Guideline for the diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients (version 2023) / 中华创伤杂志

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Inter-hemispheric Functional Connections Are More Vulnerable to Attack Than Structural Connection in Patients With Irritable Bowel Syndrome

Background/Aims@#Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disease characterized by recurrent abdominal pain and bowel dysfunction. However, the majority of previous neuroimaging studies focus on brain structure and connections but seldom on the inter-hemispheric connectivity or structural asymmetry. This study uses multi-modal imaging to investigate the abnormal changes across the 2 cerebral hemispheres in patients with IBS. @*Methods@#Structural MRI, resting-state functional MRI, and diffusion tensor imaging were acquired from 34 patients with IBS and 33 healthy controls. The voxel-mirrored homotopic connectivity, fractional anisotropy, fiber length, fiber number, and asymmetry index were calculated and assessed for group differences. In addition, we assessed their relevance for the severity of IBS. @*Results@#Compared with healthy controls, the inter-hemispheric functional connectivity of patients with IBS showed higher levels in bilateral superior occipital gyrus, middle occipital gyrus, precuneus, posterior cingulate gyrus, and angular gyrus, but lower in supplementary motor area. The statistical results showed no significant difference in inter-hemispheric anatomical connections and structural asymmetry, however negative correlations between inter-hemispheric connectivity and the severity of IBS were found in some regions with significant difference. @*Conclusions@#The functional connections between cerebral hemispheres were more susceptible to IBS than anatomical connections, and brain structure is relatively stable. Besides, the brain areas affected by IBS were concentrated in default mode network and sensorimotor network.

Inter-hemispheric Functional Connections Are More Vulnerable to Attack Than Structural Connection in Patients With Irritable Bowel Syndrome

Background/Aims@#Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disease characterized by recurrent abdominal pain and bowel dysfunction. However, the majority of previous neuroimaging studies focus on brain structure and connections but seldom on the inter-hemispheric connectivity or structural asymmetry. This study uses multi-modal imaging to investigate the abnormal changes across the 2 cerebral hemispheres in patients with IBS. @*Methods@#Structural MRI, resting-state functional MRI, and diffusion tensor imaging were acquired from 34 patients with IBS and 33 healthy controls. The voxel-mirrored homotopic connectivity, fractional anisotropy, fiber length, fiber number, and asymmetry index were calculated and assessed for group differences. In addition, we assessed their relevance for the severity of IBS. @*Results@#Compared with healthy controls, the inter-hemispheric functional connectivity of patients with IBS showed higher levels in bilateral superior occipital gyrus, middle occipital gyrus, precuneus, posterior cingulate gyrus, and angular gyrus, but lower in supplementary motor area. The statistical results showed no significant difference in inter-hemispheric anatomical connections and structural asymmetry, however negative correlations between inter-hemispheric connectivity and the severity of IBS were found in some regions with significant difference. @*Conclusions@#The functional connections between cerebral hemispheres were more susceptible to IBS than anatomical connections, and brain structure is relatively stable. Besides, the brain areas affected by IBS were concentrated in default mode network and sensorimotor network.

Expressions of CCT2 and Galectin-3 and its clinical significances in benign and malignant lesions of pancreas / 中华胰腺病杂志

