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In recent years, the use of active substances as excipients or as substitutes for other excipients in the design of modern drug delivery systems has received widespread attention, which has promoted the development of the theory of unification of medicines and excipients in the design of traditional Chinese medicine(TCM) preparations. Adopting the theory of unification of medicines and excipients to design drug delivery systems can reduce the use of excipients and thus the cost of preparations, reduce drug toxicity, increase drug solubility and biocompatibility, enhance synergistic effect, and realize targeted delivery and simultaneous delivery of multiple components. However, the research on the application of this theory in the modern drug delivery system of TCM preparations is still insufficient, with few relevant articles. In addition, the TCM active substances that can be used as the excipients remain to be catalogued. In this paper, we review the types and applications of the drug delivery systems with TCM active substances as excipients and describe their common construction methods and mechanisms, aiming to provide references for the in-depth research on the modern drug delivery systems for TCM preparations.
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Medicine, Chinese Traditional , Excipients , Drugs, Chinese Herbal , Nanomedicine , Pharmaceutical PreparationsABSTRACT
Mycobacterium leprae is virtually non-toxic. After invading the human body, it can grow and reproduce in large quantities in the tissues but does not cause any clinical symptoms. The manifestations of skin, mucous membrane and peripheral nerve damage of leprosy are mainly caused by the immune response of the body to the leprae. Schwann cells can support and nourish nerve fibers. As an important parasitic site of leprosy bacteria, Schwann cells are closely related to leprosy immunity, and the research on these cells is of great significance.
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Purpose@#We analyzed the microstructure and bone mineral density (BMD) of the trabecular bone in the femoral head of patients with osteoporosis. @*Materials and Methods@#Sixteen femoral heads with osteoporotic femoral neck fractures underwent microcomputed tomography scanning. In each tip-apex distance (TAD) of 15, 20, and 25 mm, five regions of interest (ROIs) were extracted from the central, anterior, posterior, superior, and inferior sections. A total of 15 ROIs were extracted from TADs of 15, 20, and 25 mm. The measurement parameters included BMD, percent bone volume: bone volume/total volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), structural model index (SMI), and degree of anisotropy (DOA). @*Results@#The lowest BMD and BV/TV values were observed in the inferior region and differed significantly from those in other regions (P<0.05). Lower Tb.Th and Tb.N values were observed in the inferior region compared with those in the central region (P<0.05). The highest SMI value was observed in the inferior region (P<0.05). With TAD of 15 and 20 mm, the DOA values in the inferior region were lower than those in the anterior region (P<0.05). Lower BMD and BV/TV values were observed in the anterior, central, and inferior regions of TAD of 15 mm compared with those in the corresponding regions of TAD of 25 mm (P<0.05). @*Conclusion@#Positioning the lag screw between TAD of 20 to 25 mm and in the inferior region is recommended, and TAD of less than 15 mm is not recommended.
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Rehabilitation can play an important role in the multidisciplinary management of corona virus disease 2019 (COVID-19). After a brief introduction of the epidemiology, clinical characteristics, diagnosis and treatment of the disease, this article discussed the use of physical agents, respiratory rehabilitation, intensive care rehabilitation, activities of daily living training, psychological intervention, home rehabilitation and rehabilitation of Traditional Chinese Medicine in the management of COVID-19.
