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Objective:To investigate the risk factors of severe chest trauma complicated by acute respiratory distress syndrome (ARDS).Methods:A case control study was conducted to analyze the clinical data of 120 patients with severe chest trauma admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2018 to December 2020. There were 75 males and 45 females; aged 21-72 years [(42.2±4.8)years]. The causes of injury were traffic injury in 57 patients, crush injury in 21, fall injury in 21, smash injury in 11 and others in 10. There were 34 patients accompanied by fracture of the limb, spine and pelvis, 23 by abdominal organ injury and 8 by head trauma, with the exception of simple thoracic trauma in 55 patients. The patients were divided into ARDS group ( n=25) and non-ARDS group ( n=95) according to the condition of concurrent ARDS. The two groups were compared regarding the gender, age, causes of injury, respiratory rate, lung contusion, lung infection, flail chest, chest abbreviated injury scale (AIS), hemothorax, blood pressure, partial arterial oxygen pressure (PaO 2), initial central venous pressure (CVP) on admission, combined fracture of the limb, spine and pelvis, combined head injury and combined abdominal organ injury. The correlation between the above indexes and ARDS after severe chest trauma was analyzed by univariate analysis. Multivariate Logistic regression analysis was used to determine the independent risk factors for ARDS after severe chest trauma. Results:Univariate analysis showed a positive correlation of ARDS with age, respiratory rate, lung contusion, lung infection, flail chest, chest AIS, hemothorax, blood pressure, PaO 2, initial CVP on admission, combined fracture of the limb, spine and pelvis and combined abdominal organ injury ( P<0.05 or 0.01), but not with gender, causes of injury or combined head injury (all P>0.05). Multivariate Logistic regression analysis revealed that age ≥60 years ( OR=2.45, 95% CI 1.81-7.50, P<0.01), dyspnea (respiratory rate ≥28 times/minute or <10 times/minute) ( OR=9.55, 95% CI 2.26-9.38, P<0.01), lung contusion ( OR=6.78, 95% CI 1.84-6.96, P<0.01), lung infection ( OR=27.71, 95% CI 11.97-64.14, P<0.01), flail chest ( OR=8.97, 95% CI 2.29-14.97, P<0.01), chest AIS score ( OR=5.77, 95% CI 2.85-9.20, P<0.01), above medium amount of hemothorax ( OR=6.84, 95% CI 1.69-13.39, P<0.01), blood pressure <90 mmHg ( OR=7.93, 95% CI 1.64-11.84, P<0.01), PaO 2<60 mmHg ( OR=6.39, 95% CI 1.06-9.47, P<0.01) and absent initial CVP on admission ( OR=4.56, 95% CI 1.86-8.44, P<0.01) were significantly correlated with ARDS. Conclusion:Age ≥60 years, dyspnea (respiratory rate ≥28 times/minute or <10 times/minute), lung contusion, lung infection, flail chest, chest AIS, above medium l amount of hemothorax, blood pressure <90 mmHg, PaO 2<60 mmHg and absent initial CVP on admission are independent risk factors for ARDS in patients with severe chest trauma.
