Expression of leptin receptor in gliomas and the effect of exogenous leptin on human glioma U251 cell line / 中华行为医学与脑科学杂志

Objective To clarify the expression of leptin and leptin receptor in normal brain tissues and gliomas and investigate the effect of exogenous leptin on the proliferation,migration and invasion of human glioma U251 cell line.Methods Immunohistochemical staining was used to detect the expression of leptin and leptin receptor in 50 cases of different grades of glioma tissues and 20 cases of normal brain tissues.The effects of exogenous leptin on proliferation,migration and invasion of U251 cells were detected by MTT assay,cell scratch assay and Transwell invasion assay.Results (1) The positive expression rates of leptin and leptin receptors in glioma tissues were 50.0％ and 92.0％,respectively.(2)Proliferation activity:leptin concentrations of 0 ng/ml,10 ng/ml,and 50 ng/ml had no significant difference in the proliferation of U251 cells (absorbance:0.263±0.015,0.273±0.017 and 0.277±0.006,respectively),and the leptin concentration of 100 ng/ml had a significant effect on the proliferation of U251 cells (absorbance:0.315±0.005,P＜0.05).(3)Migration ability:the migration rate of U251 cells treated with different concentrations of leptin increased significantly with the passage of time,and the migration rate was most significant at the concentration of 100 ng/ml ((93.313±3.080) ％),and the difference was statistically significant (P＜0.05).(4)Invasive ability:with the increase of leptin concentration and the prolongation of the action time,the invasive ability of U251 cells was enhanced.When leptin was used at a concentration of 100 ng/ml,the number of penetrating cells were the biggest(135±2).Conclusion Leptin and leptin receptors are involved in the occurrence of gliomas;and exogenous leptin promotes the proliferation of U251 cells and has time and dose dependability on the migration and invasion of U251 cells.

Distribution characteristics of plasma concentration of vancomycin and clinical efficacy in pediatric patients with severe pneumonia and congenital heart disease / 中国小儿急救医学

Objective To analyze the distribution characteristics of vancomycin blood concentration in children with severe pneumonia complicated with congenital heart disease( CHD) and children with simple severe pneumonia after using the same dose vancomycin,and observe the clinical efficacy at the same time. Methods Plasma concentrations in pediatric patients with severe pneumonia complicated with CHD ( CHD group) who treated by vancomycin from November 2012 to September 2013 in Shengjing Hospital of China Medical University were collected. Plasma concentrations of children with simple severe pneumonia( control group) treated by vancomycin were also collected at the same period. The blood concentration values and therapeutic effects of the two groups were recorded into the database for statistical analysis. Peak,trough con-centrations and efficacy were analyzed by receiver operating characteristic(ROC) curve. Results Twenty-five children with CHD were collected,the average peak concentration was (28. 39 ± 6. 68) mg/L,the aver-age trough concentration was (13. 34 ± 6. 62)mg/L. Control group were also 25 cases,the average peak con-centration was (16. 23 ± 2. 50) mg/L and the average trough concentration was (2. 77 ± 1. 01) mg/L. Both peak and trough concentrations of CHD children were significantly higher than those of the control group (tpeak =8. 52,Ppeak <0. 05;ttrough =7. 89,Ptrough <0. 05). In the ROC of peak,trough concentrations and effica-cy,area under the curve were 0. 74(95％CI 0. 547-0. 935,P=0. 01) and 0. 77(95％CI 0. 605-0. 935,P=0. 004) respectively,and the difference was statistically significant. Conclusion Plasma concentrations of vancomycin in children with CHD are generally higher,it is necessery to monitor plasma concentration even under regular doses,to make the application of vancomycin more safe and effective in children with CHD. There is a correlation between plasma concentration of vancomycin and clinical efficacy in children,the high-er the blood concentration,the more likely the clinical efficacy is to be effective.

