Comprehensive treatment of deep frostbite of multiple fingers after trauma: A case report.

BACKGROUND: Frostbite is becoming increasingly common in urban environments, and severe cases can lead to tissue loss. The treatment goal is to preserve tissue and function; the sooner appropriate treatment is administered, the more tissue can be saved. However, not every patient with deep frostbite seeks medical care promptly. CASE SUMMARY: We report the case of a 73-year-old male patient who was lost in the wilderness for 2 d due to trauma and confusion. He experienced deep frostbite on multiple fingers. Treatment should not be discontinued for patients with deep frostbite who present after the optimum treatment timing. Bullae that no longer form (bloody) blisters within 24 h of aspiration should be removed. Mucopolysaccharide polysulfate cream has clinical value in frostbite treatment. The patient was transferred to Chinese Academy of Medical Sciences and Peking Union Medical College Hospital 12 h after being rescued. The patient had contraindications for thrombolysis, the most effective treatment, due to intracranial hemorrhage and presenting past the optimum treatment timing. We devised a comprehensive treatment plan, which involved delayed use vasodilators and high-pressure oxygen therapy at day 49 post-injury. We experimented with mucopolysaccharide polysulfate cream to treat the frostbite. The aim of the treatment was to safeguard as much tissue as possible. In the end, the fingers that suffered from frostbite were able to be partially preserved. CONCLUSION: The case indicated that patients with severe frostbite who missed the optimal treatment time and had contraindications for thrombolysis could still partially preserve the affected limbs through comprehensive treatment.

ADCK1 is a potential therapeutic target of osteosarcoma.

We here showed that ADCK1 (AarF domain-containing kinase 1), a mitochondrial protein, is upregulated in human osteosarcoma (OS) tissues and OS cells. In primary and established OS cells, ADCK1 shRNA or CRISPR/Cas9-induced ADCK1 knockout (KO) remarkably inhibited cell viability, proliferation and migration, and provoked apoptosis activation. Conversely, ectopic ADCK1 overexpression exerted pro-cancerous activity by promoting OS cell proliferation and migration. ADCK1 depletion disrupted mitochondrial functions in OS cells and induced mitochondrial membrane potential reduction, ATP depletion, reactive oxygen species production. Significantly, ADCK1 silencing augmented doxorubicin-induced apoptosis in primary OS cells. mTOR activation is important for ADCK1 expression in OS cells. The mTOR inhibitors, rapamycin and AZD2014, as well as mTOR shRNA, potently decreased ADCK1 expression in primary OS cells. In nude mice, the growth of subcutaneous pOS-1 xenografts was largely inhibited when bearing ADCK1 shRNA or ADCK1 KO construct. Moreover, ADCK1 KO largely inhibited pOS-1 xenograft in situ growth in proximal tibia of nude mice. ADCK1 depletion, apoptosis activation and ATP reduction were detected in pOS-1 xenografts bearing ADCK1 shRNA or ADCK1 KO construct. Together, the mitochondrial protein ADCK1 is required for OS cell growth and is a novel therapeutic target of OS.

Linking intraspecific trait variability and spatial patterns of subtropical trees.

The importance of intraspecific trait variability (ITV) to the spatial distribution of individual species is unclear. We hypothesized that intraspecific trait dispersions underlying niche processes deviate more from null model expectations, by reducing their spread (range and variance), kurtosis, and standard deviation of near-neighbor distance, for species with aggregated than those with random distributions. The link between species' spatial distributions and ITV patterns was examined using an individual tree-based trait data set, in which specific leaf area, mean leaf area, leaf dry matter content, and diameter at breast height were measured for 18,773 stems of 45 species in a 4.84 ha mapped subtropical forest plot in China. The nearest-neighbor distance analysis showed that, of 45 species, 14 species were distributed in random and 31 species were distributed in aggregation, while no species was distributed in uniform in the plot. The dispersions of all studied traits in species with an aggregated distribution on average deviated more strongly from the null expectation than those in species with a random distribution and that the extent of deviation was negatively associated with the degree of spatial randomness across species. Our results indicate that niche processes are primarily responsible for the spatial structure of species with aggregated distributions, while stochastic processes drive those with random distributions. Our results highlight the fundamental role of ITV in shaping spatial patterns of co-existing species.

