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Dam construction alters the hydrodynamic conditions, consequently impacting the swimming behavior of fish. To explore the effect of flow hydrodynamics on fish swimming behavior, five endemic fish species in the upper Yangtze River basin were selected. Through high-speed video visualization and computer analysis, these species' swimming patterns under different flow velocities (0.1-1.2 m/s) were investigated. The kinematic and morphological characteristics of the fish were presented. The principal component analysis was used to analyse the main factors influencing the swimming ability of fish and to determine the correlation coefficients among fish behavior indicators. Fish exhibited three different swimming patterns under different flow velocities. Low velocity (0.1-0.3 m/s) corresponds to free motion, middle velocity (0.4-0.7 m/s) corresponds to cruising motion, and high velocity corresponds to stress motion (0.8-1.2 m/s). The fish kinematic index curves were obtained, and four of five fish species showed two extreme points, which means the optimal and adverse swimming strategies can be determined. With the increase in flow velocity, the tail-beat frequency showed an increasing trend, whereas the tail-beat angle and amplitude showed a decreasing trend. Morphological and kinematic parameters were the two main indexes that affect the swimming ability of fish, which accounts for 41.9% and 26.9%, respectively.
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Hidrodinámica , Ríos , Natación , Animales , China , Fenómenos Biomecánicos , Peces/fisiología , Peces/anatomía & histología , Análisis de Componente Principal , Grabación en VideoRESUMEN
The emergence of nanomotor provides an innovative concept for tumor treatment strategies. Conventional chemotherapeutic agents for tumors exit various therapeutic constraints due to the unique microenvironment of the tumor itself. Calcium overload, the aberrant accumulation of free calcium ions in the cytoplasm, is a well-recognized contributor to damage and even cell death in numerous cell types. Such undesired destructive processes can be a novel means applicable to cancer ion interference therapy. Herein, the chemotherapeutic drug doxorubicin (DOX) and calcium peroxide as the driving force into nanomotors through a facile and understandable experimental scheme are successfully assembled. The modification of nucleic acid aptamer and NIR-II fluorescent molecules on its surface simultaneously strengthens both the active targeting and imaging capability of tumor loci. Therefore, by a comprehensive assessment of nanomotors both in vitro and in vivo experiments, CaO2/DOX@HPS-IR-1061-AS1411 demonstrates superior killing effects on tumor cells, and the intracellular reactive oxygen species produced by nanomotors is verified by molecular biology experiments to induce apoptosis of tumor cells and further achieve tumor therapeutic effects.
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Doxorrubicina , Neoplasias , Doxorrubicina/farmacología , Doxorrubicina/química , Doxorrubicina/uso terapéutico , Humanos , Animales , Línea Celular Tumoral , Ratones , Neoplasias/tratamiento farmacológico , Neoplasias/metabolismo , Neoplasias/patología , Especies Reactivas de Oxígeno/metabolismo , Peróxidos/química , Peróxidos/farmacología , Apoptosis/efectos de los fármacos , Aptámeros de Nucleótidos/química , Aptámeros de Nucleótidos/farmacología , Nanopartículas/química , Antineoplásicos/farmacología , Antineoplásicos/química , Antineoplásicos/uso terapéutico , Ratones Desnudos , Ratones Endogámicos BALB CRESUMEN
Oil well cement is prone to corrosion and damage in carbon dioxide (CO2) acidic gas wells. In order to improve the anti-corrosion ability of oil well cement, polymer resin was used as the anti-corrosion material. The effect of polymer resin on the mechanical and corrosion properties of oil well cement was studied. The corrosion law of polymer anti-corrosion cement in an acidic gas environment was studied. The long-term corrosion degree of polymer anti-corrosion cement was evaluated using an improved neural network model. The cluster particle algorithm (PSO) was used to improve the accuracy of the neural network model. The results indicate that in acidic gas environments, the compressive strength of polymer anti-corrosion cement was reduced under the effect of CO2, and the corrosion depth was increased. The R2 of the prediction model PSO-BPNN3 is 0.9970, and the test error is 0.0136. When corroded for 365 days at 50 °C and 25 MPa pressure of CO2, the corrosion degree of the polymer anti-corrosion cement was 43.6%. The corrosion depth of uncorroded cement stone is 76.69%, which is relatively reduced by 33.09%. The corrosion resistance of cement can be effectively improved by using polymer resin. Using the PSO-BP neural network to evaluate the long-term corrosion changes of polymer anti-corrosion cement under complex acidic gas conditions guides the evaluation of its corrosion resistance.
