ABSTRACT
BACKGROUND@#The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor, which is critically involved in the pathogenesis of a variety of skin diseases. The aim of this study was to detect AhR and its downstream regulators including cytochrome P450 (CYP1A1), AhR nuclear translocation (ARNT), and aryl hydrocarbon receptor repressor (AhRR) in serum, peripheral blood mononuclear cells (PBMCs), and skin lesions in patients with atopic dermatitis (AD).@*METHODS@#Twenty-nine AD patients defined according to the criteria of Hanifin and Rajka and Chinese criteria of AD were included. Subjects without allergic and chronic diseases were recruited as controls. Patients and controls were selected from the dermatology outpatient clinic of Peking University People's Hospital from August 1 to December 31 in 2018. Enzyme-linked immunosorbent assay was performed to detect serum AhR level. The mRNA of AhR, AhRR, ARNT, and CYP1A1 in PBMCs were measured by real-time quantitative polymerase chain reaction. AhR expression in skin lesions was measured by immunohistochemistry.@*RESULTS@#AhR was significantly higher expressed in serum (41.26 ± 4.52 vs. 33.73 ± 2.49 pmol/L, t = 6.507, P < 0.001) and skin lesions (0.191 ± 0.041 vs. 0.087 ± 0.017, t = 10.036, P < 0.001) of AD patients compared with those of controls. The mRNA levels of AhR (1.572 ± 0.392 vs. 1.000 ± 0.173, t = 6.819, P < 0.001), AhRR (2.402 ± 1.716 vs. 1.000 ± 0.788, t = 3.722, P < 0.001), CYP1A1 (2.258 ± 1.598 vs. 1.000 ± 0.796, t = 3.400, P = 0.002) in PBMCs of AD patients were higher compared with those of controls. The difference in mRNA levels of ARNT was not statistically significant between the patients and controls (1.383 ± 0.842 vs. 1.000 ± 0.586, t = 1.653, P = 0.105). AhR mRNA levels in PBMCs positively correlated with eczema area and severity index score and serum interleukin-6 levels.@*CONCLUSION@#AhR and its downstream regulators were highly expressed in serum, PBMCs, and skin of AD patients, which might contribute to the pathogenesis of AD.
ABSTRACT
Objective To study the effects of five different kinds of Chinese medicine materials on dissolution of pills; To evaluate their in vitro - in vivo correlation.Methods Five different types of traditional Chinese medicine materials, such as starch, fiber, protein, grease and polysaccharide materials, were selected by uniform design to the proposed 8 model formulation and preparation of pills, and the cumulative release rate and in vivo plasma concentration of berberine hydrochloride were determined by HPLC. The effects of Chinese medicine materials on the drug release behavior of pills in vitro - in vivo were investigated. And the in vitro - in vivo correlation of the pills was evaluated.Results Starch and fiber materials could promote the release of the pills, and protein and grease materials has a blocking effect on the pills dissolution. Polysaccharide materials have no significant effect on the dissolution of the pills. Pills in vitro - in vivo correlation was significant.Conclusion Chinese medicine materials have the characteristics of medicine-assisted unity, which can control the dissolution and bioavailability of pills by adjusting the proportion of powder in the prescription. And the pills have good correlation in vitro - in vivo.
ABSTRACT
Objective To investigate the clinical effect of platelet-rich plasma combined with flap transplantation in treatment of refractory wounds.Methods Sixty patients of refractory wounds who were admitted into our hospital from April 2016 to February 2017 were enrolled in the observation group,and another sixty patients with refractory wounds who had been discharged from the hospital before April 2016 were trea-ted as the control group.All the patients accepted debridement and disinfection.Then the observation group were managed with PRP and flap transplantation,while the control group were treated with flap transplantation directly without PRP.Observed the frequency of dressing changes, rate of wound infection,healing time and recovering rate of the two groups.Measurement data were analyzed with t inspection and analysis of va-riance,and count data were compared by χ2test,and repeat data was analyzed with repeat data variance analysis.Results After one weeks' treatment,the number of wet gauze layers were(20.5 ±1.6)in the observation group,which was less than(23.3 ±6.1)in the control group with statistically significant difference(t=-3.439,P=0.001).The healing time of the observation group was(25 ±2)d,which was shorter than(43 ±5)d in the control group(t=-25.891,P=0.000).The frequency of dressing changes was(7.1 ±1.0)times in observation group, which was less than(9.3 ±1.4)times in the control group(t=-9.905,P=0.000).There were 5 cases of inflammation reaction in the obser-vation group,which was less than 18 cases in the control group(χ2=9.090,P=0.003).The cases of the skin flap survival in the observation group was 55,which was more than 41 cases in the control group,and the difference of the two groups was statistically significant(χ2=10.208, P=0.001).The average healing rate of the two groups both increased at different time points.And the average healing rate of the observation group was higher than that in the control group at different time points,and the difference was statistically significant(P<0.05).Conclusion Platelet-rich plasma can remarkably shorten the healing time,improve healing rate,reduce frequency of dressing change and promote wound healing for refractory wound.
