Analysis of the clinical characteristics and risk factors of postoperative atrial fibrillation in patients with critical burns / 中华烧伤杂志

Objective: To investigate the clinical characteristics and risk factors of postoperative atrial fibrillation (POAF) in patients with critical burns. Methods: A retrospective case series study was conducted. From January 2017 to December 2021, two hundred and twenty-seven critically burned aldult patients who met the inclusion criteria were admitted to Guangzhou Red Cross Hospital of Jinan University, including 173 males and 54 females, aged 19-83 (43±14) years. The admission years of patients were collected, and the percentage of patients complicated with POAF in each year was calculated. According to whether the patients were complicated with POAF or not, they were divided into POAF group (n=17) and non-POAF group (n=210). Following data were collected in patients in POAF group, including operation methods, duration of operation, intraoperative blood loss before occurrence of POAF each time, occurrence time and times of POAF, postoperative body temperature, blood pressure, hemoglobin, blood glucose, blood lactate, sepsis, and electrolyte, and type, duration, and treatment of POAF. General data of patients in the two groups including age, gender, burn reason, total burn area, full-thickness burn area, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sepsis-related organ failure evaluation (SOFA) scores on admission, combined with underlying diseases (hypertension, diabetes, and other types of arrhythmias), and sepsis were collected and analyzed. The mortality and factors influencing the prognosis of patients in the two groups such as mechanical ventilation time, operations times, and burn intensive care unit (BICU) length of stay were also collected and analyzed. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, chi-square test or Kruskal-Wallis H test. The multivariate logistic regression analysis was performed on the general data with statistically significant differences between the two groups, and the independent risk factors influencing the onset of POAF in 227 patients with critical burns were screened. Results: From 2017 to 2021, the percentage of critically burned patients complicated with POAF increased year by year. In POAF group, eschar debridement in limbs was the main surgical procedure prior to POAF complication, with the operation time of (3.5±1.2) h and the intraoperative blood loss volume of (365±148) mL.The POAF occurred 25 times in total in patients of POAF group, mostly within one week after the injury and within 6 hours after the operation with most of these patients having POAF only once. When POAF happened, the patients were often complicated with hypothermia, anemia, hyperglycemia, high blood lactate, sepsis, and electrolyte disturbance, and few patients had complications of hypotension. The POAF lasted (5±3) h, with all being paroxysmal atrial fibrillation, and most of POAF patients were reverted to sinus rhythm after amiodarone intervention. Most patients in the two groups suffered from flame burn, and the gender, age, and SOFA score on admission of patients in the two groups were similar (P>0.05); the APACHEⅡ score on admission, total burn area, full-thickness burn area, incidence proportion of sepsis, combined with diabetes and hypertension and other types of arrhythmias of patients in POAF group were significantly higher or larger than those in non-POAF group (t=3.47, with χ2 values of 7.44, 10.86, 12.63, 14.65, 6.49, and 7.52, respectively, P<0.05 or P<0.01). The full-thickness burn area, combined with other types of arrhythmias, and sepsis were the independent risk factors for POAF in 227 critically burned patients (with odds ratios of 4.45, 0.04, and 3.06, respectively, with 95% confidence intervals of 2.23-8.87, 0.01-0.22, and 1.77-5.30, respectively, P<0.01). Compared with those in non-POAF group, the mechanical ventilation time, BICU length of stay, number of operations, and mortality rate of patients in POAF group were significantly increased (Z=3.89, Z=2.57, t=3.41, χ2=3.72, P<0.05 or P<0.01). Conclusions: POAF is a common postoperative complication in critically burned patients, and the incidence is increasing year by year, which seriously affects the prognosis of patients. The full-thickness burn area together with other types of arrhythmias and sepsis are the high-risk factors for POAF complication in patients with critical burns.