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The construction of fish passage facilities can mitigate the negative effects of dams and other water engineering construction on river connectivity and have a significant positive effect on the conservation of local fish diversity. To attract target fishes into fish passage facilities effectively, the optimal flow velocity range to attract fish must be determined. Three local endemic species of the Mishi Reservoir were considered as the protection targets. However, their swimming abilities remain unclear. Therefore, the induced swimming speed (Uind), critical swimming speed (Ucrit) and burst swimming speed (Uburst) of three fish species were tested. Based on these results, we identified the optimal flow velocity to attract fish, which falls within the range of 0.15-0.51 m/s. A validated three-dimensional hydrodynamic model was used to simulate different schemes. By comparing the flow field simulation results of different schemes, we obtained the optimal measure to restore the flow field, namely, a multiple engineering measure combining increased the fish attraction flow in the fish collection pond and the construction of a spur dike. This study offers a solution for the specific case and enhances the database of swimming characteristics of endemic fish in the upstream reaches of the Yangtze River. It also provides a valuable reference for designing fish-attracting flows and potential measures for restoring flow fields in similar future projects.
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Peces , Natación , Animales , Ríos , Movimientos del Agua , Hidrodinámica , EcosistemaRESUMEN
Gene therapy has shown great potential in the treatment of many diseases by downregulating the expression of certain genes. The development of gene vectors as a vehicle for gene therapy has greatly facilitated the widespread clinical application of nucleic acid materials (DNA, mRNA, siRNA, and miRNA). Currently, both viral and non-viral vectors are used as delivery systems of nucleic acid materials for gene therapy. However, viral vector-based gene therapy has several limitations, including immunogenicity and carcinogenesis caused by the exogenous viral vectors. To address these issues, non-viral nanocarrier-based gene therapy has been explored for superior performance with enhanced gene stability, high treatment efficiency, improved tumor-targeting, and better biocompatibility. In this review, we discuss various non-viral vector-mediated gene therapy approaches using multifunctional biodegradable or non-biodegradable nanocarriers, including polymer-based nanoparticles, lipid-based nanoparticles, carbon nanotubes, gold nanoparticles (AuNPs), quantum dots (QDs), silica nanoparticles, metal-based nanoparticles and two-dimensional nanocarriers. Various strategies to construct non-viral nanocarriers based on their delivery efficiency of targeted genes will be introduced. Subsequently, we discuss the cellular uptake pathways of non-viral nanocarriers. In addition, multifunctional gene therapy based on non-viral nanocarriers is summarized, in which the gene therapy can be combined with other treatments, such as photothermal therapy (PTT), photodynamic therapy (PDT), immunotherapy and chemotherapy. We also provide a comprehensive discussion of the biological toxicity and safety of non-viral vector-based gene therapy. Finally, the present limitations and challenges of non-viral nanocarriers for gene therapy in future clinical research are discussed, to promote wider clinical applications of non-viral vector-based gene therapy.
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Nanopartículas del Metal , Nanotubos de Carbono , Ácidos Nucleicos , Oro , Terapia GenéticaRESUMEN
A new research idea may be inspired by the connections of keywords. Link prediction discovers potential nonexisting links in an existing graph and has been applied in many applications. This article explores a method of discovering new research ideas based on link prediction, which predicts the possible connections of different keywords by analyzing the topological structure of the keyword graph. The patterns of links between keywords may be diversified due to different domains and different habits of authors. Therefore, it is often difficult for a single learner to extract diverse patterns of different research domains. To address this issue, groups of learners are organized with negative correlation to encourage the diversity of sublearners. Moreover, a hierarchical negative correlation mechanism is proposed to extract subgraph features in different order subgraphs, which improves the diversity by explicitly supervising the negative correlation on each layer of sublearners. Experiments are conducted to illustrate the effectiveness of the proposed model to discover new research ideas. Under the premise of ensuring the performance of the model, the proposed method consumes less time and computational cost compared with other ensemble methods.