ABSTRACT
Objective To analyze related factors affecting the prognosis of patients with Acinetobacter baumannii (A.baumannii)bloodstream infection(BSI),guide clinical prevention and treatment.Methods A case-control study was conducted to retrospectively analyze patients with A.baumannii BSI in Peking University Third Hospital from January 2012 to December 2016.According to prognosis,patients were dividedinto poor prognosis group and good prognosis group. Univariate analysis and logistic regression analysis were used to analyze the risk factors of poor prognosis in patients with A.baumannii BSI.Results There were 58 confirmed cases of A.baumannii BSI,including 31 patients with poor prognosis and 27 with good prognosis. Univariate analysis revealed that risk factors for poor prognosis of A.baumannii BSI were antimicrobial use and at least two kinds of antimicrobial agent use three months before admission,at least two kinds of antimicrobial use,and carbapenems use before infection after admission,increase of white blood cell(WBC)count after infection(P<0.05). After 3-day anti-infective treat-ment,examination results of WBC count and X-ray chest film in good prognosis group were all better than poor prognosis group(P<0.05). Logistic multivariate regression analysis showed that independent risk factors for poor prognosis of A.bau m annii BSI were antimicrobial use three months before admission,at least three kinds of antimicrobial use and carbapenem use before infection after admission,increase of WBC count and WBC count>12×109/L after infec-tion,as well as increase of WBC count and WBC count>15×109/L after 3-day anti-infective treatment(P<0.05). Conclusion The probability of poor prognosis is high in patients with A.baumannii infection. For patients receiv-ing≥2 kinds of antimicrobial agents three months before admission,patients receiving≥3 kinds of antimicrobial agents as well as patients receiving carbapenems before infection after admission,the likelihood of A.baumannii BSI should be paid attention.For patients with WBC count>12×109/L after infection and WBC count>15×109/L after 3-day treatment,poor prognosis should be alerted,treatment plan needs to be adjusted in time to reduce the mortality.
ABSTRACT
Objective To investigate the effect of platelet-rich plasma (PRP) combined with negative pressure wound therapy (NPWT) on orthopedic refractory wound.Methods A total of 84 patients with chronic refractory wound were selected from January 2014 to December 2016 in Department of Osteology,Jizhong Energy Xingtai Mining Group General Hospital.The patients were divided into control group and observation group according to the admission time,42 cases in each group.The patients in the control group were treated with NPWT,and the patients in the observation group were treated with PRP and NPWT.The power of hydrogen (pH) of wound exudate,wound temperature and wound pressure ulcer scale for healing (PUSH) were compared between the two groups before and after treatment.The bacterial cuhure result was compared between the two groups after two weeks of treatment.The change of serum erythropoietin (EPO) level were observed before and four weeks after treatment,and the suitable skingrafting time,wound healing time and cure rate were observed in the two groups.Results After two weeks of treatment,the positive rate of bacterial culture in the observation group was significantly lower than that in the control group (x2 =4.850,P ＜ 0.05).The pH value of wound exudate and the wound PUSH score in the observation group were significantly lower than those in the control group(P ＜0.05),but the wound temperature in the observation group was higher than that in the control group after two weeks of treatment (P ＜ 0.05).The results of intra group comparison showed that the serum EPO level showed an upward trend within four weeks of treatment,and the difference was statistically significant at different time points in the two groups (F =7.356,8.264;P ＜ 0.05).The level of serum EPO in the observation group was significantly higher than that in the control group at the treatment of 1,2,3 and 4 weeks (P ＜ 0.05).Compared with the control group,the suitable skingrafting time was early (P ＜ 0.05),the wound healing was fast (P ＜ 0.05),and the cure rate was high in the observation group (x2 =4.720,P ＜ 0.05).Conclusion The combination of PRP and NPWT has good antibacterial effect,and can promote the EPO level and wound healing.
