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AIM: To investigate the expression changes of MMP-12 during the long-term axon regeneration induced by the lens injury after the optic nerve clamp trauma in sprague-dawley(SD)rats.METHODS: The optic nerve injury model and lens injury model of SD rats were established, and the 24 experimental animals were divided into control group; lens injury group; optic nerve injury group; lens injury combined with optic nerve injury group, with 6 rats in each group. Reference transcriptome sequencing was used to analyze the expression changes of differentially expressed genes in the injured optic nerve region, and relevant differentially expressed genes with high expression were screened. Quantitative real-time polymerase chain reaction(qRT-PCR)and enzyme-linked immunosorbent assay(ELISA)were used to quantify the expression changes of matrix metalloproteinase-12(MMP-12)in the injured optic nerve region.RESULTS: The Principal Component Analysis of transcriptome sequencing indicated that lens injury combined with optic nerve injury was the principal component of gene expression change. Analysis of gene expression differences showed that the expression of MMP-12 gene was up-regulated in the lens injury combined with optic nerve injury group. The mRNA expression level of MMP-12 in the lens injury combined optic nerve injury group was up-regulated compared with the control group, the optic nerve injury group and the lens injury group at 14d and 21d after successful modeling(P<0.05). At 7, 28d, there was no difference in expression among all groups. The protein expression level of MMP-12 in the lens injury combined with optic nerve injury group was up-regulated compared with the control group and optic nerve injury group at 7, 14 and 21d after successful modeling(P<0.05), and it was up-regulated in the lens injury group combined with optic nerve injury group compared with optic nerve injury group at 21d(P<0.05). At 28d, there was no difference in expression among all groups.CONCLUSION: The up-regulated expression of MMP-12 may be involved in the long-term regeneration of the optic nerve after lens injury.
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Acupuncture , Acupuncture Therapy , Books , Medicine, Chinese Traditional , Qi , SensationABSTRACT
Objective:To create a prediction model that could be used to stratify the risk of cardiac rehabilitation in patients with stable coronary artery disease by using test data based on cardiopulmonary exercise testing (CPET) and general clinical data. Methods:A total of 114 patients with stable coronary artery disease were consecutively enrolled from the Cardiology Coronary Artery Disease Database of our hospital from December, 2014 to December, 2018, all the patients underwent CPET before coronary angiography. LASSO was used for feature selection. A nomogram was formulated based on the results of multivariate Logistic regression analysis using the RMS package of R. The predictive power was assessed with Receiver Operating Characteristic Curve. Results:Seven predictors were identified based on LASSO: coronary angiography results, the maximum value of ventilatory equivalent for carbon dioxide (EqCO2max), lymphocyte count, fasting blood glucose levels, cardiac muscle enzyme positivity, blood homocysteine and blood urea nitrogen levels. Combined with clinical experience and weighting analysis, the final four factors were included for Logistic regression modeling: coronary angiography results, EqCO2max, lymphocyte count and fasting blood glucose levels. The area under the curve was 0.875 for the model. Conclusion:EqCO2max and lymphocyte count are key predictors for stable coronary heart disease and can be used to identify patients at high risk for cardiac rehabilitation. A risk stratification model based on CPET and laboratory tests can be used to assess risk stratification for cardiac rehabilitation in patients with stable coronary artery disease.
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Objective:To investigate the status of cardiac rehabilitation after percutaneous coronary intervention (PCI) in rural areas. Methods:A total of 2264 patients after PCI in our hospital from January, 2016 to December, 2019 were selected. The awareness rate of patients on cardiac rehabilitation knowledge was investigated through WeChat, telephone and questionnaire. Patients were divided into rehabilitation group (n = 326) and non-rehabilitation group (n = 1809) according to whether they participated in cardiac rehabilitation. Results:There were 2135 valid questionnaires. The awareness rate of cardiac rehabilitation in PCI patients with coronary heart disease in rural areas was 44.9%, the participation rate was 15.2%, and the participation rate of outpatient heart rehabilitation was only 0.56%. The scores of the MOS Item Short Form Health Survey (SF-36) were higher in the rehabilitation group than in the non-rehabilitation group (t > 4.65, P < 0.05). Conclusion:In rural areas, the knowledge of cardiac rehabilitation is poor for patients after PCI, the participation rate is low, the control rate of risk factors is low, and most patients do not return to farm work. It is important to take a way to improve the awareness and participation of cardiac rehabilitation for patients after PCI, to ensure the exact control of cardiovascular risk factors of patients.