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During the development of colorectal cancer, tumor cells will generate some cancer stem cells with self-renewal ability because they adapt to the environment. Therefore, in the treatment of colorectal cancer, it has certain potential clinical application value to effectively inhibit cancer stem cells. A small molecule EHMT-2 inhibitor, BIX-01294, was evaluated for its activity in inhibiting cancer stem cells in human colorectal cancer by in vitro and in vivo experiments. Transcriptome analysis was performed on BIX-01294 treated cells for holistic analysis to elucidate how BIX-01294 inhibits the expression of genes related to cancer stem cells. The results show that BIX-01294 significantly inhibited the proliferative phenotype of human colorectal cancer in vivo and in vitro, reduced the proportion of cancer stem cells, and inhibited some stemness-related gene. Morever, it is synergistic with 5-fluorouracil in inhibiting the proliferation of colorectal cancer. In summary, EHMT-2 is a novel target of anti-tumor drugs. The combination of BIX-01294 and 5-fluorouracil has a synergistic therapeutic effect on human colorectal cancer.
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Azepinas/uso terapéutico , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/genética , Regulación Neoplásica de la Expresión Génica , Células Madre Neoplásicas/metabolismo , Quinazolinas/uso terapéutico , Animales , Azepinas/farmacología , Biomarcadores de Tumor/metabolismo , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Movimiento Celular/genética , Proliferación Celular/efectos de los fármacos , Proliferación Celular/genética , Femenino , Fluorouracilo/farmacología , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Antígenos de Histocompatibilidad/genética , Antígenos de Histocompatibilidad/metabolismo , N-Metiltransferasa de Histona-Lisina/genética , N-Metiltransferasa de Histona-Lisina/metabolismo , Humanos , Ratones Endogámicos BALB C , Ratones Desnudos , Células Madre Neoplásicas/efectos de los fármacos , Células Madre Neoplásicas/patología , Quinazolinas/farmacología , Receptores Acoplados a Proteínas G/metabolismoRESUMEN
We investigate the fluorescence from submonolayer rhodamine 6G molecules near gold nanoparticles (NPs) at a well-controlled poly (methyl methacrylate) (PMMA) interval thickness from 1.5 to 21 nm. The plasmonic resonance peaks of gold NPs are tuned from 530 to 580 nm by the PMMA spacer of different thicknesses. Then, due to the plasmonic resonant excitation enhancement, the emission intensity of rhodamine 6G molecules at 562 nm is found to be enhanced and shows a decline as the PMMA spacer thickness increases. The variation of spectral intensity simulated by finite-difference time-domain method is consistent with the experimental results. Moreover, the lifetime results show the combined effects to rhodamine 6G fluorescence, which include the quenching effect, the barrier effect of PMMA as spacer layer and the attenuation effect of PMMA films.
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The circadian clock plays a key role in our daily physiology and metabolism. Alcohol consumption disrupts the circadian rhythm of metabolic genes in the liver; however, the potential contribution of circadian clock modulation to alcoholic liver disease (ALD) is unknown. We identified a novel liver protective agent, physcion, which can alleviate fat accumulation and inflammation in ALD mice via reprogramming the hepatic circadian clock. The model of alcoholic hepatitis was established by intragastrically administering ethanol. In vitro, physcion was investigated by treating HepG2 cells with ethanol. The role of circadian clock in Physcion caused liver protection was tested by knocking down the core circadian gene Bmal1. Physcion application caused reduced lipogenesis and alleviated inflammation in alcohol-induced mice. In alcoholic hepatosteatosis models, physcion upregulated the core circadian genes. And the circadian misalignment triggered by ethanol was efficiently reversed by physcion. Physcion attenuated lipogenesis via reprogramming the circadian clock in HepG2 cells. Suppression of Bmal1 by RNA interference abolished the protective of physcion. In addition, Physcion binds to the active pocket of BMAL1 and promotes its expression. The study identified the novel liver protective effects of physcion on alcohol-induced liver injury, and modulation of the core circadian clock regulators contributes to ALD alleviation. More importantly, strategies targeting the circadian machinery, for example, Bmal1, may prove to be beneficial treatment options for this condition.
