Attention should be paid to the exposure risk of patients with chronic wounds on the way to hospital during corona virus disease 2019 epidemic prevention and control / 中华烧伤杂志

Statistics show that 76.74% (4 688) of 6 109 patients with chronic wounds are those over 50 years of age; the proportion of patients with underlying diseases in all age groups above 50 years ranges from 78.25% to 100.00%; among the underlying diseases of chronic wound patients, the top four diseases are diabetes mellitus , cardiovascular and cerebrovascular diseases, hypertension, and respiratory diseases. The above underlying diseases and ages of patients are the susceptibility factors of corona virus disease 2019 released by National Health Commission of China. It is an unavoidable fact that patients with chronic wounds have to go to the hospital for treatment prescribed by the physician. At the same time, we found that there were not a few patients who go far afield because of various reasons when go to the hospital for treatment. During the period of epidemic prevention and control, this kind of "go far afield" style of seeking medical treatment may increase the exposure risk during transportation. Accordingly, we convened 36 wound care clinics in different regions in Shanghai to implement the "Five Measures" to encourage patients with chronic wounds to seek medical treatment proximately. The principle of this operation is that when seeking medical treatment, trying our best to reduce as much as possible the transportation distance for patients with chronic wounds to minimize the exposure risk during the epidemic period and eventually support the epidemic prevention and control campaign.

Comparative study on incisional complications between transumbilical single incision laparoscopic appendectomy and conventional laparoscopic appendectomy / 重庆医学

Objective To compare the difference in incisional complications between transumbilical single insicion laparoscopic appendectomy(TUSILA) and conventional laparoscopic appendectomy(CLA).Methods The incisional complications in 312 cases of TUSILA and 346 cases of CLA in the general surgery department of this hospital from January 2011 to December 29014 were retrospectively analyzed.The total occurrence rate of incision complications,incision infection rate and incision hernia occurrence rate were observed in the two groups.Results The incision complications occurrence rate,incision infection rate and incision hernia occurrence rate had no statistical difference between the TUSILA group and CLA group(P＞0.05).The univariate analysis showed that the incision infection was correlated with high BMI,complicating type 2 diabetes mellitus (T2DM) and indwelling drainage tube;the Spearman correlation analysis indicated that incision hernia was closely correlated with the incision infection(r=0.82,P＜0.05).Conclusion Compared with CLA,TUSILA does not increase the incision complications occurrence rate.

Experiment research of cinobufacini on TGF-β1-induced epithelial-to-mesenchymal transition in human colorectal carcinoma cells / 重庆医学

Objective To investigate the effects of cinobufacini on TGF-β1-induced epithelial-to-mesenchymal transition of human colorectal carcinoma cells in vitro.Methods The cultured colorectal carcinoma cell line(SW480) was divided into the control group,TGF-β1 (10 ng/mL) individual treatment group and co-treatment groups with TGF-β1 (10 ng/mL) + cinobufacini (2.5,5,10,20,40,80 mg/mL),which were cultured in vitro for 48 h.The proliferation of the cells were measured by CCK8 assay.The morphological changes were observed by inverted phase contrast microscope.The ability of cell invasion and migration was detected by Transwell assay.The mRNA and protein expressions of E-cadherin and Vimentin were detected with QRT-PCR and Western Blot.Results (1)Compared with the TGF-β1 (10 ng/mL) individual treatment group,TGF-β1 (10 ng/mL) + cinobufacini (10,20,40,80 mg/mL) co-treatment groups significantly had significantly proliferation inhibitory effect on SW480 (P＜0.05).(2) Compared with the normal control group,TGF-β1 individual treatment group and TGF-β1 (10 ng/mL) + cinobufacini(2.5 mg/mL) group exhibited classical mesenchymal phenotype,while the TGF-β1 (10 ng/mL) + cinobufacini (5 mg/mL) co-treatment group showed classical epithelial phenotype.(3) The ability of invasion and migration in the TGF-β1(10 ng/mL)+ cinobufacini(2.5,5 mg/mL) co-treatment group were significantly weakened compared with the TGF-β1 individual treatment group (P＜0.01).(4) QRT-PCR and Western Blot results indicated that compared with the normal control group,the Vimentin expression in the in the TGF-β1 individual treatment group was significantly increased and the E-cadherin expression was significantly decreased.Furthermore,compared with the TGF-β1 individual treatment group and control group,the Vimentin expression level in the TGF-β1 (10 ng/mL) + cinobufacini (2.5,5 mg/mL) groups was significantly decreased and E-cadherin expression was significantly increased.Conclusion Cinobufacini can inhibit TGF-β1-induced cell proliferation in human colorectal carcinoma SW480 cells,and its mechanism may be related with promoting E-cadherin expression increase,meanwhile decreasing the vimentin expression,thus inhibiting the EMT process induced by TGF-β1.

