Discussion on strengthening the training of doctor-patient communication ability in the standardized residency training in department of burns / 中华医学教育探索杂志

At present, there are some problems in doctor-patient communication in standardized residency training in department of burns, such as insufficient understanding, lack of communication skills and short of teachers' guidance. Therefore, during the rotation of burns department, we should strengthen the cultivation of communication ability by improving humanistic care, professional level and communication training. At the same time, clinical teachers should strengthen their own quality and the assessment system should be improved. Through comprehensive efforts in many aspects, we will improve doctor-patient communication ability and build a harmonious doctor-patient relationship.

Advances in the research of severe burn-related corticosteroid insufficiency / 中华烧伤杂志

Despite considerable advances in diagnosis and treatment of the critical illness-related corticosteroid insufficiency (CIRCI), it is still not clear that whether it is common in severe burn patients or not, and how clinical diagnosis, treatment, and research progress. Severe burn is a systemic disease involving the damage of multiple organs of the whole body. The course of the disease is relatively long, and there often exists persistent inflammation, immunosuppression, and catabolism. On the basis of CIRCI study, the epidemiological evidence, possible mechanism, suspicious clinical manifestations, diagnosis and treatment of severe burn-related corticosteroid insufficiency (SBRCI) were briefly reviewed in this article in order to help clinical diagnosis and treatment of SBRCI.

Osteochondral lesions of the talus:etiology, diagnosis, treatment and prospects / 中国组织工程研究

BACKGROUND: Osteochondral lesion of the talus is a common disease of foot and ankle surgery, which has the characteristics of high morbidity, high misdiagnosis rate and difficulty in curing. OBJECTIVE: To summarize the etiology, clinical manifestations, diagnostic methods, clinical grading, treatment methods, and new therapies such as cell therapy and tissue engineering for osteochondral lesion of the talus.METHODS: The first author retrieved PubMed databases for relevant articles. The keywords were "talus, cartilage". Initially, 535 articles were retrieved, and finally 70 articles were included in result analysis. RESULTS AND CONCLUSION: Trauma is still considered to be the main pathogenic factor of talus cartilage injury. According to the imaging findings, the clinical scope of talar cartilage injury can be accurately determined. The clinically applied therapies have certain shortcomings and limitations. Tissue engineering-based therapies are currently the most likely to cure osteochondral lesion of the talus.

Co-expression of β-glucosidase and Vitreoscilla hemoglobin in Escherichia coli / 生物工程学报

In producing recombinant β-glucosidase in Escherichia coli by high-cell density cultivation (HCDC), insufficient soluble oxygen is always a problem. To address it, Vitreoscilla hemoglobin (VHb) was introduced into Escherichia coli by the bicistron and T₇ promoter expression systems, to improve soluble oxygen by bacterial cells and thereby to enhance the biomass and recombinant β-glucosidase production. In the case of bicistron expression system, cell density in shaking flask reached OD₆₀₀=(4.24±0.29), 35.03% higher than that of the control without VHb. Correspondingly, the maximum activity of β-glucosidase co-expressed with VHb was (9.78±0.55) U/mL, 25.38% higher than that of the control. In a 3-L fermentor, the maximum activity of β-glucosidase was 141.23 U/mL, 35.57% higher than that of the control. In contrast, the activity of β-glucosidase co-expressed with VHb under T₇ promoter was lower than that of the control, either in flask or in fermentor. Co-expressing β-glucosidase with VHb using the bicistron expression system may improve the tolerance of E. coli to insufficient soluble oxygen and thus promote the bacterial biomass and the enzyme yield.

Bioinformatic analysis and characterization of myxobacteria laccase-like multicopper oxidases / 生物工程学报

Laccase is a widely-used environment-friendly copper-containing oxidase found in many plants, insects and fungi. Recently, more and more laccases are also found in bacteria. Myxobacteria are an important bacteria resource. However, myxobacteria are much more difficult to isolate and purify than other bacteria. We used bioinformatic approach to screen myxobacteria proteomes available in NCBI. Based on conserved sequences of four copper binding sites in multicopper oxidase, 30 potential laccase sequences were obtained. Among them, nine genes were synthesized and expressed in Escherichia coli BL21 (DE3). Seven proteins showed laccase activity when tested with traditional laccase substrates. One protein, named rSC-2, was chosen for further research because it exhibited the highest activity towards 2,6-dimethyl phenol (DMP). The molecular weight of rSC-2 was 57 kDa. Its specific activity to DMP was 0.27 U/mg. The optimal temperature and the optimal pH were 60 ℃ and 7.0, respectively. About 50% of the original activity was retained after incubation at 60 ℃ and pH 7.0-8.0 for 1 h. Metals showed different effects on rSC-2. rSC-2 activity was enhanced by several metalsat concentration of 1 mmol/L, such as Ca²⁺ and Mn²⁺. With a higher concentration of 5 mmol/L, the activity of rSC-2 was apparently inhibited. This is the first report of bioinformatics screening myxobacteria laccases in combination with expression in E. coli.