Research Progress on Hepatotoxicity Mechanism and Attenuation Methods of Psoraleae Fructus / 中国实验方剂学杂志

Psoraleae Fructus is the dried and mature fruit of the legume Psoralea corylifolia. It is warm in nature， pungent and bitter in flavor， and attributive to the kidney and spleen meridians. Its main effect include warming the kidney and assisting Yang， absorbing Qi and relieving asthma， warming the spleen and relieving diarrhea， etc.， and it also can for external use of eliminating wind and freckle. Clinically， Psoraleae Fructus is mainly used for the treatment of impotence due to kidney deficiency， soreness of waist and knees， vitiligo， etc. The existing studies have shown that Psoraleae Fructus has a variety of pharmacological effect， such as anti-tumor， anti-oxidant， anti-bacterial， anti-inflammatory， promoting bone growth and protecting cardiovascular. But at the same time， many studies at home and abroad have found that taking Psoraleae Fructus and its compounds for a long time or in large doses can cause liver toxicity， phototoxicity， nephrotoxicity， etc. The most common is liver toxicity， most of the clinical reports on the toxicity of psoralen are caused by drug-induced liver injury events， which limits the clinical use of Psoraleae Fructus and can't exert its proper therapeutic effect. Therefore， it is particularly important to fully understand the toxicological mechanism of liver injury caused by Psoraleae Fructus and its attenuation methods. In this paper， by consulting the domestic and foreign related literatures in recent years that reported the hepatotoxicity of Psoraleae Fructus， the four aspects of clinical report on liver injury， hepatotoxic components， toxicological mechanisms and attenuation methods of Psoraleae Fructus were reviewed， including bile acid stasis and oxidative stress. The hepatotoxicity of Psoraleae Fructus was discussed in terms of reaction， mitochondrial damage， liver fat deformation， etc.， and the attenuation methods of Psoraleae Fructus were summarized from the aspects of compatibility attenuation and processing attenuation， aiming to comprehensively and objectively clarify Psoraleae Fructus. The potential toxicological mechanism of lipid-induced hepatotoxicity and research progress in attenuation were expected to provide a theoretical basis for further study of Psoraleae Fructus hepatotoxicity and clinical rational use of drugs.

Relationship between serum MMP-9 level and prognosis after radical resection for Hilar cholangiocarcinoma patients

Abstract Purpose: To analyze the preoperative serum matrix metalloproteinase-9 (MMP-9) levels and prognosis of patients with hilar cholangiocarcinoma (HC) undergoing radical resection. Methods: Preoperative serum MMP-9 levels in patients with HC undergoing radical resection were detected by enzyme-linked immunosorbent assay (ELISA). The ROC curve assay was used to analyze the preoperative serum MMP-9 level to determine the most valuable cut-off point. The relationship between MMP-9 and clinicopathological features of HC patients was analyzed. Kaplan-Meier method was used to analyze the prognostic factors, and COX regression model was used to analyze the independent risk factors affecting prognosis. Results: Preoperative serum MMP-9 levels were significantly elevated in the death patients compared with the survival patients. The most valuable cut-off point for preoperative serum MMP-9 for prognosis was 201.93 ng/mL. Preoperative serum MMP-9 was associated with Bismuth-Corlette classification) and lymph node metastasis. Kaplan-Meier analysis showed that MMP-9, Bismuth-Corlette classification, Lymph node metastasis, Portal vein invasion, Hepatic artery invasion, Liver invasion, Incised margin, and Preoperative biliary drainage were related to prognosis. Cox regression model confirmed that hepatic artery invasion, liver invasion, incised margin, and MMP-9 have the potential to independence predicate prognosis in HC patients. Conclusion: Preoperative serum MMP-9 has high predictive value for prognosis and is an independent influencing factor for the prognosis of patients with hilar cholangiocarcinoma.

Progresses of PET and MRI in evaluating expression of tumor hypoxic and downstream molecules / 中国介入影像与治疗学

The growth of solid tumors can lead to changes in the hypoxic microenvironment of local tissues,and the most important regulatory factor is the hypoxia-inducible factors (HIFs).In the case of hypoxia,the downstream target genes regulated by HIF-1α regulation mainly are vascular endothelial growth factor (VEGF) and glucose transporter 1 (GLUT-1) genes,etc.In recent years,multimodality PET and MRI imaging technologies have been widely used in diagnosis of tumor diseases,and have confirmed that the parameters obtained by imaging are associated with the expression of tumor hypoxic related molecules.The molecular expression of HIF-1α within the tumor and its downstream target genes VEGF and GLUT-1 detected by PET and multifunctional MRI sequential were reviewed in this article.