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Objective:To compare the clinical efficacy of extracorporeal membrane oxygenation (ECMO) and ventilation therapy in the treatment of severe blast lung injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 37 patients with severe blast lung injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2000 to December 2021, including 23 males and 14 females; aged 26-50 years [(36.3±11.1)years]. The chest abbreviated injury score (AIS) was 3-5 points. In all, 16 patients were treated with ECMO from January 2017 to December 2021 (ECMO group) and 21 with ventilator from January 2000 to December 2016 (ventilator group). Blood gas analysis indexes [arterial pH, partial pressure of carbon dioxide (PaCO 2), partial pressure of oxygen (PaO 2), blood lactate (Lac)] and hemodynamics indexes [central venous pressure (CVP), cardiac output index (CI), pulmonary arterial systolic pressure (PASP), pulmonary capillary wedge pressure (PAWP)] were compared in the two groups at 30 minutes before treatment and at 2, 4, 6 hours after treatment. The mechanical ventilation time, ICU length of stay, acute physiology and chronic health evaluation II (APACHE II) score and mortality were measured at 7 days after treatment. Results:All patients were followed up for 24-48 months [(33.6±8.2)months]. The blood gas analysis and hemodynamic indexes were significantly improved in the two groups at 2, 4, 6 hours after treatment when compared with those at 30 minutes before treatment (all P<0.05), and the improvements were still statistically significant in ECMO group at 4, 6 hours after treatment when compared with those at 2 hours after treatment (all P<0.05), while not in ventilator group (all P>0.05). There was no significant difference in blood gas analysis indexes or hemodynamic indexes between the two groups at 30 minutes before treatment (all P>0.05). After treatment for 2, 4, 6 hours, blood gas analysis indexes and hemodynamic indexes in ECMO group were statistically different from those in ventilator group (all P<0.05). After treatment for 7 days, the mechanical ventilation time, ICU length of stay, APACHE II score and mortality were (3.2±1.2)days, (5.4±1.3)days, (14.1±3.3)points and 12.5% (2/16) in ECMO group, significantly different from (5.1±1.6)days, (7.6±1.6)days, (10.2±2.6)days and 28.6% (6/21) in ventilator group (all P<0.05). Conclusion:For severe blast lung injury, ECMO can attain rapid and continuous improvement of refractory hypoxemia and dyspnea, shorten the duration of mechanical ventilation and ICU length of stay and reduce the mortality rate when compared with ventilator therapy.
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Objective:To compare the efficacy of standardized incision and conventional incision for reduction and internal fixation of multiple rib fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 192 patients with multiple rib fracture treated in 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2020 to January 2022. There were 101 males and 91 females; aged 32-94 years [(51.5±16.6)years]. The patients underwent open reduction and internal fixation with nickel-titanium shape memory alloy embracer via standard incision such as anterior axillary longitudinal incision (standard incision group, n=96) or conventional incision such as posterolateral incision (conventional incision group, n=96). The incision length, operation time, intraoperative blood loss, number of fixed fractures, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time and length of hospital stay were compared in the two groups. The visual analogue scale (VAS) was used to evaluate pain at 1 month after operation. Postoperative complications were recorded. Results:All patients were followed up for 1-16 months [4.0(3.0, 10.5)months]. The operation time, intraoperative blood loss, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time, length of hospital stay and VAS at postoperative 1 month in standard incision group [(12.1±1.6)cm, (51.4±13.0)minutes, (191.5±16.8)ml, (2.8±0.6)days, (568.9±109.0)ml, (4.1±0.7)days, (11.4±1.7)days, (2.5±0.7)points] were better than those in conventional incision group [(13.7±1.9)cm, (62.0±8.8)minutes, (248.9±65.4)ml, (4.8±1.1)days, (655.9±121.9)ml, (5.2±0.9)days, (15.3± 1.7)days, (3.5±0.7)points] ( P<0.05 or 0.01). There was no statistical difference in the number of fixed fractures between standard incision group and conventional incision group (5.1±0.8 vs. 5.4±0.9) ( P>0.05). In standard incision group, there were 3 patients with poor wound healing, 5 with pulmonary infection, 3 with atelectasis and 3 with small pleural effusion. In conventional incision group, there were 11 patients with poor wound healing, 9 with pulmonary infection, 7 with atelectasis and 7 with small pleural effusion. The incidence of postoperative complications was 14.6% (14/96) in standard incision group and 35.4% (34/96) in conventional incision group ( P<0.01). Conclusion:For multiple rib fracture, standard incision is superior to conventional incision reduction in shortening the incision length, operation time, indwelling time of drainage tube, postoperative spontaneous ambulation time and length of hospital stay, reducing the intraoperative blood loss and postoperative thoracic drainage volume, alleviating the pain and reducing the postoperative complications.