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Objective@#To observe the clinical effects of stage-Ⅱ Meek skin grafting on adipose tissue after tangential excision in patients with extensive deep burns, and to explore the functional mechanism.@*Methods@#The medical records of 26 extensively burned patients who met the inclusion criteria and were admitted to the Department of Burns and Plastic Surgery of the Fourth Medical Center of PLA General Hospital from May 2015 to December 2017 were retrospectively analyzed. According to the treatment methods, 14 patients were enrolled in stage-Ⅰ skin grafting group (10 males and 4 females, aged 27 to 75 years), and 12 patients were enrolled in stage-Ⅱ skin grafting group (10 males and 2 females, aged 31 to 76 years). Patients in the 2 groups all underwent debridement of tangential excision, and their healthy adipose tissue was preserved. Meek skin grafting was performed just after tangential excision in patients in stage-Ⅰ skin grafting group. In patients in stage-Ⅱ skin grafting group, porcine acellular dermal matrix (ADM) was applied to cover the wound after tangential excision, and 3 days later, it was removed and Meek skin grafting was performed. The times of complement skin grafting and the wound basic healing time of patients in the 2 groups were observed and recorded. In the stage-Ⅱ skin grafting group, the adipose tissue of patients were taken from the wound center immediately after tangential excision and immediately after the removal of porcine ADM, for the observation of structure of the fault surface of adipose tissue through hematoxylin and eosin staining and microvessel density (MVD) through immunohistochemical staining. Data were processed with independent sample t test and Fisher′s exact probability test.@*Results@#(1) The times of complement skin grafting of patients in stage-Ⅱ skin grafting group was (1.83±0.17) times, which was obviously less than (3.36±0.63) times in stage-Ⅰ skin grafting group (t=2.19, P<0.05). The wound basic healing time of patients in stage-Ⅱ skin grafting group was (35.1±2.3) d, which was obviously shorter than (48.8±4.9) d in stage-Ⅰ skin grafting group (t=2.27, P<0.05). (2) Immediately after tangential excision, the intercellular substance was few between the adipose cells in adipose tissue of patients in stage-Ⅱ skin grafting group. Immediately after the removal of porcine ADM, there was regenerated granulation tissue in the intercellular space of adipose cells of adipose tissue of patients in stage-Ⅱ skin grafting group. Immediately after tangential excision, the MVD of adipose tissue of patients in stage-Ⅱ skin grafting group was 20.2±1.3 under per 400-time field, which was obviously less than 32.2±1.9 under per 400-time field immediately after the removal of porcine ADM (t=-5.38, P<0.01).@*Conclusions@#Meek skin grafting on the adipose tissue in stage-Ⅱ surgery after tangential excision could reduce the times of complement skin grafting and shorten wound healing time of patients with extensive deep burns. The mechanism may be related to the improvement of the recipient condition of adipose tissue.
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BACKGROUND: Preliminary study has prepared the three-dimensional silk fibroin/chitosan/nano-hydroxyapatite scaffold successfully.OBJECTIVE: To explore the mechanical properties, physical characteristics, chemical composition and antibiotic sustained-release ability of three-dimensional silk fibroin/chitosan/nano-hydroxyapatite scaffold loaded with levofloxacin. METHODS: Levofloxacin/chitosan (3:1) microspheres were constructed by emulsion settlement filter method. 5, 7.5 and 10 g of microspheres were added into 2％ of silk fibroin/chitosan/nano-hydroxyapatite mixed solution through freeze drying and chemical cross-linking to obtain the scaffolds loaded with antibiotics. The scaffolds loaded with antibiotics underwent scanning electron microscope observation, and chemical composition analysis. The sustained release, mechanical properties, porosity, water absorption expansion rate and hot water soluble loss rate were detected. RESULTS AND CONCLUSION: (1) Scanning electron microscope observed that there were drug microspheres at the inner wall of the scaffold, and the voidage was decreased with mass of microspheres increasing. (2) Energy spectrum analysis showed that the three kinds of scaffolds were rich in calcium and phosphonium ions. (3) The three kinds of scaffolds showed the same releasing trend, which presented with sudden-release effect at the former 3 days (release> 50％) , and then tended to be stable. The release rate was the slowest in the scaffold loaded with 10 g of microscopes, and the rapidest in the scaffold loaded with 5 g of microscopes. (4) With the mass of microspheres increasing, there was an increase in the compressive and tension abilities and hot water soluble loss rate, and a decrease in the porosity, mean pore size and water absorption expansion rate. (5) These results indicate that the three-dimensional tissue-engineered scaffold loaded with levofloxacin is constructed successfully by freeze drying and chemical cross-linking method, which holds good sustained-release effect and compressive ability, water absorption expansion rate and hot water soluble loss rate.
