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Objective To investigate the difference in the prognosis of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) caused by hepatitis recurrence after withdrawal of nucleos(t)ide analogues (NUC) and possible causes in HBeAg-positive versus HBeAg-negative chronic hepatitis B (CHB) patients. Methods A total of 108 CHB patients with HBV-ACLF caused by withdrawal of NUC who were admitted to The First Affiliated Hospital of Nanchang University from January 2017 to December 2018 were enrolled, and according to HBeAg status, these patients were divided into HBeAg-positive group with 57 patients and HBeAg-negative group with 51 patients. The two groups were compared in terms of sex, age, clinical manifestation, signs, levels of total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, prothrombin time, activated partial thromboplastin time, prothrombin time/international normalized ratio, and HBV DNA quantification on admission, complications (including hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis), and prognosis of HBV-ACLF. In addition, 48 CHB patients with continuous NUC antiviral therapy for > 2 years and HBV DNA < 20 IU/mL were enrolled, and the serum level of HBV pgRNA was measured to investigate the possible causes of the difference in the prognosis of HBV-ACLF between the patients with different HBeAg statuses. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Kruskal-Wallis H 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. Results For the 108 patients with HBV-ACLF caused by drug withdrawal and recurrence, the HBeAg-positive group had an improvement rate of 49.1% and the HBeAg-negative group had an improvement rate of 74.5%. The HBeAg-negative group had a significantly higher improvement rate than the HBeAg-positive group ( χ 2 =2.811, P =0.006). The HBeAg-positive group had a significantly higher level of HBV DNA than the HBeAg-negative group on admission ( t =-3.138, P =0.002). For the 48 CHB patients who achieved virologic response after long-term antiviral therapy, the HBeAg-positive group had a significantly higher HBV pgRNA load than the HBeAg-negative group ( H =2.814, P =0.049). Conclusion Compared with the HBeAg-positive CHB patients, HBeAg-negative CHB patients have a significantly better improvement rate of HBV-ACLF caused by hepatitis recurrence after withdrawal of NUC antiviral therapy. The difference in baseline HBV pgRNA level may be associated with the difference in the prognosis of HBV-ACLF in patients with different HBeAg statuses.
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The skin pathologic scar is a skin fibrous proliferative disease characterized by abnormal proliferation of fibroblasts and overdeposition of extracellular matrix. Unclarity of genesis and development mechanism is the main reason that restricts its diagnosis and treatment. In recent years, it has been found that microRNAs play important roles in the regulation mechanism of pathological scars. The competing endogenous RNAs (ceRNAs) have microRNA response elements which can be competitively combined with microRNAs through sponge adsorption. Through the mutual regulation of RNAs, ceRNAs regulate the expression of target gene and participate in the development of disease. Based on the ceRNA hypothesis, this paper systematically reviews the biological functions and clinical significance of ceRNAs in pathological scars of skin, and discusses the role of ceRNAs and " RNA-microRNA-RNA" regulation network in pathologic scars. The ceRNA therapy may become a new model therapy for skin scars in the future.
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OBJECTIVE:To establish a method for simultaneous determination of eugenol and thymol in mummification pastes.METHODS:HPLC method was adopted.The determination was performed on Wonda Cract C18 column with mobile phase consisted of methanol-0.2％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was 274 nm,and column temperature was set at 25 ℃.The sample size was 10 μL.RESULTS:The linear ranges of eugenol and thymol were 0.02-0.19 mg/mL (r=0.999 7) and 0.03-0.30 mg/mL (r=0.999 6).RSDs of precision,stability and reproducibility tests were all lower than 2.0％.The recoveries were 95.85％-99.84％(RSD=1.11％,n=9) and 95.81％-100.91％(RSD=1.59％,n=9).CONCLUSIONS:The method is simple and accurate,and can be applied to simultaneous determination of eugenol and thymol in mummification pastes.
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Objective @# To evaluate the therapeutic effects of erbium-doped: yttrium aluminium garnet laser (Er: YAG laser) combined with guided bone regeneration (GBR) in the treatment of peri-implantitis bone defect.@*Methods @#A total of 26 implants in 15 patients with peri-implantitis were selected and divided into experimental group (14 implants) and control group (12 implants) randomly. The experimental group was treated with Er: YAG laser combined with GBR, and the control group was treated with mechanical curettage with GBR. Clinical periodontal index test including plaque index (PI), sulcus bleeding index (SBI), probing depth (PD) and clinical attachment level (CAL) were checked at baseline, 3 months and 6 months. All the above data were statistically analyzed. @*Results @#All of the clinical periodontal index were improved after surgery. SBI, PD and CAL of the experimental group was 0.8 ± 0.2 mm, 5.8 ± 0.8 mm, and 2.3 ± 0.7 mm, while they were 1.1 ± 0.2 mm, 6.2 ± 0.6 mm, and 3.6 ± 0.6 mm in the control group. The experimental group showed better results than the control group (P< 0.05), while PI showed no difference between the 2 groups (P> 0.05). @*Conclusion@#The combined application of Er: YAG laser and GBR in the treatment of bone defect in peri-implantitis has good clinical effects.
