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INTRODUCTION: Chronic wounds are wounds that are not healed or have no healing tendency for more than 1 month due to various factors. In clinical nursing, chronic wounds are often not properly treated, and the treatment efficiency is low. Therefore, it is very important to explore effective methods to deal with chronic wounds. OBJECTIVE: To explore the effect of a self-made negative pressure suction device (NPSD) in the nursing of chronic wounds in the elderly. METHODS: A total of 50 elderly patients with chronic wounds who were hospitalised in our hospital from January 2020 to December 2022 were selected as participants by convenient sampling. According to the random number table method, they were divided into a control group and an observation group, with 25 people in each group. The control group was treated with chloroplast foam dressing, debridement gel and alginate dressing. The observation group was treated with a self-made NPSD on the basis of the control group. The wound healing of the two groups was observed. RESULTS: After the intervention of the self-made NPSD, the granulation tissue coverage rate and wound volume reduction rate of the observation group were significantly increased (p < 0.05), and the positive rate of bacterial infection was significantly decreased (p < 0.05). After 3 months of intervention, the total effective rate of the observation group was significantly higher than that of the control group (χ2 = 3.869, p = 0.0492). CONCLUSION: The self-made NPSD can effectively promote the healing of a chronic wound.
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Transplante de Pele , Cicatrização , Humanos , Idoso , Sucção , Resultado do Tratamento , Desbridamento , Transplante de Pele/métodosRESUMO
Thoracic aortic aneurysms (TAAs) develop asymptomatically and are characterized by dilatation of the aorta. This is considered a life-threating vascular disease due to the risk of aortic rupture and without effective treatments. The current understanding of the pathogenesis of TAA is still limited, especially for sporadic TAAs without known genetic mutation. Sirtuin 6 (SIRT6) expression was significantly decreased in the tunica media of sporadic human TAA tissues. Genetic knockout of Sirt6 in mouse vascular smooth muscle cells accelerated TAA formation and rupture, reduced survival, and increased vascular inflammation and senescence after angiotensin II infusion. Transcriptome analysis identified interleukin (IL)-1ß as a pivotal target of SIRT6, and increased IL-1ß levels correlated with vascular inflammation and senescence in human and mouse TAA samples. Chromatin immunoprecipitation revealed that SIRT6 bound to the Il1b promoter to repress expression partly by reducing the H3K9 and H3K56 acetylation. Genetic knockout of Il1b or pharmacological inhibition of IL-1ß signaling with the receptor antagonist anakinra rescued Sirt6 deficiency mediated aggravation of vascular inflammation, senescence, TAA formation and survival in mice. The findings reveal that SIRT6 protects against TAA by epigenetically inhibiting vascular inflammation and senescence, providing insight into potential epigenetic strategies for TAA treatment.
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Aneurisma da Aorta Torácica , Sirtuínas , Humanos , Camundongos , Animais , Aneurisma da Aorta Torácica/genética , Aneurisma da Aorta Torácica/metabolismo , Aneurisma da Aorta Torácica/patologia , Inflamação/genética , Angiotensina II/genética , Angiotensina II/farmacologia , Epigênese Genética/genética , Sirtuínas/genéticaRESUMO
AIMS: The mechanisms underlying ageing-induced vascular remodelling remain unclear. This study investigates the role and underlying mechanisms of the cytoplasmic deacetylase sirtuin 2 (SIRT2) in ageing-induced vascular remodelling. METHODS AND RESULTS: Transcriptome and quantitative real-time PCR data were used to analyse sirtuin expression. Young and old wild-type and Sirt2 knockout mice were used to explore vascular function and pathological remodelling. RNA-seq, histochemical staining, and biochemical assays were used to evaluate the effects of Sirt2 knockout on the vascular transcriptome and pathological remodelling and explore the underlying biochemical mechanisms. Among the sirtuins, SIRT2 had the highest levels in human and mouse aortas. Sirtuin 2 activity was reduced in aged aortas, and loss of SIRT2 accelerated vascular ageing. In old mice, SIRT2 deficiency aggravated ageing-induced arterial stiffness and constriction-relaxation dysfunction, accompanied by aortic remodelling (thickened vascular medial layers, breakage of elastin fibres, collagen deposition, and inflammation). Transcriptome and biochemical analyses revealed that the ageing-controlling protein p66Shc and metabolism of mitochondrial reactive oxygen species (mROS) contributed to SIRT2 function in vascular ageing. Sirtuin 2 repressed p66Shc activation and mROS production by deacetylating p66Shc at lysine 81. Elimination of reactive oxygen species by MnTBAP repressed the SIRT2 deficiency-mediated aggravation of vascular remodelling and dysfunction in angiotensin II-challenged and aged mice. The SIRT2 coexpression module in aortas was reduced with ageing across species and was a significant predictor of age-related aortic diseases in humans. CONCLUSION: The deacetylase SIRT2 is a response to ageing that delays vascular ageing, and the cytoplasm-mitochondria axis (SIRT2-p66Shc-mROS) is important for vascular ageing. Therefore, SIRT2 may serve as a potential therapeutic target for vascular rejuvenation.