Preliminary Study of Peptide From Periplaneta americana On Antitumor Immunity in L1210-Bearing Mice / 中国药学杂志

OBJECTIVE: To explore the antitumor effect and immunity change of Periplaneta americana CⅡ3 and related synthetic peptide HFDT1 in mice and to provide a base for clinical application of the materials. METHODS: Sixty BALB/c mouse tumor model with leukemia L1210 were established and divided into five groups. The mice were treated with Periplaneta americana CⅡ3 high dose, low dose, HFDT1, CTX and normal saline for 10 d, respectively. Twelve mice were as normal control group. The tumor inhibition rates and weight of body were observed in different groups. Then the results were observed including thymus and spleen index, the numbers of immune cells in peripheral blood, the ratio of splenic total lymphocytes, splenic B cell(CD45R+) and T cell(CD3+), T cell subset(CD3+ CD4+ and CD3+ CD8+ T cell), and the levels of IgG, IgA and IgM in serum through weight, auto-analysis of blood cell, flow cytometry, sandwich-antibody ELISA from thymus, spleen, peripheral blood in the mice. RESULTS: The results showed that CⅡ3 and HFDT1 inhibited the growth of mouse L1210 tumor and maintained the mouse weights. They increased the mouse thymus indexes and spleen indexes effectively and the numbers of peripheral blood immune cells. They maintained the spleen lymphocyte and regulated the ratio of T and B lymphocytes, CD3+ CD4+ T cell and CD3+ CD8+ T cell. They increased the levels of serum IgG, IgA and IgM. CONCLUSION: Periplaneta americana extract CⅡ3 and related synthetic peptide HFDT1 have a strong inhibition effect to tumor. The antitumor effect of CⅡ3 and HFDT1 may be achieved through to improve immune function. They are hoped to become efficient and low toxicity antitumor drugs. Especially HFDT1, it has an extensive application because it can be synthesized by artificial methods.

Antibiotics De-Escalation in the Treatment of Ventilator-Associated Pneumonia in Trauma Patients: A Retrospective Study on Propensity Score Matching Method / 中华医学杂志(英文版)

<p><b>Background</b>Antimicrobial de-escalation refers to starting the antimicrobial treatment with broad-spectrum antibiotics, followed by narrowing the drug spectrum according to culture results. The present study evaluated the effect of de-escalation on ventilator-associated pneumonia (VAP) in trauma patients.</p><p><b>Methods</b>This retrospective study was conducted on trauma patients with VAP, who received de-escalation therapy (de-escalation group) or non-de-escalation therapy (non-de-escalation group). Propensity score matching method was used to balance the baseline characteristics between both groups. The 28-day mortality, length of hospitalization and Intensive Care Unit stay, and expense of antibiotics and hospitalization between both groups were compared. Multivariable analysis explored the factors that influenced the 28-day mortality and implementation of de-escalation.</p><p><b>Results</b>Among the 156 patients, 62 patients received de-escalation therapy and 94 patients received non-de-escalation therapy. No significant difference was observed in 28-day mortality between both groups (28.6% vs. 23.8%, P = 0.620). The duration of antibiotics treatment in the de-escalation group was shorter than that in the non-de-escalation group (11 [8-13] vs. 14 [8-19] days, P = 0.045). The expenses of antibiotics and hospitalization in de-escalation group were significantly lower than that in the non-de-escalation group (6430 ± 2730 vs. 7618 ± 2568 RMB Yuan, P = 0.043 and 19,173 ± 16,861 vs. 24,184 ± 12,039 RMB Yuan, P = 0.024, respectively). Multivariate analysis showed that high Acute Physiology and Chronic Health Evaluation II (APACHE II) score, high injury severity score, multi-drug resistant (MDR) infection, and inappropriate initial antibiotics were associated with patients' 28-day mortality, while high APACHE II score, MDR infection and inappropriate initial antibiotics were independent factors that prevented the implementation of de-escalation.</p><p><b>Conclusions</b>De-escalation strategy in the treatment of trauma patients with VAP could reduce the duration of antibiotics treatments and expense of hospitalization, without increasing the 28-day mortality and MDR infection.</p>