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Objective:To explore the etiology, clinical diagnosis and treatment strategy of Lesch Nyhan syndrome.Methods:We retrospectively analyzed 2 patients with severe dyskinesia, mental retardation and complicated renal calculi who were admitted to the first people's Hospital of Zhengzhou in August 2019. Case 1, male, 9 years old, had multiple urinary calculi for 1 year. The patient came to the local hospital because double multiple kidney stones and bladder stonesa year ago. The patient had been treated with transurethral holmium laser lithotripsy for bladder stones. The results of infrared spectrum showed that the bladder stone was anhydrous uric acid stone. A week ago, color Doppler ultrasound showed multiple kidney stones and bladder stones. The patient was underdeveloped, mentally retarded and had a full-term cesarean section. There was no history of hypoxia, asphyxia and rescue of the patient. He had the following clinical manifestations: In the waking state, he was no language response to any stimulation. The nasolabial fold on the right was shallow and the corner of the mouth was oblique to the left. He lost the large movements such as lifting head, sitting alone, standing. The trunk showed torsion spasticity, limb muscle strength 2-3, limbs showing spastic hypertonia, limb joints stiff, hands showing fist-like, no involuntary movement and muscle fasciculation. The biceps reflex and knee tendon reflex were not elicited, and the pathological reflex was positive. Serum uric acid was 517 μmol/L. The Case 2 came from the same family, male, 6 years old, had the similar symptoms to his elder brother case 1. The family members complained on behalf of the child about intermittent fever for more than 2 years. The imaging examination of case 2 revealed kidney stones. Serum uric acid was 373 μmol/L. Whole Exome Sequencing and Sanger Sequencing were used to find the genetic causes of the two siblings. The NCBI-Homologene database was used to find the homologous sequence of the human HPRT1 gene, and the human HPRT1 gene sequence was compared with other species to analyze the protein conservation. The online website PredictProtein (http: //www.predactprotein) was used to predict the two-dimensional structure of the HPRT1 gene. The reported cases were summarized and same with the treatment plan.Results:A De novo mutation [c.571T>G(p.Tyr191Asp)] was found in the HPRT1 gene of the child, which was inherited from the mother. Lesch Nyhan syndrome can be diagnosed by the results of gene examination combined with clinical manifestations. The amino acid Tyr at the 191 position and the amino acids before and after it were highly conserved. Amino acid 191 was involved in the β-strand of the protein. We treated the patients with the lowest dose of allopurinol and children's conventional dose of potassium sodium bicitrate granules, and low purine diet. After 3 months of treatment, the serum uric acid was decreased, and the urinary calculi did not increase significantly.Conclusions:Combining with the clinical manifestations of children, HPRT1 gene might be the cause of pediatric disease and the two siblings could be diagnosed as Lesch-Nyhan syndrome. For such patients, the lowest dose of allopurinol and children's conventional dose of potassium sodium hydrogen citrate granule combined with diet could be more effective.
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Rib fracture is the most common chest trauma, accounting for almost 10% of all trauma patients. Non-surgical treatment of the fractures without significant displacement can achieve good results. Surgical treatment is often needed for multiple rib fractures, especially flail chest, which can induce severe pain, respiratory and circulatory abnormalities, accompanied by severe lung contusion and laceration, hemopneumothorax and blunt heart injury. Open reduction and internal fixation of rib fracture often involves multiple ribs. Traditional rib fracture surgery requires a large incision to achieve satisfactory exposure effect, which causes damages to the chest wall muscle, blood vessels and nerve damages, significantly increasing postoperative incision infection and dysfunctions in the upper limb, shoulder, back and long-term chest numbness and pain and seriously affecting the quality of patients' daily life. Therefore, it is gradually abandoned by surgeons. Experts have explored various minimally invasive surgical methods for the treatment of multiple rib fractures. The authors review the research progress of minimally invasive technology in the treatment of multiple rib fractures, in order to provide better help for clinical treatment.
