Research advances on thymosin β4 in promoting wound healing / 中华烧伤杂志

With the aging of population and the development of social economy, the incidence of chronic wounds is increasing day by day, while the incidence of burns and trauma remains at a high level, making wound repair an increasingly concerned area in clinical practice. Thymosin β4 is a naturally occurring small molecule protein in vivo, which is widely distributed in a variety of body fluids and cells, especially in platelets. Thymosin β4 has biological activities of promoting angiogenesis, anti-inflammation, anti-apoptosis, and anti-fibrosis, and has many important functions in wound repair. Thymosin β4 has been observed to promote the healing of various wounds, such as burns, diabetic ulcers, pressure ulcers. This paper will review the molecular structure, mechanism of wound healing promotion, pharmacokinetics, and clinical application of thymosin β4, aiming to introduce its potential in wound treatment and the shortcomings of current researches.

Research advances on signaling pathways affecting sweat gland development and their involvement in the reconstitution of sweat adenoid cells in vitro / 中华烧伤杂志

The damage of sweat glands in patients with extensive deep burns results in the loss of thermoregulation, which seriously affects the quality of life of patients. At present, there are many researches on the repair of sweat gland function, but the mechanism of human sweat gland development has not been fully clarified. More and more studies have shown that the cascaded pathways of Wnt/β-catenin, ecto- dysplasin A/ectodysplasin A receptor/nuclear factor-κB, sonic hedgehog, and forkhead box transcription factor jointly affect the development of sweat glands, and it has been reported that the cascaded signaling pathways can be used to achieve the reconstruction of sweat adenoid cells in vitro. This article reviews the signaling pathways that affect the development of sweat glands and their involvement in the reconstruction of sweat adenoid cells in vitro.

Association between microRNA-137 Gene Polymorphisms and Ischemic Post-stroke Depression / 中国康复理论与实践

Objective:To analyze the relationship between microRNA-137 gene polymorphisms and ischemic post-stroke depression (PSD). Methods:January, 2017 to January, 2019, the single nucleotide polymorphism (SNP) of rs1625579 in microRNA-137 was genotyped in 250 ischemic PSD patients and 250 healthy controls with SNaPshot. The expression of microRNA-137 was measured with quantitative real-time polymerase chain reaction in the mononuclear cells, and the association of the SNP rs1625579 with microRNA-137 expression was analyzed. Results:The allele T was more in the patients than in the controls (OR = 2.033, 95%CI 1.255 to 3.294, P = 0.003), as well as the genotype TT (OR = 2.139, 95%CI 1.272~3.595, P = 0.004). The microRNA-137 expression was less in the patients than in the controls (t = 28.23, P < 0.001). For the controls, the microRNA-137 expression was also less in those with genotype of TT than with GT and GG (t = 3.764, P < 0.001). Conclusion:The genotype TT of SNP rs1625579 in microRNA-137 is a risk factor of susceptibility to ischemic PSD, which may associate with the decrease of expression of microRNA-137.

Simultaneous liver and kidney transplantation: analysis of a single-center experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Simultaneous liver and kidney transplantation (SLKT) has been proven to be a favorable treatment for combined renal and hepatic end-stage disease. However, recipients receiving SLKT have a long medical history, poor general condition that is often accompanied by anemia, hypoalbuminemia, coagulopathy, water-electrolyte imbalance and acid-base disorders. This study aimed to explore the indications, surgical techniques, therapeutic experience, prevention and treatment of postoperative complications of SLKT.</p><p><b>METHODS</b>The clinical data of 22 SLKTs cases performed at the First Affiliated Hospital of Sun Yat-sen University from January 2001 to December 2008 were retrospectively studied. Indications for SLKT, surgical techniques, perioperative fluid management, immunosuppressive regimen and experience in prevention and treatment of postoperative complications were analyzed.</p><p><b>RESULTS</b>All operations were successfully performed. Postoperative complications occurred in 13 cases (59.1%), including pleural effusions (7), intra-abdominal bleeding (2), biliary complications (2), repeated upper gastrointestinal bleeding (1), and acute liver graft rejection (1). All complications were treated conservatively. In this study, there were five deaths during follow-up, in which three perioperative deaths occurred due to serious conditions. Mortality at 3 months was 13.6%. The one and three year patient survival rate was 81.3% and 73.9% respectively.</p><p><b>CONCLUSIONS</b>SLKT is an effective therapy for end-stage liver disease with chronic renal failure or severe damage to renal function. It is a complex surgical procedure, causing a large disturbance of circulation and fluid balance, and more postoperative complications. The SLKT surgical techniques selected are based on the experience of surgeons, the anatomy of the recipient and primary diseases. It is essential to use the correct perioperative fluid management, reasonable immunosuppressive regimen, and prevention and treatment of postoperative infections, to improve the long-term patient survival after SLKT.</p>

