Effectiveness of fascial tissue flaps and skin flaps with layered sutures for repair of wounds after excision of sacrococcygeal pilonidal sinus / 中国修复重建外科杂志

OBJECTIVE@#To investigate the feasibility and effectiveness of fascial tissue flaps and skin flaps with layered sutures for repairing wounds after excision of sacrococcygeal pilonidal sinus.@*METHODS@#Between March 2019 and August 2022, 9 patients with sacrococcygeal pilonidal sinus were admitted, including 7 males and 2 females with an average age of 29.4 years (range, 17-53 years). The disease duration ranged from 1 to 36 months, with a median of 6 months. There were 7 cases with obesity and dense hair, 3 cases with infection, and 2 cases with positive bacterial culture of sinus secretion. The wound area after excision ranged from 3 cm×3 cm to 8 cm×4 cm, with a depth of 3-5 cm, reaching the perianal or caudal bone; there were 2 cases with perianal abscess formation and 1 case with caudal bone inflammatory edema. Enlarged resection was performed during operation, and the fascial tissue flap and skin flap were designed and excised at both left and right sides of the buttock, ranging from 3.0 cm×1.5 cm to 8.0 cm×2.0 cm. A cross drainage tube was placed at the bottom of the wound, and the fascial tissue flap and skin flap were advanced and sutured in three layers, namely, 8-string sutures in the fascial layer, barbed wire reduction sutures in the dermis, and interrupted skin sutures.@*RESULTS@#All 9 patients were followed up 3-36 months, with an average of 12 months. All incisions healed by first intention, and no complication such as incisional dehiscence or infection in the operative area occurred. There was no recurrence of sinus tracts, the shape of gluteal sulcus was satisfactory, both sides of buttocks were symmetrical, local incision scar was concealed, and the shape disruption was minimal.@*CONCLUSION@#Fascial tissue flaps and skin flaps with layered sutures for repairing wounds after excision of sacrococcygeal pilonidal sinus can effectively fill the cavity and reduce the incidence of poor incision healing, with the advantages of small trauma and simple operation.

Value of baseline IgM level in predicting the treatment response of primary biliary cholangitis / 临床肝胆病杂志

Objective To investigate the association between baseline IgM level and treatment response to ursodeoxycholic acid (UDCA) in patients with primary biliary cholangitis (PBC). Methods A retrospective analysis was performed for the clinical data of 637 PBC patients who were diagnosed and treated with UDCA for the first time in The Fifth Medical Center of Chinese PLA General Hospital from January 2010 to January 2020. The PBC patients were divided into UDCA complete response group with 436 patients and UDCA poor response group with 201 patients, and baseline clinical data were compared between the two groups. According to the optimal cut-off value of IgM determined by the area under the ROC curve (AUC) of baseline indices in predicting the risk of poor treatment response, the patients were divided into IgM ≥1.5×ULN group and IgM < 1.5×ULN group, and baseline parameters, treatment response, and prognostic model score were compared between groups. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Cochran-Mantel-Haenszel test was used for subgroup analysis, and forest plots were plotted for related risk values. Results Compared with the UDCA complete response group, the UDCA poor response group had significantly higher proportion of patients with liver cirrhosis, levels of total bilirubin, aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bile acid, total cholesterol (TC), IgA, and IgM, and positive rate of anti-Gp210 antibody at baseline ( χ 2 =4.596, Z =-9.932, -8.931, -8.361, -7.836, -4.694, -3.242, and -2.115, χ 2 =15.931, all P < 0.05). The UDCA poor response group had significantly higher Mayo Risk Score, Globe score, and UK-PBC risk score than the UDCA complete response group ( t =4.092, Z =-10.910 and -11.646, all P < 0.001). Compared with the normal IgM group, the elevated IgM group had significantly higher levels of AST, ALP, TC, IgA, and IgG and a significantly higher positive rate of anti-Gp210 antibody ( Z =-3.774, -5.063, -4.344, -2.051, and -6.144, χ 2 =25.180, all P < 0.05). IgM had an AUC of 0.552 in predicting poor treatment response. Compared with the IgM < 1.5×ULN group, the IgM ≥1.5×ULN group had significantly higher levels of AST, ALP, TC, and IgG, a significantly higher positive rate of anti-Gp210 antibody, and a significantly higher poor UDCA response rate ( Z =-4.193, -5.044, -3.250, and -5.465, χ 2 =25.204 and 8.948, all P < 0.05). IgM ≥1.5×ULN had an odds ratio of 1.416 (95% confidence interval [ CI ]: 1.129-1.776, P =0.003) in predicting poor response. The subgroup analysis showed that for patients without liver cirrhosis, IgM ≥1.5×ULN had an odds ratio of 1.821 (95% CI : 1.224-2.711, P =0.003) in predicting poor response. Conclusion Baseline IgM level has an important value in predicting UDCA response. IgM level should be closely monitored during treatment in PBC patients with a high baseline IgM level, and second-line drugs should be given in time if the abnormality persists.

