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Objective To analyze the risk factors of multi-drug resistant organism (MDRO) infection after liver transplantation. Methods The clinical data of 77 recipients undergoing liver transplantation were retrospectively analyzed. According to the incidence of MDRO infection, all recipients were divided into the non-MDRO infection group (n=51) and MDRO infection group (n=26). The infection rate and strain distribution of MDRO in liver transplant recipients were summarized. The risk factors of MDRO infection in liver transplant recipients were identified. Clinical prognosis of all recipients was statistically compared between two groups. Results The infection rate of MDRO after liver transplantation was 34% (26/77), mainly carbapenem-resistant MDRO infection. The main sites of infection included lung, abdominal cavity and incision. Univariate analysis showed that postoperative tracheal intubation ≥48 h, length of intensive care unit (ICU) stay ≥72 h, length of hospital stay ≥30 d, re-operation, continuous renal replacement therapy (CRRT) and tacrolimus (Tac) blood concentration ≥15 ng/mL were the risk factors for MDRO infection after liver transplantation. Cox regression analysis indicated that postoperative tracheal intubation≥48 h, re-operation, CRRT and Tac blood concentration ≥15 ng/mL were the independent risk factors for MDRO infection after liver transplantation. The fatality in the MDRO infection group was significantly higher than that in the non-MDRO infection group [31%(8/26) vs. 10%(5/51), P=0.01]. Conclusions Postoperative tracheal intubation ≥48 h, re-operation, CRRT and Tac blood concentration ≥15 ng/mL may increase the risk of MDRO infection after liver transplantation and affect clinical prognosis of the recipients.
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OBJECTIVE：To evaluate the effects of nicorand il on the proliferation ，migration ability and Hippo/YAP signaling pathway of pulmonary artery smooth muscle cells （PASMCs）. METHODS ：Human primary PASMCs were divided into normal control group ，model group ，nicorandil low ，medium and high concentration groups （50，100，200 μmol/L），with 3 holes in each group. In addition to the normal control group ，the rest of the cells were inoculated on the gel coated medium to simulate the pulmonary hypertension environment ，so as to establish AS cell model. Then ，each drug group was added with corresponding drugs，and the normal control group and model group were added with the same volume of normal saline ，and cultured for 48 h. CCK-8 assay and Transwell assay were used for the examination of cell proliferation （by light density ）and migration ability ， respectively. mRNA expression of YAP target factors （CTGF and AREG ）were examined by qRT-PCR. Western blotting assay was used to detect the protein expression of CTGF and AREG. RESULTS ：Compared with normal control group ，light density of cells was increased significantly in model group ；the number of migration cells per field of view increased significantly ；mRNA and protein expression of CTGF and AREG were significantly increased （P＜0.01）. Compared with model group ，light density ，the number of migration cells per field of view ，mRNA and protein expression of CTGF and AREG in nicorandil low ，medium and high concentration groups were decreased significantly ， in concentration-dependent manner （P＜0.05 or P＜0.01）. CONCLUSIONS：Nicorandil can inhibit the proliferation and migration of PASMCs in AS model ，the mechanism of which cstc2019jscx-msxmX0174） may be associated with the Hippo/YAP signaling pathway.
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Objective:To report the effect of a new method to reconstruct the sensory function of sural flap and to share the experience.Methods:From May, 2018 to November, 2019, 12 patients with hand and foot injuries were treated with sural flap. Blood vessel CDFI examination was performed on 24 shanks of 12 patients before operation. The perforator site was 6.8 -20.5 cm from the lateral malleolus apex, with an average of 12.5 cm. The inner diameter of the root was 1.0-1.8 mm, with an average of 1.35 mm. Before operation, the velocity of blood flow velocity at the vascular root was 28.7-51.6 m/s, with an average of 38.8 m/s. In order to reconstruct the sensation of flap, in the design of free sural skin flaps of 8 patients, the distal sural nerve or medial and lateral sural cutaneous nerve of the perforating branch was anastomosed with the cutaneous nerve of the recipient region. In 2 cases of propeller sural flap, the severed end of sural nerve on the small propeller side was directly anastomosed or bridged with the cutaneous nerve on at the proximal edge of the skin flap donor site. In 2 cases of distal fascial-pedicled sural flap, the lateral malleolus was cut in a distal longitudinal shape to separate the sural nerve and accompanying blood vessels. After distal cutting and rotation, the sural flap was anastomosed with the superficial peroneal nerve in the recipient site or the medial cutaneous nerve of the dorsum of the dorsal foot. This method of reconstructing sensory function by anastomosing the original distal cutaneous nerve of the flap was defined as retrograde neurorrhaphy.Results:All patients were followed-up for 6 months to 1.5 years. The mechanism recovery of the peripheral pathway was excluded in the sensory function examination of flap. According to the evaluation standard for sensory function established by the British Medical Research Council in 1954, sensory recovery was as follows: 1 case for S 4; 8 cases for S 3+; 2 cases for S 3; and 1 case for S 2. Conclusion:Retrograde neurorrhaphy has definite therapeutic effects in reconstructing the sensory function of sural skin flap, and can be able to significantly increase the chances of sensory function reconstructing reconstruction the sensory function of such kind of flaps.