Relation of virtues to work engagement and subjective well-being in employees / 中国心理卫生杂志

Objective:To explore the relationship of virtues and subjective well-being,and examine the mediating effect of work engagement on the relationship between virtues and subjective well-being in employees.Methods:Totally 423 employees aged 20 to 56 years were selected from Guangdong and Zhejiang provinces.The Chinese Virtues Questionnaire (CVQ,including virtues of relationships,vitality and conscientiousness),Utrecht Work Engagement Scale (UWES) and Index of Well-being (IWB) were used to assess the employees' virtues,work engagement and subjective well-being,and the mediating effect was analyzed by using Bootstrap method.Results:The CVQ scores were positively correlated with the scores of IWB and UWES (r =0.32-0.48,Ps ＜0.01),and the UWES score was positively correlated with the IWB score (r =0.54,P ＜0.01).Bootstrap test showed that the work engagement had mediating effects on the relationships between virtue of vitality and IWB (the mediating effect was 0.12,95％ CI:0.07-0.18,P ＜ 0.001),and the work engagement also had mediating effects on the relationships between virtue of relationship and subjective well-being (the mediating effect was 0.10,95％ CI:0.04-0.15,P ＜ 0.001).Conclusion:It suggests that virtues and subjective well-being are closely related,and work engagement may have mediating effects on the relationships between virtues and subjective well-being in employees.

Theory and efficacy of stem cells from different sources in the treatment of diabetic foot / 中国组织工程研究

BACKGROUND:Stem cel is a kind of pluripotent cels with self-replication ability, which can differentiate into various cels under certain conditions. Furthermore, stem cels are rich in a variety of growth factors, which can induce the generation of vessels and nerves, and improve the blood supply of lower limbs, thereby achieving the treatment and preventions of lower limb ischemia OBJECTIVE:To summarize and compare the recent achievements in the theory and therapeutic efficacy of stem cels from different sources in the treatment of diabetic foot. METHODS:The first and second authors retrieved PubMed, Sciencedirect and Medline databases for relevant articles published from January 2000 to January 2015. The key words were “diabetic foot, pathogenesis, stem cel therapy” in English. Initialy, 186 articles were retrieved, and finaly 44 articles were included in result analysis. RESULTS AND CONCLUSION:Stem cels can be a new choice for the treatment of diabetic foot. After stem cel therapy, corresponding symptoms have been aleviated, including the generation of new blood vessels and the reshaping of the colateral vessels, the improvement of motor nerve conduction velocity and nerve reflex, the improvement of the sense of skin pain and temperature, and pain relief. It is stil unclear whether alogeneic stem cels are safe or not, but autologous stem cels, especialy bone marrow mesenchymal stem cels, can be better able to repair damaged vessels and nerves and restore the microcirculation of blood supply. Currently, we need to do more basic and clinical researches to solve the folowing problems: to confirm the effectiveness and safety of stem cel therapy for diabetic foot; to identify whether there is a difference in the differentiation and secretory activity between stem cels in diabetic patients and ordinary people; to give ful play to the treatment of diabetic foot.

Health information social service in medical college and university libraries and measures for its improve-ment / 中华医学图书情报杂志

The health information social service in medical college and university libraries was analyzed in terms of the importance attached to it, opening to readers, items of service, requirement of materials, types of readers, and charge of frees, and certain measures were proposed for improving the level of health information social service, such as updating the service concept, innovating the service, and standardizing the management.

Dye decolorization by bacterial laccase Lac15 / 生物工程学报

We screened for laccase from a marine metagenomic library and obtained a bacterial laccase Lac15 and studied its decolorization ability. Using synthetic azo dyes and anthraquinonic dyes as substrates, we investigated the dye decolorization ability of recombinant Lac15 (rLac15). The purified rLac15 had better decolorization ability towards the azo dyes than the anthraquinonic dyes. When incubated at 45 degrees C and pH 8.5 for 1 h with methylsyringate as the mediator, 20 U/L of rLac15 could decolorize 95% of 100 micromol/L Acid Red 6B (AR-6B), 93% of Reactive Blue 194 (M-2GE), 76% of Reactive Brilliant Orange (K-7R) and 66% of Reactive Blue 171 (KE-R). The decolorization ability of rLac15 decreased with the dye concentration increasing. However, more than 80% of M-2GE and AR-6B were degraded even when the dye concentration was up to 200 micromol/L. At room temperature, rLac51 exhibited significant decolorization ability, with 96% of AR-6B, 86% of M-2GE, 66% of K-7R and 66% of KE-Rdegraded within 24 h at 25 degrees C. rLac15 has the potential of industrial applications.