Role of T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain in the immune mechanism of autoimmune hepatitis and its prospects in treatment / 临床肝胆病杂志

The imbalance of immune tolerance plays a key role in the pathogenesis of autoimmune hepatitis (AIH), and the abnormal expression of coinhibitory signal molecules for regulatory T cells (Treg) may be one of the important reasons for the destruction of autoantigen tolerance. As a coinhibitory signal molecule, T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain (TIGIT) is an inhibitory receptor mainly expressed on Treg. This article elaborates on the immune mechanism of Treg associated with AIH and the role of TIGIT in the development, progression, and treatment of autoimmune diseases, so as to find the treatment strategy with TIGIT as the candidate target for AIH.

Research advances in clinical treatment of adult autoimmune hepatitis / 临床肝胆病杂志

Autoimmune hepatitis (AIH) is an immune-mediated inflammatory injury of hepatocytes, which can develop into liver cirrhosis and end-stage liver disease. Timely immunosuppressive therapy can help patients achieve biochemical remission and even histological remission and thus improve prognosis. However, adverse drug reactions during treatment and recurrence after withdrawal are commonly seen, and therefore, standard therapy, dose reduction at the right time, and timely drug withdrawal are important for improving patients’ prognosis. This article summarizes the advances in guidelines for the diagnosis and treatment of AIH and related studies in China and globally, so as to provide a reference for clinicians in the treatment of AIH.

Application of 10 s contrast agent injection protocol combined with 80 kV tube potential in carotid artery CTA procedure / 中华放射医学与防护杂志

Objective:To investigate the feasibility of tube potential of 80 kV combined with personalized contrast agent protocol in carotid artery CT angiography (CTA).Methods:A total of 136 consecutive patients undergoing neck CTA were prospectively enrolled in this study. The patients were randomly divided into Groups A, B, C and D. Tube potential of 100 kV and 15 s contrast agent injection protocol was used for Group A (53 cases) as conventional group, while tube voltage of 80 kV and 10 s contrast agent injection protocol was used for Groups B, C and D as experimental groups, with the contrast agent dosages of 20, 25 and 30 ml used according to the body weights of ≤50 kg(Group B, 20 cases), 50-70 kg (Group C, 38 cases), and 70-90 kg (Group D, 25 cases), respectively. The subjective and objective evaluation results of image quality and the effective doses were compared among the four groups.Results:The effective doses in Groups B, C and D were 1.54±0.91, 1.89±1.08 and 2.14±1.27 mSv, respectively, significantly lower than that in Group A [(5.66±0.56) mSv] ( F=169.34, P<0.05). The image quality of four groups met the requirements of clinical diagnosis. No significant differences were found in subjective evaluation and diagnostic efficacy of the four groups ( P>0.05). The CT number of carotid artery, signal-to-noise ratio and contrast-to-noise ratio of the neck region were significantly lower in Groups B, C and D compared with Group A ( F=14.9, 12.94, 14.43, P<0.05). The CT numbers of target carotid vessel were all higher than 250 HU. Conclusions:The scanning protocol of low tube potential (80 kV) combined with 10 s contrast agent injection protocol could not only reduce the doses of radiation and contrast agent, but also preserve the diagnosis effect. Thus, this scanning protocol was feasible and valuable in clinical application.

Investigation of serum minerals levels in elderly population in Tianjin / 天津医药

Objective To investigate the levels of 8 minerals that are related to human health in serum of elderly popu?lation in Tianjin and to provide evidence based guidance for scientifical and rational dietary. Methods Venous blood was collected from 714 elderly people and the levels of 8 minerals were examined by inductively coupled plasma-mass spec?trometry (ICP-MS). Results The percentage of the elderly people who are short of at least one mineral was up to 92.7%. The percentages of deficiency in serum zinc, manganese, magnesium, chrome, iron, calcium, copper, selenium are 79.3%, 73.4%, 58.5%, 42.4%, 39.8%, 23.0%, 1.5%and 0.6%respectively . The level of Ferrum in men’s serum is higher than that in women, while the levels of calcium, chrome and copper in men’s serum are lower than those in women. Conclusion The level of the minerals is generally low in the elderly population from Tianjin and ways were needed in improving dietary.

