The correlation analysis between plasma sclerostin levels and bone turnover markers and inflammation factors in hemodialysis patients / 中国医师进修杂志

Objective:To explore the correlation between plasma sclerostin (SOST) and bone turnover markers and inflammatory factors in hemodialysis patients.Methods:One hundred and eight patients admitted to Changsha Central Hospital Affiliated to Nanhua University from January 2018 to May 2019 were selected. The levels of plasma SOST at admission and at 3, 6 and 12 months of dialysis were determined by enzyme-linked immunosorbent assay. They were divided into low- SOSTgroup (56 cases) and high- SOSTgroup (52 cases) based on the mean value of SOST. The levels of serum bone turnover markers β-Ⅰ collagen carboxy-terminal peptide (β-CTX) and osteocalcin (OC), propeptide of type Ⅰ procollagen (PINP), full parathyroid hormone (iPTH), N-terminal osteocalcin (N-MID-OC), inflammatory factors interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) were compared between the two groups, abdominal aortic calcification (ACC) score was performed, and Pearson linear correlation analysis was used to analyze the relationship between SOST level of hemodialysis patients and bone turnover markers, inflammatory factors and ACC scores.Results:The baseline levels of β-CTX, OC, PINP, iPTH, and N-MID-OC in the low- SOST group were higher than those in the high- SOST group: (976.03 ± 205.27) ng/L vs. (781.34 ± 150.45) ng/L, (175.31 ± 50.49) ng/L vs. (125.75 ± 40.17) ng/L, (321.45 ± 82.14) μg/L vs. (259.41 ± 75.36) μg/L, (345.26 ± 102.65) ng/L vs. (198.52 ± 45.71) ng/L, (19.96 ± 5.01) μg/L vs. (17.41 ± 4.23) μg/L, the differences were statistically significant ( P<0.05). The baseline levels of IL-1β, IL-6, CRP, TNF-α and ACC scores in the low- SOST group were higher than those in the high- SOST group: (19.31 ± 6.01) ng/L vs. (15.23 ± 4.75) ng/L, (76.85 ± 20.34) ng/L vs. (57.98 ± 15.02) ng/L, (8.15 ± 2.36) mg/L vs. (7.23 ± 1.79) mg/L, (178.37 ± 55.52) ng/L vs. (157.42 ± 10.15) ng/L, (5.96 ± 1.78) scores vs. (5.11 ± 1.15) scores, the differences were statistically significant ( P<0.05). After treated for 3, 6 and 12 months, the levels of β-CTX, OC, PINP, iPTH, N-MIC-OC in hemodialysis patients were increased, the level of SOST was decreased, the levels of IL-1β, IL-6, CRP, TNF-α increased and ACC scores were increased, the differences were statistically significant ( P<0.05). The Pearson linear correlation analysis showed that SOST level and bone turnover markers β-CTX ( r = -0.465, P<0.001), OC( r = -0.498, P<0.001), PINP( r = -0.511, P<0.001), iPTH ( r = -0.396, P = 0.012), N-MID -OC ( r = -0.323, P = 0.031) and inflammatory factors IL-1β( r = -0.305, P = 0.046), IL-6( r = -0.318, P = 0.041), CRP( r = -0.327, P = 0.034) and TNF-α( r = -0.378, P = 0.024) in hemodialysis patients were negatively correlated, and negatively correlated with abdominal aortic calcification scores ( r = -0.301, P = 0.048). Conclusions:Plasma SOST level in hemodialysis patients is lower, which is negatively correlated with bone turnover markers, inflammatory factors, and calcification scores. Low SOST level can induce vascular calcification by mediating bone metabolism disorders and aggravating the body′s inflammatory response, and increase the risk of hemodialysis vascular calcification.