Effect of PGE1 on the expression of Apaf-1 and TLR4 in rats with cerebral ischemia-reperfusion injury / 中华行为医学与脑科学杂志

Objective To explore the effects of prostaglandin E1 (PGE1) on the expression of Apaf-1 and TLR4 in rats with cerebral ischemia-reperfusion(CIR) injury.Methods 32 healthy adult male Wistar rats were randomly divided into four groups,which were sham operated group (n=8),CIR model group (n=8) and PGE1 pretreated groups (low dose,12 μg · kg-1;high dose,24 μg · kg-1,n =8).Rat model of cerebral ischemia/reperfusion was established by bilateral common carotid artery ligation.The expression of Apaf-1 and TLR4 was detected with immunohistochemical staining method in hippocampus and epencephalon.Results After 20 min of ischemia and reperfusion for 24 h,compared with sham operated group (Apaf-1:hippocampus (0.87±0.78),epencephalon (0.67 ±0.43);TLR4:hippocampus (2.43 ± 1.17),epencephalon (1.97± 1.033)),the number of positive cells of Apaf-1 (hippocampus (11.83± 2.26);epencephalon(5.80±1.30) and TLR4 (hippocampus(16.90±2.86);epencephalon(12.90±2.66)) was increased in CIR model group (P＜0.05).Compared with CIR model group,the positive cell numbers of Apaf-1 (hippocampus:low dose(9.83±2.12),high dose(5.50± 1.17);epencephalon:low dose(4.87± 1.38),high dose(2.73±1.172)) and TLR4 (hippocampus:low dose (11.53± 2.40),high dose (9.13 ± 2.54);epencephalon:low dose (9.07 ± 2.07),high dose (4.47 ± 1.68)) were reduced dose-dependently in PGE 1 pretreatment all group (all P ＜0.05).Conclusion PGE1 can inhibit the expression of Apaf-1 and TLR4 in hippocampus and epencephalon of rat with cerebral ischemia-reperfusion injury.

Protective Effects of Soluble Ornithine Cyclase Activator Cinaciguat on Human Umbilical Vein Endothelial Cells under the Condition of High Glucose / 中国药房

OBJECTIVE:To study the protective effects of soluble ornithine cyclase activator cinaciguat(called CIN for short) on human umbilical vein endothelial cells (HUVECs) under the condition of high glucose. METHODS:HUVECs were treated with glucose 33.3 mmol/L to induce oxidative stress injury model. HUVECs were divided into normal group,high glucose group and high glucose+CIN 0.01,0.1,1 and 10 μmol/L groups. The cell viability was detected by MTT assay,and the survival rate of cells was callulated. Besides,HUVECs were divided into normal group,normal+CIN 1 μmol/L group,high glucose group,high glucose+CIN 1 μmol/L group. MDA content and SOD activity were determined by TBA method and xanthine oxidase method;mRNA expression of ICAM-1 and VCAM-1 were determined by RT-PCR. RESULTS:Compared with normal group,survival rate decreased in high glucose group(P0.05). Compared with normal group,MDA content and mRNA expression of ICAM-1 and VCAM-1 increased in high glucose group,while SOD activity decreased(P0.05). Compared with high glucose group,MDA content and mRNA expression of ICAM-1 and VCAM-1 decreased in high glucose+CIN 1 μmol/L group,while SOD activity increased(P<0.05). CONCLUSIONS:CIN can protect high glucose-induced HUVECs injury in vitro. The mechanism may be associated with in-hibition of oxidative stress and inflammatory response.

Lay emphasis on the treatment and exploration of extraordinary injuries / 中华烧伤杂志

Treatment of "extraordinary injuries" is a major challenge for surgeons major in burn care and plastic surgery, though they are experts in wound treatment and repair. The "extraordinary injuries" is very complicated, and its treatment needs multidisciplinary cooperation. Surgeons not only have to master the relevant knowledge, but also should have the expertise to choose the appropriate treatment targeting the special pathological characteristics of the extraordinary wounds. Therefore, surgeons should learn and aggregate more knowledge regarding extraordinary injuries, strengthen muture communication, and encourage research work.