Effects of hyperbaric oxygen preconditioning on human stress responses during acute exposure to high altitude / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the effects of hyperbaric oxygen preconditioning (HBOP) on human stress responses during acute exposure to high altitude and the possible mechanism.</p><p><b>METHODS</b>Eight male subjects were treated with HBOP for 3, 5, and 7 days, followed by acute exposure to hypoxia simulating an altitude of 4,000 m. Subjects at rest were divided into sea-level control group, simulated high-altitude group, and 5-day HBOP intervention group, while subjects after physical load were divided into sea-level control group, simulated high-altitude group, 3-day HBOP intervention group, and 7-day HBOP intervention group. The physical load test was performed for each subject before and after HBOP, and the plasma levels of dopamine (DA), epinephrine (E), norepinephrine (NE), and adrenocorticotropic hormone (ACTH) were determined before and after exercise. The physical load test was performed by stepping up on to a 30 cm-high stepping stool at a rate of 25/min for 5 minutes, which was a type of moderate physical exercise. The stepping rate and timing were controlled by a metronome.</p><p><b>RESULTS</b>The levels of DA, E, NE, and ACTH at rest and after physical load were significantly higher in subjects acutely exposed to high altitude than in the sea-level control groups (all P<0.05). Moreover, the levels of DA, E, NE, and ACTH at rest were significantly higher after acute exposure to high altitude in the 5-day HBOP intervention group than in the simulated high-altitude group (all P<0.01). Except for the ACTH level in the 3-day HBOP intervention group, the levels of DA, E, NE, and ACTH after physical load were significantly higher after acute exposure to high altitude in the 3-day and 7-day HBOP intervention groups than in the simulated high-altitude group (all P<0.01).</p><p><b>CONCLUSION</b>HBOP can elevate the plasma expression of DA, E, NE, and ACTH, and then speed up the establishment of a new balance of homeostasis to adapt to the acute hypoxia at high altitude.</p>

Clinical observation on 308-nm monochromatic excimer light for the treatment of amelanotic nevus / 中华皮肤科杂志

Objective To evaluate the efficacy and safety of 308-nm monochromatic excimer light for the treatment of amelanotic nevus.Methods Eighteen patients with amelanotic nevus were treated with 308-nm monochromatic excimer light twice a week for five consecutive weeks.Melanin content index (MCI) was measured in the lesions before and after the treatment.After the final exposure,a three-month follow-up was carried out.Results After the start of treatment,the MCI in lesions increased in a session-dependent manner and approximated to 100％ of that in perilesional normal skin after six sessions of treatment.The follow-up revealed a decrease trend in MCI after the end of the treatment,which was nearly equal to that in perilesional normal skin one month later,and dropped to about 90％ of that three months later.No side effects such as blisters or scar were observed during the treatment.Conclusions The 308-nm monochromatic excimer light is safe and effective for the treatment of amelanotic nevus.Re-exposure to 308-nm monochromatic excimer light after three months is recommended as consolidation therapy.

Cloning and antimicrobial activity of pigeon avian beta-defensin 5 / 生物工程学报

The objective of the study was to clone avian beta-defensin (AvBD) 5 gene from pigeon bone marrow tissues and liver tissues, to express the recombinant AvBD5 protein in E. coli, and to determine its antimicrobial activity. The mRNA of duck AvBD5 was cloned from pigeon bone marrow tissues and liver tissues by RT-PCR. In addition, phylogenetic relationships between amino acid sequence of the pigeon AvBD5, AvBDs from other avian species, and some mammalian beta-defensin-5 were analyzed. The cDNA of pigeon AvBD5 was sub-cloned into pGEX-6p-1 vector to construct recombinant plasmid pGEX-pigeon AvBD5. The recombinant protein was expressed into E. coli and purified. Antimicrobial activity and physical-chemical stability of the recombinant fusion protein were measured in vitro. The complete nucleotide sequence of both cDNAs contained 201 bp nucleotides, encoding a polypeptide of 66 amino acids. Both beta-defensins have six conserved cysteines. Phylogenetic relationships were analyzed. Both pigeon AvBDs shared the highest amino acid homology (87.9% and 78.8%) with duck AvBD5. So it was named as pigeon AvBD5alpha (bone marrow) and AvBD5beta (liver). Both recombinant plasmids were transformed into E. coli BL21 and the bacteria were induced with Isopropyl beta-D-1-Thiogalactopyranoside (IPTG). After purification, antibacterial activity of the purified was investigated. In addition, effect of ionic strength on the antibacterial activity, and hemolytic recombinant protein activity of the purified recombinant protein were investigated. A 32 kDa protein was highly expressed. Both purified recombinant pigeon AvBD5alpha and AvBD5beta exhibited extensive antimicrobial activities against 12 bacteria, including Gram-positive and Gram-negative. In high salt ions concentrations, antibacterial activity of both recombinant proteins was decreased. In addition, the hemolysis activity of recombinant protein was extremely low.