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Objective To summarize the experience of complex hepatic artery reconstruction in orthotopic liver transplantation. Methods Clinical data of 7 liver transplantation recipients who underwent complex hepatic artery reconstruction from January 2015 to March 2019 were retrospectively analyzed. Among them, 4 recipients received classical liver transplantation and 3 cases underwent piggyback liver transplantation. Intraoperative general conditions including anhepatic phase, intraoperative blood loss, hepatic artery anastomosis time and operation time of the recipients were recorded. The clinical prognosis and complications were observed. Results In two donors, variant right hepatic artery was used for vascular reconstruction. The celiac trunk or the common hepatic artery of the donors was anastomosed with the common hepatic artery of the recipients. Iliac artery bypass was employed in 2 cases, and then the hepatic artery of the donors was anastomosed with the abdominal aorta of the recipients. The superior mesenteric artery of 1 donor was end-to-end anastomosed with the common hepatic artery of the recipient. The celiac trunk of 1 donor was anastomosed with the splenic artery of the recipient. Only 1 case was required to undergo secondary liver transplantation due to acute hepatic artery thrombosis after hepatic artery anastomosis. All the 6 recipients successfully completed the liver transplantation. No perioperative death was observed. The anhepatic phase endured from 49 to 77 min. The intraoperative blood loss was ranged from 300 to 1 500 mL. The anastomosis time of hepatic artery was 23-56 min. The operation time was ranged from 5.3 to 11.1 h. The length of postoperative hospital stay was 23-56 d. Neither hepatic artery thrombosis nor stenosis occurred. The liver function of all recipients was basically restored to normal within postoperative 2 weeks. No severe surgical complications occurred. The liver graft achieved excellent function. Conclusions Appropriate identification of the hepatic artery variation, proper management of liver artery of the donors and recipients and reconstructing the blood supply of liver graft are the crucial procedures of liver transplantation.
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Objective To report our efficacy of one-stage definite treatment of Gustilo type Ⅲ open fractures of long bone by plate osteosynthesis.Methods A retrospective case series study was conducted of the 69 cases who had undergone plate osteosynthesis for one-stage definite treatment of Gustilo type Ⅲ open fractures of long bone from January 2006 to June 2016 at Microsurgery and War Trauma Center of Chengdu Military Command,59 Hospital of Chinese PLA.They were 47 males and 22 females with an average age of 34.2 years (from 2 to 62 years).There were 27 shaft fractures of tibia or fibula (13 cases of type ⅢA,12 cases of type Ⅲ B and 2 cases of type Ⅲ C),4 fractures of distal tibia (2 cases of type Ⅲ A and 2 cases of type ⅢB),14 shaft fractures of ulna or radius (9 cases of type ⅢA,3 cases of type ⅢB and 2 cases of type Ⅲ C),12 factures of humeral shaft (7 cases of type Ⅲ A,3 cases of type Ⅲ B and 3 cases of type Ⅲ C),3 fractures of distal humerus (all type ⅢC),6 fractures of femoral shaft (5 cases of type ⅢA and one type Ⅲ C),and 3 fractures of distal femur (2 cases of type ⅢA and one type ⅢC).The intervals between injury and operation ranged from 4 to 17 hours,averaging 9.6 hours.After thorough debridement,osteosynthesis was performed with locking compression plate,limited contact dynamic compression plate or/and reconstruction locking plate,or 1/3 tubular plate.Direct closure with decreased tension or without tension was used for type Ⅲ A injury;deep open defects were repaired with perforator flaps,neurovascular axis flaps,traditional axis flaps and muscular flaps,or local flaps;limb reconstructions included neurovascular repair in 12 cases,tendon and ligament repair in 5 cases,and muscle reconstruction in 3 cases.Superficial defects were covered by skin grafts simultaneously or secondarily.Results The duration of hospitalization averaged 19 days (from 5 to 37 days).Partial necrosis occurred in one case of sural neurovascular axis flap.Superficial infection with multiple antibiotic-resistant bacteria occurred in 2 cases.Follow-up for the 69 patients ranged from 12 to 27 months (average,19.2 months).No deep bone infection occurred.Implant breaking occurred in 4 cases and implant loosening in one.The implant failures were corrected by change into intramedullary nails or plate refixation (respectively in 2 cases) in addition to bone graft.Bone union was achieved after 5 to 15 months (average,7.7 month)with satisfactory aesthetic and functional outcomes.Conclusion For patients with Gustilo type Ⅲ open fracture of long bone,especially those with metaphyseal,intraarticular or upper limb fracture and pediatric ones,plate osteosynthesis can be a satisfactory one-stage definite treatment besides intramedullar nailing and external fixation,providing that through debridement and satisfactory soft-tissue coverage can be achieved.