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Objective:To investigate the effects of ultrasound-guided thoracic paravertebral block on the changes of analgesic efficacy and inflammatory response in patients with multiple rib fractures.Methods:A retrospective case-control study was performed in 48 patients with multiple rib fractures admitted to 909th Hospital of Joint Logistics Support Force from July 2016 to December 2018. There were 30 males and 18 females, with the age range of 18-69 years[(41.1±10.4)years]. The number of fractured ribs was 3-9 (5.7±1.9). All patients were stabilized with the memory alloy embracing fixator. Thoracic paravertebral block group received ultrasound-guided thoracic paravertebral block and intravenous analgesia group received patient controlled intravenous analgesia, with 24 patients in each group. The visual analogue scale (VAS) was observed and recorded in the resting/cough state before induction of anesthesia(T1), and 1 h (T2), 6 h (T3), 24 h (T4) and 48 h (T5) after surgery. Blood samples were taken simultaneously from the vein for determination of plasma neutrophil elastase (NE), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) concentrations by ELISA method.Results:In the resting state, there was no significant difference between two groups in VAS at T1 ( P>0.05); the VAS in two groups at T2-T5 decreased significantly compared with T1 ( P<0.01); the VAS at T2-T4 in thoracic paravertebral block group [(3.4±0.7)points, (3.2±0.8)points, (3.1±0.7)points] was significantly lower than that in intravenous analgesia group [(4.8±0.9)points, (4.4±0.7)points, (3.9±0.8)points]( P<0.01 ). In the cough state, there was no significant difference between two groups in VAS at T1 ( P>0.05); the VAS at T2-T5 in intravenous analgesia group was all higher than 6 points[(7.7±1.0)points, (7.6±1.3)points, (7.4±1.2)points, (7.1±0.9)point], and was significantly higher than those in thoracic paravertebral block group [(3.6±0.7)points, (3.3±0.7)points, (3.2±0.6)points, (2.9±0.7)points] ( P<0.01). There was no significant difference between two groups in plasma levels of NE, TNF-α and IL-6 at T1 ( P>0.05). Their levels at T2 in two groups were significantly increased, but were decreased at T5 compared with those at T1 ( P<0.01). The plasma levels of NE, TNF-α and IL-6 were significantly lower in thoracic paravertebral block group at T2-T5 [NE: (65.5±19.0)ng/ml, (42.5±12.5)ng/ml, (26.3±9.3)ng/ml, (20.9±7.9)ng/ml; TNF-α: (8.7±1.9)pg/ml, (6.0±1.3)pg/ml, (3.9±0.9)pg/ml, (2.8±0.8)pg/ml; IL-6: (11.5±3.6)pg/ml, (6.7±1.8)pg/ml, (3.6±1.0)pg/ml, (2.5±0.7)pg/ml] than those in intravenous analgesia group[NE: (76.7±18.2)ng/ml, (51.4±15.1)ng/ml, (35.5±10.0)ng/ml, (28.6±9.0)ng/ml; TNF-α: (10.0±2.1)pg/ml, (6.8±1.5)pg/ml, (4.7±1.1)pg/ml, (3.6±1.0)pg/ml; IL-6: (16.2±4.2)pg/ml, (8.7±2.1)pg/ml, (5.7±1.2)pg/ml, (3.5±0.7)pg/ml] ( P<0.05 or 0.01). Conclusion:Compared with intravenous analgesia, ultrasound-guided thoracic paravertebral block can provide better analgesic effect, reduce the plasma levels of inflammatory cytokines that result from trauma and surgery, and down-regulate inflammatory response.
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Objective To explore the relationship between the expression of transcription factor ⅡB-related factor 1 (Brf1) and the prognosis of non-small cell lung cancer (NSCLC).Methods Collected 96 cases of NSCLC Surgical specimens and clinical data of patients from January 2013 to August 2015 in our hospital.First of all,we compared the expression of Brf1 in NSCLC tissues and adjacent lung tissues by Western blot and RT-qPCR.Then,Immunohistochemistry was used to detect the expression of Brf1 in NSCLC tissues,and analysis of the relationship between Brf1 expression level and clinical case characteristics.Survival curves were plotted using the Kaplan-Meier method and Log-rank test and multivariate Coxv regression analysis were performed.Results Western blot and RT-qPCR results showed that the expression of Brf1 in NSCLC tissues was significantly higher than that in adjacent lung tissues (P ＜0.01).The positive expression rate of Brf1 in 96 cases of NSCLC was 72.9％.The Brf1 expression level was higher in the poorly differentiated group than in the moderately-highly differentiated group(Mean Rank 62.33 ＞ 43.89,Z =-2.914,P =0.004),and the lymph node metastasis group was higher than the non-metastasis group(Mean Rank 60.34 ＞ 42.58,Z =-3.055,P =0.002),which was independent of patient gender,age,smoking status,tumor size,TNM stage,and pathological type (P ＞0.05).Single-factor survival analysis by Log-rank test showed that the survival rate of Brf1 positive expression group was lower than that of the negative group (x2 =7.560,P ＜0.01).Multivariate analysis of Cox regression model found that Brf1 positive expression (HR =2.043,95％ CI:1.082-3.860) was an independent observational index that affects the prognosis of patients with NSCLC.Conclusion Brf1 is overexpressed in NSCLC tissues,and Brf1 negative expression has a good clinical prognosis,suggesting that Brf1 may be one of the indicators of malignant degree and prognosis of NSCLC.