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InP QDs have shown a great potential as cadmium-free QDs alternatives in biomedical applications. It is essential to understand the biological fate and toxicity of InP QDs. In this study, we investigated the in vivo renal toxicity of InP/ZnS QDs terminated with different functional groups-hydroxyl (hQDs), amino (aQDs) and carboxyl (cQDs). After a single intravenous injection into BALB/c mice, blood biochemistry, QDs distribution, histopathology, inflammatory response, oxidative stress and apoptosis genes were evaluated at different predetermined times. The results showed fluorescent signals from QDs could be detected in kidneys during the observation period. No obvious changes were observed in histopathological detection or biochemistry parameters. Inflammatory response and oxidative stress were found in the renal tissues of mice exposed to the three kinds of QDs. A significant increase of KIM-1 expression was observed in hQDs and aQDs groups, suggesting hQDs and aQDs could cause renal involvement. Apoptosis-related genes (Bax, Caspase 3, 7 and 9) were up-regulated in hQDs and aQDs groups. The above results suggested InP/ZnS QDs with different surface chemical properties would cause different biological behaviors and molecular actions in vivo. The surface chemical properties of QDs should be fully considered in the design of InP/ZnS QDs for biomedical applications.
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Indio/química , Indio/toxicidad , Riñón/efectos de los fármacos , Fosfinas/química , Fosfinas/toxicidad , Puntos Cuánticos/química , Puntos Cuánticos/toxicidad , Animales , Apoptosis/efectos de los fármacos , Apoptosis/genética , Dióxido de Carbono/química , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Radical Hidroxilo/química , Indio/administración & dosificación , Indio/farmacocinética , Inflamación/inducido químicamente , Inyecciones Intravenosas , Riñón/metabolismo , Ratones , Ratones Endogámicos BALB C , Estrés Oxidativo/efectos de los fármacos , Fosfinas/administración & dosificación , Fosfinas/farmacocinética , Puntos Cuánticos/administración & dosificación , Sulfuros/administración & dosificación , Sulfuros/química , Sulfuros/farmacocinética , Sulfuros/toxicidad , Propiedades de Superficie , Distribución Tisular , Compuestos de Zinc/administración & dosificación , Compuestos de Zinc/química , Compuestos de Zinc/farmacocinética , Compuestos de Zinc/toxicidadRESUMEN
Multiple sclerosis (MS) is an autoimmune disease characterized by T cell infiltration and demyelination of the central nervous system (CNS). Experimental autoimmune encephalomyelitis (EAE) is a classical preclinical animal model of MS. In this study, we found that rotating magnetic field (RMF) treatment exerts potential preventive effects on the discovery of EAE, including reducing the severity of the disease and delaying the onset of the disease. The results indicated that RMF (0.2 T, 4 Hz) treatment increases the accumulation of CD4+ cells in the spleen and lymph nodes by downregulating the expression of CCL-2, CCL-3 and CCL-5, but has no significant effect on myelin oligodendrocyte glycoprotein (MOG) specific T cell responses. Simultaneously, RMF treatment adjusted the imbalance between regulatory T (Treg) cell and T helper 1 (Th1) cells or T helper 17 (Th17) cells by increasing the proportion of Treg cells and inhibiting the ratio of Th1 and Th17 cell subsets. These findings suggest that exposure to RMF may improve EAE disease by promoting CD4+ cell accumulation into peripheral lymphoid tissue, improving the imbalance between Treg and Th1/Th17 cells. Therefore, as a mild physical therapy approach, RMF, is likely to be a potential way to alter the development of EAE.
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Linfocitos T CD4-Positivos , Encefalomielitis Autoinmune Experimental , Ganglios Linfáticos/patología , Magnetoterapia/métodos , Esclerosis Múltiple , Bazo/patología , Linfocitos T Reguladores , Células TH1 , Células Th17 , Animales , Recuento de Células/métodos , Citocinas/análisis , Encefalomielitis Autoinmune Experimental/inmunología , Encefalomielitis Autoinmune Experimental/patología , Encefalomielitis Autoinmune Experimental/terapia , Ratones , Esclerosis Múltiple/inmunología , Esclerosis Múltiple/terapia , Glicoproteína Mielina-Oligodendrócito/inmunología , Resultado del TratamientoRESUMEN
Precision medicine has received attention both in and outside the clinic. We focus on the latter, by exploiting the relationship between individuals' social interactions and their mental health to predict one's likelihood of being depressed or anxious from rich dynamic social network data. Existing studies differ from our work in at least one aspect: they do not model social interaction data as a network; they do so but analyze static network data; they examine "correlation" between social networks and health but without making any predictions; or they study other individual traits but not mental health. In a comprehensive evaluation, we show that our predictive model that uses dynamic social network data is superior to its static network as well as non-network equivalents when run on the same data. Supplementary material for this work is available at https://nd.edu/~cone/NetHealth/PSB_SM.pdf.