Objective To investigate the expressions of CCT2 and Galectin-3 in pancreatic ductal adenocarcinoma,para-carcinoma tissues,benign lesions and normal tissues and to assess their clinicopathological significances.Methods 106 cases of pancreatic ductal adenocarcinoma,35 cases of matched para-carcinoma tissues ≥2 cm away from cancerous tissues,55 cases of pancreatic benign lesions (20 cases of chronic pancreatitis,20 cases of adenoma,15 cases of intraepithelial neoplasia),and 13 cases of normal tissues were collected.The gender,age,maximal tumor diameter,differentiation,TNM stage,the presence of lymph node metastasis and surrounding tissue infiltration of the patients with pancreatic ductal adenocarcinoma were recorded.EnVision immunohistochemistry was used to detect the expression of CCT2 and Galectin-3.Univariate and multivariate anlysis were applied to analyze the factors influencing the postoperative survival of the patients.Results The positive rates of CCT2 and Galectin-3 in 106 cases of pancreatic ductal adenocarcinoma were 54.7％ and 50.9％,which was 25.7％ and 28.6％ in 35 cases of para-carcinoma tissues,23.6％ and 20.0％ in 55 cases of pancreatic benign lesions,and negative expression in 13 cases of normal tissues.CCT2 and Galectin-3 positivity rate in pancreatic ductal adenocarcinoma was significantly higher than para-carcinoma tissues,pancreatic benign lesions and normal tissues,and the differences were statistically significant (P ＜ 0.05).Positivity rate of CCT2 and Galectin 3 expression in the patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis was significantly higher than that in patients with TNM stage Ⅰ-Ⅱ and no lymph node metastasis;the positivity rate of CCT2 expression in pancreatic ductal adenocarcinoma with surrounding organ infiltrated was obviously higher than that without surrounding organ infiltrated;the positivity rate of Galectin 3 expression in poorly differentiated adenocarcinoma was obviously higher than that in well differentiated adenocarcinoma;and all the differences were statistically significant (all P ＜0.05).The expression of CCT2 and Galectin-3 had no obvious correlation with the patients' gender,age and maximal tumor diameter.The survival period of 106 cases of pancreatic ductal adenocarcinoma was 2-24 months with the average of 9.4±0.7 months.The 1-year and 2-year postoperative survival rate after surgery was 27.3％ (n =29)and 2.8％ (n =3).The survival period of patients with poorly differentiated degree,larger maximal tumor diameter,advanced TNM stage,the presence of lymph node metastasis and surrounding tissue invasion,and positive expression of CCT2 and Galectin 3 was shorter than that of patients with well differentiated degree,smaller maximal tumor diameter,early TNM stage,the absence of lymph node metastasis and surrounding tissue invasion,and negative expression of CCT2 and Galectin 3,and the difference was statistically significant (P ＜0.05).Cox multivariate analysis showed that poorly differentiated degree,maximal tumor diameter ≥5 cm,TNM stage Ⅲ-Ⅳ,the presence of surrounding invasion and lymph node metastasis,and positive expression of CCT2 and Galectin 3 were independent risk factors for influencing patients' prognosis.Conclusions CCT2 and Galectin 3 were highly expressed in pancreatic ductal carcinoma,which was associated with the biological behaviors and prognosis of the tumor.

Bile acids and bariatric surgery / 中华胃肠外科杂志

As an essential metabolic molecule, bile acids regulate triglyceride, cholesterol, energy metabolism. Bariatric surgery offers a treatment that can reduce weight and induce metabolic syndrome, but the mechanism is still unclear. New researches reveal that serum bile acids are elevated after surgery, as well as the improvement of metabolic disease. The surgery changes gastrointestinal tract, resulting in a short circuiting of the enterohepatic circulation of bile acids. Here we review the bile acids metabolism and their effect after bariatric surgery.

Follow-up of total hip replacement using domestic prosthesis in 33 hips / 中国组织工程研究

BACKGROUND: Total hip replacement has been widely used in the treatment of severer hip diseases in China.However,most of prostheses are designed according to Caucasian osteometric measurements,whether those prostheses are suitable for Orientals is still in dispute.It is emerging to design prostheses for Orientals,there are few reports addressing therapeutic effect after replacement.OBJECTIVE: To follow up the long-term results of total hip replacement using domestic designed dual-assembly total hip prosthesis.METHODS: Totally 30 patients(33 hips)who underwent total hip replacement at the Department of Orthopaedic Surgery,China-Japan Union/Affiliated Hospital of Jilin University,from June 1987 to December 1996,were followed up.The designed dual-assembly total hip prosthesis was produced by Central Iron & Steel Research Institute,which was similar to bipolar prosthesis with a polyethylene acetabular cup.First generation cementing techniques were applied.The average age at the time of the operation was 56.5 years(30-81 years)and the average follow-up period was 8.5 years(5.0-14.4 years).Standard anteroposterior radiographs of the hip and clinical examinations were used to analyze therapeutic efficacy.RESULTS AND CONCLUSION: The total excellent and good rate was 68.6%.The imaging examination showed that there were16 hips(48.5%)had aseptic loosening and 11 hips(33%)had heterotrophic bone formation.Additionally,two cases suffered from infection and one case suffered from dislocation.The utilization of prosthesis achieved certain curative effects.However,the design and cement technology have problems due to limitation of conditions,which should be solved in further experiments.