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Objective To confirm the optimal tissue sampling location of current injury combined with the histopathological observation in specific parts of electrocution based on previous animal experiments. Methods Twenty-three human cases from the autopsy through the hand-to-foot circuit pathway were analyzed. Additional ten autopsy patients who died from traffic accidents and sudden cardiac attacks were used as the control group. All cases were extracted the soft tissues from the upper anterior wrist and medial malleolus to further observe and analysis the L/S axis ratio of the nuclei of the skeletal muscle cells (SkMCs) and artery smooth muscle cells (ASMCs). Results The age of the 23 eligible electrical deaths ranged from 19 to 59 years, including 19 cases were male and 4 cases were female. 3 cases were high-voltage 20 cases were low voltage. The occurrence rate of electric marks averaged 31.18% in all cases. The incidence of the classical arborizing pattern of fine branching was 36.4%, appearing on the pleura in 5 cases (22.7%). The nuclei of the SkMCs and ASMCs nuclei in the anterior wrist and medial malleolus within the electrical current pathway were obviously stretched, narrowed, and coalesced, presenting a nuclear polarization and arranging as line-like and moniliform patterns. The L/S axis ratio of those nuclei in the anterior wrist and medial malleolus were markedly increased as compared with the control group (p < 0.001). Through the ROC curve analysis, the critical diagnostic values of the L/S axis ratio of those nuclei were respectively 4.84 and 3.81. Conclusion These findings suggest that the soft tissues of the anterior wrist and/or the medial malleolus, as the narrowest parts of the limbs, could be used as the sites for tissue sampling and considered as necessary locations for histopathological examinations to determine the electrocution in medicolegal identification.
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Objective@#To construct a recombinant short-hairpin RNA (shRNA) lentiviral vector targeting the β-catenin gene in cochlear precursor cells (CPCs) in mice, and to investigate its inhibitory effect.@*Methods@#PCR was used for the multiplication of the β-catenin gene, and shRNA oligo was designed based on the β-catenin gene to construct an interference vector. Gateway Technology was used to construct shRNA lentiviral vector which carried the β-catenin gene, and then 293FT cells were transfected with the constructed lentiviral vector and helper plasmids pLV/helper-SL3, pLV/helper-SL4, and pLV/helper-SL5. The virus supernatant was collected to obtain viral particles, and then mouse CPCs were transiently infected with the recombinant lentivirus with four different concentrations (0, 5, 10, and 20 μl) . The shRNA control group was established. Quantitative real-time PCR and Western blot were used to investigate the inhibitory effect of shRNA β-catenin lentiviral vector on β-catenin.@*Results@#The recombinant shRNA β-catenin lentiviral vector was successfully constructed, and the virus titers of shβ-catenin and shβ-catenin-control were 5.05×107 and 4.34×107, respectively. The results of in vitro experiments showed that in CPCs transfected with four different concentrations of recombinant lentivirus, the content of β-catenin protein gradually decreased with the increase in concentration, and there was a significant difference between groups (P<0.05) ; the CPCs transfected with shβ-catenin had significantly lower mRNA expression of β-catenin than those in the shβ-catenin-control group (P<0.05) .@*Conclusion@#The constructed lentiviral vector targeting the β-catenin gene has a high infection efficiency, and the successful construction of lentiviral vectors provides a technical support for analyzing the role of β-catenin in the differentiation of CPCs into auditory hair cells.