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Biología Computacional , Salud Mental , Red Social , Humanos , Modelos BiológicosRESUMEN
We report the generation of single negatively charged silicon vacancy (SiV-) color centers by focusing a femtosecond (fs) laser on top of a high-purity diamond coated with a layer of Si nanoball. Under the interaction of a high-intensity fs laser, Si atoms were ionized and implanted into the diamond, accompanied with the creation of vacancies. After annealing at 850°C in vacuum for 1 h, the photoluminescence spectra of bright spots around the created crater presented a typical strong zero-phonon line at around 737 nm of SiV- centers. Bright single SiV- color centers could be observed with a maximum saturating counting rate of 300×103 counts/s. We explain the formation mechanism of SiV- centers in diamond via a Coulomb explosion model. The results demonstrate that fs laser ablation can be utilized as a very promising tool to conveniently fabricate single bright SiV- centers in diamond.
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Chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are two pathologically distinct chronic lung diseases that are associated with cigarette smoking. Genetic studies have identified shared loci for COPD and IPF, including several loci with opposite directions of effect. The existence of additional shared genetic loci, as well as potential shared pathobiological mechanisms between the two diseases at the molecular level, remains to be explored. Taking a network-based approach, we built disease modules for COPD and IPF using genome-wide association studies-implicated genes. The two disease modules displayed strong disease signals in an independent gene expression data set of COPD and IPF lung tissue and showed statistically significant overlap and network proximity, sharing 19 genes, including ARHGAP12 and BCHE. To uncover pathways at the intersection of COPD and IPF, we developed a metric, NetPathScore, which prioritizes the pathways of a disease by their network overlap with another disease. Applying NetPathScore to the COPD and IPF disease modules enabled the determination of concordant and discordant pathways between these diseases. Concordant pathways between COPD and IPF included extracellular matrix remodeling, Mitogen-activated protein kinase (MAPK) signaling and ALK pathways, whereas discordant pathways included advanced glycosylation end product receptor signaling and telomere maintenance and extension pathways. Overall, our findings reveal shared molecular interaction regions between COPD and IPF and shed light on the congruent and incongruent biological processes lying at the intersection of these two complex diseases.
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Fibrosis Pulmonar Idiopática/genética , Pulmón/metabolismo , Enfermedad Pulmonar Obstructiva Crónica/genética , Quinasa de Linfoma Anaplásico/metabolismo , Matriz Extracelular/metabolismo , Femenino , Redes Reguladoras de Genes , Estudio de Asociación del Genoma Completo , Productos Finales de Glicación Avanzada/genética , Productos Finales de Glicación Avanzada/metabolismo , Humanos , Fibrosis Pulmonar Idiopática/metabolismo , Sistema de Señalización de MAP Quinasas/genética , Masculino , Fenotipo , Enfermedad Pulmonar Obstructiva Crónica/metabolismo , Homeostasis del Telómero/genéticaRESUMEN
Understanding the relationship between individuals' social networks and health could help devise public health interventions for reducing incidence of unhealthy behaviors or increasing prevalence of healthy ones. In this context, we explore the co-evolution of individuals' social network positions and physical activities. We are able to do so because the NetHealth study at the University of Notre Dame has generated both high-resolution longitudinal social network (e.g., SMS) data and high-resolution longitudinal health-related behavioral (e.g., Fitbit physical activity) data. We examine trait differences between (i) users whose social network positions (i.e., centralities) change over time versus those whose centralities remain stable, (ii) users whose Fitbit physical activities change over time versus those whose physical activities remain stable, and (iii) users whose centralities and their physical activities co-evolve, i.e., correlate with each other over time. We find that centralities of a majority of all nodes change with time. These users do not show any trait difference compared to time-stable users. However, if out of all users whose centralities change with time we focus on those whose physical activities also change with time, then the resulting users are more likely to be introverted than time-stable users. Moreover, users whose centralities and physical activities both change with time and whose evolving centralities are significantly correlated (i.e., co-evolve) with evolving physical activities are more likely to be introverted as well as anxious compared to those users who are time-stable and do not have a co-evolution relationship. Our network analysis framework reveals several links between individuals' social network structure, health-related behaviors, and the other (e.g., personality) traits. In the future, our study could lead to development of a predictive model of social network structure from behavioral/trait information and vice versa.