Preparation of low immunogenic porcine dermal scaffold and evaluation of its cytocompatibility / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the changes in the structure and cytocompatibility of porcine acellular dermal matrix, which was prepared with dermal reticular layer, treated with matrix metalloproteinase 7 (MMP-7), genipin, and vacuum freeze-drying.</p><p><b>METHODS</b>Fifty-four pieces of porcine dermal reticular layer, prepared with lateral abdominal skin were obtained from healthy large Yorkshire pig with mechanical method under sanitary condition, each 10.0 mm×5.0 mm in size and 0.5 - 0.6 mm in thickness. They were divided into normal control group (A(1), without treatment, n = 6), decellularization group (B, decellularized, n = 12), decellularization + MMP-7 group (C, treated with MMP-7 after decellularization, n = 12), decellularization + MMP-7 + genipin group (D, treated with MMP-7 and genipin after decellularization, n = 12), and decellularization + MMP-7 + genipin + vacuum freeze-drying group (E, treated with MMP-7, genipin, and vacuum freeze-drying after decellularization, n = 12) according to the random number table. Meanwhile, 6 pieces of human acellular dermal matrix, with the same size and thickness as listed above, were taken as control group (A(2), without treatment) in the cytocompatibility tests. HE staining and scanning electron microscope were used to detect the cell number and the change in tissue structure in dermal scaffold in groups A(1) and B-E. Immunohistochemical staining was used to determine residual vimentin, laminin and collagen IV in groups A(1), B, and C. Cytotoxicity tests were employed to test the cytotoxicity of the leaching solutions of groups B-E. Human fibroblasts were seeded on the surface of dermal scaffold in groups A(2) and B-E. The proliferation of fibroblasts were determined on post culture day (PCD) 3, 7, and 14, and the content of IL-6 and IL-8 in the supernatant were determined on PCD 3 and 7 with enzyme-linked immunosorbent assay. Data were processed with two-way analysis of variance and LSD- t test.</p><p><b>RESULTS</b>Granular structure with hair follicle in pale yellow color was observed in group A(1). Small amount of hair, epithelial root sheath, nuclei, cell debris-like structure, vimentin, laminin, and collagen IV were observed in group B but not in group C, D, or E, which had been treated with MMP-7. The toughness of dermal scaffold was stronger in groups D, E than in groups B and C as observed in gross condition observation. The collagen fibers of dermal scaffold in groups C-E maintained their structural integrity with similar arrange as that of group A(1). The interspaces among collagen fibers in groups C-E were all increased, while those of groups C and D were similar but larger than that in group B; the interspace in group E was the largest. Groups B-E scored level 0 or 1 in the cytotoxicity test. Fibroblasts could proliferate on the surface of dermal scaffold in groups A(2) and B-E. Furthermore, with the extension of culture time, fibroblasts gradually became to be stratified to form multiple layers, and they proliferated toward the dermis. High density of fibroblasts was observed on the surface in groups D and E and in the deep layer in groups A(2) and C. On PCD 7, the contents of IL-6 [(132 ± 14), (104 ± 9), (122 ± 14), (120 ± 12), (128 ± 17) pg/mL] and IL-8 [(135 ± 18), (102 ± 17), (127 ± 18), (134 ± 23), (141 ± 24) pg/mL] in the supernatant in groups A(2) and B-E were significantly higher than those on PCD 3 [(55 ± 13), (34 ± 8), (48 ± 8), (50 ± 13), (49 ± 12) pg/mL] and [(93 ± 19), (63 ± 11), (82 ± 15), (82 ± 16), (89 ± 16) pg/mL], with F values respectively 98.869, 184.038, 125.531, 93.237, 87.265 and 15.694, 23.451, 22.801, 19.607, 18.808, P values below 0.05. The differences among groups A(2) and B-E in the levels of IL-6 and IL-8 at each time point were statistically significant (with F values respectively 2.809, 3.301 and 3.757, 3.266, P values below 0.05). The differences among groups A(2), C, D, and E in amount of IL-6 and IL-8 at each time point were not statistically significant (with t values respectively 0.058 - 1.905 and 0.034 - 1.295, P values above 0.05), but they were all higher than those in group B (with t values respectively 3.707 - 5.612 and 2.785 - 4.079, P values below 0.05).</p><p><b>CONCLUSIONS</b>The low immunogenic porcine dermal scaffold treated with MMP-7, genipin, and vacuum freeze-drying after decellularization, has good cytocompatibility. The growth of only a few fibroblasts in the dermal scaffold may be correlated with genipin, which increases tissue toughness.</p>