Nucleosides-based identification model for Fritillariae Cirrhosae Bulbus / 中国中药杂志

A high performance liquid chromatography( HPLC) method was established for the fast,and precise determination of ten nucleosides in Fritillariae Cirrhosae Bulbus and its counterfeits. Then multivariate statistical analyses,such as clustering analysis,principal component analysis( PCA),and Fisher' s linear discriminant analysis( LDA),were conducted to establish a discriminant function model for an integrated analysis. The results indicated that data acquisition time of a single sample was shortened within 16 min by the HPLC method. In the range of 5-1 000 mg·kg~(-1),the mass concentrations of all nucleosides exhibited good linear relationships with the corresponding peak areas( R2> 0. 999). The spiked recoveries were in the range of 93. 83%-108. 9% with RSDs of0. 12%-1. 3%( n = 5). The limit of quantitation( LOQ) was 0. 98-4. 13 mg·kg~(-1). As revealed by the clustering analysis,Fritillariae Cirrhosae Bulbus and the counterfeits could be discriminated into two clusters based on the content of nucleosides. Fisher's LDA could achieve this discrimination,while PCA dimension reduction failed. The accuracy of the discriminant function model established on the screened characteristic indicators reached 97. 5%. The present study proposed a new identification method of Fritillariae Cirrhosae Bulbus with one-dimensional indicators,which is simple,accurate,and reliable. It can provide a scientific basis for further optimizing the identification techniques for Fritillariae Cirrhosae Bulbus and inspiration for quality control strategy development of Chinese medicinal materials.

Cytological study on aptamer selection for bladder cancer through CELL-SELEX / 医学研究生学报

ObjectiveThe methods based on bladder cancer markers which could be applied to early diagnosis and postoperative recurrence monitoring of bladder cancer were current research hotspots. This study aims to screen aptamers that specifically recognize human bladder cancer cell lines (EJ, T24, BIU87) through cell-based systematic evolution of ligand by exponential enrichment (CELL-SELEX).MethodsFor CELL-SELEX screening, bladder cancer cell lines EJ, T24, and BIU87 were used as positive control cells. HCV 29 (human normal urothelial cell line), 293T (human embryonic kidney cell line), huh7 (human hepatocellular carcinoma cell line) were used as negative control cells. PCR upstream primers were labeled with FITC, downstream primer was labeled with Biotin. ssDNA fragments collected from each round were amplified by PCR, and the amplified product was then purified using a DNA purification Kit. The biotin-streptavidin magnetic separation methods were used to isolate the PCR product to obtain secondary FITC-ssDNA for the next CELL-SELEX round. The screening process was monitored by flow cytometry. ssDNA pool with the highest binding rates to bladder cancer cell lines(EJ, T24, and BIU87) was selected to PCR amplification, product purification, molecular cloning, and sequencing. According to the sequencing results, the secondary structure of the aptamer was pre-simulated by Dnaman software. Aptamer labeled with FITC was synthesized in vitro, flow cytometry was used to detect the binding rate of the aptamer to bladder cancer cell lins (EJ, T24 and BIU87).ResultsWith the advance of the CELL-SELEX process, the binding rate of FITC-ssDNA to bladder cancer cell lins (EJ, T24, and BIU87) increased gradually. By the 15th round, the binding rate of FITC-ssDNA to EJ cells reached the highest level. The apt1 had the highest enrichment among the 15th round ssDNA pool. By the 18th round, the binding rate of FITC-ssDNA to T24 or BIU87 cells reached the highest level. The apt2 and apt3 had the highest enrichment among the 18th round ssDNA pool. DNA structure prediction showed that the secondary structure of apt1, apt2, and apt3 was mainly stem-loop structure. Flow cytometry showed that the highest binding rate was FITC-apt1 to EJ cells, FITC-apt2 to T24 cells, and FITC-apt3 to BIU87 cells, respectively. There is no significant combination between these aptamers with the negative cells.ConclusionIn this study, three kinds of aptamers with high specificity for bladder cancer cell lines were successfully screened by CELL-SELEX. The apt1 can specifically recognize EJ cells, apt2 can specifically recognize T24 cells and apt3 can specifically recognize BIU87 cells, all of which provide experimental evidence for early diagnosis and targeted therapy technology research of bladder cancer.