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Sirtuína 2 , Remodelação Vascular , Camundongos , Humanos , Animais , Idoso , Sirtuína 2/metabolismo , Proteína 1 de Transformação que Contém Domínio 2 de Homologia de Src , Espécies Reativas de Oxigênio/metabolismo , Envelhecimento , Camundongos KnockoutRESUMO
The phenomenon of aggregation-induced emission (AIE) is inseparable from molecular aggregation and self-assembly. Therefore, the combination of AIE and supramolecular self-assembly is well-matched. AIE-guided dynamic assembly (AGDA) could effectively respond to the endogenous stimuli (such as pH, enzymes, redox molecules) and exogenous stimuli (temperature, light, ultrasound) in the disease microenvironment, so as to achieve specific imaging and diagnosis of the disease lesions. Moreover, AGDA also dynamically adjust the intramolecular motions of AIE molecules, thereby adjusting the energy dissipation pathways and realizing the switch between photodynamic therapy and photothermal therapy for superior therapeutic effects. In this review, we aim to give an overview of the constructing strategies, stimuli-responsive imaging, regulation of intramolecular motion of AGDA in recent years, which is expected to grasp the research status and striving directions of AGDA for imaging and therapy.
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Nanomedicina , Imagem Óptica/métodos , Humanos , Fotoquimioterapia , Fototerapia , Espécies Reativas de OxigênioRESUMO
Tumor metastasis is an important cause of tumor treatment failure. Its molecular mechanism is closely related to tumor cells remodeling immune cells and immunosuppressive microenvironment, so as to create a suitable soil for tumor cell invasion and growth. "Huoxue Huayu" is one of the important therapeutic principles in cancer treatment, but the influence of Huoxue drugs on tumor metastasis has been controversial in clinical application. In this paper, we systematically summarized the comparative study of Huoxue drugs and Yiqi Huoxue drugs in tumor metastasis in recent years, and discussed the differences of molecular mechanisms of Huoxue drugs and Yiqi Huoxue drugs in anti-tumor metastasis from the perspective of immune remodeling, so as to provide scientific basis for clinical rational application of Huoxue drugs and Yiqi Huoxue drugs.
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PURPOSE: This study aims to explore the characteristics and related factors of insomnia of patients after operation for gastric cancer. METHODS: A cross-sectional survey was carried out and finally 115 patients with insomnia after operation for gastric cancer were included. The general information, gastric cancer-related information, sleep quality, and other symptoms were investigated. RESULTS: â The Pittsburgh sleep quality index score of most insomnia patients after gastric cancer surgery was 11-15 points, and the sleep quality rating was "poor". â¡ The sleep quality of patients with insomnia after surgery for gastric cancer is related to the number of chemotherapy cycles, fatigue, and depression. ⢠The probability of reduced sleep quality with the number of chemotherapy cycles >6 is 3.640 times that of ≤6. The probability of reduced sleep quality during moderate to severe fatigue was 4.390 times that of patients with no or mild fatigue. CONCLUSION: Attention to related factors may be associated with improvement of sleep quality in patients with gastric cancer after surgery.
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Distúrbios do Início e da Manutenção do Sono , Neoplasias Gástricas , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Fadiga , Humanos , Sono , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/etiologia , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/cirurgiaRESUMO
In order to cope with the impact of current coronavirus disease 2019 (COVID-19), the continued extension of financial subsidy period for new energy vehicles at the national level is a strong measure to support the sustainable development of new energy vehicle (NEV) industry. This paper further explores the promotion impact of government subsidies on NEV diffusion, and establishes a three-stage evolutionary game model. Based on the actual application, the NEV diffusion process is simulated in four kinds of authoritative networks. Results show that: (1) in the scale-free network, the subsidy rate must be high enough to promote full NEV diffusion, and the larger the network scale, the higher the threshold of subsidy rate; (2) in the small-world network, the larger the network scale, the more beneficial it is for full NEV diffusion; (3) for the small-scale network, topological characteristics have little effect on NEV diffusion depth, and only affect the speed when NEV diffusion reaches the stable state; (4) for the large-scale network, NEV diffusion in the scale-free network is more sensitive to the subsidy rate than that in the small-world network; (5) network topologies influencing NEV diffusion can be divided into two priorities. Finally, relevant policy recommendations are presented.