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Objective@#To observe the effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn.@*Methods@#Clinical data of 40 children with deep partial-thickness burn wounds on trunk and limbs, admitted to our burn ward from January 2016 to June 2017, conforming to the study criteria, were retrospectively analyzed. They were divided into conventional treatment group (CT, n=19) and minimally invasive tangential excision group (MITE, n=21) according to the different treatments. The patients in group CT were treated with eschar-reserving therapy firstly. When tangential excision was performed, the roller knife was used, and no necrotic tissue left on the wound bed was considered the proper depth of excision. Razor-thickness skin grafting was performed to cover the wound when adipose tissue exposed markedly after tangential excision. Dressing change was performed within 48 h after the operation and repeated every 2 days. Unhealed wounds were covered by razor-thickness skin grafting. The patients in group MITE were treated with tangential excision in the early stage post burn. The tangential excision was operated with electric dermatome, and the thickness was set at 0.1 mm to excise the surface of eschar until the sporadic punctate hemorrhage on wound surface was observed and some necrotic tissue was left on the wound bed. Porcine acellular dermal matrix was applied after tangential excision. The first dressing change was often performed about 1 week after the operation. Razor-thickness skin grafting was performed to cover the unhealed wounds. The length of wound healing, high fever, antibiotic usage, and hospital stay, times of later operation, and hospitalization expenses of patients in the 2 groups were recorded. The excisional eschar and wound bed tissue of patients in group MITE were harvested for pathological observation. Data were processed with t test and Fisher′s exact probability test.@*Results@#(1) There were no statistically significant differences in length of high fever and length of hospital stay and hospitalization expenses between patients in the 2 groups (t=-1.67, -1.93, 0.31, P>0.05). The lengths of wound healing [(24.8±2.5) d] and antibiotic usage [(4.4±0.7) d] of patients in group MITE were significantly shorter than those in group CT [(33.3±2.5) and (7.0±0.7) d, t=-2.44, -2.44, P<0.05], and times of later operation of patients in group MITE [(0.29±0.14) times] were significantly less than those in group CT [(0.79±0.21) times, t=-2.03, P<0.05]. (2) The thickness of the excisional eschar of patients in group MITE was about 150 μm. The eschar has epidermis and upper dermis. Some necrotic tissue was left on the wound bed.@*Conclusions@#The treatment for pediatric deep partial-thickness burn wounds on trunk and limbs with minimally invasive tangential excision using electric dermatome in the early stage post burn can accelerate wound healing, shorten length of antibiotic usage, and reduce times of later operations.
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Objective@#To investigate the early immune effects of rabies vaccine combined with human rabies immunoglobulin (HRIG).@*Methods@#Rapid fluorescent focus inhibition test (RFFIT) was used to test the titers of rabies virus neutralizing antibodies (RVNA). The titers of RVNA of persons who had exposed to rabies at degree III on day 0, day 1, day 7, day 14 and day 45 were compared. The dynamic curves and seroconversion rates (SCR) of RVNA in persons of different genders, age and vaccine regimens (Essen and Zagreb) groups were analyzed.@*Results@#No significant differences of SCR among different genders, age and vaccine regimens groups were observed on the same day. SCR could be 100% on day14 in different groups. The dynamic curves of RVNA within the first 14 days showed the models of gradual rise, rapid rise and rapid decline.@*Conclusions@#The dynamic curves of RVNA within the first 14 days varied when rabies vaccines were used in combination with HRIG, and not all subjects were proved to be protected based on the RVNA detection within this period.
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BACKGROUND: As a physical factor, negative pressure can promote the osteogenic differentiation and endothelial differentiation of mesenchymal stem cells. If a negative pressure exerts effects on the epidermal differentiation of mesenchymal stem cells, it will be highly important for the combination use of negative pressure and mesenchymal stem cells in wound healing. OBJECTIVE: To explore the effect of negative pressure on the epidermal differentiation of bone marrow mesenchymal stem cells. METHODS: Bone marrow mesenchymal stem cells of New Zealand white rabbits were isolated and cultured. Then, the passage 3 cells were induced for epidermal differentiation under negative pressure (-16.625 kPA, twice a day, once for 4 hours) as experimental group. Another cells induced under no negative pressure were used as control group. After induction, cell growth curve was drawn in each group, and the expression of cytokeratin 5 and cytokeratin 10 mRNA was examined by real-time PCR at 2 weeks after induction. RESULTS AND CONCLUSION: The cell growth of the experimental group was inhibited, and the mRNA expression of cytokeratin 5 and cytokeratin 10 was significantly increased compared with the control group (P < 0.05). These findings indicate that under the condition of negative pressures, the epidermal differentiation ability of bone marrow mesenchymal stem cells is increased, and in contrary, the cell proliferation is inhibited.