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Objective To investigate the effect of perioperative secondary thoracotomy on the risk of thrombosis in patients with thoracic trauma.Methods A retrospective case control study was conducted on the clinical data of 175 patients with thoracic trauma who underwent thoracotomy from January 2000 to December 2016.According to whether the patients underwent secondary thoracotomy,they were divided into secondary thoracotomy group (36 cases) and the control group (139 cases).In the secondary thoracotomy group,there were 25 males and 11 females,with age of (65.4 ± 5.5) years and thoracic abbreviated injury score (AIS) of (3.8 ±0.6) points.In the control group,there were 98 males and 41 females,with the age of (64.6 ±5.3)years and thoracic AIS of (3.7 ±0.8)points.The ICU stay,thoracic drainage,bed rest time,and the incidence of thrombosis in two groups were compared,and the levels of endothelin (ET-1),D-dimer aggregation and platelet were measured.Logistic regression analysis was used to analyze the impact of secondary thoracotomy on the risk of thrombosis.Results Compared with the control group,patients in the secondary thoracotomy group had longer ICU stay [(4.2 ± 1.4) d ∶(1.8± 1.0)d](P＜0.01),more thoracic drainage [(1 550 ±250)ml ∶ (635 ± 184)ml] (P＜0.01),and longer bed rest time [(5.4 ± 1.6) days ∶ (1.5 ± 0.9) days] (P ＜ 0.01).There were significant differences in levels of ET-1 and D-dimer aggregation between two groups (P＜0.01).There was significant difference in platelet count after 5 days (P ＜ 0.01).Twelve cases of deep venous thrombosis (33％) occurred in the secondary thoracotomy group,of which six cases died of thrombus related complications.Eight cases (5.7％) of deep venous thrombosis occurred in the control group,all of which recovered (P ＜ 0.05).In multivariate analysis,ET-1 (OR =7.46,95％ CI 4.53-11.06,P ＜ 0.05),D-dimer aggregation (OR =4.28,95％ CI 2.65-8.37,P ＜ 0.05),and platelet count (OR =1.13,95 ％ CI 0.56-1.98,P ＜ 0.05) were independent risk factors for thrombosis events.Conclusions Perioperative secondary thoracotomy increases the risk of thrombotic events.ICU hospitalization,thoracic drainage,and bed time are associated with thrombosis events.ET-1,D-dimer aggregation,and platelet count are independent risk factors for thrombosis events.
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Objective To analyze the rules of acupoint selection in treating knee osteoarthritis with acupuncture and moxibustion therapy based on data mining; To provide references for clinical treatment.MethodsArticles about treating knee osteoarthritis with acupuncture and moxibustion were retrived from China National Knowledge Infrastructure (CNKI), Wanfang academic periodical full-text database, Chinese Journal Full-text Database (VIP) and SinoMed in China from Jan. 1st 2006 to Jan. 1st 2016. The database of acupuncture and moxibustion prescription was set up. The Apriori association rules, system cluster analysis and factor analysis were adopted in order to analyze the rules of acupoint selection for knee osteoarthritis.ResultsTotally 190 articles were included, covering 228 acupuncture- moxibustion prescriptions, 65 acupoints and the total frequency for 1736 times. The usual acupoints in the lower limbs were Dubi (ST35), Neixiyan (EX-LE 4), and Yanglingquan (GB34). The main maridians were Stomach Meridian of Foot-Yangming, Spleen Meridian of Foot-Taiyin, and Gallbladder Meridian of Foot-Shaoyang, accounting to for 1626 times (93.66%). Cluster analysis achieved other four groups of acupoint selection based on syndrome differentiation.ConclusionLocal acupoints and dialectical point selection were important principle in treating knee osteoarthritis combined with acupoint selection based on syndrome differentiation.