Commelina communis L. extract inhibits hypoxia/reoxygenation-induced apoptosis of cardiomyocytes and expression of inflammatory factors through regulating NADPH oxidase 4 (Nox4) / 中华微生物学和免疫学杂志

Objective:To investigate the effects of Commelina communis L. on hypoxia/reoxygenation (H/R)-induced apoptosis of myocardial cells and expression of inflammatory factors through regulating NADPH oxidase 4 (Nox4). Methods:H9c2 cells were subjected to H/R to establish the injury model. These cells were then treated with different concentrations of Commelina communis L. extract. Cell activity and apoptosis were measured by MTT method and flow cytometry, respectively. Superoxide dismutase (SOD), malondialdehyde (MDA) and lactate dehydrofenase (LDH) levels were detected. ELISA was performed to detect TNF-α, IL-1β and IL-6 levels. Western blot was used to detect the expression of Bcl-2-associated X protein (Bax), cysteine-containing aspartic protease 3 (Caspase-3) and Nox4. Real-time quantitative PCR (qPCR) was used to measure the expression of Nox4 at mRNA level. H9c2 cells were transfected with si-Nox4 and subjected to H/R. Changes in the activity and apoptosis of H9c2 cells, and the expression of SOD, MDA, LDH and inflammatory factors were observed after inhibiting Nox4 expression. H9c2 cells transfected with pcDNA3.1-Nox4 were treated with Commelina communis L. extract and subjected to H/R to evaluate the effects on the cell activity and apoptosis, as well as the expression of SOD, MDA, LDH and inflammatory factors. Results:The survival rate and SOD activity of H9c2 cells exposed to H/R were significantly reduced, but the apoptosis rate, the levels of Caspase-3, Bax protein, MDA, LDH TNF-α, IL-1β and IL-6, and the expression of Nox4 at both mRNA and protein levels were dramatically increased ( P<0.05). As with inhibition of Nox4 expression, Commelina communis L. extract at the concentrations of 10 μg/ml and 20 μg/ml could obviously increase the survival rate and SOD activity of H9c2 cells after H/R exposure, and reduce the apoptosis rate and the expression of Caspase-3, Bax protein, MDA, LDH TNF-α, IL-1β and IL-6, as well as Nox4 expression at mRNA and protein levels ( P<0.05). Overexpression of Nox4 reversed the effects of Commelina communis L. extract on promoting cardiomyocyte cell activity and SOD activity, inhibiting cell apoptosis, and downregulating the expression of Caspase-3, Bax protein, MDA, LDH, TNF-α, IL-1β and IL-6 in the H/R injury model. Conclusions:Commelina communis L. could protect against H/R-induced myocardial cell injury, improve cell activity, and inhibit cell apoptosis and the expression of inflammatory factors through regulating Nox4 expression.

HPLC fingerprint of Ermiao Pills and chemical constituents analysis by UPLC-LTQ-Orbitrap / 中草药