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It is known that silibinin has antioxidant, anti-tumor, anti-inflammatory and immunomodulatory effects, and which is widely used for liver damage caused by a variety of reasons. In recent years, it is found that silibinin has potential anti-allergic reactions. However, even larger doses of silibinin still show no significant side effects . The rare literature reports that silibinin can cause allergic reactions. The paper reports a middle-aged patient who orally took silibinin for the prevention of tuberculosis chemotherapy-induced liver damage, and he occurred symptoms of lip pain and anabrosis, foreign body sensation, and difficulty eating one day after treatment. The patient was misdiagnosed as"vesicular stomatitis"and was treated by anti-viral therapy. The patient was discharged from the hospital after treating allergic reactions. As a safe and effective drug for prevention of liver damages in clinic, silibinin should be alert to induce possible allergies when there are local skin manifestations such as lip pain and anabrosis.
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Objective To investigate the value of BIS-guided TCI with propofol and remifentanil for inter-ventional embolization therapy of cerebral aneurysm. Methods Sixty-eight patients of both sexes undergoing elec-tive cerebral aneurysm embolization were randomly divided into two groups:Group A(TCl with propofol and remi-fentanil),Group B(BIS-guided TCl with propofol and remifentanil). Group A was adjusted the concentration of propofol depending on clinical experience and hemodynamic changes,while group B adjusted the concentration of propofol depending on BIS which was maintained between 45 to 60. The total anesthesia time and dosage of propo-fol,duration of recovery and extubation,the incidence of restlessness and hypoxemia at extubion were recorded. In-traoperative awareness and incidence of nausea and vomiting were also recorded as postoperative visiting after 24 hours. Results In comparison two groups,The total amount of propofol in group B decreased obviously(P <0.05),duration of recovery and extubation of group B was shorter(P < 0.05). The recovery of consciousness,tid-al volume and respiratory rate of group B was faster than others. Incidence of hypoxemia was lower in group B(P <0.05). Conclusion BIS-guided TCI with propofol and remifentanil for interventional,which can improve the sur-gical safety and anesthetic accuracy,is suitable for interventional embolization therapy of cerebral aneurysm.
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<p><b>OBJECTIVES</b>To explore the possible biological mechanism of skeletal muscle contusion repair through researching the changes in expression of autophagy-related genes and proteins in SD rats with acute skeletal muscle contusion.</p><p><b>METHODS</b>Six rats were randomly selected as the control group from 30 male SD rats, acute skeletal muscle contusion model were established in the remaining 24 rats with self-made hitter, then the model rats were randomly divided into 4 groups (3 d, 5 d, 7 d, 14 d groups, =6). On the 3, 5, 7 and 14 day after injury, injured gastrocnemius of each group was harvested. The morphological and the ultra-microstructure changes of gastrocnemius after injury were observed by HE staining and transmission electron microscope (TEM) respectively. The relative protein levels of (LC3-Ⅱ) and P62 of each group were observed by Western blot. The relative mRNA levels of atg7, atg10, atg12, atg16L1 of each group were observed by RTPCR.</p><p><b>RESULTS</b>The results of HE staining showed that compared with the control group, the inflammation reached its peak on the 5 day after injury, new muscle fibers were clearly observed in 7 d group. The results of TEM showed that, compared with the control group, oncotic mitochondria could be clearly seen in the 3 d, 5 d, 7 d groups. Also, the Z line changed from disappearing to drift thickening, sarcoplasmic reticulum dilatation gradually improved, there was no evident difference between the 14 d group and the control group, suggesting that the damage has preliminarily healed. The results of Western blot showed that the expressions of LC3-Ⅱand P62 were increased at first and then decreased. The expression of LC3-Ⅱwas markedly up-regulated in the 3 d, 5 d, 7 d groups compared with the control group and the 14 d group (<0.01). Similarly, compared with the control group, the expression of P62 reached its peak on the 3 day after injury (<0. 