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OBJECTIVE@#By defining the inclusion criteria of the lost acupuncture technique and sorting out the content of lost acupuncture technique (possibly lost acupuncture technique), this article aimed to provide ideas and methods of the inheritance of acupuncture technique.@*METHODS@#The whole entries of @*RESULTS@#A total of 364 items of acupuncture technique were retrieved, including 17 items of lost acupuncture technique and 12 items of possibly lost acupuncture technique.@*CONCLUSION@#The lost acupuncture technique is defined as the acupuncture technique recorded in ancient classics but can not be retrieved in modern literature of clinical application or expert's experience. The change of government or alternation of dynasty, the evolution of acupuncture-moxibustion theories and education are the related causes of lost acupuncture technique.
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Acupuncture Therapy , China , MoxibustionABSTRACT
Objective:To explore the time-dependent changes of blood pressure with the increase of exercise intensity and its clinical significance in Cardiopulmonary Exercise Test for female patients with hypertension. Methods:From August, 2018 to August, 2019, 64 patients (hypertension group) who did not take β-receptor blockers and dihydropyridine calcium antagonists were selected from grade 1 and grade 2 hypertension women excluding myocardial ischemia with Cardiopulmonary Exercise Test. And 86 healthy women (non-hypertension group) excluding myocardial ischemia from the same period of Cardiopulmonary Exercise Test were selected as the controls for retrospective analysis. The time-dependent changes of blood pressure with the increase of exercise intensity were compared between two groups. Results:The blood pressures at resting for three minutes, anaerobic threshold and peak were significantly higher in the hypertension group than in the non-hypertension group (Z > 3.306, P < 0.001). There was no significant difference in peak oxygen uptake between two groups (Z = 1.549, P > 0.05). Conclusion:The blood pressure of the patients with grade 1 and grade 2 hypertension is prone to over elevation, who should pay more attention on blood pressure in sports and rehabilitation.
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Objective To detect the molecular characterization of polysaccharide purified from Amusium pleuronectes, so as to investigate its role of intervention to the formation of hepatic fibrosis caused by Schistosoma japonicum infection. Methods The crude polysaccharide from A. pleuronectes was extracted and further purified, and the molecular weight and monosaccharide composition were determined by the high pressure size exclusion chromatography and PMP pre-column derivatization method, respectively. A total of 50 female BALB/c mice were randomly divided into five groups：A (normal group), B (experimental group), C (polysaccharide group), D (praziquantel), and E (polysaccharide + praziquantel group). The mice in B, C, D, or E groups were attacked on the abdominal skin by using the cercariae of S. japonicum (30 ± 2 for each mouse) respectively. After 8 weeks, the mice in C, D, and E groups were administrated by polysaccharide and/or praziquantel, and the mice in B group were instead of saline. All the livers and sera were collected after 16 weeks. HE staining was employed for the livers, and serum IFN-γ and IL-13 were measured by using ELISA kits. Results The molecular weight of purified polysaccharide from A. pleuronectes was 11.7 kDa. Compared with A and B groups, the serum levels of IFN-γ in C, D, and E groups were significantly increased (F = 63.525, P < 0.01). However, the serum levels of IL-13 in C, D, and E groups were significantly decreased (F = 99.788, P < 0.01) compared with that in B group. HE staining showed that the egg nodules and hepatic fibrosis were observed in B, C, D, and E groups. The number of egg nodules and fibrosis degree in E group were milder than those in B group (χ2 = 7.875, P < 0.05). Conclusions The polysaccharide from A. pleuronectes has an obvious effect in preventing hepatic fibrosis process induced by S. japonicum infection, particularly combining with the administration of praziquantel.