Repair of cervical postradiation ulcer following radical mastectomy with lower trapezius myocutaneous flap / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the clinical effects of ipsilateral lower trapezius myocutaneous flap for repairing cervical ulcer as a result of radiotherapy after radical mastectomy.</p><p><b>METHODS</b>Six patients with cervical ulcers as a result of radiotherapy after radical mastectomy were hospitalized from March 2010 to February 2015, suffering from persistent pain in different degrees. The wound area ranged from 6 cm × 4 cm to 10 cm × 6 cm before debridement, 8 cm × 5 cm to 16 cm × 10 cm after debridement. Ipsilateral lower trapezius myocutaneous flap was used to repair the wound after thorough debridement, with the area ranging from 10 cm × 7 cm to 20 cm × 13 cm. The donor sites were sutured directly or covered with medium-thickness skin graft obtained from the back.</p><p><b>RESULTS</b>Pain was obviously relieved in all the patients 2 days after surgery. The wounds in five patients were healed, while necrosis of superficial skin approximately 1 cm in diameter appeared at the distal end of one myocutaneous flap, and it healed after dressing change. During the follow-up period of 3 to 18 months, no recurrence of ulcer was found, the texture of the myocutaneous flaps was soft with good appearance, and the donor sites healed well.</p><p><b>CONCLUSIONS</b>On the basis of thorough debridement, it is feasible to repair the cervical ulcer as a result of radiotherapy after radical mastectomy with the ipsilateral lower trapezius myocutaneous flap.</p>

Treatment should be individualized for burn injury in extraordinary regions or caused by uncommon agents / 中华烧伤杂志

Burn wounds in extraordinary regions or caused by uncommon agents need individualized treatment according to their individual particularity. A perusal of papers to be published in this issue showed that most of burn units have paid attention to burn injuries pertaining to this category in their regular performance, and individualized treatment has been advocated. Accordingly, the treatment result of burns of this category has been improved. Furthermore, aesthetic and functional recovery has also been emphasized, thus the quality of life of the victim has been improved evidently, and they are able to return to family and society early.

Analysis of clinical characteristics of 443 patients with inhalation injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the epidemiological characteristics of inhalation injury and to summarize the clinical application experience of diagnostic standard of burn of larynx.</p><p><b>METHODS</b>Medical records of 443 patients with inhalation injury admitted to our burn unit from January 1999 to June 2013 were analyzed, including gender, age, severity of inhalation injury, complications and diseases before injury; total area and that of full-thickness burn injury, admission time after burn, and burn condition of larynx of patients with different degrees of inhalation injury; treatment and outcome including rate, time, and complication of tracheotomy, mortality, and cause of death. Data were processed with nonparametric Kruskal-Wallis test and chi-square test. The relationship between severity of inhalation injury and total burn area, degree of burn of larynx, tracheotomy rate, and mortality was assessed by Spearman correlation analysis.</p><p><b>RESULTS</b>(1) Among the patients, there were 353 (79.7% ) male and 90 (20.3% ) female, with the ratio of male to female 4:1. There were 64 (14.4%) patients younger than or equal to 20 years, 203 (45.8%) patients older than 20 years and younger than or equal to 40 years, 144 (32.5%) patients older than 40 years and younger than or equal to 60 years, and 32 (7.2%) patients older than 60 years. The numbers of patients with mild, moderate, and severe inhalation injury were respectively 297, 108, and 38. Seven patients suffered from complications, and 21 patients had diseases before injury. There were statistically significant differences among the patients with different degree of inhalation injury in regard to total burn area and full-thickness burn area (with H values respectively 73.752 and 142.830, P values below 0.01), while no statistically significant difference was observed in admission time after burn ( H = 1.528, P > 0.05). Correlation analysis showed that severity of inhalation injury was positively correlated with total burn area (r = 0.399, P < 0.001). Among the patients with mild inhalation injury, incidences of patients with mild, moderate, and severe burn of larynx were respectively 68.0% (202/297), 32.0% (95/297), and 0, and those among the patients with moderate inhalation injury were respectively 0,53.7% (58/108), and 46.3% (50/108). There were statistically significant differences in degree of burn of larynx of patients with different degree of inhalation injury (χ2 = 336.703, P < 0.001). Correlation analysis showed that severity of burn of larynx was positively correlated with severity of inhalation injury (r = 0.700, P < 0.001). (2) The rate of tracheotomy was 37.02% (164/443). The rates of tracheotomy in patients with mild, moderate, and severe inhalation injury were respectively 10.44% (31/297), 87.96% (95/108), and 100.00% (38/38), χ2 = 271.654, P < 0.001. Correlation analysis showed that the rate of tracheotomy was positively correlated with severity of inhalation injury (r = 0.784, P < 0.001). Tracheotomy was done mainly within 6 h post burn (63.4%, 104/164). The incidence rate of complication of tracheotomy was 5.5% (9/164). (3) Thirty-one patients died, with a mortality rate of 7.00%. The mortality rates of patients with mild, moderate, and severe inhalation injury were respectively 1.01% (3/297), 12.96% (14/108), and 36.84% (14/38), H = 74.273, P < 0.001. It was found that the mortality was positively correlated with severity of inhalation injury (r = 0.371, P < 0.001). The causes of death of the patients were respectively sepsis (14, 45.2%), respiratory failure (7, 22.6%), airway obstruction (2, 6.5%), airway hemorrhage (2, 6.5%), cerebral hemorrhage (2, 6.5%), cardiac accident (2, 6.5%), and diabetes insipidus (1, 3.2%), and 1 (3.2%) patient quit treatment and discharged from hospital for economic reason.</p><p><b>CONCLUSIONS</b>Among the patients with inhalation injury, male is dominated in number, and the young adults formed the highest constituent ratio. The severity of inhalation injury was correlated with total burn area, severity of burn of larynx, tracheotomy rate, and mortality. With the guidance of diagnostic criteria of burn of larynx and indication of tracheotomy, the risk of laryngeal obstruction can be eliminated. The early preventive tracheotomy can decrease the difficulty and risk of the operation.</p>