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BACKGROUND: Low vitamin D status in pregnancy was proposed as a risk factor of preeclampsia. METHODS: We assessed the effect of vitamin D supplementation (4,400 vs. 400 IU/day), initiated early in pregnancy (10-18 weeks), on the development of preeclampsia. The effects of serum vitamin D (25-hydroxyvitamin D [25OHD]) levels on preeclampsia incidence at trial entry and in the third trimester (32-38 weeks) were studied. We also conducted a nested case-control study of 157 women to investigate peripheral blood vitamin D-associated gene expression profiles at 10 to 18 weeks in 47 participants who developed preeclampsia. RESULTS: Of 881 women randomized, outcome data were available for 816, with 67 (8.2%) developing preeclampsia. There was no significant difference between treatment (N = 408) or control (N = 408) groups in the incidence of preeclampsia (8.08% vs. 8.33%, respectively; relative risk: 0.97; 95% CI, 0.61-1.53). However, in a cohort analysis and after adjustment for confounders, a significant effect of sufficient vitamin D status (25OHD ≥30 ng/ml) was observed in both early and late pregnancy compared with insufficient levels (25OHD <30 ng/ml) (adjusted odds ratio, 0.28; 95% CI, 0.10-0.96). Differential expression of 348 vitamin D-associated genes (158 upregulated) was found in peripheral blood of women who developed preeclampsia (FDR <0.05 in the Vitamin D Antenatal Asthma Reduction Trial [VDAART]; P < 0.05 in a replication cohort). Functional enrichment and network analyses of this vitamin D-associated gene set suggests several highly functional modules related to systematic inflammatory and immune responses, including some nodes with a high degree of connectivity. CONCLUSIONS: Vitamin D supplementation initiated in weeks 10-18 of pregnancy did not reduce preeclampsia incidence in the intention-to-treat paradigm. However, vitamin D levels of 30 ng/ml or higher at trial entry and in late pregnancy were associated with a lower risk of preeclampsia. Differentially expressed vitamin D-associated transcriptomes implicated the emergence of an early pregnancy, distinctive immune response in women who went on to develop preeclampsia. TRIAL REGISTRATION: ClinicalTrials.gov NCT00920621. FUNDING: Quebec Breast Cancer Foundation and Genome Canada Innovation Network. This trial was funded by the National Heart, Lung, and Blood Institute. For details see Acknowledgments.
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Suplementos Dietéticos , Preeclampsia/prevención & control , Primer Trimestre del Embarazo/sangre , Tercer Trimestre del Embarazo/sangre , Vitamina D/análogos & derivados , Adolescente , Adulto , Femenino , Humanos , Incidencia , Preeclampsia/sangre , Preeclampsia/epidemiología , Embarazo , Factores de Riesgo , Vitamina D/administración & dosificación , Vitamina D/farmacocinéticaRESUMEN
OBJECTIVE: To study the feasibility of applying expanded forehead axial flaps with fascia pedicles carrying bilateral frontal branches of superficial temporal artery and vein (expanded forehead axial flap with double pedicles in brief, EFAF-DP) in repairing scars in submaxillary region. METHODS: Sixteen patients with mandibular scars hospitalized in Department of Burns and Plastic Surgery of the First Hospital Affiliated to Fuzhou General Hospital in Nanjing Military Area Command from July 2005 to December 2009 were repaired with EFAF-DP. The operation consisted of 3 stages. Before operation, the location and course of superficial temporal arteries and veins (STAV) and their frontal and parietal branches were identified with Ultrasonic Doppler blood flow detector. In stage I, STAV were dissected from the frontalis muscle as a pedicle to form a skin soft tissue space to hold the dilator of a proper size. In stage II, after gradual dilation by repeated filling with saline, the dilator was removed. EFAF-DP was dissected to repair mandibular scar. Donor site was closed with sutures. In stage III, flap pedicles were divided and pruned. RESULTS: Flap sizes ranged from 25 cm × 6 cm to 33 cm × 16 cm. The duration of dilation was 3-5 months, with 3.6 months in average. Ten patients underwent the operation of EFAF-DP transplantation and cervical skin dilatation. All