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Objective To detect the molecular characterization of polysaccharide purified from Amusium pleuronectes, so as to investigate its role of intervention to the formation of hepatic fibrosis caused by Schistosoma japonicum infection. Methods The crude polysaccharide from A. pleuronectes was extracted and further purified, and the molecular weight and monosaccharide composition were determined by the high pressure size exclusion chromatography and PMP pre-column derivatization method, respectively. A total of 50 female BALB/c mice were randomly divided into five groups：A (normal group), B (experimental group), C (polysaccharide group), D (praziquantel), and E (polysaccharide + praziquantel group). The mice in B, C, D, or E groups were attacked on the abdominal skin by using the cercariae of S. japonicum (30 ± 2 for each mouse) respectively. After 8 weeks, the mice in C, D, and E groups were administrated by polysaccharide and/or praziquantel, and the mice in B group were instead of saline. All the livers and sera were collected after 16 weeks. HE staining was employed for the livers, and serum IFN-γ and IL-13 were measured by using ELISA kits. Results The molecular weight of purified polysaccharide from A. pleuronectes was 11.7 kDa. Compared with A and B groups, the serum levels of IFN-γ in C, D, and E groups were significantly increased (F = 63.525, P < 0.01). However, the serum levels of IL-13 in C, D, and E groups were significantly decreased (F = 99.788, P < 0.01) compared with that in B group. HE staining showed that the egg nodules and hepatic fibrosis were observed in B, C, D, and E groups. The number of egg nodules and fibrosis degree in E group were milder than those in B group (χ2 = 7.875, P < 0.05). Conclusions The polysaccharide from A. pleuronectes has an obvious effect in preventing hepatic fibrosis process induced by S. japonicum infection, particularly combining with the administration of praziquantel.
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OBJECTIVE@#To explore the incidence and risk factors for the acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) after resection of esophageal carcinoma.@*METHODS@#We retrospectively analyzed 422 consecutive patients admitted to the Department of Critical Care Medicine with esophageal carcinoma undergoing esophagectomy from January 2010 to December 2016 in Peking University Cancer Hospital. ALI/ARDS were diagnosed, the patients were divided into ALI/ARDS group and control group without ALI/ARDS, the differences of clinical features were contrasted between the two groups, and the multivariate Logistic regression modeling was used to identify the independent risk factors for ALI/ARDS.@*RESULTS@#In the study, 41 ALI/ARDS cases were diagnosed, making up 9.7% (41/422) of all the enrolled patients undergoing esophagectomy. Comparisons of the ALI/ARDS group and the control group indicated significant statistical differences in the average length of their hospital stay [(18.9±9.7) d vs. (14.8±3.6) d, P=0.011], the proportion of the patients who needed mechanical ventilation support [51.2% (21/41) vs. 9.4% (36/381), P<0.001] and in-hospital mortality [31.7% (13/41) vs. 5.0% (19/381), P<0.001]. Univariate analysis showed significant differences between the patients with ALI/ARDS and without ALI/ARDS in smoking history (P=0.064), preoperative forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (P=0.020), diffusing capacity of the lung for carbon monoxide (DLCO) (P=0.011), body weight index (BMI) (P=0.044), American Society of Anesthesiologists (ASA) physical status classification (P=0.049) and one lung ventilation duration (P=0.008), while multivariate Logistic regression analysis indicated that preoperative FEV1/FVC (OR=1.053, P=0.016, 95%CI 1.010-1.098), ASA physical status classification (OR=2.392, P=0.033, 95%CI 1.073-5.335) and one lung ventilation duration (OR=0.994, P=0.028, 95%CI 0.989-0.999) were the independent risk factors for ALI/ARDS after esophagectomy.@*CONCLUSION@#ALI/ARDS was a serious complication in patients undergoing esophagectomy associated with increment in length of hospital stay and in-hospital mortality. Multivariate Logistic regression analysis indicated that preoperative FEV1/FVC, ASA classification and one lung ventilation duration were the independent risk factors for ALI/ARDS after esophagectomy. Carefully assessing the patient before operation, shortening one lung ventilation duration were the key points in preventing ALI/ARDS after esophagectomy.