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Objective To investigate the causes and managements of postoperative complications of proximal femoral nail anti-rotation(PFNA)in treating intertrochanteric fractures. Methods A total of 155 patients with intertrochanteric fractures were treated with PFNA from January 2011 to December 2017.Causes and managements of postoperative complications were analyzed and discussed. Results At an average follow-up of 48 months(range ,12~72 months) ,the rate of good postoperative recovery in hip function was 96.0% . Among 155 patients ,the internal fixation-associated postoperative complications occurred in 15(9.7% )patients.Details were as follows :7 cases had spiral blade breakage into the femoral head or inwardly ,in whom 5 cases received artificial joint replacement whereafter.5 cases had coxa vara ,mainly in patients with obvious posterior fracture of the femoral intertrochanter with obviously bone fragments.3 cases had delayed fracture healing due to the fracture damaging calcar femorale ,or extensive soft tissue dissection during the operation on small trochanter. The Harris function score was 82 points. Conclusions The location of the PFNA spiral blade ,as an important factor ,is correlated with postoperative complications ,while severe osteoporosis ,unstable fractures ,and poor fracture reduction increase the incidence of surgical complications.
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Objective To summarize the clinical experience of small-for-size graft of pediatric donor liver transplantation in the treatment of acute liver failure in an adult recipient. Methods Clinical data of application of small-for-size graft of pediatric donor liver transplantation in an adult recipient was retrospectively analyzed and literature review was performed. Results The pediatric donor was aged 4.5 years old and the weight of donor liver from donation after brain death was 544.6 g. The body mass of recipient was 52 kg. The graft-to-recipient weight ratio was 1.05%. The classic orthotopic liver transplantation was performed. Postoperative recovery was not satisfying. The recipient suffered from brain edema, stress gastrointestinal bleeding, acute kidney injury, small-for-size liver syndrome, atelectasis, lung infection, fungal infection, abdominal infection, pleural effusion and other postoperative complications. After symptomatic and comprehensive treatment, the function of liver graft was gradually restored and regenerated to the normal size of adult liver at postoperative 2 to 3 weeks. The patient was discharged after 102 d hospitalization. During the follow-up at postoperative 10 months, the liver function was evaluated normal and the quality of life was favorable. Conclusions Pediatric small-for-size donor livers can be successfully transplanted to the adult recipients. Nevertheless, it is necessary to select the appropriate recipients, surgical methods and fine perioperative management according to the conditions of the donor livers.
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Objective To observe the application of mtDNA COI genes in common sarcosaphagous flies species identification. Methods 30 sarcosaphagous fly samples were indentified by morphological method which collected in different regions belonging to 2 families, 4 genera and 6 species. MtDNA was extracted for the PCR amplification reaction in COI gene. The PCR products were purified through agar gel electrophoresis and sequenced. Sequences of 498 bp in COI gene were disposed by multiple-alignment software of DNAMAN. Sequences divergence of 498 bp between and within species of COI gene were processed by software of MEGA. Results It was showed that there is a certain sequence differences between the 30 samples from 6 species. The intraspecific and interspecific divergence of sequence variation ranged from 0.1% to 1.6% and 2.2% to 11.2% respectively. All the species can be identified successfully by this method. Conclusion Species identification of sarcosaphagous flies can be conducted by sequence analysis and phylogenetic tree of COI gene. This method can be effectively used in fast and accurate identification in forensic entomology.