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With the information section of the 187th Central Hospital of PLA as an example , the paper introduces the application of the PDCA cycle model in the quality management of its information services .As a result, it finds that the service satisfaction degree after the implementation of the PDCA cycle is significantly higher than that before the implementation .It indicates that the management method with the PDCA cycle can optimize the information service process and promote the continuous improvement of information service quality .
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Objective:To study the serological reactions in cynomolgus monkeys infected with hepatitis B virus ( HBV). Methods:To select 1 to 3 days old or adult healthy cynomolgus monkeys by artificial breeding to observe the virology screening in laboratory a month to confirmed healthy animals ,randomly divided into control group and infection group .Infection group vaccination serum HBV carriers 0.5 ml (HBV-DNA≥108 copies) single cages,observe each group behavioral changes daily after inoculation 1 to 12 weeks, each week to confirmed the degree of liver inflammation through the HBV-M, HBV-DNA, liver function and on the B-guided, liver tissue inflammation by routine HE staining .Results: Adult monkeys did not induce positive reaction after vaccination , there were three young monkeys appear HBsAg , HBcAb and 2 appear HBV-DNA reaction, ALT poison attack occurred in HBsAg-positive began to increase after one week , one month after the peak , which was 180 U/L, after gradually decreased , continuing a month later near normal .AST higher than a week after the normal reference values were flat curve , representing the peak ALT after a month later, HBsAg positive cynomolgus monkeys HE staining showed mild hepatitis partial liver tissue lesions .Conclusion:HBV-M, HBV-DNA, ALT, AST and liver histopathology after HBV infection have changed , this result showing that it's produce inflammation and induction the response of immune .
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Objective To investigate the blood and chest fluid level of Th17 cell and IL-17 in patients with tuberculous pleural effusion and its pathological role.Methods Flow cytometry and enzyme linked immunosorbent assay (ELISA) were used to measure the blood and chest fluid level of Th17 cell and IL-17 from 30 patients with tuberculous pleural effusion,20 patients without tuberculous pleural effusion,and 20 healthy persons.Results The blood level of Th17 cell and IL-17 wwere higher in tuberculous pleural effusion than in the other two groups(P ＜0.05).The chest fluid level of Th17 cell and IL-17 in patients with tuberculous pleural effusion were significantly higher than those in patients without tuberculous pleural effusion (P ＜ 0.05 ).The chest fluid level of Th17 cell and IL-17 in patients with and without tuberculous pleural effusion were significantly higher than that of the blood serum level.After treatment for 1,3,7 and 14 days,tbe blood serum and chest fluid level of Th17 cell and IL-17 were obviously lower.( P ＜ 0.01 ).After treatment for 1 day,the blood level of Th17 cell was obviously lower than before treatment( P ＜ 0.01 ).After treatment for 3 days,the chest fluid level of Th17 cell was obviously lower than before treatment( P ＜0.01 ).After treatment for 3 days,the blood serum level of IL-17 was obviously lower than before treatment (P ＜ 0.01 ).After treatment for 7 days,the chest fluid level of IL-17 was obviously lower than before treatment ( P ＜0.01 ).Conclusion Th17 cell and IL-17 might play an important role in the pathogenesis of tuberculous pleural effusion and they were correlated with disease progression and the therapeutic effect.
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Objective To investigate the expression of monocyte chemoattractant protein-1(MCP-1)and CCR2 in peripheral blood and pleural fluid of tuberculous pleurisy patients.Methods Flow cytometry was used to detect the expression of CCR2 in the peripheral blood mononuclear cell and pleural fluid cell of tuberculous pleurisy patients;ELISA was used to detect the content of MCP-1 in serum and pleural fluid.Results MCP-1 in surem and pleural fluid and CCR2 in the peripheral blood mononuclear cell and pleural fluid cell of tuberculous pleurisy patients was significantly higher than that of the healthy normal controls[MCP-1:(340.8±220.8)and(9.0±3.8)ng/L,P＜0.01;CCR2(18.2±10.1)%and(6.9±3.5)%,P＜0.05];Both MCP-1 and CCR2 were detected in pleural fluid and both of them were positivley correlated(r=0.227,P＜0.05).Conclusion The expression of MCP-1 and CCR2 in peripheral blood of tuberculous pleurisy patient are significantly elevated which are significance molecule participating in the pathogenesis of tuberculous pleurisy.