Isolation, identification and bioactivity characterization of goose avian beta-defensin 3 / 生物工程学报

The objective of the study was to clone avian beta-defensin (AvBD) 3 gene from goose tissues, express the recombinant AvBD3 protein in Escherichia coli, and determine its antimicrobial activity. The mRNA of goose AvBD3 was cloned from spleen and bursa of Fabricius of the gooses by RT-PCR. The sequence analysis showed that the genefragment of AvBD3 contained 182 bp, and encoded 60 amino acids. Homology analysis showed that goose AvBD3 shared the highest percentage of amino acid homology (100%) with chicken AvBD3. The cDNA of goose AvBD3 was sub-cloned into BamH I and Sal I sites of pGEX-6p-1 vector to construct recombinant plasmid pGEX-goose AvBD3. The recombinant plasmid was transformed into E. coli BL21 and the bacteria was induced with IPTG It was demonstrated by SDS-PAGE that a 31 kDa protein which was equal to goose AvBD3 protein in molecular weight was highly expressed. The purified recombinant goose AvBD3 exhibited extensive antimicrobial activity against twelve bacteria strains, including Gram-positive and Gram-negative investigated. At high salt ions conditions, antimicrobial activity of recombinant goose AvBD3 protein against both Staphylococcus aureus and Pasteurella multocida decreased significantly. In addition, hemolysis activity of the recombinant protein was extremely low, and the recombinant protein remained antimicrobial activity under different pH values.

Microstructure and ultrastructure changes of multiple organ tissue and hemodynamic effects in swine after cardiopulmonary resuscitation / 中华急诊医学杂志

Objective To investigate the microstructure and ultrastructure changes of cardiac muscle, pallium, lung, liver and kidney tissue and hemodynamic effects after the success of cardiac arrest (CA)-cardiopulmonary resuscitation(CPR) of swine. Method A total of 16 Beijing swine(weight 29 ～ 35 kg)were randomly (random number) divided into normal-control group ( n = 8) and standard CPR group ( n = 8). The swine of the former group were only given anesthetized and intubated, without ventricular fibrillation and CPR. The swine of the latter group were given standard CPR after 4 min of untreated VF, from 10 min after restoration of spontaneous cirkg) and keep for 6 h. And cardiac output (CO), left ventricular maximal rate of systolic pressure ( + dp/dtmax),maximum reduction of left ventricular diastolic velocity ( - dp/dtmax), heart rate (HR) and mean arterial pressure (MAP) of these animals before ventricular fibrillation and 0.5 h, 2 h, 4 h, 6 h after ROSC have been monitored.All swine were put to death after 6 h,and got their cardiac apex, pallium, left lung, right lobe of liver and upper pole of left kidney quickly for microstructure and ultrastructure studies. Statistical analysis was performed using two paired samples t test. Results At different time points after restoration of spontaneous circulation, the cardiac output (CO),left ventricular maximal rate of systolic pressure ( + dp/dtmax), maximum reduction of left ventricular diastolic velocity (- dp/dtmax) were significantly lower than before ventricular fibrillation, with significant difference ( P ＜ 0.05). And HR of different time points were increased significantly ( P ＜ 0.05), with no significantly difference between MAP of each time points ( P ＞ 0.05). Compared with the normal-control group, the cardiac muscle, pallium, lung, liver and kidney tissue of the swine in standard CPR group were found different degree of damages in their microstructure and ultrastructure sections. The damages of the cardiac muscle, pallium, and lung tissue were more obviously. Conclusions Sudden cardiac arrest(CA)-cardiopulmonary resuscitation(CPR) could cause different degree of damages and hemodynamic effects on the body, through our ROSC 6 h model, the damages of the cardiac muscle, pallium and lung were more severity, the damages of liver and kidney were lighter.