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Objective:To investigate the Repetitive transcranial magnetic stimulation combined with biofeedback non motor symptoms on clinical effects and serum levels of IL-6,CRP and TNF-α of Parkinson's disease.Methods:84 cases of Parkinson's disease in our hospital were randomly divided into experimental group and control group,with 42 cases in each group.The control group were treated with EMG and EEG biofeedback,while the experimental group were treated with repetitive transcranial magnetic stimulation on the basis of the control group.Then the serum levels of C reactive protein (CRP) and interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α),the non motor symptoms questionnaire (NMSQuest),Parkinson's disease Sleep Scale (PDSS) and Hamilton Depression Scale (HAMD) score in the two groups were observed and compared before and after the treatment.Results:Compared with before treatment,the serum levels of CRP,IL-6 and TNF-α,the NMSQuest and HAMD in the two groups decreased after the treatment,while the PDSS score increased,and the differences were statistically significant (P＜0.05);Compared with the control group,the serum levels of CRP,IL-6 and TNF-α,NMSQuest and HAMD in the experimental group were lower,while the PDSS score was higher,and the differences were statistically significant (P＜0.05).Conclusion:Repetitive transcranial magnetic stimulation combined with biofeedback can reduce the serum levels of IL-6,CRP and TNF-α in patients with Parkinson's disease,which has better clinical effect on the non motor symptoms.
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Objective T o explore the m etabolic characteristics of lethal bradycardia induced by m yocardial ischem ia in rat's serum . Methods A rat m yocardial ischem ia-bradycardia-sudden cardiac death (M I-B-SC D ) m odel w as established, w hich w as com pared w ith the sham-operation group. T he m etabolic pro-file of postm ortem serum w as analyzed by gas chrom atography-m ass spectrom etry (G C-M S ), coupled w ith the analysis of serum m etabolic characteristics using m etabolom ics strategies. Results T he serum m etabolic profiles w ere significantly different betw een the M I-B-SC D rats and the control rats. C om pared to the control rats, the M I-B-SC D rats had significantly higher levels of lysine, ornithine, purine, serine, alanine, urea and lactic acid; and significantly low er levels of succinate, hexadecanoic acid, 2-ketoadipic acid, glyceraldehyde, hexendioic acid and octanedioic acid in the serum . T here w ere som e correlations am ong different m etabolites. Conclusion T here is obvious m etabolic alterations in the serum of M I-B-SC D rat. B oth lysine and purine have a high value in diagnosing M I-B-SC D . T he results are expected to provide references for forensic and clinical applications of prevention and control of sudden cardiac death.
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Objective@#To report operative techniques and clinical results of free sural cutaneoadipofascial flap containing the neurovascular axis based on a dominant peroneal perforating artery (DPPA, with a caliber≥0.8 mm) and its concomitant veins for reconstruction of dorsal forefoot soft tissue defects.@*Methods@#The flap was applied in 32 cases with middle to large soft tissue defects in the dorsal forefoot from Aug. 2009 to Dec. 2014. DPPAs arising from the posterolateral intermuscular septum was located and assessed preoperatively with color Doppler flow image and computed tomography angiography. According to the location, size, and shape of the defects, one of these DPPAs was chosen for flap planning. The flap was harvested from the posterolateral aspect of the leg. The neighboring neurovascular axis (one or more of that of the sural nerve, the medial cutaneous nerve, the lateral cutaneous nerve of calf and the sural communicating nerve) was included to ensure vascular supply. According to skin laxity of the donor site, the width of the full harvesting part which should be able to cover the region of the recipient site where pressure and friction force were prominent while wearing shores was decided; the rest was harvested as an adipofascial flap (without skin) to get enough size. After transfer to recipient site, the flap was revascularized by anastomosing the perforating artery and its venae comitantes with appropriate recipient vessels, and reinnervated (antegrade or retrograded methods). Skin grafting was performed on the adipofascial surface of the flap primarily or secondarily. The defects in donor site of the leg was closed directly.@*Results@#All flaps (ranged from 7.5 cm×5.0 cm to 23.0 cm×13.0 cm) were transplanted successfully, and no vascular or donor site problems occurred. All primary skin grafts (19 cases) was partially lost, but only 2 of them need a second grafting. Adipose necrosis occurred in 4 of 13 cases receiving secondary grafting but only needed wound care before surgery. Following up for 11-26 months showed both satisfactory functional and cosmetic results without problems of shoe wearing. Flap sensibility restored at least to the degree of S3.@*Conclusions@#The cutaneoadipofascial flap combines the advantages of perforator, neurocutaneous axis, free and adipofascial flaps leaving only suture scar in the donor leg, and is a satisfactory method for free-style and acute coverage of dorsal forefoot defects.