Evaluation of conventional TBNA needle aspiration smear and embedding in the diagnosis of central airway peripheral lesions / 中国内镜杂志

Objective To evaluate the yield of conventional transbronchial needle aspiration (C-TBNA) in the diagnosis of patients with central airway peripheral lesions. Methods This was a retrospective study, 77 patients with central airway peripheral lesions were enrolled from January 2011 to March 2017. Specimens were smeared and/or embedded. Results The positive diagnostic value for malignant lesions were 92.86% (52/56), and 42.86%(9/21) for benign lesions. The average value was 79.22% (61/77). Conclusions C-TBNA had high positive rate of diagnosis and less complications for cent ral airway peripheral lesions.

Detangling the Effects of Environmental Filtering and Dispersal Limitation on Aggregated Distributions of Tree and Shrub Species: Life Stage Matters.

The pervasive pattern of aggregated tree distributions in natural communities is commonly explained by the joint effect of two clustering processes: environmental filtering and dispersal limitation, yet little consensus remains on the relative importance of the two clustering processes on tree aggregations. Different life stages of examined species were thought to be one possible explanation of this disagreement, because the effect of environmental filtering and dispersal limitation are expected to increase and decrease with tree life stages, respectively. However, few studies have explicitly tested these expectations. In this study, we evaluated these expectations by three different methods (species-habitat association test based on Poisson Clustering model and spatial point pattern analyses based on Heterogeneous Poisson model and the jointly modeling approach) using 36 species in a 20-ha subtropical forest plot. Our results showed that the percentage of species with significant habitat association increased with life stages, and there were fewer species affected by dispersal limitation in later life stages compared with those in earlier stages. Percentage of variance explained by the environmental filtering and dispersal limitation also increases and decreases with life stages. These results provided a promising alternative explanation on the existing mixed results about the relative importance of the two clustering processes. These findings also highlighted the importance of plant life stages for fully understanding species distributions and species coexistence.

Photosynthetic and growth responses of Schima superba seedlings to sulfuric and nitric acid depositions.

A continuing rise in acid deposition can cause forest degradation. In China, acid deposition has converted gradually from sulfuric acid deposition (SAD) to nitric acid deposition (NAD). However, the differing responses of photosynthesis and growth to depositions of sulfuric vs. nitric acid have not been well studied. In this study, 1-year-old seedlings of Schima superba, a dominant species in subtropical forests, were treated with two types of acid deposition SO4 (2-)/NO3 (-) ratios (8:1 and 0.7:1) with two applications (foliar spraying and soil drenching) at two pH levels (pH 3.5 and pH 2.5) over a period of 18 months. The results showed that the intensity, acid deposition type, and spraying method had significant effects on the physiological characteristics and growth performance of seedlings. Acid deposition at pH 2.5 via foliar application reduced photosynthesis and growth of S. superba, especially in the first year. Unlike SAD, NAD with high acidity potentially alleviated the negative effects of acidity on physiological properties and growth, probably due to a fertilization effect that improved foliar nitrogen and chlorophyll contents. Our results suggest that trees were damaged mainly by direct acid stress in the short term, whereas in the long term, soil acidification was also likely to be a major risk to forest ecosystems. Our data suggest that the shift in acid deposition type may complicate the ongoing challenge of anthropogenic acid deposition to ecosystem stability.

[Applicability analysis of spatially explicit model of leaf litter in evergreen broad-leaved forests].