Objective To establish a quality assessment method for Ermiao Pills (EP) based on HPLC fingerprint and qualitatively analyze the chemical constituents. Methods The chromatographic column Shiseido C18 (250 mm × 4.6 mm, 5 μm) was used, acetonitrile-0.1% formic acid as mobile phase with gradient elution at the flow rate of 1.0 mL/min, and the detection wavelength was 330 nm. The standard chromatographic fingerprint was synthesized from chromatogram of the mixed standard herbs of Phellodendron Rupr. and Atractylodes DC, and the similarity evaluation of Ermiao Pills samples was carried out by the Similarity Evaluation System for Chromatographic Fingerprints of TCM (Chinese Pharmacopoeia Commission, version 2012A). Ultra high-performance liquid chromatography coupled with linear ion trap-Orbitrap Elite mass spectrometer (UPLC-LTQ-Orbitrap) was used to characterize the chemical constituents of Ermiao Pills. A Thermo Scientific Syncronis C18 (100 mm × 2.1 mm, 1.9 μm) column and a gradient elution of acetonitrile-0.1% formic acid were used for UPLC separation. The combination of ESI-LTQ-Orbitrap mass analyzer with a linear ion trap was applied for high resolution mass spectrometry and collision-induced dissociation (CID). Results The chromatographic fingerprints were generated with 10 common peaks. The similarity scores of 20 samples between each material batch and the reference fingerprint ranged from 0.869-0.992. Twenty-one components were identified via referring to reference components and literatures and analyzing MS data, they were neo-chlorogenic acid, magnocurarine, xanthoplanine, magnoflorine, 3-O-feruloylquinic acid, menisperine, demethyleneberberine, oxyberberine, columbamine, jatrorrhizine, berberubine, palmatine, berberine, syringic acid, caffeic acid, (E)-4-(3-hydroxyprop-1-en1yl)-2-methoxyphenol, atractylenolide II, acetosyringone, atractylenolide I, selina-4(14), 7(11)-dien-8-one, and atractylodin. Conclusion The established method of fingerprint is specific, combined with LC-MS qualitative analysis, can be used for the quality evaluation of Ermiao Pills, giving support to quality control comprehensively.

The application of dynamic high-frequency ultrasound in the diagnosis of Zenker diverticulum / 中国医学装备

Objective:To explore the diagnostic value of high-frequency ultrasound for Zenker diverticulum.Methods: 15 patients who were suspected as Zenker diverticulum through the diagnosis of using high frequency ultrasound were analyzed in the research. Their appearances of ultrasound were summarized, and these results were compared with barium meal at upper gastrointestinal tract and results of postoperative pathology, respectively.Results: In 15 patients, 4 cases were confirmed by adopting barium meal at upper gastrointestinal tract, and 11 cases were confirmed by adopting postoperative pathology. All of lesions in 15 cases were located on the back of left side of the thyroid gland, and there were 3 kinds of sonographic appearance. The first kind was equal echo lesion, and there were spots and schistoses without echo inside lesion, their form showed a semicircle shape. The second kind was hypoechoic, the form showed irregularity or semi cyclic annular, and the border was clear, and there were strong echogenic spots. The third kind was hyperechoic lesions, and the strong echo were movable with morphological changing after the slight pressure of search unit, and slim half ring low echo wall can be seen indistinctly around lesions.Conclusion:High-frequency ultrasonography is a convenient, rapid and non-invasive method for the diagnosis of Zenker diverticulum, and it is helpful to grasp its ultrasonogram characteristic and examination method in early detection of disease, avoiding misdiagnosis and missed diagnosis. Therefore, it has important clinical value.

Evaluation of risk factors and prognosis on diodone-induced acute kidney injury according to ESUR and KDIGO criteria / 中南大学学报(医学版)

OBJECTIVE@#To investigate the incidence, risk factors and prognosis for contrast-induced acute kidney injury (CI-AKI) according to ESUR and KDIGO criteria in patients undergoing angiography.
@*METHODS@#We evaluated 260 patients undergoing angiography and/or intervention therapy from April 2011 to January 2012 in the Second Xiangya Hospital of Central South University. All patients received low-osmolality contrast agent (ioversol). Serum creatinine was measured before angiography or at 48 or 72 h after procedure. The multivariate logistic regression was used to analyze the risk factors of CI-AKI. The major adverse events were observed in a year of follow-up.
@*RESULTS@#Among the 260 patients, 23 experienced CI-AKI and the incidence was 8.8% according to ESUR criteria. Twelve patients experienced CI-AKI and the incidence was 4.6% according to KDIGO criteria. The multivariate logistic regression analysis showed that diabetes mellitus and dehydration were the independent risk factors for CI-AKI according to ESUR criteria; In another KDIGO criteria, chronic kidney disease (CKD), hypercholesterolemia and diabetes mellitus were the independent risk factors for CI-AKI. The prognosis study showed that the mortality of patients with CI-AKI were significantly higher than those without CI-AKI (P<0.05).
@*CONCLUSION@#The incidence of CI-AKI is associated with diagnostic criteria. Diabetes mellitus, CKD, dehydration and hypercholesterolemia were the independent risk factors for CI-AKI. CI-AKI is a relevant factor for mortality in a year after angiography and/or intervention therapy.