Steinmann pin poking closed reduction axial combined with lateral multiple hollow screws internal fixation in repair of calcaneal fractures / 中国组织工程研究

BACKGROUND:The treatment of calcaneal fractures using open surgery is likely to cause greater trauma. OBJECTIVE:To explore the clinical effect of steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation in repair of Sanders II, III type calcaneal fractures. METHODS:The clinical data of 73 patients with Sanders II, III type calcaneal fractures were retrospectively analyzed and divided into conventional group (n=36) and experimental group (n=37) according to the treatment method. Patients in these two groups were respectively treated with conventional open reduction internal fixation and steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation. RESULTS AND CONCLUSION:Compared with the conventional group, the hospital stays of patients in experimental group were shorter, hospital costs reduced. There were no obvious changes in the foot rating from the American Association of Ankle Injuries, B?hler angle and Gissane angle. The incidence of complications was significantly decreased. These results demonstrate that the treatment of Sanders II, III type calcaneal fractures with conventional open reduction and bone plate internal fixation and steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation can obtain the basic equivalent clinical effect, however, the treatment of steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation have more obvious advantages, such as a shorter hospital stays, less hospital costs, and also can effectively control the complications.

Repeatable tendo-achilles tenotomy in the treatment for congenital club-foot / 中国现代医生

Objective To explore the treatment of repeatable tendo-achilles tenotomy in Ponseti approach for congenital clubfoot. Methods Retrospective analysis of 117 patients (137 feet) with congenital clubfoot treated with serial casting in Ponseti approach from March 2008 to June 2014. A repeatable tendo-achilles tenotomy was performed on 102 pa-tients (116 feet) (84.67%) when less than 15o of ankle dorsiflexion and 70oof foot abduction. The foot-abduction brace was used postoperatively and follow-up termly. Results All of 117 patients were follow-up for 3 to 48 months, averag-ing 26.3 months. The results of 112 (131 feet) (91.97%) were satisfactory. The tendo-achilles tenotomy was performed averaged 1.4 times in the patients taken surgery. The tendon performed tenotomy were all connected and patients walk with normal gait later. Conclusion The results of the treatment of repeatable tendo-achilles tenotomy for congenital clubfoot ware satisfactory. This surgery performed in Ponseti approach will always achieve a successful result.

Optimization of the Extraction Technology for Oligosaccharides of Morinda officinalis by Response Surface Methodology / 中国药房

OBJECTIVE:To optimize the extraction technology of oligosaccharides of Morinda officinalis. METHODS:The liq-uid/solid ratio,extraction time and temperature were chosen as factors,and the yield of oligosaccharides was estimated as index. On the basis of single-factor experiments,using a 3-factor,3-level Box-behnken central composite experimental design,two-poly-nomial regression equation of extraction rate of oligosaccharide was established,and it was analyzed by response surface methodolo-gy to obtain the optimum extraction conditions,and the verification test was conducted. RESULTS:The optimum extraction condi-tions were as follows as material/liquid ratio of 23∶1(ml/g),extraction time of 1.7 h,and extraction temperature of 93℃,extract-ing for twice. Under these conditions, the estimated and observed average values of extraction rate of oligosaccharides were 10.37% and 10.29%(RSD=0.20%,n=3),respectively. The deviation value was 0.06%. CONCLUSIONS:The response surface methodology can be used to optimize the extraction process of oligosaccharides of M. officinalis.