flaps survived with healing of wounds. Disorder of venous return at the distal end of one flap was seen after second stage surgery, and it was corrected after comprehensive treatment including relieving spasm and improving venous return. Donor site wounds healed with normally grown hair without cicatricial alopecia along the hairline. Few hairs grew around mandible in one female patient out of the three (no hair grew on flaps of other two patients). This female patient and two male patients requesting for beard plasty received laser depilation treatment 1 to 3 months after discharge, with good result. Other male patients received no special treatment for their beard, and they shaped their beard with shaver. Sixteen patients were followed up for 6 to 24 months, and the shape of the flaps and beard (excluding female patients) were satisfactory with good appearance, satisfactory skin color and texture. The mobility of neck was obviously improved. CONCLUSIONS: EFAF-DP provides bigger areas of a thin flap besides promoting vascularization of new vessels of flap. Extra expanded skin can be directly sutured at the fringe of hairline, which makes skin grafting unnecessary, and decreases the incidence of secondary deformity in donor sites. Some hair carried by the flaps can be directly used for beard reconstruction after rotation to help the male patients have a better appearance.
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Cicatriz/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Expansión de Tejido , Adolescente , Adulto , Femenino , Humanos , Masculino , Cirugía Plástica/métodos , Arterias Temporales/trasplante , Venas/trasplante , Adulto JovenRESUMEN
OBJECTIVE: To observe the early change in plasma brain natriuretic peptide (BNP) level in burn patients with long delayed fluid resuscitation of burn shock and its clinical significance. METHODS: Thirty-six burn patients with second and third degree of burn covering 32%-92% total body surface area were enrolled for the study, among them 10 patients were complicated with serious heart failure (heart failure group), and 26 patients rallied from shock after delayed fluid resuscitation without heart failure (stable group). The level of plasma BNP, lactate dehydrogenase (LDH), MB isoenzyme of creatine kinase (CK-MB), and left ventricle ejection fraction (LVEF) were determined at admission and 3 hours after hospitalization, and 24, 48, 72, 168 hours after the injury in both groups with electrochemiluminescence (ECL). RESULTS: Compared with stable group, the plasma BNP level (ng/L) of heart failure group at 3 hours after hospitalization, and 24, 48, 72 hours after the burn injury increased significantly (3 hours after hospitalization: 1 521.38+/-121.11 vs. 391.36+/-63.27, 24 hours after burn: 2 516.86+/-193.25 vs. 360.79+/-146.56, 48 hours after burn: 1 587.76+/-169.23 vs. 398.92+/-77.46, 72 hours after burn: 974.45+/-166.33 vs. 283.43+/-68.15, all P<0.01), the level of LVEF lowered significantly (3 hours after hospitalization : 0.33+/-0.03 vs. 0.58+/-0.09, 24 hours after burn: 0.36+/-0.09 vs. 0.60+/-0.10, 48 hours after burn: 0.35+/-0.08 vs. 0.62+/-0.11, 72 hours after burn: 0.39+/-0.10 vs. 0.64+/-0.10, all P<0.05). The levels of LDH (micromolxs(-1) xL(-1)) in stable group were 2.87+/-0.50 at admission, 3.02+/-0.43 3 hours after hospitalization, 4.02+/-0.87 24 hours after burn, 6.90+/-0.87 48 hours after burn, 3.64+/-0.75 72 hours after burn, 2.67+/-0.45 168 hours after burn while in heart failure group, they were 2.97+/-1.40, 3.84+/-0.37, 4.29+/-0.45, 8.50+/-0.38, 3.84+/-0.62, 2.30+/-0.38, respectively; and CK-MB (U/L) in stable group were 59.12+/-13.75 at admission, 70.39+/-10.72 3 hours after hospitalization, 79.29+/-17.27 24 hours after burn, 67.44+/-12.77 48 hours after burn, 30.28+/-7.13 72 hours after burn, 21.44+/-3.15 168 hours after burn while in heart failure group, they were 65.76+/-16.38, 81.46+/-7.92, 86.43+/-14.19, 72.53+/-11.27, 36.39+/-6.18, 22.85+/-7.26, respectively. No statistically significant difference was found in changes in both LDH and CK-MB between two groups (all P>0.05). CONCLUSION: Determination of the plasma BNP is a simple and useful method in detecting heart failure during resuscitation of shock after a serious burn injury.