Anti-proliferative and apoptotic effects of S1, a tetrandrine derivative, in human gastric cancer BGC-823 cells / 中国天然药物

The aim of the study was to investigate the anti-proliferation and apoptosis-inducing effects of S1, a novel tetrandrine derivative, in human gastric cancer BGC-823 cells and explore the possible mechanism of action. The anti-proliferative activity was determined by MTT assay; the induction of cell cycle arrest and apoptosis were detected by flow cytometry. Quantitative real time RT-PCR and Western blotting were used to evaluate the mRNA and protein expression levels in mitochondrial pathway. S1 significantly reduced cell viability and induced a G2/M phase arrest and apoptosis in dose- and time-dependent manner. Further studies showed that S1 increased mRNA and protein expression of Bax and the Bax/Bcl-2 ratio. Moreover, S1 decreased the protein expression of procaspase-9 and procaspase-3, suggesting that the induction of apoptosis may be related to the alteration of the ratio of Bax/Bcl-2 and the activation of caspases. These findings suggested that S1 merits further investigation as a novel therapeutic agent for the treatment of human gastric cancer.

The effect of up-regulation of HtrA2 gene expression via radiation in human uveal melanoma cells / 中国癌症杂志

Background and purpose: Uveal melanoma (UM) is the most common primary intraocular malignancy in adult. Due to a high tendency for early metastasis the treatment of UM is very difficult. This study aimed to explore an effective approach for the treatment of patients with UM, we designed a strategy that combined HtrA2 gene therapy and radiation therapy. Methods:pIRES-Egr1-Omi/HtrA2 (pEgr1-HtrA2) recombinant plasmids were constructed and transfected into human UM cells (OCM-1) in vitro. The transfected cells were exposed to irradiation. HtrA2 mRNA and protein levels were detected by qRT-PCR and Western blot respectively. Assays that evaluated the apoptosis inducibility caused by HtrA2 gene therapy combined with radiation was performed by lfow cytometry. Followingly, the effects of HtrA2 overexpression on the in vitro radiosensitivity of uveal melanoma cells were investigated by clonogenic formation assay. The in vivo effects of HtrA2 gene therapy combined with radiation therapy were evaluated in different groups. Results:The recombinant plasmids could be successfully transferred into OCM-1 cells and transfection of pEgr1-HtrA2 plasmids combined with radiotherapy caused dramatically elevation of HtrA2 compared with non-irradiation cells in mRNA and protein levels, which was associated with increased apoptosis.Furthermore, we observed that the transfection of pEgr1-HtrA2 could significantly enhance radiosensitivity of OCM-1 cell in vitro. In mice bearing xenograft tumors, pEgr1-HtrA2 combined with radiation therapy signiifcantly inhibited tumor growth compared with the other treatment groups (P<0.05). Conclusion:Our ifndings indicate that radiation-inducible gene therapy may have potential to be a more effective and speciifc therapy for uveal melanoma because the therapeutic gene can be spatially or temporally controlled by exogenous radiation.