The spatially explicit model of leaf litter can help to understand its dispersal process, which is very important to predict the distribution pattern of leaves on the surface of the earth. In this paper, the spatially explicit model of leaf litter was developed for 20 tree species using litter trap data from the mapped forest plot in an evergreen broad-leaved forest in Tiantong, Zhejiang Pro- vince, eastern China. Applicability of the model was analyzed. The model assumed an allometric equation between diameter at breast height (DBH) and leaf litter amount, and the leaf litter declined exponentially with the distance. Model parameters were estimated by the maximum likelihood method. Results showed that the predicted and measured leaf litter amounts were significantly correlated, but the prediction accuracies varied widely for the different tree species, averaging at 49.3% and ranging from 16.0% and 74.0%. Model qualities of tree species significantly correlated with the standard deviations of the leaf litter amount per trap, DBH of the tree species and the average leaf dry mass of tree species. There were several ways to improve the forecast precision of the model, such as installing the litterfall traps according to the distribution of the tree to cover the different classes of the DBH and distance apart from the parent trees, determining the optimal dispersal function of each tree species, and optimizing the existing dispersal function.

[The value of coexisting pneumonia and British Thoracic Society CURB-65 score in predicting early mortality rate in patients with acute exacerbation of chronic obstructive pulmonary disease].

OBJECTIVE: To investigate the value of coexisting pneumonia and British Thoracic Society CURB-65 score in predicting early mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: In this prospective study, 483 consecutive in-patients with AECOPD were recruited between January 2010 and September 2012, including 295 males and 188 females. The patients were aged 45 to 92 years. They were divided into 2 groups: non-pneumonia (npAECOPD) and with pneumonia (pAECOPD). The start point of this study was the date when the patients were admitted into the respiratory ward, and the endpoint was the 30 day mortality. Clinical and demographic data were collected for all the patients, and the value of coexisting pneumonia and CURB-65 in predicting in-hospital mortality and 30 day mortality were assessed and compared. RESULTS: According to the inclusion/exclusion criteria, eventually 457 patients were included in this research, with 278 males and 179 females, and an average age of (75 ± 9) years. Of the 457 patients, 120 (26.3%) patients were in the pAECOPD group and 337 (73.7%) patients in the npAECOPD group. The in-hospital mortality, the 30 day mortality and the assisted ventilation rate were significantly higher in the pAECOPD group as compared to the npAECOPD group 18.3% (22/120) vs 4.7% (16/337), 21.7% (26/120) vs 7.4% (25/337); 49.2% (59/120) vs 27.0% (91/337), χ(2) = 18.1 - 21.4, all P < 0.05, respectively. Furthermore, the in-hospital mortality of the pAECOPD patients with CURB-65 score < 2, = 2 and > 2 was 4.4% (2/45), 15.2% (7/46) and 44.8% (13/29), respectively, while that of the npAECOPD patients was 0.9% (1/113), 3.4% (4/119) and 10.5% (11/105), respectively. The 30 day mortality of the pAECOPD patients with CURB-65 score < 2, = 2 and > 2 was 4.4% (2/45), 19.6% (9/46) and 51.7% (15/29), respectively, while that of the npAECOPD patients was 0.9% (1/113), 5.0% (6/119) and 17.1% (18/105), respectively. Stratified by CURB-65 Score, the in-hospital and 30 day mortality were both significantly higher in the pAECOPD group than in the npAECOPD group when CURB-65 was ≥ 2 (χ(2) = 5.8 - 10.1, P < 0.05 and P < 0.01, respectively). The AUROC analysis of CURB-65 as a predictor for early mortality resulted in an area under curve of 0.744. CONCLUSIONS: In patients with AECOPD, coexisting pneumonia is not only a risk factor for in-hospital mortality, but also a predictor for the treatment of assisted ventilation. CURB-65 score may be a good predictor for early mortality in patients with AECOPD.

Scaling relationships among twig size, leaf size and leafing intensity in a successional series of subtropical forests.