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Objective@# To investigate the influence of different concentrations of CaCl2 on the hemolytic activity of candida strains. @*Methods @#A total of 25 candida strains were selected, including 21 candida strains recovered from clinical specimens, and 4 reference strains of C. albicans (ATCC 90028) (American Type Culture Collection, Manassas, VA, USA), C. glabrata (ATCC 90030), C. krusei (ATCC 6258), and C. tropicalis (ATCC 13803) respectively. CaCl2 was added at concentrations of 0%, 0.5%, 1% and 2.5 g % (wt/vol). Plates were cultured at 37 ℃ in a 5% CO2 atmosphere for 24-72 h, and the hemolytic index (Hi) was analyzed. @*Results @#comparsions of the hemolytic indices among the groups treated with 0.5% CaCl2 (Hi = 2.247 ± 0.079), 1% CaCl2 (Hi = 2.013 ± 0.092), 2.5% CaCl2 (Hi = 2.150 ± 0.066) and the control (Hi = 2.749 ± 0.103) reached statistical significance (P < 0.001). @*Conclusion@#CaCl2 may produce a decrease activity in the hemolysis of candida species.
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Objective To study the impact of tumor necrosis factor-α (TNF-α) and its antagonist on the expressions of intestinal mucosa claudin-1,Zonula Occludens-1 (ZO-1) and myosin light chain kinase (MLCK) in rat models of acute liver failure.Methods Fifty four healthy male SpragueDawley (SD) rats were randomly divided into normal control group,model group and intervention group according to a random number table.Rats in normal control (n=6) group were intraperitoneally injected with 0.9％ saline (12 mL/kg).Rats in model group (n=24) and intervention group (n=24) were intraperitoneally injected with a full dose of D-galactosamine (D-GalN) at a dose of 1 200 mg/kg to establish model of acute liver failure,while rats in intervention group were intraperitoneally injected with TNF-α antagonists (rhTNFR∶Fc) at a dose of 12.5 mg/kg before 24 hours given D-GalN.At each time point of hour 8,24,48 and 72,six rats in both model group and the intervention group were sacrificed,respectively,while the normal control group were all anesthetized and sacrificed at 72 h.Models were repeated five times.Serum liver function was detected by biochemical method,and serum TNF-α level was detected by enzyme-linked immunosorbent assay (ELISA).Hematoxylin-eosin (HE) stained sections of liver and terminal ileum were examined under an optical microscope for pathological changes;and protein expression of the terminal ileum Claudin-1,ZO-1 protein and MLCK were determined by immunohistochemistry and Western blot.Means among groups were compared with t test.Results Acute liver failure was successfully induced in the D-GalN injected rats.In the model group,alanine aminotransferase (ALT) began to decline,total bilirubin continued to rise,and enzyme-jaundice separation developed at hour 72.But total bilirubin in intervention group at hour 72 was decreased.Light microscope showed that at hour 72,villus lodged at terminal ileum in the model group with part of villus tip failing off in the model group.Villus mucosa and submucosa interstitial were edema and infiltrated with numerous neutrophils.The terminal ileum kept integrate in the intervention group,and villus mucosa and submucosa were mild edema and only infiltrated with a small amount of neutrophil.Expressions of tumor necrosis necrosis factor (TNF)-α in rats of model group and intervention group were gradually increased and peaked at hour 24 ([239.83 ± 15.81] and [182.71± 17.08] ng/L,respectively),which were significantly higher than that of the control group ([24.19±3.57] ng/L,t=22.68and 15.73,respectively;both P＜0.01).Expression of serumTNF-α in the intervention group was significantly lower than that of model group (t=4.58,P＜0.01).Expressions of Claudin-1 and ZO-1 in model group decreased gradually at an early stage and reached the lowest level at hour 24 (0.355 ± 0.068 and 0.387 ± 0.091,respectively),which were both significantly lower than that of control group (1.640±0.188 and 1.015±0.150,respectively;t=12.87 and 7.14,respectively;both P＜0.01).In the intervention group,expressions of Claudin-1 and ZO-1 also decreased to the lowest level at hour 24 (1.051 ± 0.370 and 0.642 ± 0.082,respectivley),which were both significantly lower than that of control group (t =2.84 and 4.36,respectively;both P＜0.05),but significantly higher than model group with stastically difference (t =3.70 and 4.15,respectively;both P＜0.01).MLCK protein levels in the model and intervention group were gradually increased,which peaked at hour 24 (1.298±0.194 and 1.033 ± 0.073,respectively),significantly higher than the control group (0.460±0.069,t=8.16 and 11.44,both P＜0.01);and MLCK in the intervention group was lower than that in the model group with statistically difference (t=2.56,P＜0.05).Conclusions Expression of serum TNF-α in rat model of acute liver failure increases,which leads to decreased expression of Claudin-1 and ZO-1,and increased expression of MLCK,makes cell shrunk and cell gap increased.TNF-α antagonist could significantly reduce the inflammation and liver cell apoptosis,improve liver function by inhibiting MLCK expression and preventing decrease of Claudin-1 and ZO-1 proteins.