Unplanned decannulation of tracheotomy tube in massive burn patients: a retrospective case series study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation (UD) in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients.</p><p><b>METHODS</b>A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square (χ(2)) or Fisher's exact test.</p><p><b>RESULTS</b>Patients with UD were often burned with head and neck (67%) and combined with inhalation injury (62%). The majority of them (76%) were transferred patients, occurred early (55%) and were accidental UD (79%). UD events tended to happen in day shift (90%) and to be associated with the medical procedure that was performing by caregivers at besides (79%). Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients' death.</p><p><b>CONCLUSIONS</b>UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.</p>

Treatment of femur periprosthetic fracture after total hip arthroplasty in elderly patient / 中华老年医学杂志

ObjectiveTo discuss treatment experiencing in femur periprothetic fracture after hip arthroplasty in pre-, intra- and post-surgery.Methods From March 2005 to May 2011, 27 patients (11 males, 16 females) aged ＞75 years with femur periprothetic fracture after hip replacement were studied. The mean time from primary hip replacement to femur perprosthetic fracture was 63 months(ranging from 7 to 83 months). According to vanconver classification, type A applying steel wire of character for 8 bind technique was 5 cases, type B applying prolonging stem technique locking compress plate (LCP)technique surrounding instrument technique was 19 cases and type C applying bone graft and plate fixation technique was 3 cases. All patients were followed up from 9 to 25 months (average, 16 months). The results of treatment were evaluated by Harris score and X rays. Results Bony heal was obtained in 22 patients and was not obtained in five cases among whom bony heal occurred in 3 cases and 2 patients could only keep prothetic and limb stable after receiving the bone graft once more. Walking was free in 14 cases,9 cases needed assistant walking instrument,and only 4 cases stayed in the bed freely. Harris score for last follow-up was 52 to 93 (mean 76).Conclusions Based on the patient general status, the fracture types and practical and stable principle, the effective methods can get good results in the treatment of femur periprosthetic fracture in aged patient.

Effects of nerve growth factor combination with Insulin on wound healing with Ⅱ degree deep scald and the expression of HIF-1α and VEGF in diabetic rats / 中国医师杂志

Objective To investigate the effects of local application of NGF combined with Insulin on wound healing with Ⅱ degree deep scald and the expression of HIF-1α and VEGF in diabetic rats. Methods 60 male Wistar rats were used in the study by intraperitoneal injection of streptozotocin (STZ). Deep partial thickness scalding was engendered on the back of the rats after one month. Then these rats were random divided into group B (scalding of the rats with diabetes, n = 15), C (insulin control, n = 15), D ( NGF control, n = 15) and E ( NGF and insulin supplementation, n = 15). And group A ( nomal control,n = 15) was created by normal rats of partial thickness scalding. The wound area, wound healing rate, and grey of HIF-1α and VEGF immunohistochemistry staining were determined on the 3rd, 7th, 15th, and 21st day post scalding days (PSDs). Results Compared to those in groups A, B, C and D, the wound healing rate in group E increased significantly since the 7th PSD [(25.33 ± 2. 32 ) %, P ＜ 0.05]. The wound healing rate in group C and D increased significantly compared with group B [( 16. 68 ± 1.95 ) %, ( 18.29±1. 70)%, P ＜0.05]. Compared to group A, the group D increased significantly since the 15th PSD [(54. 84 ±3.60)%, P ＜0. 05]. The expression of HIF-1α and VEGF in group E began to increase slower than other groups after the 7th day ( P ＜0. 05 ). Conclusion Local application of NGF combined with Insulin could be beneficial to the regeneration of capillary vessel in the burn wounds of the rats with diabetes,as well as to accelerate wound healing by redress anoxia and decrease the expression of HIF-1α and VEGF.

Chronic wound: Pathogenesis and current treatments / 第二军医大学学报

Chronic wound has very complicated pathogenesis and is difficult to treat; the situation has been improving owing to the progress in wound healing research and the clinical application of new techniques. This article focuses on the pathogenesis of chronic wound and introduces progress in various kinds of treatment, such as skin substitute, growth factors, negative pressure treatment, etc.

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.