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Objective To explore the mechanism of the secondary deterioration of neurological symptoms in Wilson' s disease (WD) at early stage of treatment using D-penicillamine. Methods Forty non-treated WD patients, 32 of encephalic and 8 hepatic type respectively, were enrolled in the study. Their neural symptoms were scored using modified Young grade. Cerebrospinal fluid (CSF) copper, serum copper, urinary copper, neuron specific enolase (NSE) in CSF and the albumin ratio CSF/serum (AR) were measured at the same time. After 3 months of treatment with D-penicillamine, neural symptoms of patients were scored again. All dates were analyzed. Results After 3 months of treatment with D-penicillamine, 15 patients (46. 9%) developed a secondary deterioration in neurological symptoms. The concentration of copper and the NSE in CSF of patients whose neural symptom was increasingly deteriorated. The serum copper declined after treatment((0. 37± 0. 09) vs (0. 25 ± 0. 08) mg/L, t = 3. 17, P < 0. 05). The 24 hours urinary copper of patients whose symptoms had deteriorated was much lower than that of patients who had not. No significant change was found in AR ratio before and after the treatment (9. 53 ± 3.18vs12.24±3.17) in the worsened group (t=1.45, P>0. 05). Conclusions The degree of the injury in the neural system and the dose of penicillamine may affect the deterioration of the neural symptom.
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AIM: To study the effect of bone marrow stem cell transplantation on mdx mice at different ages. METHODS: The bone marrow stem cells of C57BL/6 mice (4 - to-weeks age) were cultured in vitro for 3 days, then injected intravenously into the 6 -week and 8-week aged mdx, which were preconditioned with 7 Gy ? ray. 12 weeks after being transplanted, the mdx mice were studied for the dystrophin protein expression on the skeletal muscle membrane. RESULTS: Three months after transplanted with bone marrow stem cells, about 16% and 7% muscles cells in 6-week and 8-week mdx mice expressed dystrophin protein, respectively. CONCLUSION: 12 weeks after transplantation with bone marrow stem cells of homologous series mice, different amounts of dystrophin protein expressed on the membrane of skeletal muscle cells were observed in different aged mdx mice. Bone marrow stem cell transplantation show more benefic effect for younger mdx mice.
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AIM: To detect dystrophin expression in skeletal muscles of mdx mice after bone marrow transplantation (BMT), and to evaluate the effect of BMT on Duchenne muscular dystrophy (DMD). METHODS: Bone marrow cells were cultured for three days, and then transplanted into mdx mice irradiated lethally through tail veins. After 4 and 6 months, dystrophin expression on myocytes membranes in mdx mice was detected by fluorescent immunohistochemical staining. The centrally nucleated fibers (CNF) were calculated by HE staining, and the physiologic parameters measured and the motor function detected by traction test, rotating rods test and rotating wheels test were also observed. RESULTS: Until 4 and 6 months after BMT, dystrophin was expressed partly on myocytes membranes in mdx mice, and the ratio of CNF decreased, physiologic functions improved, the motor ability reinforced in treated group. CONCLUSION: After BMT, marrow stem cells settled in injured skeletal muscles and bone marrow, then differentiated into myocytes with dystrophin expression and caused the improvement of pathology, physiology and motor function in treated group finally. These results give a powerful proof for the treatment of DMD with BMT.
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AIM:To examine the relationship between the gene defect,change of protein hydrophobicity,spacial structure change and clinical phenotypes of Duchenne muscular dystrophy(DMD),and to explore the molecular pathogenesis of DMD.METHODS:The gene sequences of 59 cases of DMD/BMD patients with deletion from mutation were analyzed.The relationship between the protein hydrophobicity,3D-spacial structure and clinical phenotypes was examined by biological informatic technology.RESULTS:50 cases of frameshift mutation were all DMD.In other 5 cases with codon mutation that involved the 3rd hydrophobic region,4 cases were diagnosed as DMD and the rest one was BMD.The exon 3 deletion leaded to the intortion of dystrophin N-terminal,which in turn affected the combination of dystrophin and troponin resulting in the DMD pathopoiesis.CONCLUSION:The severity of clinical phenotypes of muscular dystrophy diseases is related to whether the deletion destroys the reading frame,involves the 3rd hydrophobic region or changes the protein special structure.The biological informatic technology provides a new potential research methodology for studying the pathogenesis of DMD.