Scaling relationships among twig size, leaf size and leafing intensity fundamentally influence the twig-leaf deployment pattern, a property that affects the architecture and functioning of plants. However, our understanding of how these relationships change within a species or between species as a function of forest succession is unclear. We determined log-log scaling relationships between twig cross-sectional area (twig size) and each of total and individual leaf area, and leafing intensity (the number of leaves per twig volume) for 78 woody species along a successional series in subtropical evergreen forests in eastern China. The series included four stages: secondary shrub (S1), young (S2), sub-climax (S3) and climax evergreen broadleaved forests (S4). The scaling slopes in each of the three relationships did not differ among the four stages. The y-intercept did not shift among the successional stages in the relationship between twig cross-sectional area and total leaf area; however, the y-intercept was greatest in S4, intermediate in S3 and lowest in S2 and S1 for the relationship between twig size and individual leaf area, while the opposite pattern was found for the twig size-leafing intensity relationship. This indicates that late successional trees have few but large leaves while early successional trees have more small leaves per unit twig size. For the relationship between twig cross-sectional area and total leaf area, there was no difference in the regression slope between recurrent (appear in more than one stages) and non-recurrent species (appear in only one stage) for each of the S1-S2, S2-S3 and S3-S4 pairs. A significant difference in the y-intercept was found in the S2-S3 pair only. In the relationship between twig cross-sectional area and individual leaf area, the regression slope between recurrent and non-recurrent species was homogeneous in the S1-S2 and S3-S4 pairs, but heterogeneous in the S2-S3 pair. We conclude that forest succession caused the shift in the intercept, but did not affect scaling slopes for relationships among twig size, leaf size and leaf intensity. For recurrent species, the invariant scaling slope in the twig-leaf size relationship between adjacent pairs of successional stages may be related to their phenotypic plasticity by adjusting their twig and leaf deployment strategy to similar to what the non-recurrent species display.

[Topographic distribution patterns of forest gap within an evergreen broad-leaved forest in Tiantong region of Zhejiang Province, Eastern China].

To explore the effects of multi-dimensional topographic factors on forest gap distribution, the forest gaps in a 20 hm2 dynamic monitoring plot of an evergreen broad-leaved forest in Tiantong region of Zhejiang were taken as the objects to study the distribution patterns of the gap fraction, gap density, and gap area under the effects of altitude, slope degree, slope shape, slope aspect, and slope position by using a geographic information system (GIS) software. In the plot, the gap fraction was 13.1% , gap density was 9.5 ind.hm-2, and average gap area was 137.82 m2. Because of the greater intensity of typhoon disturbance at high altitudes, the gap fraction and gap density at the high altitude (> or =500 m) sections were significantly larger than those at the medium and low altitude (<500 m) sections. The heavy precipitation produced by typhoon could easily cause small scale landslide, and thus, lead to the gap fraction and gap density being larger in valley area than in side-slope and ridge. It was suggested that typhoon and its produced heavy precipitation could be the main causes of the significant differences in the forest gaps along the gradients of altitude and slope position.

Plant trait-species abundance relationships vary with environmental properties in subtropical forests in eastern china.

Understanding how plant trait-species abundance relationships change with a range of single and multivariate environmental properties is crucial for explaining species abundance and rarity. In this study, the abundance of 94 woody plant species was examined and related to 15 plant leaf and wood traits at both local and landscape scales involving 31 plots in subtropical forests in eastern China. Further, plant trait-species abundance relationships were related to a range of single and multivariate (PCA axes) environmental properties such as air humidity, soil moisture content, soil temperature, soil pH, and soil organic matter, nitrogen (N) and phosphorus (P) contents. At the landscape scale, plant maximum height, and twig and stem wood densities were positively correlated, whereas mean leaf area (MLA), leaf N concentration (LN), and total leaf area per twig size (TLA) were negatively correlated with species abundance. At the plot scale, plant maximum height, leaf and twig dry matter contents, twig and stem wood densities were positively correlated, but MLA, specific leaf area, LN, leaf P concentration and TLA were negatively correlated with species abundance. Plant trait-species abundance relationships shifted over the range of seven single environmental properties and along multivariate environmental axes in a similar way. In conclusion, strong relationships between plant traits and species abundance existed among and within communities. Significant shifts in plant trait-species abundance relationships in a range of environmental properties suggest strong environmental filtering processes that influence species abundance and rarity in the studied subtropical forests.

[Effects of nitrogen and phosphorus fertilization on litterfall production and nutrient dynamics in a Schima superba forest in Zhejiang Province of East China].