Clinical and pathological analysis of acute rejection following orthotopic liver transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute rejection is one of the most important factors for prognosis following liver transplantation. With the use of potent immunosuppressants, acute rejection does not always present typical manifestations. Moreover, other complications often occur concomitantly after liver transplantation, which makes early diagnosis of acute rejection more difficult. Acute rejection is best diagnosed by liver biopsy. Differentiation of clinical manifestations and pathological features plays an important role in achieving individualized immunosuppressive treatment and prolonging long term survival of patients given orthotopic liver transplants.</p><p><b>METHODS</b>From January 2004 to December 2006, 516 orthotopic liver transplantations were performed at the First Affiliated Hospital, Sun Yat-sen University. For patients who suffered acute rejection, clinical manifestations, histopathological features, diagnosis and anti-rejection treatment were summarized and analyzed.</p><p><b>RESULTS</b>In 86 cases (16.7%), of the 516 recipients, 106 episodes of acute rejection occurred, which included 9 with histopathological borderline changes, 36 Banff I rejections, 48 Banff II and 13 Banff III. Among these, 36 were cured by adjusting the dose of immunosuppressant and 65 were reversed by methylprednisolone pulse treatment. Five were methylprednisolone resistant, 3 of whom were given OKT3 treatment and 2 underwent liver retransplantation.</p><p><b>CONCLUSIONS</b>Due to potent immunosuppressive agents, acute rejection following an orthotopic liver transplantation lacks typical clinical manifestations and pathological features. Acute rejection is best diagnosed by liver biopsy. Designing rational individualized immunosuppressive regimen based on clinical and pathological features of acute rejection plays an important role in prolonging long term survival of patients.</p>

Liver retransplantation: a single-centre experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The curative effect of liver transplantation for patients with end-stage liver disease was encouraging in recent years and the 5-year patient survival rate can reach up to 70%. However, some patients might lose grafts due to a variety of reasons, including bile duct complications, vascular complications, primary non-function, graft rejection and disease recurrence etc. Liver retransplantation (re-LT) was the only available means for those patients whose initial grafts had failed, but the inferior outcomes of re-LT compared to primary liver transplantation (PLT) continue to be a major concern. This study aimed to analyze the indications for re-LT, optimal timing of re-LT, and strategies to improve the survival rate after re-LT.</p><p><b>METHODS</b>From January 2001 to December 2006, we performed 738 liver transplants and 39 re-LT (5.3%) at our center. A retrospective analysis was performed to identify factors (indication for re-LT, preoperative score of model for end-stage liver disease (MELD), interval to re-LT from primary liver transplantation, methods of vascular and biliary reconstruction and common causes of death) associated with survival.</p><p><b>RESULTS</b>Mean follow-up period was 1.8 years (1 to 5 years). Patients with MELD score less than 20 were better than those whose MELD score was > 20 and MELD score > 30 (1-year survival, 80.0% versus 50.0% and 3/5). The perioperative survival rate of patients who received re-LT at an interval of more than 30 days and less than 8 days after the initial transplantation was higher than those who received retransplantation between 8 to 30 days following the first operation (88.5% and 74.3% versus 50.0%). The main causes of death were infection (60.0%), multiple organ failure (20.0%), vascular complications (10.0%) and biliary fistula (10.0%) in perioperative period. The overall patient survival rate of 1-month, 6-month and 1-year was 80.0%, 76.7% and 66.7%, respectively.</p><p><b>CONCLUSIONS</b>Our study suggested the favorable results after re-LT. The analysis also showed optimal timing of operation, refined surgical techniques, individualized immunosuppressive regimen and effective prophylaxis and treatment of perioperative infection play an important role in achieving a higher survival after re-LT.</p>

Effect of Yuxingchangzhi Decoction on level of norepinephrine and 5-hydroxyptamin in serum of patients with post-stroke depression / 中国康复理论与实践

@#ObjectiveTo evaluate the effect of Yuxingchangzhi Decoction on level of norepinephrine (NE) and 5-hydroxyptamin (5-HT) in serum of patients with post-stroke depression. Methods76 patients with post-stroke depression were treated with Yuxingchangzhi Decoction or placebo for 4 weeks. Before and after treatment, all the patients were evaluated with the Hamilton Rating Scale for Depression (HAMD),while the level of NE and 5-HT in serum of patients were measured.ResultsThe total score of HAMD of the patients of Yuxingchangzhi Decoction group was significantly different before and after treatment (P<0.01),while that of the placebo group was not significantly different (P>0.05). The NE and 5-HT level in serum of patients of the Yuxingchangzhi Decoction group were significantly different before and after treatment (P<0.01),but that of the placebo group was not significantly different (P>0.05). ConclusionYuxingchangzhi decoction can raise NE,5-HT level in patients with post-stroke depression and alleviate symptoms of depression significantly.