Pathogens distribution and drug sensitivity of chronic dacryocystitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the pathogens and drug sensitivity of chronic dacryocystitis in order to provide evidence for clinical drug use. METHODS:Lacrimal secretion of 171 cases with chronic dacryocystitis was sampled for pathogenic bacteria culture identification and drug sensitivity test. Based on the results, the isolation rate of pathogens strains, the pathogens kind of chronic dacryoeystitis, main pathogens of chronic dacryocystitis, and sensitive drug for pathogens were analyzed. RESULTS: The isolation rate of pathogens strains was 76. 61% ( 131 cases ). The pathogens constituting the chronic dacryocystitis were predominantly gram-positive coccus,the percentage was 72. 52% (95 cases), among which staphylococcus hominis occupied 27. 48% ( 36 cases), staphylococcus epidermidis 16. 79% (22 cases), streptococcus viridans 12. 98% (17 cases). The majority of these bacteria were sensitive to cefoperazone-sulbactam, tobramycin, gentamicin and levofloxacin. For gram -positive coccus, cefoperazone - sulbactam, gentamicin and tobramycin were the most sensitive drug. For gram-negative bacilli, cefoperazone - sulbactam, tobramycin and levofloxacin were most sensitive drug. CONCLUSION: Staphylococcus hominis is the main pathogen of chronic dacryocystitis, tobramycin can be used as the first choice for local treatment of chronic dacryocystitis.

Application of case introduction and assessment approach of the team in strengthening the skills training of school nursing students / 中国医学装备

Objective: To explore the effect of case introduction and assessment approach of the team in strengthening the skills training of school nursing students. Methods:Selected 289 undergraduate nursing students from grade 2010 as experimental group, 281 students from grade 2010 as control group, the experimental group adopted case introduction and assessment approach of the team, the latter used the traditional assessment method, after the end of the training, two groups of students were operating examination and questionnaire survey. Results:The nursing students in the experimental group of operating examination results was better than the control group(P<0.05).The application of case introduction and assessment approach of the team can develop good teamwork spirit(86.30%), communication skills(71.85%), consciousness of active learning(81.11%), clinical decision-making(75.93%), and clinical adaptive-ability(87.04%). Conclusion:The model of case introduction and assessment approach of the team can improve the clinical comprehensive ability partly.

Effects of hydrodynamics-mediated RNAi on Mfn2 expression, blood sugar and fat levels in mice / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of hydrodynamics-mediated RNAi for Mfn2 gene expression in liver and the levels of blood sugar and fat in mice.</p><p><b>METHODS</b>Fifty-six male BALB/c mice were randomly divided into normal control group (NC, n = 8), negative control group (HK, n = 24) and transfection group (Mfn2, n = 24) according to random digits table. 1.5 ml plasmid (negative control or Mfn2 shRNA, 75mug for each mouse) diluted into phosphate buffered solution (PBS) was injected into the HK and Mfn2 groups mice via hydrodynamic intravascular injection. Mfn2 mRNA and protein expression in hepatic tissue was detected by RT-PCR and Western-blot 24 hours, 72 hours and 120 hours respectively after injection. At the same time, the levels of fasted blood sugar (FBS) and triglyceride (TG) were measured.</p><p><b>RESULTS</b>Compared with HK mice, the expressions of Mfn2 mRNA (1.00+/-0.03 vs 1.14+/-0.07, t = 4.027, P = 0.007; 1.01+/-0.053 vs 1.18+/-0.07, t = 4.234, P = 0.006) and protein (7.81+/-0.80 vs 8.01+/-0.08, t = 2.941, P = 0.042; 8.05+/-0.15 vs 8.56+/-0.014, t = 4.883, P = 0.039) decreased markedly in Mfn2 mice in 72 and 120 hours after injection. In the fasting state, in 24 hours after injection, FBS in Mfn2 group was significantly lower than that in HK group [(2.65+/-0.70 vs 5.28+/-0.82) mmol/L, t = 6.879, P value less than 0.01] and TG was also significantly higher than that in HK group [(1.96+/-0.32 vs 1.12+/-0.16) mmol/L, t = -6.711, P value less than 0.01]. No statistical differences found between the NC and HK groups for FBS and TG (F = 1.412, P = 0.26; F = 2.711, P = 0.14). The plasma glucose level in Mfn2 mice was significantly higher than that in HK mice [(7.23+/-0.82 vs 5.18+/-0.69) mmol/L, t = 2.050, P value less than 0.01; (7.00+/-0.67 vs 6.05+/-0.76) mmol/L, t = 3.57, P = 0.023] in 72 and 120 hours after injection. However, no differences found between the two groups for blood TG [(1.53+/-0.27 vs 1.37+/-0.18) mmol/L, t = 0.160, P = 0.23; (1.84+/-0.30 vs 1.52+/-0.37) mmol/L, t = 0.330, P = 0.503].</p><p><b>CONCLUSION</b>The data indicate that hydrodynamics- mediated RNAi for Mfn2 gene can effectively inhibit the expression of target gene in mice liver in 72 and 120 hours after shRNA administration, and the inhibition of hepatic Mfn2 can induce glycometabolic and fat metabolic disorder.</p>