A retrospective analysis of 5 cases of major burns treated by goat acellular dermal matrix combined with hyaluronic acid / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of the goat acellular dermal matrix combined with hyaluronic acid (h-GADM) in the treatment of major burns.</p><p><b>METHODS</b>A retrospective analysis of 5 patients with major burns undergoing combines microskin and h-GADM grafting. All patients were male, aged 33 to 50 years, and mean burn area were 83% ± 11%, which III degree wounds 60% to 90%. After extensive burns patients admitted to hospital in accordance with conventional treatment processes included fluid resuscitation, airway management, wound management, infection control and other treatment. The patients received the surgery after the shock of spending and hemodynamically stable. Summarized the feasibility and operative techniques of the new method, and elaborated on details by a typical case as an example.</p><p><b>RESULTS</b>All the 5 patients were survival, go through the shock period smoothly, not haven any serious complications as lung infection, wound sepsis, septicemia and kidney failure occurred. A total of nine mircoskin graft operations were undergoing and covered 17 limbs. The average time of the h-GADM desquamtion was (17.7 ± 2.7) days after operation, the hospitalization time was (115 ± 27) days. After (72 ± 6) days, the residual wound was less than 5% total body surface area.</p><p><b>CONCLUSION</b>The h-GAMD can be a good alternative to cadaver skin in the treatment of major burns.</p>

Application of enteral nutritional emulsion (TPF-D) or enteral nutritional emulsion (TP) in patients with chronic wound and diabetes / 中华临床营养杂志

Objective To compare the effectiveness of enteral nutritional emulsion (TPF-D) and enteral nutritional emulsion (TP) in patients with chronic wound and diabetes (CWD). Methods Totally 20 CWD patients in Beijing Jishuitan Hospital from June 2008 to June 2010 were enrolled in this study. Enteral nutritional emulsion (TP) was used for the first 5 days ( TP group) and enteral nutritional emulsion (TPF-D) was used for the second 5 days (TPF-D group). Changes of mean amplitude of glycemic excursions (MAGE), insulin dosage, and prealbumin (PA) were compared between TPF-D group and TP group. The adverse effects and post-operational complications were also observed. Results The every-day MAGE was (2. 56 ±0. 35) mmol/L in TPF-D group, which was significantly lower than that in TP group [ (3.23 ± 0. 42) mmol/L] ( P = 0. 01 ). The mean insulin dosage was (9.6 ± 1.7) U in TPF-D group, which was significantly lower than that in TP group [ ( 12. 2 ± 2. 5 ) U ] ( P =0.03 ). The increase of PA showed no significant difference between TPF-D group [ ( 12.7 ± 3. 3) mg/L] and TP group [ ( 13.4 ± 2. 8 ) mg/L ] ( P = 0. 08 ). No enteral nutrition-related adverse effect or post-operation complication was noted. Conclusion Compared with TP, TPF-D is more suitable for the CWD patients.