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OBJECTIVE:To provide reference for the establishment of quality standard for Jinbo capsule. METHODS:TLC was conducted for the qualitative identification of Phellodendron chinense and Melia toosendan in preparation;HPLC was used for the content determination of berberine hydrochloride in preparation;the column was Diamonsil C18 with mobile phase of acetoni-trile-0.1% phosphoric acid (50∶50,V/V) at flow rate of 1 ml/min,detection wavelength was 265 nm,column temperature was 25 ℃ and volume injection was 10 μl. RESULTS:TLC spots of P. chinense and M. toosendan in preparation were clear and well-separated. The linear range of berberine hydrochloride was 0.044-0.154 mg/ml(r=0.999 9);RSDs of precision,reproducibili-ty and stability tests were no more than 2.0%,recovery was 98.36%-102.15%(RSD=1.11%,n=9). CONCLUSIONS:The meth-od is simple,accurate and reproducible,and can be used for the quality control of Jinbo capsule.
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<p><b>OBJECTIVE</b>To study the intestinal expression of defensin-5 (RD-5), soluble phospholipase A2 (sPLA2) and lysozyme in acute liver failure (ALF) using rat models, and to determine the relation of these expressions to intestinal bacterial translocation.</p><p><b>METHODS</b>Forty-eight healthy male Sprague-Dawley rats were divided into a control group (n=8) and a model group (n=40; intraperitoneal injection of 10% D-galactosamine). The model group was further divided into five subgroups according to the time lapse after model establishment (8, 16, 24, 48, and 72 hours). At the end of the experiments, homogenates of mesenteric lymph nodes, liver and spleen were cultured in agar for bacterial outgrowth.Hematoxylin-eosin stained sections of liver and terminal ileum were examined under an optical microscope to assess pathological changes. mRNA expression of RD-5, sPLA2 and lysozyme in the terminal ileum was determined by reverse transcription-polymerase reaction (RT-PCR), and protein expression of sPLA2 and lysozyme from the same anatomic location was determined by western blotting and immunohistochemistry. Means between groups were compared with one-way analysis of variance.</p><p><b>RESULTS</b>ALF was successfully induced in the D-galactosamine injected rats. No bacteria grew in the organ cultures from the control group, while 8.3%, 37.5% and 58.3% of the rats in the 24-, 48-and 72-hour model groups showed positive cultures. Despite this, the structure of the terminal ileum from the rats in the 72-hour model group was nearly intact, without obvious necrosis of mucosal epithelial cells. Expression of RD-5 and sPLA2 mRNA in the model groups gradually increased at early time points and peaked at 16 hours after induction of ALF (1.291+/-0.153 and 1.131+/-0.128), which was significantly higher than that detected in the control group (0.725+/-0.116 and 0.722+/-0.112, t=69.25, 95.71, all P<0.01). After that, the expression of RD-5 and sPLA2 mRNA progressively decreased, and by 72 hours after the induction of ALF, the expression (0.415+/-0.104 and 0.425+/-0.076) was significantly lower than that of the control group (t=31.55 and 44.98, all P<0.01). Lysozyme mRNA expression in the model group peaked at 8 hours after ALF induction (1.211+/-0.107), which was higher than that of the control group at this time point (0.853+/-0.093), and by 72 hours after ALF induction it declined to 0.704+/-0.103, which was significantly lower than that of the control group (t=9.224; all P=0.009). In addition, at 72 hours after ALF induction the protein expression of both lysozyme and sPLA2 was significantly lower in the model group (0.327+/-0.086 and 0.382+/-0.057) than in the control group (0.583+/-0.121 and 0.650+/-0.093, t=12.28 and 15.83, P=0.004 and 0.001). Similar results were obtained with immunohistochemical staining.</p><p><b>CONCLUSION</b>The function of the ileal mucosal immune barrier in the rat model of acute liver failure decreased, along with decreases in expression of RD-5, sPLA2 and lysozyme in the Paneth cells.At the same time, the rate of organ bacterial translocation increased without obvious injury to the intestinal mucosa structure.</p>
Subject(s)