High-frequency Oscillations and the Seizure Onset Zones in Neocortical Epilepsy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To study the characters of high-frequency oscillations (HFOs) in the seizure onset zones (SOZ) and the nonseizure onset zones (NSOZ) in the electrocorticography (ECoG) of patients with neocortical epilepsy.</p><p><b>METHODS</b>Only patients with neocortical epilepsy who were seizure-free after surgery as determined with ECoG were included. We selected patients with normal magnetic resonance imaging before surgery in order to avoid the influence of HFOs by other lesions. Three minutes preictal and 10 min interictal ECoG as recorded in 39 channels in the SOZ and 256 channels in the NSOZ were analyzed. Ripples and fast ripples (FRs) were analyzed by Advanced Source Analysis software (ASA, The Netherlands). Average duration of HFOs was analyzed in SOZ and NSOZ separately.</p><p><b>RESULTS</b>For ripples, the permillage time occupied by HFOs was 0.83 in NSOZ and 1.17 in SOZ during the interictal period. During preictal period, they were 2.02 in NSOZ and 7.93 in SOZ. For FRs, the permillage time occupied by HFOs was 0.02 in NSOZ and 0.42 in SOZ during the interictal period. During preictal period, they were 0.03 in NSOZ and 2 in SOZ.</p><p><b>CONCLUSIONS</b>High-frequency oscillations are linked to SOZ in neocortical epilepsy. Our study demonstrates the prevalent occurrence of HFOs in SOZ. More and more burst of HFOs, especially FRs, means the onset of seizures.</p>

Transcription of cytoskeleton protein genes in differentiation of neurons from mouse embryonic stem cells induced by small molecules / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the transcription of cytoskeleton protein genes in differentiation of neurons from mouse embryonic stem (ES) cells induced by all-trans retinoic acid (RA), and to explore the possibility of setting up a method to screen small molecules with promoting or inhibiting effect.</p><p><b>METHODS</b>The hanging drop method was employed for embryonic body formation to mimic embryo development in vivo. Reverse transcriptase PCR (RT-PCR) was performed to investigate mRNA expression of the neuron-specific cytoskeleton proteins including Mtap2, Nefm and beta-tubulin III which were regarded as the inducing effect indexes of RA. Morphological evaluation and immunocytochemistry staining were conducted to identify the neural derivatives. Moreover, the inducing effects of six synthetic molecules were further evaluated.</p><p><b>RESULT</b>RA up-regulated the mRNA expression of Mtap2 and Nefm, especially Mtap2 increased by 1.27 times, which was consistent with the morphological alteration. However, there was no significant changes of beta-tubulin III expression. With addition of the six synthetic molecules, the transcription of Mtap2 was inhibited, while the Nefm mRNA expression was up-regulated in some degree, especially for molecule 1 and 3 that was increased by 1.4 and 1.2 times, which, however, was not parallel to the morphological changes.</p><p><b>CONCLUSION</b>The transcriptional levels of Mtap2 and Nefm are both up-regulated in the RA-induced differentiation of ES cells towards neurons. The up-regulation of Mtap2 is consistent with the morphological alteration, which might be the key landmark in the RA-induced differentiation of ES cells into neurons.</p>

Treatment of skeletal Class II adult patients with microscrew implant anchorage and multi-loop edgewise arch wire / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effects and mechanisms of the microscrew implant anchorage (MIA) combined with multi-loop edgewise arch wire (MEAW) technique in the treatment of skeletal Class II adult patients.</p><p><b>METHODS</b>Eleven adult patients with skeletal Class II high-angle malocclusions were treated with fixed appliances. The spaces were closed by the springs from the MIA to the hook on the archwire. The height of the hook and the direction of the force were different according to the intrusion and retraction of upper anterior teeth. In the finishing stage, MEAW technique and modified class II elastics (from the first loop of MEAW to the MIA) were used for final detailing. Cephalometric analysis was used to evaluate the effect after treatment.</p><p><b>RESULTS</b>After treatment, the decrease of SNA, ANB and FMA were (2.86 +/- 1.05) degrees , (2.82 +/- 0.96) degrees and (2.95 +/- 1.35) degrees , respectively. The torque control of upper anterior teeth was good. The protrusion of lower incisors and the molar extrusion were avoided. The upper molars were moved distally by (3.00 +/- 2.19) mm.</p><p><b>CONCLUSIONS</b>The treatment of adult patients with skeletal Class II high angle malocclusions with MIA and MEAW technique could not only improve the facial esthetics but also avoided the common side effects of traditional Class II elastics.</p>