01), and returned to normal level on the 14 day. The results of RT-PCR showed that the expression of atg10 mRNA in the natural recovery group of 3 d, 5 d, 7 d, 14 d was firstly decreased and then increased, the atg10 mRNA was markedly down-regulated in the 3 d, 5 d, 7 d groups compared with the control group and the 14 d group (<0. 01). The expression of atg7, atg12, atg16L1 mRNA was generally increased at first and then decreased, it was markedly up-regulated in the 3 d, 5 d, 7 d groups compared with the control group and the 14 d group (<0.01, <0.05, <0.01).</p><p><b>CONCLUSIONS</b>The above results indicate that the autophagy is involved in repair of skeletal muscle injury by its autophagyrelated factors,regularly changes after contusion, and the rate of damage repair may be related to the level of autophagy.</p>
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Animals , Male , Rats , Autophagy , Contusions , Muscle, Skeletal , Wounds and Injuries , RNA, Messenger , Rats, Sprague-DawleyABSTRACT
<p><b>PURPOSE</b>To observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury.</p><p><b>METHODS</b>Data of 160 multiple trauma patients with a major abdominal or pelvic injury were retrospectively analyzed. They were admitted into the Department of Emergency of the First Affiliated Hospital of Zunyi Medical College from October 2013 to April 2016. Eighty-seven patients who received emergent intervention for embolization and haemorrhage control were set as group A, including 72 males and 15 females, with an average age of (39.32 ± 14.0) years. Patients underwent emergent intervention for embolization and hemostasis. The other 73 patients who received traditional surgeries were set as group B, including 62 males and 11 females, with an average age of (38.48 ± 13.12) years. The time from admission to emergency intervention, the time of interventional embolization, transfusion during hospitalization, length of stay and prognosis were observed. The whole treatment and prognosis were compared between group A and group B.</p><p><b>RESULTS</b>In group A, the average time from admission to intervention exploration was (132.05 ± 86.80) min, the average operation time was (149 ± 49.69) min, the average hospitalization time was (18.37 ± 4.71) days, the average amount of RBC transfusion during hospitalization was (7.2 ± 4.33) units, and the mortality was 4.60% (4 patients died). The corresponding data in group B were respectively (138.95 ± 82.49) min, (183 ± 52.39) min, (22.72 ± 6.63) days, (12.23 ± 5.43) units, and 9.59% (7 cases died). There was no statistical difference in the time from admission to operation between the two groups (p > 0.05), but there was statistical difference in operation time, RBC transfusion, hospitalization time, prognosis, and mortality between the two groups (all p < 0.05).</p><p><b>CONCLUSION</b>The emergent intervention for embolization and haemorrhage control of multiple trauma patients with a major abdominal or pelvic injury and visceral organ haemorrhage has the advantages of less trauma, shorter operation time, shorter hospital stay, less blood transfusion in comparison to the traditional emergency surgeries.</p>
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The chemical constituents of Plantaginis Semen with hypoglycemic effect was investigated in this paper. The previous results of the in vivo hypoglycemic effect showed that 60% ethanol extract of Plantaginis Semen decreased the levels of FBG and improved the glucose tolerance in high fat diet(HFD)-induced diabetic C57BL/6 mice. Then, in the present study, the above potential bioactive extract was separated and purified by silica gel, ODS, Sephadex LH-20 column chromatography, medium pressure liquid chromatography(MPLC)and preparative HPLC. The structures of isolated compounds were identified by physicochemical properties and spectral analyses. Eight compounds were obtained and identified as 4, 4a, 5, 7a-tetrahydro-7-(hydroxymethyl)cyclopenta[c]pyran-3(1H)-one(1), iridolactone(2), pedicularislacton(3), rehmaglutin C(4), geniposidic acid(5), p-hydroxylphenylglycerol(6), 1, 2-benzenediol-4-(2-hydroxyethyl)(7), and 3-buten-2-one-4-[3-(β-D-glucopyranosyloxy)-4-hydroxyphenyl](8). Among them, compounds 1-5 were iridoids, and 6-8 were phenolic acids. Compound 1 was a new natural product, and compounds 2-4, 6 and 8 were isolated from the Plantaginaceae family for the first time.