In 2011, an investigation was made on the litterfall production and nutrient dynamics in a phosphorus-limited subtropical evergreen broadleaved forest dominated by Schima superba in Tiantong, Zhejiang Province of East China under different levels of nitrogen (N) and phosphorous (P) fertilization. After the N and P fertilization, the annual litterfall production ranged from 6.82 to 8.30 t x hm(-2) x a(-1), with three peaks in May or June, August, and October, respectively. Under fertilization, the annual average N and P concentrations of the litterfall (except the annual average N concentration under P fertilization) increased, and had a seasonal variation. There were no significant differences in the nitrogen return amount (60.05-71.47 kg x hm(-2) x a(-1)) and phosphorus return amount (2.94-3.93 kg x hm(-2) x a(-1)) of the litterfall among different treatments. As compared to the control, the N:P ratio of the litterfall under fertilization was higher at the beginning of the experiment (spring, 2011), but lower in the winter, 2011, indicating that nitrogen and phosphorus fertilization could alter the original nitrogen and phosphorus limited conditions of the studied forest ecosystem.

[Spatial heterogeneity of soil properties and its relationships with terrain factors in broad-leaved forest in Tiantong of Zhejiang Province, East China].

By using geostatistical methods, this paper studied the spatial heterogeneity and distribution patterns of soil pH, total carbon, total nitrogen, and total phosphorus in an evergreen broad-leaved forest in Tiantong of Zhejiang Province, and the effects of terrain factors (elevation, convexity, and slope) on the soil properties were quantified based on RDA ordination and partial regression analysis. The coefficient of variation for the soil pH, total carbon, total nitrogen, and total phosphorus was 5.18%, 42.98%, 36.55%, and 46.27%, respectively, and the spatial dependence of the soil properties was at a scale of 81.6-54.5 m. The soil pH, total carbon, and total nitrogen had moderate spatial autocorrelation, while the soil total phosphorus had a strong spatial autocorrelation. The soil pH, total carbon, and total nitrogen showed scattered spatial distribution, while the soil total phosphorus presented banded type. Among the terrain factors, convexity had the strongest effects on the soil pH and total phosphorus, both of which had negative correlation with convexity, and the convexity could explain 21.24% and 14.62% of the spatial variability of soil pH and total phosphorus, respectively. Elevation had the most powerful effects on the soil total carbon and total nitrogen, both of which had positive correlation with elevation, and the elevation could explain 10.54% and 10.60% of the spatial variability of soil total carbon and total nitrogen, respectively. There existed differences in the effects of different terrain factors on the spatial variability of the soil properties, which was related to the effects of terrain factors on the distribution of acidic rainfall in the region and on the local soil moisture content and air temperature.

[The study in immunology after skin transplantation].

Skin grafting has been one of the most important approaches for covering burn wounds, however long-term survival of allogeneic or xenogeneic skin graft is currently not successful. How to induce immune tolerance for life-time survival of allogeneic or xenogeneic skin graft is still remote objective to be solved. However, clinicians and scientists in China have worked very hard and made great contribution to this field during the past 50 years, no matter how difficult it is. They are the respected pioneers in the understanding of immunological change in "Chinese Method" skin grafting, its local immune tolerance, immunology of pre-treatment of skin graft, etc. Herein, the most outstanding and impressive progresses in immunological responses after skin grafting in the past 50 years in China have been reviewed and presented for memory, for future and for extending a salute.

[Experimental study on the antibacterial effects of zirconium phosphate gauze loaded with silver on the common bacteria on rat burn wound].

OBJECTIVE: To investigate the antibacterial effects of zirconium phosphate gauze loaded with silver on rat burn wounds seeded with commonly seen bacteria. METHODS: Wistar rats were employed in the study and were scalded and infected. The minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC) of zirconium phosphate loaded with silver were determined by double dilution in tubes. The effect on wound healing and the subeschar bacterial count of the rat burn wounds were observed after the wounds had been covered by gauze loaded with zirconium phosphate and silver, and also with the gauze which has been rinsed for 20 times. RESULTS: The MIC of silver loaded zirconium phosphate on Staphylococcus aureus, Pseudomonas aeruginosa and E. coli were 8, 8 and 16 mg/L, respectively, while the MBC were 16, 8 and 32 mg/L, respectively. The subeschar bacterial count in the burn wounds with the gauze with silver loaded zirconium phosphate was ten times lower than that in those which were treated with gauze with SD-Ag and 100 times lower than that with ordinary gauze. But there was no difference in the bacterial count between the wounds which were treated with fresh gauze with silver loaded zirconium phosphate and that with the gauze which has been rinsed for 20 times (P > 0.05). Furthermore, wound healing seemed to be better with the gauze with silver loaded zirconium phosphate when compared with those by the other two kinds of gauze. CONCLUSION: The silver loaded zirconium phosphate was found to be bacteriocidal against bacteria commonly seen in the burn wounds.