Construction and identification of eukaryotic expression plasmid of recombinant human hypoxia-inducible factor-1? / 吉林大学学报(医学版)

Objective To construct the eukaryotic expression plasmid of recombinant human hypoxia-inducible factor-1?(HIF-1?) and get ready for the coloning and expressing of HIF-1? gene. Methods The total RNA was isolated from blood cells,and cDNA library was constructed by reverse transcription PCR method.PIREGFP containing EGFP fragment and cDNA were used as templet,the three designed primers (EGFP-linker,HIF-1? upstream and HIF-? downstream)were put into,after amplification the target gene fragment was inserted into the shuttle vector T,and transfected with E.coli DH5?,the bacterial colonies containing recombinant plasmids were identified by LB/KANA-agar plate,and the recombinant plasmids were extracted and purified.All sequences amplified by PCR were confirmed by complete sequencing.The correct sequences were cloned into the pVAX1 vector.Results The amplified fragments were about 870,1 199,672 bp by PCR,they were inserted into the shuttle vector T and sequenced. The result of sequencing was identical with that provided by GenBank.The final plasmid about 1 800 bp was obtained by the identification of enzyme digestion and it had same molecular size as expected.Conclusion The eukaryotic expression plasmid pVAX1-EGFP-linker-HIF-1? of recombinant human HIF-1? is successfully constructed.

Biological responses of osteoblast-like cells in different maturation stages under shear flow / 中国矫形外科杂志

[Objective]To sturdy the biological responses of osteoblast-like cells in different maturation stages under shear flow.[Method]Flow chamber system was used to apply shear flow stimulation of 4.62dyn?s/cm~2 for 2 hours on osteoblast-like cell MC3T3-E1 of different maturation stage induced by osteogenic media,and then samples for dsDNA content and ALP activity analysis were collected.[Result]On 24 hours after simulation,there was not obvious change of ALP activity with non-osteogenic inducing group,an increase was observed in the group of 4 days of differentiation,while an decrease in the group of 8 days of differentiation.[Conclusion]Biological responses of osteoblast-like cells in different maturation stages under shear flow is quite different,and this may be an important role in bone growth and reconstruction.

Effects of insulin on mitogen-activited protein kinase of vascular smooth muscle cells in spontaneously hypertensive rat / 中国病理生理杂志

AIM:To explose the possible existing pathway of intracellular signaling transduction in hypertensive induced by insulin in rat vascular smooth muscle cells proliferation which involved mitogen-activated protein kinase. METHODS:Male spontaneously hypertensive rat (SHR) aorta and WKY(6 weeks old) were isolated and then cultured to make the purified vascular smooth muscle cells.6-8th generation of VSMC were interfered with insulin in vitro . MAPK activity was determined by myelin basic protein method and its volume was measured with Western Blot. And [ 3 H]-TdR was used to measure DNA synthesis in VSMC proliferation. RESULTS: After the interfered with insulin the DNA synthesis was increased obviously in SHR group. MAPK activity and its contains in SHR were increased more than the control group. Protein kinase C inhibitor decreased MAPK activity induced by insulin. CONCLUSION:Proliferation of SHR VSMC in vitro was correlated with increased activity of MAPK. Insulin can affect MAPK induced activity. So an insulin-PKC-MAPK axis may exist in hypertensive VSMC.