Induction of ERBB2 Nuclear Transport after Radiation in Breast Cancer Cells / 华中科技大学学报（医学）（英德文版）

ex-pression in breast cancer cells with high ERBB2 expression. It was concluded that radiation could induce ERBB2 nuclear transport, and nuclear ERBB2 may correlate with radiation resistance in breast cancer cells with high ERBB2 expression.

The use of composite sodium lactate and sorbitol composition in fluid resuscitation for shock in patients with major burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of the use of sodium lactate and sorbitol (CISS) in the fluid resuscitation for shock in patients with major burns.</p><p><b>METHODS</b>Fifty - three adult patients with major burns (hospitalized within 6 hours after burns) were randomly divided into A (n = 24, with i.v. infusion of 50 g/L CISS, 2 000 ml per day) and B (n = 29, with i. v. infusion of 50 g/L glucose, 2 000 ml per day) groups. The amount of electrolytes and colloid as the main resuscitation fluids was calculated according to the formula in both groups. Meanwhile, additional electrolytes and insulin were supplemented to the patients in the B group. The result of combating shock, energy supply, and side effects in the two groups were observed. The changes in hepatic and renal function, and the changes in electrolytes were monitored. The amount of fluid supplementation and urinary volume were recorded. The level of blood glucose of each patient was determined at the admission time and 24, 48, and 72 hours after injury.</p><p><b>RESULTS</b>No obvious difference was found in control of shock and energy supply between A and B group. There was no side effects or damage to hepatic and renal function related to infused fluids in A group. But the patients of the B group required supplementation of exra electrolytes and insulin during the fluid resuscitation period in order to maintain the normal levels of electrolytes and blood glucose, and this was not necessary in group A. The diuretic effect in group A was better than that in group B (average urinary volume in the first two 24 hours: group A: 1.9 +/- 0.6 and 3.3 +/- 0.8 L; group B:1.0 +/- 0.5 and 2.3 +/- 0.8 L).</p><p><b>CONCLUSION</b>The use of CISS during shock stage of the patients with major burns could be beneficial to the replenishment of blood volume, control of shock, promotion of diuresis and subsidence of edema. It could also provide electrolytes and energy, without the influence on the level of blood glucose.</p>

Long-term result of repair of deeply burned hands with large sheet of split-thickness autoskin grafting with the preservation of denatured dermis / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the long-term results of repair of burn hands with large sheet of split-thickness autoskin grafting with the preservation of denatured dermis.</p><p><b>METHODS</b>One hundred and fifty-two hands in 86 burn patients with deep partial thickness and full thickness burn were enrolled in the study. The burned hands were treated by tangential excision and grafted with large sheet of split-thickness autoskin with the preservation of denatured dermis. The patients were followed-up from 3 months to 3 years. The skin color, elasticity, degree of contracture and the functional grading of the operated hands were observed.</p><p><b>RESULTS</b>Good function was found in one hundred and forty-one out of the 152 burn hands (92.8%). For the rest 11 hands, pigmentation was found in 4, poor appearance in 4, and 3 hands with both poor appearance and function.</p><p><b>CONCLUSION</b>Large sheet of split-thickness autoskin grafting with the preservation of denatured dermis could be an optimal choice for the management of hands with deep partial thickness burn, and it could restore the appearance and function of the hands satisfactorily.</p>