Animals , Male , Rats , Bacterial Translocation , Defensins , Disease Models, Animal , Galactosamine , Injections, Intraperitoneal , Intestines , Liver Failure, Acute , Muramidase , Phospholipases A2 , Protein Precursors , RNA, Messenger , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To summarize the therapeutic effect of 5 kinds of flaps for the treatment of skin and soft tissue defect in the hallex.</p><p><b>METHODS</b>From Jan. 2008 to Jun. 2013, 24 cases with skin and soft tissue defects in the hallex were treated with 5 kinds of reversed flaps, including medial foot dorsal neurocutaneous flaps, medial foot neurocutaneous flaps, lateral tarsal flaps, anterior malleous flaps, medial cross leg and saphenous nerve flaps. The defects size ranged from 3 cm x 2 cm to 5 cm x 3 cm, with the flap size from 3. 5 cm x 2. 5 cm to 5. 5 cm x 4. 0 cm.</p><p><b>RESULTS</b>Partial superficial necroisis happened at the distal end of one foot dorsal medial neurocutaneous flap. One third flap necrosis occurred in 1 foot medial neurocutaneous flap due to too tight suture at flap pedicle and resulted thrombosis. All the other 23 flaps survived completely. 15 cases were followed up for 3-36 months with normal walking function and satisfactory appearance. Among the 8 cases with nerve anastomosis, 4 cases were followed up with 2-point discrimination distance of 8-11 mm. the flaps without nerve anastomosis also had protective sense due to nerve ingrowth.</p><p><b>CONCLUSIONS</b>Skin and soft tissue defects in the hallex can be treated with different appropriate flaps. The hallex length can be reserved with satisfactory function and appearance.</p>
Subject(s)
Humans , Foot Injuries , General Surgery , Graft Survival , Hallux , Wounds and Injuries , General Surgery , Necrosis , Plastic Surgery Procedures , Soft Tissue Injuries , General Surgery , Surgical Flaps , Pathology , TransplantationABSTRACT
<p><b>BACKGROUND</b>The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline. Colorectal cancer multidisciplinary team (MDT) working model is recommended by UK and other countries, but there is little information on the impact of MDT working on management of colorectal cancer in China. The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.</p><p><b>METHODS</b>A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery, the pre-MDT cohort include 297 patients, recruited from January 1999 to November 2002, and the MDT cohort had 298 patients enrolled from December 2002 to September 2006. Information recorded included: TNM stage from histological reports, degree of differentiation, the number of examined lymph nodes and CT TNM staging performed or not, and its accuracy, including local and distant recurrence.</p><p><b>RESULTS</b>The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group. CT TNM staging was more accurate in the MDT group compared to the pre-MDT group (P = 0.044). The rate of tumor recurrence in the MDT group was lower than pre-MDT group (log-rank test, P < 0.001). Multivariate analysis revealed that age (P = 0.001), management after inception of the MDT (P = 0.002), degree of differentiation (P = 0.003), number of examined lymph nodes (P = 0.002), and TNM stage (P = 0.000) were important factors that independently influence overall survival.</p><p><b>CONCLUSIONS</b>The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients. MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis, evidence-based decision making, and optimal treatment planning.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Colorectal Neoplasms , Diagnostic Imaging , Pathology , General Surgery , Disease Management , Interdisciplinary Communication , Neoplasm Staging , Radiography , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effects of primary deep venous valvular incompetence of lower limb (PDVI) to the occurrence of deep vein thrombosis (DVT) after human total knee replacement (TKR).</p><p><b>METHODS</b>One hundred and twenty-six patients who planed to receive TKR were examined by color doppler flow imaging (CDFI). The patients were divided into 2 groups depending on whether they were found backstreaming in femoral vein or not. When the refluxing time > 1 s, the patients were included in PDVI group; When the refluxing time < or = 1 s, the patients were included in without PDVI group. In 7 d after operation all the patients were re-examined by CDFI to find if there was DVT. The results were tested by chi2 statistical analysis.</p><p><b>RESULTS</b>Among the 126 patients, 54 had PDVI, and 72 without PDVI. Fifty patients had DVT, total incidence rate 39.7% (50/126). In PDVI group 33 patients had DVT (61.1%, 33/54); In without PDVI group 17 patients had DVT (23.6%, 17/72), which was lower than PDVI group (chi2 = 21.227, P < 0.05).</p><p><b>CONCLUSIONS</b>PDVI may be a risk for occurrence of DVT after TKR.</p>