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AIM: To observe skeletal muscle damage of mdx mice after overload exercise, and protection to muscle damage induced by exercise due to myoblast transplantation (MTT). METHODS: Muscle samples of C 57 mice were minced and digested with trypsin, and myoblasts were cultured ex vivo , purified and detected by immunohistochemistry stains. The myoblasts were injected into muscle of left limb of mdx mice, whereas the right limb was injected with DMEM liquid as control. Mice were submitted to exercise for 3 days starting 1 month after MTT, and then Evans blue was injected intravenously through the tail vein. The muscle cryostat sections of mdx mice were made, and then detected the immunofluorescence of dystrophin. Under a fluorescence microscope, the number of fiber stained with Evans blue and dystrophin was counted, analyzed quantitatively with image software. RESULTS: Under a fluorescence microscope, only 10 37%?2 87% muscle fibers in the myoblast grafted muscles were stained with Evans blue. In contrast, 26 82%?14 85% muscle fibers in right control muscles were stained. Significant differences between these two groups were showed ( P
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AIM: To observe the effects of overload exercise on skeletal muscles in X-linked muscular dystrophy(mdx) mice.METHODS: Mdx mice and C57 mice were carried out swimming and hanging tail movement tests (mdx mice as control did not exercise). It lasted for 13 minutes each time per day, and lasted 3 days. Evans blue was injected into tail vain. The mice were killed the next day, and the hind limbs were taken photographs after skins were flayed. The gastrocnemius muscles and diaphragms cryostat sections were made. Under a fluorescence microscope, Evans blue staining was seen. Then the sections were tested by routine HE staining, the histological change of muscles was analyzed under a light microscope.RESULTS: Many blue colored longitudinal lines were observed in skeletal muscles of mdx mice, whereas they were hardly seen in control mdx and C57 mice. Under a fluorescence microscope, some muscle fibers of mdx mice were stained with Evans blue, few muscle fibers of control mdx mice were stained, and C57 mice were not. Under a light microscope, HE staining of muscles showed some degenerated muscle fibers became round in shape and the myonuclei became condensed, or necrotic fibers had amorphous structures, most of them in the degenerated and necrotic fibers of diaphragms C57 mice did not have these changes.CONCLUSION: Overload exercise did harm to skeletal muscles of mdx mice; Vital staining with Evans blue is useful not only for distinguishing degenerating muscle fibers, but also for studying the degeneration process in dystrophin-deficient muscle.
ABSTRACT
AIM: To investigate the correlation between the expression of neuron-specific protein and apoptosis in the process of differentiation from rat bone marrow stromal cells into neuron with brain-derived neurotrophic factor (BDNF). METHODS: The 5th passage MSCs were induced by BDNF and 2-mercaptoethanol (?-ME), respectively. At 1 h, 6 h, 12 h and 24 h, nestin, neuron specific enolase (NSE), microtubulease associated protein (MAP)-2 and glail fibrillary acidic protein (GFAP) were detected by Western blotting. Cell cycle and apoptosis were examined by flow cytometry. RESULTS: Nestin and NSE of neuron-like cells induced by BDNF and ?-ME were all positive by Western blotting. At 12 h, nestin and NSE turned to negative and apoptosis was detected in ?-ME group, nestin and NSE still positive and apoptosis wasn't detected in BDNF group. Till 24 h, nestin and NSE in BDNF group were negative but apoptosis still not detected. Notably, GFAP (glial astrocyte marker) was detected and MAP-2 wasn't detected in the two induced groups. CONCLUSION: The down-expression of neuron-specific protein correspondingly with apoptosis in the process of differentiation from MSCs into neuron with ?-ME shows that apoptosis may be one of the causes of induced cell death. BDNF induction was not the cause of apoptosis. Other factors may include for the cell death in the presence of neuron-specific protein expression induced by BDNF.