Subject(s)
Humans , Acute Lung Injury/etiology , Esophagectomy/adverse effects , Respiration, Artificial , Respiratory Distress Syndrome, Newborn/etiology , Retrospective Studies , Risk FactorsABSTRACT
BACKGROUND:The non-steroidal anti-inflammatory drug celecoxib,used for the treatment of senile degenerative knee osteoarthritis,has a rapid onset of action and few side effects.However,it cannot prevent the occurrence and development of knee osteoarthritis.Celecoxib withdrawal is likely to induce a rebound increase in inflammation that may aggravate symptoms.Diacerein is a drug used to improve articular cartilage metabolism.It can delay the progression of senile degenerative knee osteoarthritis,but has a slow onset of action.Whether combined treatment with celecoxib and diacerein provides complimentary actions to achieve a better therapeutic effect on senile degenerative knee osteoarthritis remains unclear.Whether combined treatment with celecoxib and diacerein provides complimentary actions to achieve a better therapeutic effect on senile degenerative knee osteoarthritis remains unclear.OBJECTIVE:To investigate the effectiveness and safety of celecoxib combined with diacerein in the treatment of senile degenerative knee osteoarthritis.METHODS:This is a prospective,single-center,randomized controlled trial.Three hundred patients with senile degenerative knee osteoarthritis who receive treatment at the Department of Orthopedics,Second Affiliated Hospital of Nanjing Medical University,China will be randomly assigned to celecoxib (200 mg,once a day,orally),diacerein (50 mg,twice a day,orally),and ccelecoxib+diacerein (celecoxib 200 mg,once a day,orally and diacerein 50 mg,twice a day,orally) groups,with 100 patients in each group.Patients in each group will be treated for 12 successive weeks,and a 36-week follow-up will be performed.The primary outcome measure of this study is the 20-meter walk pain visual analogue scale score before and 1,4,12,24,and 36 weeks after treatment.The secondary outcome measures of this study include osteoarthritis index and X-ray image findings of the knee before and 1,4,12,24,and 36 weeks after treatment,as well as the incidence of adverse events at 1,4,12,24,and 36 weeks after treatment.This study was approved by the Ethics Committee of the Second Affiliated Hospital of Nanjing Medical University,China (approval No.(2017)KY-091).The study protocol will be performed in strict accordance with the Declaration ofHelsinki formulated by the World Medical Association.Written informed consent of the study protocol and procedure will be obtained from each patient.Participant recruitment will begin in January 2018.Sample and data collection will begin in January 2018 and end in December 2018.Outcome measures will be analyzed in January 2020.The trial will end in February 2020.Results will be disseminated through presentations at scientific meetings and/or by publication in a peer-reviewed journal.This trial was registered with the Chinese Clinical Trial Registry (registration No.ChiCTR-IOR-17013867).DISCUSSION:Results from this study will help to determine whether celecoxib and diacerein complement each other to produce a long-acting,safe,reliable,and rapid-onset analgesic effect in patients with senile degenerative knee osteoarthritis.
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Objective To study the effect of miR-141 on the proliferation of head and neck squamous cell carcinoma (HNSCC) cells. Methods The expressions of miR-141 in 19 HNSCC tissues and the matched adjacent normal tissues were analyzed by qRT-PCR. The miR-141 in Hep-2 or SCC-9 cells was overexpressed or down-regulated by miR-141 mimics or miR- 141 ASO transfection. Then the effects of overexpression or down-regulation of miR-141 on cellular proliferation were analyzed by MTT experiment. The targeted genes of miR-141 were predicted by bioinformatics algorithms. Results The expression of miR-141 in HNSCC tissues was found significantly lower than that in matched normal tissue (P<0. 05). Overexpression of miR141 significantly inhibited the proliferation of Hep-2 and SCC-9 cells, and down-regulation of miR-141 significantly promoted the proliferation of Hep-2 and SCC-9 cells (P<0. 05). Bioinformatics algorithms showed that ZEB1 was likely to be a targeted gene of miR-141 in HNSCC. Conclusion miR-141 may inhibit HNSCC cell proliferation via ZEB1.
