[Application of laser speckle perfusion imaging in predicting wound healing time of burn patients].

Objective: To explore the application effect of laser speckle perfusion imaging (LSPI) in predicting wound healing time of burn patients. Methods: LSPI was performed in 84 adult burn patients hospitalized in department of burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital within post injury hour (PIH) 24 to 72 to detect the blood perfusion values of the wounds. The wound healing time was recorded. The 128 wounds were divided into superficial group (wound healing time shorter than or equal to 14 d, n=57) and deep group (wound healing time longer than 14 d and shorter than or equal to 28 d, n=71) according to the healing time. The blood perfusion values of the two groups were compared. Data were processed with t test or chi-square test. The receiver operating characteristic (ROC) curve was drawn and Youden index was calculated to determine the optimal critical blood perfusion value of wound healing time of the two groups, and the validity of the critical value was assessed by Kappa consistency test. Results: (1) The blood perfusion value of woundsin superficial group was (6.8±1.8) perfusion unit (PU), which was significantly higher than (3.5±1.3) PU in deep group (t=11.404, P<0.01). (2) The total area under ROC curve of blood perfusion value to predict wound healing time was 0.931 (with 95% confidence interval 0.887-0.975, P<0.01). Combined with Youden index, 5.52 PU was chosen as the optimal critical value of wound healing time of the two groups, with sensitivity of 76.9% and specificity of 94.7%. (3) The healing time of 44 wounds predicted was shorter than or equal to 14 d, and the healing time of 84 wounds predicted was longer than 14 d and shorter than or equal to 28 d, while the actual number of wounds was 57 and 71, respectively. The Kappa coefficient of consistency test was 0.754 (P<0.01). Conclusion: LSPI is a useful method to predict the healing time of burn wounds.

Modified radical vaginal hysterectomy for cervical cancer treatment.

OBJECTIVES: The aim of this study was to modify vaginal radical hysterectomy (VRH), design a series of surgical instruments specialised for this procedure, and to study the feasibility, morbidity, and outcome of cervical cancer patients treated with modified laparoscopic-assisted radical vaginal hysterectomy (LARVH). MATERIALS AND METHODS: A total of 86 patients with early-stage cervical cancer (IB 1-IAl) underwent modified VRH and laparoscopic pelvic lymphadenectomy and para-aortic lymphadenectomy. Special instruments and modified procedures were used in VRH. Data were collected on operating time, blood loss, ureter separation time, nodal count, hospital stay, and complication recurrence and survival rates. RESULTS: All patients successfully completed LARVH. Median operating time was 238 minutes, mean blood loss was 283 ml, median time for ureter separation was 18.5 minutes, median time to post-operative exhaustion was 23 hours, urine recovery was 10.3 days, and median hospital stay was 9.2 days. On average, 23.2 lymph nodes were harvested. Except for one case of left internal iliac vein with intraoperative and postoperative complications, no other major complications occurred, particularly no bladder and ureter injury. Surgical margins were negative in all cases. After median follow-up of 46 months, recurrence rate and overall survival for 84 patients were 3.57% and 97.62%, respectively. DISCUSSION: Modified VRH with laparoscopic pelvic lymphadenectomy is an oncologically valid alternative for early stage cervical cancer treatment with minimal intraoperative and postoperative complications. The modification of this procedure and special instruments can enhance the feasibility and the safety of treatment.

High frequency variations of Helicobacter pylori isolates in individual hosts in a Chinese population.

BACKGROUND: Colonization of individual hosts by multiple Helicobacter pylori genotypes may be one reason why this infection is persistent and difficult to eradicate. METHODS: In order to study the diversity of H. pylori in individuals, a modified randomly amplified polymorphic DNA (RAPD) method was applied using primary culture isolates instead of passaged cultures. RESULTS: The results showed that variations in H. pylori were prevalent among individuals in the Chinese population, and the incidence of multiple colonization was 99.1% (115/116), significantly higher than in other reports. Moreover, the number of RAPD genotypes was found to be significantly associated with the process of disease development (p<0.05). Indeed, a trend for a higher number of RAPD genotypes within a single host (up to five genotypes) was observed as the disease developed or became more serious. After subculturing for three generations in our experiment, some genotypes present in the primary cultures were lost. The different genotypes in one patient may have originated from a single ancestral strain, as determined by analysis of six H. pylori housekeeping gene alleles, most of which were shown to be identical. CONCLUSIONS: These results suggest that investigating isolates of the primary culture will better reflect the H. pylori diversity in individuals. Also, they indicate that continuous variation of one strain in the gastric microenvironment may be the main cause of H. pylori diversity in individuals in the Chinese population.

MicroRNA-375 targets AEG-1 in hepatocellular carcinoma and suppresses liver cancer cell growth in vitro and in vivo.