The Value of 64-slice Spiral CT Angiography in Diagnosis of Acute Severe Chest Pain / 实用放射学杂志

Objective To evaluate the value of 64-slice spiral computed tomography angiography(CTA) in diagnosis of acute severe chest pain caused by vascular diseases.Methods 34 cases with acute severe chest pain caused by vascular lesions confirmed clinically underwent CTA examinations.The images were processed with multi-planar reconstruction,maximal intensity projection,curved planar reconstruction and volume rendering,then the imaging features were analysed.Results CTA showed acute aortic dissection in 13 cases,acute pulmonary embolism in 9 cases and acute coronary syndrome in 12 cases,all cases were confirmed by clinic.Conclusion 64-slice CTA has very important practical value in diagnosis of acute severe chest pain.

Mechanism of supplementation of glutamine dipeptide on improving wound healing after operation on burns / 中华临床营养杂志

Objective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g ·kg-1· d-1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor- ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera- tion but without significant difference [control group: (2. 24±0. 84) μg/ml, study group: (2. 32±0.92) jig/ml, normal value: (1.27±0.44) μg/ml]. On the post-operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31±1. 05) ng/ml] was significantly higher than that of control group [ (3. 04±1. 01) μg/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with- out significant difference [ (33. 3±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.

Repair of soft tissue defects with artificial dermis in 20 cases / 中国组织工程研究

In order to study and appraise the application of artificial dermis in repairing skin defect or organization damage, 20 patients underwent artificial dermis transplantation at the Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2008 to April 2009 were collected. Patients with skin damage or depth portion organization (tendon, joint and bone appears externally) was perform debridement and artificial dermis transplantation, followed by split thickness autoskin transplantation. The survival of artificial dermis and split thickness autoskin was observed. After transplantation, the depth portion organization of patients were covered efficiently, all grafts survived without obvious scar proliferation. The results demonstrated that the prompt application of artificial dermis can reduce the surgery risk, relieve the surgery to damage, and reduce the scar production in repairing organization damage or depth portion organization expose.

Treatment of Chronic Ulcers on Limbs in Diabetes Patients Using Povidone Iodine Water Bath Therapy / 中华医院感染学杂志

OBJECTIVE Chronic ulcers on the limbs are a common problem in diabetic patients with pathological changes in nerve and vessels.Such ulcers can result in disablement and may even be life-threatening.The treatment of these chronic ulcers is a difficult issue in current medical practice.The development of an effective and easily handled treatment is,therefore,an important topic in the management of diabetes to improve patients′ quality of life. METHODS Povidone iodine water bath was given to 54 diabetes patients with chronic ulcer on their limbs at a time when their glucose levels were controlled by insulin to FBG

Detection of β2-microglobulin and fibronection contents in patients with nasopharyngeal carcinoma and their clinical significance / 中国耳鼻咽喉头颈外科

Objective:To study the clinical significance of β2-microglobin(β2-MG)and fibronection (Fn) contents in patients with nasopharyngeal carcinoma.Methods:The contents of serum β2-MG and Fn were detected by radioimmunoassay and agar-diffusion methods in 60 patients with nasopharyngeal carcinoma before and after radiotherapy,also in 60 normal subjects as control group.Results:The contents of serum β2-MG and Fn were 2.99±1.11mg/L(β2-MG)and 134.60±28.93mg/L(Fn) in 60 patients with nasopharyngeal carcinoma,2.16±0.50mg/L(β2-MG)and 196.16±34.65mg/L(Fn)in 60 health subjects,respectively.Those results showed that the content of β2-MG in patients group was higher than that in control group (P＜0.05),and the content of Fn in patients group was lower than that in control group(P＜0.05).After radiotherapy of patients group,the content of β2-MG were lower(2.16±0.55mg/L)than that before radiotherapy(P＜0.05).Conversely,the content of Fn was higher(180.53±34.66mg/L)than after radiotherapy(P＜0.05).Conclusions:The detection of serum β2-MG and Fn have clinical significance on the evaluation prognosis of patients with nasopharyngeal carcinoma.