Gene gun-delivered human basic fibroblast growth factor gene facilitates the healing of deep partial thickness burn wounds / 中国组织工程研究

BACKGROUND: A large amount of in vivo and in vitro experiments have confirmed that, basic fibroblast growth factor (bFGF) has been widely utilized in various tissues and cells, it can facilitate the wound healing.OBJECTIVE: To observe the efficacy and feasibility of gene gun-mediate delivery of human bFGF on the healing of deep partial thickness bum wounds.DESIGN, TIME AND SETTING: Randomized design,an observational trial was performed at the Military Central Laboratory of Changhai Hospital in the Second Military Medical University of Chinese PLA between December 2007 and October 2008.MATERIALS: SD rats of clean grade, weighing 200-250 g, irrespective of genders, ware involved in this study.METHODS: Natural human bFGF gene was recombined and optimized, then eukaryotic expression vector pCI-neo-bFGF was constructed taking pCI-neo as a vector, and transfeoted with human embryonic kidney cells 293 T cells. Dot blot and Western blot methods were utilized to determine the bFGF expression. Rat model of deep partial thickness burn wounds was processed into transgene process using gene gun technique, pCI-neo-bFGF-transfected ones served as experiment group while pCI-neo-transfected ones served as controls.MAIN OUTCOME MEASURES:Wound healing time was recorded and the efficacy was evaluated. The contents of hydroxyproline and collaganase Ⅰ in burn wound tissues were determined at 24 hours, 48 hours, 96 hours, 7 days, 10 days and 14 days following transgene process.RESULTS: the recombinant pCI-neo-bFGF was transfected with human embryonic kidney 293T cells. Dot blot and Western blot analysis have showed that, the constructed pCI-neo-bFGF expression vector could express human bFGF, and the expression of synthesized gene was remarkably higher than that of natural gene under fluorescence microscope; gene gun-mediated transgene experiment have showed that, the wound healing time was (13.00+1.31) days in the experiment group and (14.75±1.28) days in the control group, with significant differences (P＜0.05). The contents of hydroxyproline and collagenase Ⅰ reached a peak at 5 days after the injury, that is 48 hours after transfection, and then gradually decreased and maintained at a certain level. The experiment group had higher hydroxyproline levels compared with control group at different time points (P＜0.05, P＜0.01); the collagenase Ⅰ in the experiment group was notably higher than that in the control group at 48 hours and 96 hours after transfection (P＜0.01).CONCLUSION: Gene gun-mediated delivery of human bFGF can short the time of wound healing, increase the contents of hydroxyproline and collagenase Ⅰ during the healing period, accelerate the healing of deep partial thickness burn wounds.

Genetic polymorphism of D6S477, D9S1118, D18S865, D19S400, and D20S161 short tandem repeat loci in Qingdao Han population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To illuminate the preliminary genotype and allele frequency distribution of D6S477 and the other four short tandem repeat(STR) loci in Chinese Han population in Qingdao area and to probe the possibility of their genetic application.</p><p><b>METHODS</b>Two hundred ACD-blood specimens were collected from the unrelated individuals in Qingdao. The DNA samples were extracted with Chelex method and were amplified by polymerase chain reaction technique. The PCR products were analyzed by polyacrylamide gel electrophoresis and displayed using silver staining.</p><p><b>RESULTS</b>The authors obtained the allele frequency distribution and preliminary genotype of D6S477, D9S1118, D18S865, D19S400 and D20S161 STR loci. No deviation from Hardy-Weinberg equilibrium was observed in the five loci.</p><p><b>CONCLUSION</b>All the five loci have higher chance of exclusion and discriminating power, and they will be useful markers for researches in genetics.</p>

Relationship between three thrombophilic gene mutations and unexplained recurrent early spontaneous abortion / 中华妇产科杂志

Objective To explore the relationship of methylenetetrahydrofolate reductase (MTHFR)gene C677T,factor V(FV)gene G1691A and prothrombin(PT)gene G20210A polymorphisms to unexplained recurrent early spontaneous abortion(URESA).Methods One hundred and twelve patients with URESA and 100 women with at least 1 normal pregnancy and without any miscarriage were analyzed for MTHFR,FV and PT gene polymorphisms by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Results MTHFR gene T/T genotype and T allele frequencies were increased in URESA patients[38.4%(43/112)and 59.8%(134/224)]versus controls[18.0%(18/100)and 43%(43/100),P

Chronic wound:pathogenesis and current treatments / 第二军医大学学报

Chronic wound has very complicated pathogenesis and is difficult to treat;the situation has been improving owing to the progress in wound healing research and the clinical application of new techniques.This article focuses on the pathogenesis of chronic wound and introduces progress in various kinds of treatment,such as skin substitute,growth factors,negative pressure treatment,etc.