MicroRNAs (miRNAs) are believed to have fundamental roles in tumorigenesis and have great potential for the diagnosis and treatment of cancer. However, the roles of miRNAs in hepatocellular carcinogenesis are still not fully elucidated. We investigated the aberrantly expressed miRNAs involved in hepatoma by comparison of miRNA expression profiles in cancerous hepatocytes with normal primary human hepatocytes, and 37 dysregulated miRNAs were screened out by twofold change with a significant difference (P<0.05). Clustering analysis based on 13 miRNAs with changes over 15-folds showed that the miRNA expression patterns between the cancerous and normal hepatocytes were clearly different. Among the 13 miRNAs, we found that miR-375 was significantly downregulated in hepatocellular carcinoma (HCC) tissues and cell lines. Overexpression of miR-375 in liver cancer cells decreased cell proliferation, clonogenicity, migration/invasion and also induced G1 arrest and apoptosis. To unveil the molecular mechanism of miR-375-mediated phenotype in hepatoma cells described above, we examined the putative targets using bioinformatics tools and found that astrocyte elevated gene-1 (AEG-1) was a potential target of miR-375. Then we demonstrated that miR-375 bound directly to the 3'-untranslated region of AEG-1 and inhibited the expression of AEG-1. TaqMan quantitative reverse transcriptase-PCR and western blot analysis showed that miR-375 expression was inversely correlated with AEG-1 expression in HCC tissues. Knockdown of AEG-1 by RNAi in HCC cells, similar to miR-375 overexpression, suppressed tumor properties. Ectopic expression of AEG-1, conversely, could partially reverse the antitumor effects of miR-375. In a mouse model, therapeutic administration of cholesterol-conjugated 2'-O-methyl-modified miR-375 mimics (Chol-miR-375) could significantly suppress the growth of hepatoma xenografts in nude mice. In conclusion, our findings indicate that miR-375 targets AEG-1 in HCC and suppresses liver cancer cell growth in vitro and in vivo, and highlight the therapeutic potential of miR-375 in HCC treatment.

The effects of a novel therapeutic device on acute kidney injury outcomes in the intensive care unit: a pilot study.

Despite decades of improvements in the provision of renal replacement therapy, the morbidity and mortality associated with acute kidney injury (AKI) in the intensive care unit (ICU) setting remains extremely high. Much of the morbidity and mortality of this disorder is the consequence of systemic cellular damage that results from immune dysregulation. This is a prospective, single-arm, single-center study designed to evaluate the safety and efficacy of treatment with a selective cytopheretic device (SCD) on clinical outcomes in AKI requiring renal replacement therapy in the ICU. The patients enrolled in the trial were compared with historical case-matched controls with respect to age and Sequential Organ Failure Assessment (SOFA) score. The mortality for the case-matched controls was 77.78%, whereas the mortality in the SCD treatment group was 22.22% (p = 0.027). Multiple regression analysis identified treatment with SCD as the only significant variable affecting mortality among age, SOFA score, average change in urine output over the first 7 days during or after treatment. Mean total urine output in the 10 subjects receiving SCD treatment increased from a baseline of approximately 500 ml/d to more than 2,000 ml/d by day 7 of treatment. The SCD represents a novel therapeutic approach to alter the acute inflammatory response seen in AKI, and further evaluation of the safety and efficacy of the device is being evaluated in a multicenter investigation in the United States under an Food and Drug Administration (FDA) approved investigational device exemption (IDE).

Core genome haplotype diversity and vacA allelic heterogeneity of Chinese Helicobacter pylori strains.

The human gastric pathogen, Helicobacter pylori, has co-evolved with its host and established itself in the human stomach possibly millions of years ago. Therefore, the diversity of this bacterium is important in its clinical manifestations. Our aim has been to evaluate the genetic diversity of 40 H. pylori clinical isolates from four different parts of China. The methods of multi-locus sequence typing and vacA allele genotyping were used to assess their genetic diversity. To discriminate MLST, the vacA genotype method was used to identify strains. Patients from the northern, eastern, southern, and southwestern parts of China were recruited randomly from the cities of Beijing, Shanghai, Guangzhou, and Chongqing, respectively. Most of the sequence types are new and have never been reported in the database of the H. pylori multi-locus sequence typing system. The most prevalent vacA genotype in patients was s1a/m2 (80.0%), followed by s1b/m2 (17.5%). In contrast, the s1a/m1 genotype was scarcely represented (2.5%). The vacA genotype varied for each ST. These results showed that the MLST method offers high resolution of the H. pylori isolates in China when compared to vacA genotyping. The vacA allelic s1a has been correlated with the peptic ulcer. Because of the paucity of data on human isolates due to the absence of systematic investigations of H. pylori in China, the data provide useful information for understanding the epidemiology of H. pylori in China from the viewpoint of nucleotide sequence databases.

Structure of the spontaneous all night sleep in epileptics with polysomnography.

Twenty epileptics and 11 healthy controls were investigated with polysomnography. Epileptics with interictal discharges had significantly longer total recording time and longer REM latency than the controls (P<0.05). Epileptics had a more fragmentized sleep than controls. Sleep efficiency of patients with interictal discharges was lower than that of patients without them (P<0.05). Among the patients with interictal discharges, those with partial seizures had a significantly higher arousal number than those with generalized seizures (P<0.05). The number of NREM stage shifts in patients with partial seizures tended to be higher than in those with generalized seizures.

[Injection of 5-fluorouracil in the treatment of tubal pregnancy through salpingo-catheter under hysteroscopy].

Seventeen women with unruptured tubal pregnancy were given 5-FU through salpingo-catheter under hysteroscopy. In one case the injection failed because the tube opening could not be found. The success rate of salpingo-catheterization was 94.12% (16/17). The cure rate for the tubal pregnancies was 88.24% (15/17). 12 cases received injection once and 3 cases twice. The dose of 5-FU per injection was 250 mg in 10 ml solution. Serum beta-hCG test became negative in 7 to 14 days after the treatment, and signs and symptoms disappeared. Salpingography were done in 8 cases after 2 to 3 months, and all the diseased tubes were found patient. There was little side effects due to this treatment, which is more effective, convenient and less traumatic than injecting 5-FU to the affected site through laparoscopy or systemic administration. It may turn out to be an effective, simple, safe and acceptable new method for treating early tubal pregnancy.