Interchange of facial scar flap with upper arm subdermal vascular network skin flap to improve facial appearance / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the result of subdermal vascular network skin flap raised from the upper arm to interchange with a facial skin flap carrying a scar resulted from previous burn.</p><p><b>METHODS</b>A transit flap was designed in the anterior medial aspect of the upper arm according to the reverse design method. The subdermal vascular network flap in the upper arm with length-width ratio less than 1.5:1 was raised with the pedicle located outside of the intermuscular septum of musculus biceps/triceps brachialis. The length-width ratio of the facial scar flap should be less than 1.2:1. The two flaps were cross-grafted to repair the facial wound left by raising the scar flap. The pedicles of the flaps were divided on 14 approximately 15 post-operative days (PODs).</p><p><b>RESULTS</b>The two flaps survived with satisfactory appearance in 9 patients with this method.</p><p><b>CONCLUSION</b>Interchange of facial scar flap with subdermal vascular network skin flap from the upper arms could be a new, reliable and effective method for the facial plastic surgery.</p>

Repair of rabbit tendon by autologous bone marrow mesenchymal stem cells / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of rabbit bone marrow mesenchymal stem cells (MSCs) as seed cells for the repair of tendon defect.</p><p><b>METHODS</b>The MSCs were isolated, amplified and identified by detection of surface protein CD44 mRNA. A 3 cm long defect was made in the Achilles tendon of the rabbit. The rabbits were divided into experimental (E) and control (C) groups. The autologous MSCs were implanted into a collagen-polyglycolic acid (PGA) scaffold to form a tissue-engineered tendon, which was then transplanted to bridge the defect in the E group, while only collagen-PGA was transplanted to bridge the defect in the C group. The transplanted tendon was observed grossly and microscopically at 4, 8, 12 weeks after operation.</p><p><b>RESULTS</b>The cultured MSCs exhibited positive staining of CD44 on 11 days after in vitro culture. A tendon-like tissue could be discerned at the operation site in the E group 4 weeks after operation. Tendon-like cells similar to normal tendon tissue, being axially arranged in collagen matching the mechanical direction, with uniform morphology could be seen in E group 12 weeks after operation. The newly regenerated tissue in C group adhered to the adjacent tissue and was smaller than that in E group. The collagen fibers in the regenerated tissue were loose with reticular and filiform structure, and the cells were arranged disorderly 12 weeks after the transplantation.</p><p><b>CONCLUSION</b>It is feasible to repair the tendon defect with autologous MSCs as seed cells.</p>

Repair of the penial injury in patients inflicted by high-voltage electrical injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the repair and reconstruction of penial defect in patients inflicted by high-voltage electrical injury.</p><p><b>METHODS</b>Among one hundred and fifty three patients inflicted with high-voltage electrical injury, 6 suffered from penial injury (including 3 with necrosis of whole penis, 1 with partial necrosis of penis, 1 with partial necrosis of penial shin and 1 with necrosis of entire skin of penis) were enrolled in the study. The penis was repaired by direct suture of the residual skin following excision of necrotic skin in one case, by skin grafting in two case, by scrotum skin flap transplantation in 3 cases.</p><p><b>RESULTS</b>The appearance and function of the penis in three cases were satisfactory, and the result was also satisfactory in one patient who underwent reconstructive operation at late post injury stage. The penis was totally lost in 2 patients.</p><p><b>CONCLUSION</b>The skin necrosis of penis after high-voltage injury could be repaired with scrotum skin flap. Total necrosis of the penis could be reconstructed with abdominal skin flap.</p>