Association between islet xenograft rejection mediated by activated macrophages and upregulated chemokines / 中南大学学报(医学版)

Objective Our previous study has shown that porcine antigen-primed and CD4 + T cells activated macrophages are capable of the ecognition and rejection of porcine xenografts but not mouse allografts, and therefore suggested the involvement of signaling between the graft and macrophages in this specific graft recognition and destruction. Methods NOD-SCID mice were transplanted with fetal pig pancreatic fragment (FPP) before adoptive transfer with exogenous macrophages isolated from rejecting FPP xenografts of BALB/c recipient mice. The exogenous macrophages were tracked by Ly5.1 surface antigen or via CSFE staining. Gene expression of CCR2 and CCR5 and their chemokines in transplanted FPP xenografts was evaluated by real-time PCR. Results After the adoptive transfer, recently transplanted but not established FPP xenografts were rejected by exogenous activated macrophages. In the meantime, greater level of chemokine gene expression was detected in recently-transplanted compared with the established xenografts. Furthermore, expression of both CCR2 and CCR5 genes was enhanced significantly in activated macrophages when compared with non-activated macrophages. Conclusion Upregulated chemokines were associated with macrophage recruitment and destruction of islet xenografts.

Elemental contents in organs and tissues of Chinese adult men / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To provide basis of reference values for relevant parameters of Chinese Reference Man.</p><p><b>METHODS</b>Eighteen kinds of major organ or tissue samples, including muscle, rib, liver, and so on, were obtained from 4 areas (Hebei, Shanxi, Jiangsu, and Sichuan provinces) with different dietary patterns in China in autopsy of 16 healthy adult men, who had just encountered sudden deaths. At the same time, whole blood samples were collected from 10 volunteers living in each of these areas. The concentrations of 56 elements in these samples were detected by using Inductively Coupled Plasma Mass Spectrometry (ICP-MS), Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES), and Graphite Furnace Atomic Absorption Spectrometry (GF-AAS) techniques. Based on obtained concentrations and reference values of these organ or tissue weights for Chinese Reference Man, the relative elemental burdens in these organs or tissues as well whole body were also estimated.</p><p><b>RESULTS</b>The concentrations of 56 elements in 18 main organs or tissues were determined all together and their elemental organ or tissue and whole body burdens were estimated. Furthermore, the distributions of important elements for radiation protection in these organs or tissues were emphatically discussed.</p><p><b>CONCLUSION</b>By summing with past related results, the total results obtained from the series of research may provide more reliable and better representative basis of these reference values for Chinese Reference Man than before.</p>

Impact on the model of rat osteoarthritis of jingu tablet / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the influence of Jingu tablet (JGT) on the development and repair of osteoarthritis (OA).</p><p><b>METHOD</b>The admixture of 4% papain and 0.3 mol x L(-1) cysteine was injected into the rat's knee joint to make the model of rat OA, and distilled water, Gucining Capsule and JGT was given ig simultaneously to treat for 4 weeks in succession, and then animals were killed to measure every index.</p><p><b>RESULT</b>JGT could obviously improve the scope of activities of knee joint. There were significant differences between every dosage group and model group. In every dosage group, JGT could suppress the swelling of thickness of slippery membrane of joint, alleviate the inflammation symptoms of OA and obviouslical improve the pathologicol changes of slippery membrane and cartilage. JGT could also obviously reduce the content of MDA of slippery membrane and lighten the degree of cell damage.</p><p><b>CONCLUSION</b>JGT can lighten the retrograde affection of joint cartilage, obviously suppress the slippery membrane's inflammation and alleviate the scathing degree of cell. Therefore JGT has definite remedial effect to OA.</p>