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Objective To investigate the clinical results of free super-thin peroneal artery perforator flap containing neurovascular axis in reconstruction of hand or foot soft tissue defects.Methods A retrospective case series study was made on 23 cases of hand or foot soft tissue defects admitted from January 2006 to March 2013.There were 16 males and 7 females,with a mean age of 33 years (range,17-51 years).Wounds were located in dorsal hand (n =12),dorsal pedis or amputated forefoot (n =8),greater thenar (n =2) and index finger (n =1) respectively.Defects ranged in size from 5.0 cm × 3.5 cm to 11.5 cm × 7.5 cm.Flap elevating was performed underneath the deep fascia and the perforator supplying the flap was dissected thoroughly,ligated and cut at the location arose from the peroneal artery.Most of the deep fascia except stripe shaped areas along the main blood supply chains was moved sharply and the fat underlying thinned primarily to the subdermal vascular network.After transferred to the recipient site,the flaps were revascularized by anastomosis of the perforating artery and its venae comitantes to appropriate recipient vessels.A total of 15 cases received innervated flap reconstruction.Flap vascularity and cosmetic results were recorded.Hand function was evaluated with the standard set up by the hand surgery branch of Chinese Medical Association.For foot reconstruction,shoe wearing status,gait,pressure-sore,flap sensibility,donor site appearance and complications were evaluated.Results All flaps were transplanted successfully with satisfactory cosmetic results,except that one flap used to cover dorsal ring finger defect left slightly bulky appearance.Mean duration of follow-up was 19 months (range,11-26 months).For hand reconstruction,the functional results were excellent in 6 cases and good in 9 cases.Repairing of foot defects with the flaps caused no problem of shoe wearing and no sore occurred.Normal gait was acquired except two cases of partially amputated foot.If innervated,flap sensibility was restored at least to the degree of S3.Protective sensation and touchpressure sensation were restored in eight non-innervated cases,and two of them were recovered to the degree of S3.There was only suture or small grafting scars on the donor leg and partially sensibility loss of lateral foot without functional defects in 13 cases.Conclusion Free super-thin peroneal artery perforator flap containing neurovascular axis is an easy and reliable technique that can attain satisfactory results for accurate coverage of hand or foot soft tissue defects.
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Background:Colorectal polyps,especially adenomatous polyps are the precusor of colorectal cancer. Screening and polypectomy by using colonoscopy is an important approach for prevention of colorectal cancer. Aims:To conduct a retrospective analysis among 1 613 cases of patients with colorectal polyps in Jiading District,Shanghai,China for guiding the management of colonoscopy surveillance of colorectal polyps. Methods:A total of 2 652 colorectal polyps detected by colonoscopy from Jan. 2013 to Aug. 2014 in the Endoscopy Center of Shanghai Ruijin Hospital Northern Branch were recruited in the study. Clinicopathological features of the polyps,coincidence rate of biopsy pathology and polypectomy pathology,and the re-detected polyps in colonoscopic follow-up were analyzed. Results:In 2 652 colorectal polyps,1 996 (75. 3% )were located in distal colon;adenomatous polyps accounted for 77. 5%(2 056 / 2 652)of the polyps detected by colonoscopy,of which 804(39. 1% )were found to have intraepithelial neoplasia. Both biopsy pathology and polypectomy pathology were obtained in 447 polyps,with an overall coincidence rate of 60. 4% ;as for adenomas,the coincidence rate was 68. 1% . Two hundred and eighteen pathologically proved polyps were found in a 1. 5-year colonoscopic follow-up, among which 74. 3% were adenomatous polyps;the re-detection rate of polyps located in proximal colon or less than 1. 0 cm in diameter was significantly higher than polyps located in distal colon and more than 1. 0 cm in diameter, respectively(12. 3% vs. 6. 9% and 9. 0% vs. 4. 5% ,P all < 0. 01). Conclusions:Adenomatous polyps account for high proportion of colorectal polyps detected by colonoscopy. Pathological examination of resection specimens and periodical follow-up are important for patients with colorectal polyps after endoscopic polypectomy.