AFM study of cisplatin-induced apoptosis on hepatocellular carcinoma HepG2 Cells / 实用医学杂志

Objective To study the effect of cisplatin on the hepatocellular carcinoma HepG2 cells by Atomic Force Microscopy (AFM), then analysis the changes of ultrastructural in HepG2 cells during apoptosis induced by cisplatin at nanoscale level. Methods HepG2 cells were treated with cisplatin for 24h and 48h. The ultrastructural change of cell surface was detected by AFM , the inhibitory rate and apoptotic rate of cell were examined by MTT and fow cytometry. Results AFM images showed that with the prolongation of cisplatin-inducing, the deformation change of HepG2 cells varying degree. The cells appeared larger pore size of cell membrane, the value of cell membrane particle sizes, Rp-v, Ra, Rq and Meant Ht were significant increased. The inhibitory rate and apoptotic rate were significant increased. Conclusions Cisplatin induced shrinkage in cell morphology, pore formation and roughness increasing in cell membrane, thereby inducing apoptosis in HepG2 cells.

A comparative study on the effects of transabdominal preperitoneal hernia repair and open hernia repair surgery in the treatment of adult inguinal hernia / 中国综合临床

Objective To evaluate the clinical outcomes of different stages of transabdominal preperitoneal hernia repair (TAPP) and open hernia repair surgery (Rutkow) in treating adult inguinal hernia.Methods The clinical data of patients with inguinal hernia undergoing hernia repair(TAPP,TAPP Ⅰ group:56 patients administered TAPP during January 2003 to December 2005 ; TAPP Ⅱ group:76 patients administered TAPP during January to December 2010) and Rutkow hernia-ring filling (Rutkow group:78 patients administered Rutkow during January 2003 and December 2005) were analyzed retrospectively.Clinical indexes and effective indicators were observed to compare the treatment effects of the operation procedures,including duration of surgery,post-operation hospital stay,post-operation leaving bed time,post-operation free activity time,hospitalization costs,time of beginning taking food,and complications.Results The TAPP Ⅱ group had significantly shorter average length of stay,time of beginning taking food,post-operation leaving bed time and post-operation free activity time than the other two groups (average length of stay:(2.6 ± 1.6) d vs.(4.1 ±2.6) d vs.(4.2 ± 1.9) d; time of beginning taking food:(8.6 ± 3.1) h vs.(22.2 ± 3.8) h vs.(20.7 ± 3.2)h;post-operation leaving bed time:(4.6 ±2.2) h vs.(18.3 ±2.3) h vs (20.5 ±3.1) h;Post-operation free activity time:(8.6 ± 2.9) d vs.(15.2 ± 3.3) d vs.(17.1 ± 3.8) d ; P ＜ 0.05).There were no significant differences between TAPP Ⅰ and Rutkow groups on average length of stay,time of beginning taking food,postoperation leaving bed time and post-operation free activity time (P ＞ 0.05).TAPP Ⅰ group had significantly longer duration of operation than the other two groups ((113.3 ± 18.6) min vs.(50.4 ± 11.8) min vs.(48.6 ± 12.1) min,P ＜ 0.05).There was no difference on surgery duration between Rutkow and TAPP Ⅱ groups (P ＞ 0.05).No difference was observed regarding rates of postoperative complications and recurrence (P ＞ 0.05).Conclusion With the advancement of technology,TAPP shows more advantages compared to traditional herniorrhaphy,such as minimal trauma,fewer complications and shorter duration of operation and lower recurrence rate.TAPP is an excellent hernia repair for inguinal hernia.

Mechanism of the skin lesions in diabeitic rats / 中华内分泌代谢杂志

Four weeks after SD diabetic rats were induced by streptozotocin,skin thickness was obviously reduced with obscure multilayer epithelium features.Moreover,the thickness of epidermic layers in diabetic rat skin was significantly thinner than that ofnornlal rat skin at the eighth week[(0.016±0.006 vs 0.041±0.007)mm,P<0.01].The percentage of G2/M phase cells in epidermic layers of diabetic group was significantly lower than that in the normal group.At the twelfth week,skin microangiopathy was easily detected in the diabetic group.The blood levels of advanced glycation end products(AGEs)and malonialdehyde were significantly increased and glutathione decreased in diabetic rats compared with control rats(aU P<0.01),along with the increased contents of local glucose and AGEs in the skin of diabetic rats.These results suggest that the local accumulation of glucose and AGEs seems to be one of the important mechanisms in the pathogenesis of diabetic skin lesions.