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<p><b>OBJECTIVE</b>To sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems.</p><p><b>METHODS</b>We retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems.</p><p><b>RESULTS</b>FGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score.</p><p><b>CONCLUSION</b>Both ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.</p>
Subject(s)
Aged , Humans , Age Factors , Fournier Gangrene , Diagnosis , Mortality , General Surgery , Prognosis , Retrospective Studies , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
<p><b>OBJECTIVE</b>Using infant and child feeding index (ICFI) to evaluate the relationship between infant feeding and physical development indicators in rural areas of Lhasa.</p><p><b>METHODS</b>In July and August 2010 in the rural areas of Lhasa, the multi-stage cluster random sampling method was adopted to select 540 Tibetan children who were between 6 to 35 months of age. There were 70, 79 and 391 cases in 6 to 8, 9 to 11 and 12 to 35-month-old group respectively. The basic status of infants, information about breastfeeding and complementary feeding were collected by using designed questionnaires. Their height and weight were measured to calculate the children's weight for age Z-score (WAZ), height for age Z-score (HAZ) and weight for height Z-score (WHZ) and assess feeding index score (out of 17 scores) and analyze the relationship between feeding index and HAZ, WAZ and WHZ.</p><p><b>RESULTS</b>The mean ICFI score of 540 cases was 8.90 ± 2.82.It was 6.84 ± 3.16, 8.16 ± 2.78 and 9.41 ± 2.55 for 6 to 8, 9 to 11 and 12 to 35-month-old infants respectively. There was significant difference between the different month group (F = 30.99, P < 0.05).For the three month groups, the scores of WAZ were 0.10 ± 1.18, -0.09 ± 1.20 and -0.38 ± 0.96; HAZ were -0.60 ± 1.68, -1.02 ± 1.72 and -1.30 ± 1.30; WHZ were 0.62 ± 1.23, 0.69 ± 0.96 and 0.43 ± 0.95 respectively. The ICFI scores of 9 to 11, 12 to 35 and 6 to 35-month-old infants were positively correlated with HAZ (correlation coefficients were 0.25,0.12 and 0.09 respectively, all P values <0.05). There was no correlation with WAZ (correlation coefficients were 0.15,0.08 and 0.03 respectively, all P values >0.05) and WHZ (correlation coefficients were -0.08, -0.02, and -0.07 respectively, all P values >0.05). There were no correlation between ICFI score with HAZ, WAZ and WHZ for 6 to 8 month-old infants (correlation coefficient were 0.06,0.16 and -0.07 respectively, all P values >0.05).</p><p><b>CONCLUSION</b>To some extent, the feeding index can effectively reflect the growth status of these infants and can serve as a comprehensive assessment of feeding situations among Tibetan children in rural areas of Lhasa.</p>
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Child, Preschool , Female , Humans , Infant , Male , Breast Feeding , Child Development , China , Infant Food , Nutritional Status , Rural Population , SomatotypesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the sodium content and energy of commercial dishes in 4 Chinese restaurants in Beijing.</p><p><b>METHODS</b>From June to August of 2011, 4 medium-sized restaurants were selected by convenience sampling method. Overall, 47 commercial dishes (including 9 cold dishes and 38 cooked dishes) consumed at least 6 times by consumers and provided by at least 2 restaurants were selected. One complete serving was selected for each dish to investigate its energy and sodium content, and calculate its sodium density.</p><p><b>RESULTS</b>The median value of sodium content in cold dishes and cooked dishes were 580, 522 mg/100 g (Z = 0.83, P > 0.05) or 1427, 2301 mg/serving (Z = 2.03, P < 0.05); the median sodium density for cold and cooked dishes were 1902 and 670 mg/1000 kJ (Z = 2.81, P < 0.01); the median value of energy in cold dishes and cooked dishes were 514, 717 kJ/100 g (Z = 2.15, P < 0.05) or 1113, 3492 kJ/serving (Z = 4.03, P < 0.05). Of the 47 dishes, 46.8% (22/47) exceeded the daily recommendation of sodium content for Chinese residents (2200 mg).</p><p><b>CONCLUSION</b>The commercial dishes in medium-sized Chinese restaurants provide a relatively higher energy and sodium. Cold dishes contain less energy but have high sodium density, so the sodium from these dishes could not be ignored.</p>
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China , Cooking , Energy Intake , Food Analysis , Restaurants , Sodium, DietaryABSTRACT
To be the representative fruition resulted from the rapid development in micro-nano theory and technology, atomic force microscopy (AFM) has greatly promoted the expansion of biological research in micro-nano scale, and facilitated the birth and development of micro-nano biology as an important technique in its 25-year evolutional progress. Based on the fundamental principles and detection modes of AFM, as well as the author’s research findings and work experience in this field, the paper reviews the application of AFM in the study on ultrastructure and biomechanical properties of cells and biomacromolecules in the aspects of biological structure and morphology, surface physicochemical characterization and mechanical manipulation of biological macromolecules, and focus on some important scientific and technical problems on AFM in micro-nano biomedical research needed to be improved and solved urgently, with exploratory insights and recommendations for potential users in ultrastructure and biomechanics of cells and biomacromolecules.