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Quemaduras/complicaciones , Péptido Natriurético Encefálico/sangre , Resucitación/métodos , Choque/sangre , Adolescente , Adulto , Niño , Preescolar , Femenino , Fluidoterapia , Insuficiencia Cardíaca/etiología , Humanos , Masculino , Persona de Mediana Edad , Choque/etiología , Choque/terapia , Adulto JovenRESUMEN
OBJECTIVE: To investigate the protective effects of the reduced glutathione (GSH) on hepatic injury after delayed resuscitation in patients with severe burn. METHODS: Forty severely burned patients with hepatic injury after delayed resuscitation were randomly divided into two groups: treatment group (T, 20 cases) and control group (C, 20 cases). In the T group, the patients were treated with GSH for 7-14 days, while the patients in the C group were treated with same quantity of "energy mixture" as control. The venous blood sample of each patient of the two groups was collected and examined for the content of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltranspeptidase (gamma-GT), alkaline phosphatase (ALP), total bilirubin (TBIL), and direct bilirubin (DBIL) before the treatment and 7 days and 14 days after the treatment. RESULTS: The contents of the enzymes in the T group were significantly decreasing gradually in all patients after 7 days and 14 days of treatment (P<0.05 or P<0.01). In the C group, the enzymes showed a decrease in quantity 7 days after the management but without statistical significance. However, they still showed significant decrease on 14th day with the "energy mixture" treatment (all P<0.05). After 14 days of the treatment, ALT, AST, gamma-GT, TBIL and DBIL showed obvious decrease in the T group compared to the C group (all P<0.05), but there was no significant difference in ALP between the two groups. CONCLUSION: The results of this study indicates that early use of GSH may be beneficial in the management of protecting hepatic injury after delayed resuscitation for severe burn.
Asunto(s)
Quemaduras/fisiopatología , Glutatión/uso terapéutico , Hígado/fisiopatología , Adolescente , Adulto , Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Quemaduras/sangre , Quemaduras/tratamiento farmacológico , Niño , Preescolar , Femenino , Humanos , Lactante , Hígado/efectos de los fármacos , Masculino , Persona de Mediana Edad , Resucitación , Adulto Joven , gamma-Glutamiltransferasa/sangreRESUMEN
OBJECTIVE: To investigate the changes in myocardial dynamics in early phases of burn shock of dogs and the effects of rapid fluid infusion in delayed resuscitation. METHODS: Twelve mongrel dogs were randomly divided into control (n=6) and burn (n=6) groups. The dogs in burn group were subjected to 35% total body surface area (TBSA) III degree burn and were resuscitated with lactate Ringer's solution 6 hours postburn. The volumes and rates of fluid infusion were controlled basically on the urinary output of 1.0 mlxkg(-1)xh(-1) and cardiac output (CO) of 70%-80% of pre-burn values. The mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), maximum rate of intraventricular pressure rise/down (+/-dp/dt max) and cardiac index (CI) were determined at 0.5, 1,2, 6, 7, 8, 10 and 24 hours postburn. RESULTS: The MAP, LVSP, +/-dp/dt max and CI were significantly lowered from their baseline and those of control group at 0.5 hour postburn, and they kept declining until 6 hours postburn. They showed a tendency of elevation and reached or approached the levels of that in control group within 2 hours of resuscitation, and the differences were not significant between the two groups 4 hours after burn (all P>0.05). The amount of infusion fluid within the first 4 hours of resuscitation was (3.63+/-0.99) ml/kg per 1% TBSA. CONCLUSION: The myocardial dynamics is depressed in the early stage of burn, the effective way to improve it is to infuse a large amount of fluid rapidly when resuscitation is delayed.