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Objective To observe the apoptosis of human large cell lung cancer NCI-H661 cells induced by crotoxin,and to explore its mechanism. Methods The growth suppression of crotoxin on the NCI-H661 cells was detected by CCK-8 colorimetry,and the formation of NCI-H661 cells was observed by the plat colony experiment. This experiment included 4 groups:negative control group,crotoxin group(60 μg/ ml cro-toxin acted for 24 h),crotoxin + SB203580 group(pretreated cells using 5 μmol/ L SB203580 for 1 h,then 60 μg/ ml crotoxin acted for 24 h),SB203580 group(pretreated cells using 5 μmol/ L SB203580 for 1 h,then cultivated cells using complete culture solution). They were detected that the cell cycle and apoptosis rate of NCI-H661 cells treated with crotoxin by the flow cytometry. Additionally,they were tested that the change of the cell cycle and apoptosis rate after the NCI-H661 cells were treated with crotoxin and the activity of p38MAPK was inhibited by SB203580. Results When the concentration of crotoxin was greater than or equal to 30 μg/ ml,the inhibitory effect of crotoxin on the activity of NCI-H661 cells and colony formation,and inhibi-tion rate rose with increasing function of time and drug concentration. Flow cytometry showed that the apoptosis rate of crotoxin group and crotoxin + SB203580 group were(16. 70 ± 1. 38)% and(2. 15 ± 0. 54)% ,com-pared to the control group(1. 47 ± 0. 29)% ,and the former difference was statistically significant and the latter was not statistically significant(t = - 18. 763,P = 0. 000;t = - 1. 935,P = 0. 125). The G1 period cells of crotoxin group and crotoxin + SB203580 group were(57. 25 ± 1. 09)% and(48. 04 ± 1. 03)% ,compared to the control group(47. 46 ± 0. 69)% ,and the former difference was statistically significant and the latter was not statistically significant(t = - 13. 124,P = 0. 000;t = - 0. 809,P = 0. 464). Conclusion Crotoxin can promote the apoptosis of human large cell lung cancer NCI-H661 cells,and this effect may be related to the excitation of p38MAPK signal pathway.
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<p><b>OBJEVTIVE</b>To study the effect of spvB/spvC gene on Salmonella virulence and the Host immune.</p><p><b>METHODS</b>STM.211, STM.211-Delta;spvB, STM.211-Delta;spvC, STM.211-Delta;spvB.spvC and PBS were infected with 0.2 mL 10(5) CFU corresponding strain respectively by intraperitoneal. We observed the mental status, movement, diarrhea, weight, pelage changed hair of the infected mouse. Then the level of IL-10, IL-12, IFN-γ were detected by ELISA. Finally, we observe the pathological changes of liver and spleen with the general view and the microscope.</p><p><b>RESULTS</b>Infection symptoms of STM.211, STM.211-Delta;spvB and STM.211-Delta;spvC were significantly worse than PBS group, but there was no significant difference between STM.211-spvB.spvC group and PBS group. The secretion of IFN-γ and IL-12 of STM.211, STM.211-Delta;spvB, STM.211-Delta;spvC group were significantly lower than those in the STM.211-Delta;spvB.spvC group (P<0.05), but IL-10 secretion was significantly higher than STM.211-Delta;spvB.spvC group (P<0.05). There were no statistical significance among the STM.211, STM.211-Delta;SpvB, STM.211-Delta;spvC groups (P>0.05).</p><p><b>CONCLUSIONS</b>Salmonella virulence can be affected obviously by spvB combined with spvC gene, but not by spvB or spvC. spvB/spvC gene can inhibit the TH1 cytokines (IFN-γ and IL-12) secretion but promote the TH2 cytokines (IL-10) expression, leading immune response trend to TH2 shift. It shows that spvB/spvC gene can help the bacteria evade the host immune defenses, leading to aggravation of infection.</p>
Subject(s)
Animals , Cytokines , Allergy and Immunology , Interleukin-12 , Mice , Salmonella , Genetics , Virulence , Salmonella Infections , Allergy and Immunology , Virulence , Virulence Factors , GeneticsABSTRACT