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Objective To explore the effect of pedicled omental flap with Da Vinci surgical system for breast reconstruction,so as to facilitate the application of robot-assisted surgery in the breast reconstruction after breast cancer(BC) surgery.Methods A luminal BC patient,administrated in March 2017,received Da Vinci robot-assisted filling with pedicled omental flap after extensive lumpectomy and sentinel lymph node biopsy.Blood supply,wound healing,cosmetic outcome,complications and satisfaction of the patient were evaluated.Results The wound healed well,with no obvious scar.The reconstructed breast had desirable volume and looked symmetrical against the other side.The cosmetic outcome was excellent and the patient was satisfied with the surgery.No recurrence or metastasis was found during the twomonth post-operational follow-up.Conclusion Da Vinci robot-assisted breast reconstruction with pedicled omental flap has the advantages of clear vision,precise movement and flexible machinery joint.Breast conservation and autologous reconstruction with this technique substantially improves the psychological and social well-being of the patient.
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Objective To compare the treatment effect of autologous blister skin grafting with ReCell autologous chromocyte grafting on cicatricial depigmentation caused by deep burn.Methods Thirty-four patients with cicatricial depigmentation caused by deep burn who were admitted into hospital from May 2012 to February 2015 were included in this study.The total 61 depigmentation areas were randomly divided into two groups;32 areas from 18 patients were treated with autologous blister skin grafting,and the other 29 areas from 16 patients were trea-ted with ReCell autologous chromocyte grafting.In the autologous blister skin grafting treated group,epidermis from the depigmentation area was removed by grinding with a BY-II AM type epidermal graft vitiligo treatment equipment.Then the autologous blister skin was harvested with the suction blistering method and grafted onto the wound of depigmentation area.In the ReCell autologous chromocyte grafting treated group,split-thickness skin flap was harvested by electric dermatome.Then the donor skin was processed into chromocyte suspension with the ReCell assay kit and evenly sprayed onto the depigmentation areas.The wound healing time and the pigment recovery 3 months after surgery were observed.Results The wound healing time of autologous blister skin grafting treated group was significantly shorter than that of ReCell autologous chromocyte grafting treated group (P <0.05 ).The effective rate of pigment recovery 3 months after surgery in autologous blister skin grafting treated group was markedly higher than that of ReCell autologous chromocyte grafting treated group(P <0.05 ). Conclusion The autologous epidermal grafting treatment using grinding and suction blistering method is simple and easy to perform,marked-ly effective,with no suture scar and low surgical risk,thus serving as a promising and ideal therapeutic method for burn scar depigmentation.