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<p><b>OBJECTIVE</b>To investigate the clinical characteristics, diagnosis and treatment of digestive tract leakage after orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>Sixty-one recipients had digestive tract leakage in early stage after OLT among 1173 cases from January 2000 to December 2010. There were 55 male and 6 female patients, aging from 36 to 61 years, with a median of 45 years. Digestive tract leakage included bile leakage (46 cases), gastric leakage (5 cases), duodenal leakage (1 case), jejunal leakage (4 cases), ileal leakage (1 case) and colon transversum leakage (4 cases). Ten of recipients with gastrointestinal leakage had 1 to 3 times of abdominal surgery before OLT. Abdominal drainage was used in 28 cases with bile leakage, and additionally, endoscopic retrograde cholangiopancreatography, endoscopic nasobiliary drainage and stenting were performed for 8 of them, and surgical neoplasty for another 18 patients with bile leakage. Simple surgical neoplasty of perforation was performed for 13 patients with gastrointestinal leakage, and diverticulectomy and neoplasty for 1 case with duodenal leakage, and partial jejunostomy for one severe jejunal leakage. Nutritional support was administered for all of cases.</p><p><b>RESULTS</b>The incidence rate of digestive tract leakage in early stage after OLT was 5.20% (61/1173). Intra-operative iatrogenic injury of gastrointestinal tract was occurred in 6 cases with gastrointestinal leakage. After treatment, 11 cases died of multiple organ failure resulted from severe infection, with mortality of 18.0% (11/61), including 4 cases with bile leakage, with the mortality of 8.6% (4/46), and 7 cases with gastrointestinal tract leakage, with the mortality of 46.6% (7/15). The remanent 50 cases through comprehensive treatment with a span of 1 to 3 months recovered and discharged healthily. No digestive tract leakage reoccurred in the follow-up of 6 to 84 months.</p><p><b>CONCLUSIONS</b>The morbidity of digestive tract leakage in early stage after OLT is low, but its mortality is high, especially for gastrointestinal tract leakage. High dose corticosteroids therapy, history of abdominal operation and intra-operative iatrogenic injury may be high risk factor. Comprehensive treatment is crucial for improving prognosis.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Digestive System Fistula , Diagnosis , Therapeutics , Drainage , Liver Transplantation , Postoperative Complications , Diagnosis , TherapeuticsABSTRACT
Objective: To investigate the influence of total body irradiation with different doses of 60Coγ on wound breaking strength during wound healing in rats. Methods: Rats were exposed to 60Coγ radiation at dosages of 4,6 ,and 8 Gy. Within 30 min after irradiation, full thickness skin wounds were made on the shaved back of rats to establish animal models of irradiated-trauma injury plus skin wounds (n=20), and non-irradiated rats with pure incision injury were used as controls (n=10). The rats were sacrificed at day 10 after treatment, and the full thickness skin wounds were harvested. Bio-mechanics method and histopathology examination were used to evaluate the wound breaking strength and histological features after healing. Results: The wound breaking strength of model groups were greatly retarded with the increase of irradiation doses. Statistical results showed that on day 10 the wound breaking strength values were significantly different between 4 Gy group ([114.26±0.29] g) and control group ([117.12±1.86] g, P>0.05), and the wound breaking strength values of 6 Gy group ([91.87±1.96] g) and 8 Gy group ([55.26±2.64] g) were significantly lower than that of the control group (P<0.05). H-E staining showed that the wounds in the irradiation trauma groups had looser and disorder collagenous fiber and less fibroblast proliferation than control group. Conclusion: Radiation injury may result in delayed wound healing, and the wound breaking strength decreases with the increase of irradiation dose in model of irradiation injury plus full thickness skin wounds.