Application of Gasless Laparoscopic Cholecystectomy to Elderly Patients / 中国微创外科杂志

Objective To investigate the effects of low-pressure carbon dioxide pneumoperitoneum (CLC) and gasless abdominal distension (GLC) on elderly patients during laparoscopic cholecystectomy. Methods The clinical data,including operation time,hospital stay,surgical complications,and changes of other systems,of 36 elderly patients were analyzed. All the patients were older than 65 years when they received laparoscopic cholecystectomy in our hospital from January 2005 to December 2007. Among the cases,CLC (CO2 pressure:8-10 mm Hg) was used in 24,and GLC was employed in 12. The fourth generation artificial rib lifting apparatus was used for GLC. Results All the procedures were completed by laparoscopy,no patient was converted to open surgery. The operation time of the CLC and GLC groups was (46.2?14.8) min and (52.4?18.6) min respectively (t=-1.087,P=0.285). The vital signs of all the cases were stable during the operation,no carbon dioxide retention or cardiovascular affairs occurred. The hospital stay was (10.5?6.8) d in group CLC and (8.9?5.5) d in group GLC (t=0.706,P=0.485). The patients were followed up for 6 to 42 months,no complications occurred during the period. Conclusions GLC is safe for elderly patients with similar efficacy to that of low-pressure CLC.

Jurisprudential Reflections on Physician-Patient Relationship in the New Era / 中国医学伦理学

With the development of modern medicine,to see a doctor is no longer a simple process of diagnosis or taking drugs.Human have deeply recognized medical science and health from a simple biomedical model to a social,psychological and biomedical model.On the one hand,people seek help from medical science.On the other hand,people fear that malpractice could occur.It has been in a love-hate mentality for people to seek medical and legal relief.In the new era,physician-patient relationship needs to be recognized again from medical staff,patients and legal angles.The combination of medicine and law is the requirement of development of the times.No matter how strong the law is,and no matter how much we hope the legislation is from strength to strength,moderation is still the virtues of the law.Medical perspective is still required in the examination of medical activity.

Investigation of melatonin receptor gene and protein expression in human peripheral blood lymphocytes / 中国病理生理杂志

AIM: To investigate the melatonin receptor (MR) gene and protein expression in the human peripheral blood lymphocytes. METHODS: Total RNA of human peripheral lymphocytes was isolated by single step method of acid guanidinium-thiocyanate-phenol-chloform, mt 1 and MT 2 mRNA were determined by the reverse transcription-polymerase chain reaction(RT-PCR). Immunohistochemistry was applied to identify and localize mt 1 and MT 2 protein. RESULTS: 1 1 kb mt 1 mRNA was detected by Northern blot, but 1 1 kb MT 2 mRNA was not detected. The mt 1 cDNA fragment of the expected size of 370 bp was determined and the MT 2 cDNA fragment of the expected size of 320 bp was not determined by RT-PCR. Sequencing result indicated that the positive product coincided with the cDNA of human mt 1. The mt 1 protein was observed by immunohistochemistry. These buffy positive granules were scattered with some areas stronger than the others, and primarily located in cytoplasm and membrane, with rare location in nucleus; meanwhile the MT 2 protein was not observed. CONCLUSION: These results demonstrated the mt 1 mRNA and protein expression in human peripheral leukocytes. It is indicated that melatonin has directly immune-regulative effects on peripheral lymphocytes.

Histochemical changes of skin in diabetic rats / 中国病理生理杂志

AIM: To explore the histochemical changes o f diabetic skin and the pathogenesis of impaired wound healing in diabetes. METHODS: 54 male Sprague-Dawley (SD) rats weighing 200-220 g wer e randomized into control and STZ-induced diabetic groups. The shaved skin speci mens from the back of rats were collected in 4, 8 and 12 weeks post STZ-inductio n, respectively. Hematoxylin-eosin dye was used for histological examination. Me a nwhile, the skin glucose contents were measured by Beckman's autoanalyzer. Skin AGEs concentrations were assessed by detecting total fluorescence in tissue coll agen and immunohistochemistry assay. RESULTS: The skin thickness in diabetic animals was decreased, w ith the features of multilayer epithelium structure disappeared in epidermis and collagen fibers atrophied, swollen and degenerated in dermis; The inflammatory responses in the dermis of diabetic animals were increased obviously. The result s also revealed that skin glucose contents in diabetic rats [(2.64?1.03)mg/ g skin] were 2-3 times higher than those in the controls [(0.74?0.33)mg/g s kin] (P