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<p><b>OBJECTIVE</b>To investigate the effects of different concentrations of lipopolysaccharide (LPS) on proliferation and apoptosis of human umbilical cord mesenchymal stem cells (hUCMSCs) in vitro, and to explore their possible mechanism.</p><p><b>METHODS</b>hUCMSCs from umbilical cord tissue of full-term healthy fetus delivered by caesarean section were isolated and cultured in vitro using tissue attachment method. The 3rd passage hUCMSCs were used in the study. Cells were divided into groups A, B, C, D, and E, which were treated with DMEM/F12 medium containing 0, 0.1, 1.0, 10.0, and 100.0 µg/mL of LPS respectively. In groups B, C, D, and E, methyl-thiazole-tetrazolium assay was used to detect proliferative activity of hUCMSCs at post treatment hour (PTH) 12, 24, and 48 (denoted as absorption value), with 5 samples in each group at each time point; apoptosis of hUCMSCs at PBH 24 was identified with acridine orange-ethidium bromide (AO-EB) staining, with 4 samples in each group; apoptotic rate of hUCMSCs was determined by flow cytometer, with 5 samples in each group. Above-mentioned indexes were determined in group A at the same time points. Data were processed with analysis of variance and LSD- t test.</p><p><b>RESULTS</b>(1) There was no statistically significant difference in proliferative activity of hUCMSCs at PTH 12 among groups A, B, C, D, and E (with t values from -1.67 to 1.33, P values above 0.05). Compared with that of group A, proliferative activity of hUCMSCs was increased in groups B, C, and D at PTH 24 and 48 (with t values from -13.42 to 17.34, P < 0.05 or P < 0.01), especially so in group C. Proliferative activity of hUCMSCs was lower in group E at PTH 24 and 48 than in group A (with t values respectively 8.64 and 17.34, P values below 0.01). (2) Obvious apoptosis of hUCMSCs was observed in group E but not in the other 4 groups with AO-EB staining. (3) Apoptosis rates of hUCMSCs in groups A, B, C, D, and E were respectively (3.1 ± 0.6)%, (2.6 ± 0.7)%, (2.9 ± 0.8)%, (3.1 ± 0.4)%, (25.1 ± 2.7)% (F = 272.19, P < 0.01). Apoptotic rate of hUCMSCs in group B, C, or D was respectively close to that in group A (with t values respectively 1.22, 0.57, -0.14, P values above 0.05), but it was higher in group E than in group A (t = -17.63, P < 0.01).</p><p><b>CONCLUSIONS</b>hUCMSCs proliferation may be promoted by low concentration of LPS. hUCMSCs proliferation is inhibited or induced to apoptosis along with the increase in concentration of LPS, and it may be related to activation of different major molecular signaling pathways by different concentrations of LPS.</p>
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Humans , Apoptosis , Cell Proliferation , Endotoxins , Lipopolysaccharides , Pharmacology , Membrane Proteins , Mesenchymal Stem Cells , Cell Biology , Signal Transduction , Umbilical Cord , Cell BiologyABSTRACT
<p><b>OBJECTIVE</b>To observe and study the effects of sivelestat on acute lung injury in dogs with severe burn-blast combined injury.</p><p><b>METHODS</b>Thirty-two male beagle dogs of clean grade were divided into 4 groups: uninjured group (U), combined injury control group (CIC), combined injury+low dose of sivelestat group (CI+LS), combined injury+high dose of sivelestat group (CI+HS), with 8 dogs in each group. Except for the dogs in group U which were not injured, the dogs in the other 3 groups were inflicted with severe burn-blast combined injury. According to the Parkland formula, the dogs in groups U and CIC were infused with physiological saline, and the dogs in groups CI+LS and CI+HS received sivelestat with the dosage of 0.5 and 2.0 mg·kg(-1)·h(-1) respectively in addition. The 24 h continuous intravenous infusion was carried out for 2 days. At post injury hour (PIH) 6, CT scanning was conducted to observe the lung damage. At PIH 2, 6, 12, 24, and 48, mean arterial pressure (MAP), respiratory rate (RR), extra vascular lung water (EVLW), pulmonary vascular permeability index (PVPI), PaO2, and PaCO2 were measured; the contents of neutrophil elastase (NE), IL-8, and TNF-α were determined by ELISA. At PIH 48, all the dogs were sacrificed, and the lung tissues were harvested to measure the wet to dry lung weight ratio. The same examination was carried out in the dogs of the group U at the same time points. Data were processed with analysis of variance of repeated measurement and LSD test.