A case control study on the relationship between trace elements and human neural tube defects / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the relationship between multi-trace elements levels in hair and human neural tube defects as well as other risk factors.</p><p><b>METHODS</b>Using 88 paired cases and controls, an 1:1 matched case control study was carried out. The study subjects were collected from the China-U. S. Collaborative Project on Neural Tube Defects Prevention and Birth Defects Surveillance System. Risk factors were obtained by field investigation with standardized questionnaires and hair trace elements levels were determined by AAS and ICP-MS methods. Microwave digestion was used to digest hair samples. The detected elements would include three groups, namely nutritional elements: Cr, Mn, Cu, Zn, Co, Mo; toxic elements: Pb, As, Cd, Hg; and Lanthanons: Y, La, Pr, Nd. Cox Proportional Hazard Regression Model was used to perform risk factors analysis.</p><p><b>RESULTS</b>Pregnancy fever appeared to be a risk factor of neural tube defects (OR = 6.525, P = 0.034) while hair zinc level (OR = 0.541 microg/100 g, P = 0.02) and times of prenatal physical examination (OR = 0.634, P < 0.001) served as two protective factors appeared in the last model.</p><p><b>CONCLUSION</b>Zinc deficiency might serve as a risk factor for human neural tube defects, suggesting that the avoidance of pregnancy infection together with more periodical prenatal physical examination might reduce the incidence of neural tube defects.</p>

Experimental study on islet cells in rats under condition of three-dimensional microgravity / 中华外科杂志

<p><b>OBJECTIVE</b>To study the survival rate and secretory function of islet cells in rats under condition of three-dimensional microgravity.</p><p><b>METHODS</b>Isolated islet cells were assigned to flask-cultured or bioreactor-cultured. Survival rate of islets cultured for days 3, 7, 14 in stationary flasks or microgravity bioreactors was measured by AO-PI double-staining. Cultured islets were identified by dithizone (DTZ) staining, and insulin contents of different culture liquids were measured by radioimmunoassay.</p><p><b>RESULTS</b>Pancreatic islets stained nacarat with DTZ were easily visualized. When islet cells were cultured for 7 days and 14 days, survival rate of bioreactor-cultured islets was (0.9000 +/- 0.0107)% and 0.8038% +/- 0.0092% and higher than flask-cultured islets (P < 0.01). Insulin level of bioreactor-cultured islets is (70.875 +/- 0.31) m micro /L on the cultured 7 days while flask-cultured islets is (41.246 +/- 0.35) m micro /L. There was statistically significant difference of insulin production between the two groups (P < 0.01). Bioreactor-cultured islet contents were higher than flask-cultured on the cultured 14, 21 and 30 days (P < 0.01).</p><p><b>CONCLUSIONS</b>Islet cells survival rate and secretory function revealed that bioreactor-cultured islets functioned better compared with flask-cultured islets.</p>

Analysis of intelligence profile,personality and behaviour of children with primary generalized epilepsy / 中国康复理论与实践

@#ObjectiveTo evaluate the intelligence profile,personality and behaviour disorders of children with primary generalized tonic and/or clonic seizures.MethodsUsing Chinese modification of Wechsler Intelligence Scale for Children,Eysenk Personality Questionnaire(EPQ),and Achenbach Child Behaviour Check List,neuropsychological assessment of 35 cases aged 6-14 years and the normals with the similar age and sex were makenand compared.ResultsExcept picture completion ,all the subtests scales of children with epilepsy were significantly lower than those of the controls (P<0.01). A significant difference of average FIQ(P<0.001) was observed between experimental group (85.86) and control group (103.60).There were 13 cases(37.14%) in experimental group whose FIQ were in broderline range, FIQ of 5 cases(14.29%) was in lower range,while none abnormal in the controls.The children with epilepsy had more abnormal behaviours than that of the controls(abnormal rates were 38.71% and 6.45% respectively).Statistical analysis showed no difference of EPQ scales between the two groups.Conclusions Children with primary generalized epilepsy maybe complicate with cognitive deficit and behaviour disorder.