<p><b>BACKGROUND</b>The controversy on the treatment strategy for severe acute pancreatitis (SAP) has never stopped for the past century. Even now surgical procedures play a decisive role in the treatment of SAP, especially in managing the related complications, but the rational indications, timing, and approaches of surgical intervention for SAP are still inconclusive.</p><p><b>METHODS</b>Clinical data of 308 SAP patients recruited during January 2000-January 2013, including 96 conservatively treated cases plus 212 surgically intervened cases, were comparatively analyzed. Based on the initial surgical intervention time, the surgical intervention group was split into two: early intervention group (within 2 weeks) 103 cases, and late intervention group (after 2 weeks) 109 cases.</p><p><b>RESULTS</b>In the conservative treatment group, the cure rate was 82.29% (79/96), the death rate was 13.54% (13/96), and 4 cases self-discharged, while in the surgical intervention group, the cure rate was 84.43% (179/212) and the death rate was 10.85% (23/212) with 10 cases self-discharged. The difference was of no statistical significance between these two groups (P > 0.05). In surgical intervention group, the death rate 15.53% (16/103) in the early surgical intervention group was higher than that of late surgical intervention group 6.42% (7/109), and the difference was statistically significant (P < 0.05).</p><p><b>CONCLUSIONS</b>Both conservative treatment and surgical intervention play important roles in the treatment of SAP, and the indication, timing, and procedure should be strictly followed. Surgery earlier than 2 weeks after onset of the disease is not recommended in patients with necrotizing pancreatitis only when there are specific indications, such as multiple organ failure, which does not improve despite active treatment, and in those who develop abdominal compartment syndrome.</p>
Subject(s)
Adult , Aged , Antacids , Therapeutic Uses , Female , Humans , Male , Middle Aged , Pancreatectomy , Pancreatitis, Acute Necrotizing , Drug Therapy , General Surgery , Therapeutics , Retrospective Studies , Somatostatin , Therapeutic UsesABSTRACT
Objective To explore the characteristics of diffusion weighted imaging (DWI) of lumbar sacral nerve roots (LSNR)in normal and degenerative lumbosacral vertebrae. Methods The research recruited 20 normal volunteers and 31 patients with spinal stenosis on conventional MRI and DWI scans in lumbosacral spine. We measured the areas from lumbar 3 to sacral 1 at the intervertebral spaces and reconstructed the 3D maximum intensity projection (MIP) and counted the apparent diffusion coefficient (ADC)of LSNR and ganglions. Results In the control group, 196 (98%) LSNR ran symmetrically and lateroinferiorly and 200 ganglions were well defined on MIP of DWI. In the patients group, 74 LSNR showed changes of compression on both T1WI and T2WI, in which DWI appeared thin and distorted in 59 (80%). The ADC value of LSNR were(1.70 ± 0.40)× 10-3 mm2/s and(1.98 ± 0.57) × 10-3 mm2/s separately in normal volunteers and patients (P=0.000), while the ADC values of ganglions were(1.42 ± 0.21)× 10-3 mm2/s and (1.54 ± 0.53)× 10-3 mm2/s respectively in normal volunteers and patients (P=0.000). Conclusion DWI can display the pattern and course of LSNR and ganglions, which indicate that ADC values of compressed LSNR and ganglions are higher than normal ones.
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ObjectiveTo investigate the clinical features and the efficacy of medium-and long-term immune suppression in the treatment of Crohn's disease (CD) in Chinese Han nationality.MethodsThe clinical data and diagnosis methods of 178 CD patients between 2003 and 2010 were analyzed.All patients received predinisone and immune suppression (azathioprine) treatment.The patients were followed up every 2 weeks.Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were reviewed every 4 weeks.CD activity index (CDAI) was scored every 3 to 6 months.ResultsThe peak age for onset of CD was between 18 to 30 years old,and the mean time from the appearance of symptoms to diagnosis was (8.3±3.7) months.About 34.8％ (62/178 cases) patients had corresponding complications at time of diagnosis due to the progress of the disease.The average dosage of azathioprine was (1.24±0.16) mg/kg,and the total withdrawal rate due to adverse effect was 15％ (25/167 cases).The surgical intervention rate was 15.1％ (22/146 cases) during long-term follow-up.ESR and CRP of patients decreased obviously and tended to normal after 3 months treatment.The CDAI score significantly decreased after 6 months treatment.Conclusions Most Chinese patients had a good tolerance of immune suppression and achieved better medium- and long-term clinical efficacy at the dosage lower than that recommended by European and United States guidelines.