[Effect of ligustrazine on airway remodeling in asthmatic rats].

OBJECTIVE: To observe the effect and mechanism of ligustrazine on the airway remodeling. METHODS: Thirty-two SD rats were randomly divided into 4 groups: the normal group (A), the model group (B), the ligustrazine low-dose group (C, 40 mg/kg) and the ligustrazine high-dose group (D, 80 mg/kg), with 8 rats in each group. The chronic asthmatic model was established by repeated inhalation of ovalbumin. The changes of collagen and transforming growth factor-beta(1) (TGF-beta(1)) contents in the airway wall, the thickness of smooth muscle and basement membrane, inner and outer diameter were measured by the computerized image analysis system. RESULTS: The thickness of smooth muscle and basement membrane were (11.3 +/- 1.3, 11.3 +/- 1.7) microm in D group, (19.7 +/- 1.8, 19.8 +/- 1.6) microm in B group, the difference being significant (P < 0.01), as compared with A group [(10.6 +/- 1.2) microm, (9.8 +/- 1.6) microm] and C group [(11.6 +/- 0.9) microm, (12.3 +/- 1.8) microm], the difference being not significant (all P > 0.05). The difference in the ratio of inner diameter to outer diameter was significant between D group (0.77 +/- 0.06) and B group (0.63 +/- 0.05), P < 0.01. The contents of collagen type III and TGF-beta(1) were (21 +/- 5, 26 +/- 5) in D group, (55 +/- 7, 69 +/- 14) in B group, the difference being significant (P < 0.01). The differences were also significant when C group [32 +/- 8, 38 +/- 10] was compared with D group (P < 0.05) and B group (P < 0.01). The contents of collagen type I showed no difference among the 4 groups (A group: 34 +/- 13, B group: 44 +/- 8, C group: 36 +/- 8, D group: 39 +/- 8; all P > 0.05). A close correlation between TGF-beta(1) and collagen type III was demonstrated (r = 0.844 2, P < 0.01). CONCLUSION: Ligustrazine might suppress airway remodeling by decreasing the expression of TGF-beta(1) and reducing deposition of collagen.

[An experimental study on the role of indirect antigen presentation pathway on the immunogenetic of epidermal cells].

OBJECTIVE: To explore the role of indirect antigen presentation pathway on the immunogenecity of epidermal cells. METHODS: Human epidermal cells (HEC), allogeneic human peripheral blood lymphocytes (PBL) and mononuclear cells (PBM, including monocytes) were isolated and cultured in vitro. HECs were transfected by human-originated CTLA4Ig-adenovirus vector. The CTLA4Ig expression was observed. Allogeneic PBLs or PBMs were added to the transfected and non-transfected HECs with simple cultured PBLs and PBMs as the control. The proliferation of PBL and PBM was determined by (3)H-TdR incooperation. RESULTS: HECs could be successfully transfected by CTLA4Ig-adenovirus vector and expressed corresponding proteins. The non-transfected HECs could stimulate slight proliferation of allogeneic PBLs (P < 0.05) and stimulate remarkable proliferation of PBMs (including monocytes) (P < 0.05). The proliferation reaction of PBLs and PBMs decreased significantly (P < 0.05) after being stimulated by HEC which was modulated by CTLA4Ig genes. CONCLUSION: Indirect antigen presentation pathway might play important roles in the HEC immunogenicity which could be evidently inhibited by CTLA4Ig.