</p><p><b>RESULTS</b>(1) CT images showed some exudative lesions in the dogs of groups CIC and CI+LS but not in the dogs of groups U and CI+HS. (2) No statistically significant differences were observed in MAP at each time point between every two groups (with P values above 0.05). The RR values in group U were significantly different from those of the other 3 groups at all time points (with P values below 0.05). The values of EVLW and PVPI in 3 combined injury groups were significantly different from those in group U at PIH 6, 12, 24, and 48 (with P values below 0.05). The values of RR and EVLW in group CI+LS were significantly different from those in group CI+HS at PIH 12, 24, and 48 (with P values below 0.05). The values of PVPI in group CI+LS were significantly different from those in group CI+HS at PIH 24 and 48 (with P values below 0.05). (3) The levels of PaO2 and PaCO2 showed significant differences between group U and the other 3 groups at each time point (with P values below 0.05). The levels of PaO2 in group CI+LS were significantly different from those in CI+HS group at PIH 12, 24, and 48 (with P values below 0.05). The level of PaCO2 showed significant differences between group CI+LS and group CI+HS at PIH 24 and 48 (with P values below 0.05). (4) The contents of NE (except for PIH 2), TNF-α, and IL-8 showed significant differences between group U and the other 3 groups at each time point (P < 0.05 or P < 0.01). At PIH 2, 6, 12, 24, and 48, the contents of NE in groups U, CIC, CI+LS, and CI+HS were respectively (69 ± 21), (83 ± 24), (80 ± 20), (75 ± 17), (72 ± 27) pg/mL; (66 ± 24), (196 ± 20), (231 ± 26), (252 ± 25), (266 ± 22) pg/mL ; (71 ± 22), (180 ± 27), (214 ± 21), (194 ± 24), (218 ± 20) pg/mL; (68 ± 22), (136 ± 24), (153 ± 22), (146 ± 26), (150 ± 28) pg/mL. NE values in group CI+HS were statistically different from those in groups CIC and CI+LS at PIH 6, 12, 24, and 48 (with P values below 0.05). The contents of TNF-α in group CI+LS were statistically different from those in groups CIC and CI+HS at PIH 24 and 48 (with P values below 0.05). The contents of IL-8 in group CI+LS were statistically different from those in group CI+HS at PIH 24 and 48 (with P values below 0.05). (5) At PIH 48, the wet to dry lung weight ratio of group CIC was statistically different from that in group CI+LS or group CI+HS (with P values below 0.05); there was also difference between group CI+LS and group CI+HS (P < 0.05).</p><p><b>CONCLUSIONS</b>Sivelestat, especially in a high dose, exerts a protective effect in acute lung injury after burn-blast combined injury through improving the index of blood gas analysis, ameliorating pulmonary edema, and lowering the production of pro-inflammatory mediators.</p>
Subject(s)
Animals , Dogs , Male , Acute Lung Injury , Drug Therapy , Blood Gas Analysis , Burns , Capillary Permeability , Extravascular Lung Water , Glycine , Infusions, Intravenous , Interleukin-8 , Pulmonary Edema , Serine Proteinase Inhibitors , Sulfonamides , Tumor Necrosis Factor-alphaABSTRACT
Objective Statistics and analyze the effect of comprehensive prevention measures for the ventilator associated pneumonia (VAP) morbidity and mortality,and investigate its actual applicate situation in the clinical.Methods Statistics and analyze the clinical date of 183 cases of our ICU mechanical ventilation patients in 2012 (group A),including morbidity,mortality,time of endotracheal intubation,length of stay and the primary pathogenic bacteria,and to compared with the relevant clinical data of 192 cases of our ICU mechanical ventilation patients in 2011 (group B),summarize and analysis the actual applicate situation of the comprehensive prevention measures in the clinical through the data contrast.Results The incidence of VAP in group A was lower than that in group B [31.7％(58/183) vs.58.3％(112/192)] (P ＜ 0.05),but the mortality was no statistical difference in both groups (P ＞ 0.05) ; the endotracheal intubation time and the average length of stay in group A were less than those in group B [6.3 d vs.10.6 d,7.6 d vs.11.9 d](P＜0.05); the main pathogenic bacterium of VAP with mainly gram-negative bacilh.Conclusions Comprehensive prevention measures can effectively reduce the incidence of VAP,but the mortality rate has no significant effect,need further clinical research;comprehensive prevention measures to reduce patients with tube time also confirm its effectiveness.Comprehensive prevention measures are economical and practical,is worth in clinical promotion.