the rural doctor's ability. Some tactics was also put forward to promote the technology extension effect. This study provided some suggestions which could be used as references for the government making decision.
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Objective To investigate the proportion of follicular fluid CD56~+ natural killer (NK) cells to the total lymphocytes and the ac-tivated CD56~+ NK cells to the total CD56~+ NK cells. To provide an evidence for improving the clinical pregnancy rate in in vitro fertilization (IVF) treatment by regulating the function of NK cells. Methods Triple color flow cytometry was used to analyze the proportion of CD56~+ NK cells and activated CD56~+ NK cells in mature follicular fluid. The IVF treatment outcome was closely followed up. The relationship be-tween the proportion of CD56~+ NK cells and activated CD56~+ NK cells and the IVF treatment outcome was analyzed statistically. Results The proportion of CD56~+ NK cells and activated CD56* NK cells in mature follicular fluid of women who got pregnancy by IVF treatment was (15.57±3.10)% and (2.63±0.94)% respectively,while the proportion of the women who didn't get pregnancy was (19.12±5.37)% and (4.06±2.08)% respectively,which was significantly higher than the pregnant group(P< 0.05). Conclusion The women with lower propor-tion of CD56~+ NK cells and activated CD56~+ NK cells in mature follicular fluid of is easier to get pregnancy by IVF. An altered NK cells pro-file in follicular fluid could therefore influence fertility in IVF treatment outcome.
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Objective To investigate the immunologic etiology of pregnancy induced hypertention (PIH)by studying the changes of T H1 and T H2 cell ratio in the peripheral blood from patients with severe PIH. Methods We examined the cell percentage of T H1 cell(secreting cytokine IFN ?) and T H2 cell(secreting cytokine IL 4),which were from CD4 positive, by flow cytometry tri stained with PerCP CD4,FITC IFN ? and PE IL 4 monoclonal antibody. The blood samples were from severe PIH patients and normal third trimester patients. Results The percentage of T H1 cell 38.01?9 04% from the peripheral blood of severe PIH partuients was significantly higher than that of the normal partuients of the third trimester 30.26?8.65%, while the percentage of T H2 cell 2.25? 0.61% was much lower P