Determination of Melamine in Foods by Solid Phase Extraction-High Performance Liquid Chromatography / 环境与健康杂志

Objective To establish a solid phase extraction(SPE)-high performance liquid chromatography(HPLC)method for determination of melamine in foods. Methods Melamine in sample was extracted with extractive agent. After centrifugation, the supernatant fluid was purified by Waters Oasis MCX cartridge,and detected with HPLC method. Chromatographic column of TIANHE C18(250 mm?4.6 mm,5 ?m) was used at 35 ℃ and mobile phase was water(containing 0.01 mol/L 1-hexanesulfonic acid sodium salt and 0.01 mol/L citric acid)∶ acetonitrile = 94∶6 (V∶V) at a flow rate of 1.0 ml/min. Injection volume was 20 ?l. Results In the range of 0.80 to 80.0 mg/L, the regression equation was y=84.64 x-6.127 1 with the correlation coefficient of 0.999 98. The detection limit of melamine in foods was 0.5 mg/kg. The average rates of recovery were 88.0%-96.0% and the relative standard deviation was less than 5%. Conclusion The method established in the present paper is applicable to determination of melamine in foods with good precision,accuracy and sensitivity.

Immunomodulation of lower polypeptide from sea cucumber in mice / 中国海洋药物

Objective To investigate the immunomodulation of lower polypeptide from sea cucumber in mice.Methods Effects of polypeptide from sea cucumber on the immunity were studied by the observation of the serum hemolysins level(HC_(50)),the plaque-forming cell (PFC),the phagocytosis of the phagocytes and the activities of NK cells.Results To compare experiment groups with control group,the enhancement facilitation of HC_(50),PFC,phagocytosis ability of macrophage and activity of NK cell was observed.Conclusion The results indicated that polypeptide from sea cucumber has the function of immunomodulation in mice.

Effect of Avermectins on Expression of HSP70 mRNA in Rats Hepatic Tissue / 环境与健康杂志

Objective To understand the expression of heat shock protein(HSP70) mRNA induced by avermectins in the hepatic tissue of rats.Methods Wistar rats aged 6 weeks were randomly divided into 4 groups,12 in each including 6 male and 6 female.The rats in the experimental groups were treated with avermectins by gavage once a day at the doses of 2.5,1.25 and 0.625 mg/kg respectively for 14 consecutive days,one group was the negative control.The general state was concerned and after the exposure,the content of total protein(TP) in the serum was determined,the hepatic tissue was sampled to examine the expression of HSP70 mRNA by polymerase chain reaction(PCR).Results The content of TP in the serum in the 2.5 mg/kg group was lower than that in the control group(P

Study on Optimization Subsystem of Cost Accounting in Sanatorium Branch / 医疗卫生装备

Objective To solve the problem of hospital Bureau class cost accounting system to manage the Branch class cost. Methods The system was optimized by extracting the raw data of localization, collecting income and expenditure account of flexible specialization, and setting subclass accounting ratio ways of rationalization. Results The optimization subsystem has been a fundamental change in cost accounting management and creates more effective. Conclusion According to the special requirement of sanatorium financial process, information system and cost accounting ways, the new system can be optimized in design and implementation method and achieve better effects during the implementation and operation.

Expression of HSP70 mRNA Induced by Chlorpyrifos in Rat Hepatic Tissue / 环境与健康杂志

Objective To understand the expression of heat shock protein(HSP70)mRNA induced by chlorpyrifos in the hepatic tissue of rats.Methods Wistar rats aged 6 weeks were divided into 4 groups,12 in each including 6 male and 6 female,the rats in the experimental groups were treated with chlorpyrifos by gavage once a day at the doses of 17 mg/kg?bw,8.5 mg/kg?bw and 4.25 mg/kg?bw respectively for 14 consecutive days,one group was the negative control.After the exposure,the hepatic tissue was sampled to examine the expression of HSP70 mRNA by polymerase chain reaction(PCR).Results The expression of HSP70 mRNA in the hepatic tissue in the groups of 17 mg/kg?bw,8.5 mg/kg.bw was significantly up-regulated with a dose-response relationship compared with the negative control group.Conclusion The expression of HSP70 mRNA is a sensitive parameter for early exposure assessment of chlorpyrifos.