ABSTRACT
<p><b>BACKGROUND</b>A good postoperative alignment in total knee arthroplasty (TKA) is the key to achieving satisfactory results. We assessed the effect of femoral and tibial resection on the overall alignment after conventional TKA.</p><p><b>METHODS</b>We conducted a retrospective analysis of 212 primary TKAs in 188 patients. Intramedullary (IM)-guided resection was applied on the femoral side while extramedullary (EM)-guided resection was used on the tibial side. Using full-length X-ray, the preoperative femoral valgus angle and lower extremity alignment, as well as 2-week postoperative femoral and tibial prosthetic coronal alignment and overall lower extremity alignment, were measured.</p><p><b>RESULTS</b>Postoperatively, good prosthetic alignment was achieved in 191 cases (90.1%) on the tibial side and in 144 cases (67.9%) on the femoral side (χ2 = 5.441, P = 0.02). Multiple linear regression analysis was used to assess the effect of different alignment sides on the overall alignment in the coronal plane. Data were divided into five subgroups based on the valgus or varus status of the prostheses. The standardized regression coefficients of the femoral and tibial prosthetic alignment on the overall alignment were 0.666 and 0.414, respectively; in varus on both sides were 0.658 and 0.377, respectively; in valgus, 0.555 and 0.030; femoral side varus and tibial side valgus, 0.702 and 0.211; femoral side valgus and tibial side varus, -0.416 and 0.287. The study showed that the overall low extremity alignment was statistically influenced by the prosthetic alignment, except for the tibial prosthetic alignment when femoral prosthesis was in valgus (P = 0.153).</p><p><b>CONCLUSIONS</b>In conventional TKA, tibial side EM-guided resection may offer satisfactory postoperative alignment, and femoral resection relying on IM guide may lead to more undesirable results. Postoperative coronal alignment is mainly affected by the femoral resection. Therefore, femoral side operation should receive adequate attention from the surgeons.</p>
Subject(s)
Humans , Arthroplasty, Replacement, Knee , Methods , Asian People , Bone Malalignment , Femur , General Surgery , Postoperative Period , Retrospective Studies , Tibia , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To understand the epidemiological features of viral hepatitis, and provide scientific evidence for developing strategies for prevention and control.</p><p><b>METHODS</b>Through descriptive epidemiological methodology, the epidemiological characteristics of 1121 viral hepatitis cases in Chongwen District (1997-2006) were studied. chi2-test was used in ratio comparison.</p><p><b>RESULTS</b>There were 1121 viral hepatitis cases occurring in the past decade, and the incidence rate was declining by year with the average of 27.10/ 100,000. Of which, the incidence rate of viral hepatitis B was the highest (13.90/ 100,000), viral hepatitis C (1.38/100,000) was the lowest. The proportion of viral hepatitis B was the highest (575, 51.29%) and viral hepatitis C (57, 5.08%) was the lowest. The incidence of viral hepatitis A, B and no-typing was declining year by year, while viral hepatitis C and E was climbing. Most viral hepatitis A and E cases occurred in Spring and Winter, and the difference of incidence rate between male and female was observed (chi2 = 188.39, P < 0.001). The findings also showed that viral hepatitis might occur in all kind of occupation, but most were workers (306, 27.3%) and officers (209, 18.64%). For the age distribution, 20 -49 years old group took the majority (749, 66.82%); and for the transmission route, blood transfusion (7.64/ 100,000) was significantly higher than fecal-oral route (3.02/ 100,000) (chi2 = 5.09, P < 0.01).</p><p><b>CONCLUSION</b>It is necessary to raise and increase the public awareness for viral hepatitis prevention and control, and enhance immunization. Moreover, effective measures should be taken to the safety of blood and blood products, and to prevent nosocomial infection.</p>