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BACKGROUND: To explore the kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19. METHODS: This observational study enrolled 20 patients with COVID-19, who were hospitalized between January 20-April 6, 2020, in the two COVID-19 designated hospitals of Zhoushan, Zhejiang and Rushan, Shandong, China, The laboratory findings, imaging, serum response to viral infection, and viral RNA level in the throat and stool samples were assessed from onset to recovery phase in patients with COVID-19. RESULTS: SARS-COV-2 RNA was positive as early as day four. It remained positive until day 55 post-onset in the sputum-throat swabs and became negative in most cases (55%) within 14 days after onset. Lymphocytopenia occurred in 40% (8/20) of patients during the peak infection period and returned to normal at week five. The most severe inflammation in the lungs appeared in week 2 or 3 after onset, and this was completely absorbed between week 6 and 8 in 85.7% of patients. All patients had detectable antibodies to the receptor binding domain (RBD), and 95% of these patients had IgG to viral N proteins. The antibody titer peaked at week four. Anti-S IgM was positive in 7 of 20 patients after week three. CONCLUSIONS: All COVID-19 patients in this study were self-limiting and recovered well though it may take as long as 6-8 weeks. Our findings on the kinetic changes in imaging, serum response to viral infection and viral RNA level may help understand pathogenesis and define clinical course of COVID-19.
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Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/imunologia , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/imunologia , Adolescente , Adulto , Idoso , Betacoronavirus/genética , COVID-19 , Teste para COVID-19 , Vacinas contra COVID-19 , Criança , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Proteínas do Nucleocapsídeo de Coronavírus , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Proteínas do Nucleocapsídeo/imunologia , Pandemias , Fosfoproteínas , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2 , Escarro/virologia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
AIM: To investigate whether patients with refractory epilepsy and healthy infants differ in gut microbiota (GM), and how ketogenic diet (KD) alters GM. METHODS: A total of 14 epileptic and 30 healthy infants were recruited and seizure frequencies were recorded. Stool samples were collected for 16S rDNA sequencing using the Illumina Miseq platform. The composition of GM in each sample was analyzed with MOTHUR, and inter-group comparison was conducted by R software. RESULTS: After being on KD treatment for a week, 64% of epileptic infants showed an obvious improvement, with a 50% decrease in seizure frequency. GM structure in epileptic infants (P1 group) differed dramatically from that in healthy infants (Health group). Proteobacteria, which had accumulated significantly in the P1 group, decreased dramatically after KD treatment (P2 group). Cronobacter predominated in the P1 group and remained at a low level both in the Health and P2 groups. Bacteroides increased significantly in the P2 group, in which Prevotella and Bifidobacterium also grew in numbers and kept increasing. CONCLUSION: GM pattern in healthy infants differed dramatically from that of the epileptic group. KD could significantly modify symptoms of epilepsy and reshape the GM of epileptic infants.
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Dieta Cetogênica/efeitos adversos , Epilepsia Resistente a Medicamentos/dietoterapia , Microbioma Gastrointestinal/fisiologia , Intestinos/microbiologia , Convulsões/dietoterapia , Bacteroides/isolamento & purificação , Pré-Escolar , Cronobacter/isolamento & purificação , Epilepsia Resistente a Medicamentos/microbiologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Proteobactérias/isolamento & purificação , Convulsões/microbiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
AIM: To determine whether oral administration of Bifidobacterium infantis CGMCC313-2 (B. infantis CGMCC313-2) inhibits allergen-induced airway inflammation and food allergies in a mouse model. METHODS: Ovalbumin (OVA)-induced allergic asthma and ß-lactoglobulin-induced food allergy mouse models were used in this study. Following oral administration of B. infantis CGMCC313-2 during or after allergen sensitization, histopathologic changes in the lung and intestine were evaluated by hematoxylin and eosin (HE) staining. In the allergic asthma mouse model, we evaluated the proportion of lung-infiltrating inflammatory cells. OVA-specific IgE and IgG1 levels in serum and cytokine levels in bronchoalveolar lavage fluid (BALF) were also assessed. In the food allergy mouse model, the levels of total IgE and cytokines in serum were measured. RESULTS: Oral administration of B. infantis CGMCC313-2 during or after allergen sensitization suppressed allergic inflammation in lung and intestinal tissues, while the proportion of infiltrating inflammatory cells was significantly decreased in the BALF of allergic asthma mice. Moreover, B. infantis CGMCC313-2 decreased the serum levels of total IgE in food allergy mice, and reductions in IgE and IgG1 were also observed in OVA-induced allergic asthma mice. The expression of interleukin-4 (IL-4) and IL-13 in both serum and BALF was suppressed following the administration of B. infantis CGMCC313-2, while an effect on serum IL-10 levels was not observed. CONCLUSION: B. infantis CGMCC313-2 inhibits the secretion of allergen-induced IgE, IL-4 and IL-13, and attenuates allergic inflammation.