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<p><b>OBJECTIVE</b>To investigate the effect of Campath-1H induction on immunosuppression in small intestine transplantation.</p><p><b>METHODS</b>Clinical data of a patient who underwent small intestine transplantation were retrospectively summarized.</p><p><b>RESULTS</b>Intraoperative Campath-1H induction by intravenous injection was administered. Triple immunosuppression(FK506, MMF and methylprednisolone) was used postoperatively. The lymphocyte and leukocyte decreased significantly following Campath-1H induction, and returned to normal after adjusting the dose of immunosuppressant and use of colony stimulating factor. There were no acute rejection, graft versus host disease, or severe infection during the immediate postoperative period. The patient recovered and discharged.</p><p><b>CONCLUSION</b>Intraoperative Campath-1H induction and postoperative triple immunosuppression using FK506, MMF, and methylprednisolone may prevent rejection and graft versus host disease in the early stage after small intestine transplantation.</p>
Subject(s)
Adult , Humans , Male , Alemtuzumab , Antibodies, Monoclonal, Humanized , Therapeutic Uses , Graft Rejection , Immunosuppression Therapy , Immunosuppressive Agents , Therapeutic Uses , Intestine, Small , Transplantation , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To summarize the treatment outcomes after combined en bloc liver and pancreas transplantation.</p><p><b>METHODS</b>Five patients with end-stage liver disease and type 2 diabetes mellitus received combined en bloc liver and pancreas transplantation after hepatectomy.</p><p><b>RESULTS</b>Five operations were performed successfully. The operative time ranged from 9 to 16 hours and blood loss from 1600 to 3000 ml. Postoperatively, one patients developed pulmonary infection, one died of graft-versus-host disease(GVHD), and one experienced acute renal failure. No intestinal fistula, anastomotic leakage, biliary complications, chronic and acute rejection and pancreatitis were seen. Liver function index including alanine aminotransferase, aspartate aminotransferase and total bilirubin returned to normal levels a week after surgery, while levels of C peptide and blood glucose resumed within 1 to 2 weeks. Apart from 1 case died of GVHD, the other 4 maintained normal liver function during the follow up ranging from 2 to 23 months and no insulin was required for the diabetes.</p><p><b>CONCLUSION</b>Combined en bloc liver and pancreas transplantation is technically feasible and an effective treatment for multi-organ diseases.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Diabetes Mellitus, Type 2 , General Surgery , Liver Failure , General Surgery , Liver Transplantation , Pancreas Transplantation , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate the safety and feasibility of steroids minimization immunosuppressive regimen in liver transplantation.</p><p><b>METHODS</b>One hundred and sixteen patients in line with the selecting criteria from January 2005 to June 2008 were divided into three groups according to the withdrawal of steroids: 40 cases in 3 months withdrawal group, 40 cases in 7 d withdrawal group and the other 36 cases in 24 h withdrawal group. The difference of recipients' survival, infection, acute rejection and steroids resistant acute rejection, wound healing, recurrence of HBV and hepatocellular cell (HCC), new on-set of diabetes, hyperlipidemia and hypertension between the three groups were compared.</p><p><b>RESULTS</b>The difference of recipients' survival, acute rejection including steroids resistant acute rejection, recurrence of HBV and HCC, hyperlipidemia between the three groups were not significant (P > 0.05), the incidence of wound un-healing and hypertension in 24 h withdrawal group was significantly lower than that in the other 2 groups (P < 0.05), the incidence of infection and new on-set diabetes in 24 h withdrawal group and 7 d withdrawal group was significantly lower than that in 3 months withdrawal group (P < 0.05).</p><p><b>CONCLUSION</b>Steroids minimization immunosuppressive strategy is safe and feasible in liver transplantation field, it will significantly reduce the steroids related complications without increasing the risk of rejection.</p>