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Asma/induzido quimicamente , Bifidobacterium longum subspecies infantis , Hipersensibilidade Alimentar/prevenção & controle , Intestinos/imunologia , Probióticos , Alérgenos/química , Animais , Líquido da Lavagem Broncoalveolar , Citocinas/sangue , Modelos Animais de Doenças , Hipersensibilidade Alimentar/terapia , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Inflamação , Interleucina-13/sangue , Interleucina-4/sangue , Lactoglobulinas/química , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/químicaRESUMO
Some coumarin-based fluorophores were synthesized and characterized by elemental analysis, (1)H NMR, (13)C NMR and MS. The solid-state photoluminescence properties were studied. The benzocoumarins display interesting solid-state emission properties with an emission at wavelengths ranging from 532 to 645 nm, when excited by a 325 nm helium-cadmium laser at room temperature. The results demonstrated that the luminescent colors can be tuned from green to red by simply varying molecular structure. The benzocoumarin-phenyl boronic acid hybrid, 4-(3-oxo-3-(2 -oxo-2H-1-naphtho[2,1-b]pyran-3-yl)-prop-1-enyl)phenyl boronic acid, showed obvious fluorescence response to water. Whereas the free compound was very weakly fluorescent in tetrahydrofuran (THF), the addition of water leads to an appearance of strong blue-green fluorescence and a dramatic increase of emission intensity. Besides, 3-(3-(3,4,5-trimethoxyphenyl)-prop-2-enoyl)-2H-1-benzopyran-2-one exhibited second order nonlinear optical response to laser pulses. A noticeable second harmonic generation (SHG) under pulsed excitation at 1064 nm was observed. Preliminary nonlinear measurements on powder samples showed that the second harmonic generation efficiency is roughly 5.8 times that of potassium dihydrogen phosphate (KDP).
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Cumarínicos/química , Corantes Fluorescentes/química , Dinâmica não Linear , Fenômenos Ópticos , Absorção , Espectrometria de FluorescênciaRESUMO
Four new antipyrine derivatives were synthesized and characterized by elemental analysis, FT-IR, (1)H NMR, (13)C NMR spectroscopy, and a representative compound 1b was confirmed based on the X-ray crystallographic analysis. The antipyrine-phenylboronic acid 1b crystallizes in the monoclinic space group P2(1)/c, and displays an E configuration about the CN double bond. The absorption and fluorescence spectra of these compounds were investigated. Replacement of a six-membered phenyl group with a five-membered thienyl unit in the antipyrine derivatives resulted in a bathochromic shift approximately 21 nm, while the bithienyl system caused a strong bathochromic effect of 53 nm relative to the substituted phenyl groups. The bithienyl-antipyrine hybrid 1c displayed a turn-on fluorescence response to water, acetic acid (HOAc) and sulfuric acid (H(2)SO(4)) in ethanol solution, but no fluorescence response toward alkali. Whereas the free compound was very weakly fluorescent in ethanol, the addition of water, HOAc and H(2)SO(4) leads to an appearance of strong blue fluorescence and a dramatic increase of emission intensity.
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Antipirina/química , Antipirina/síntese química , Absorção , Cristalografia por Raios X , Etanol/química , Fluorescência , Ligação de Hidrogênio , Conformação Molecular , Soluções , Espectrometria de Fluorescência , ÁguaRESUMO
OBJECTIVE: To determine occupational hazards in work sites of a large solid waste landfill and analyze their adverse health effects. METHOD: The national standardized detection methods were used to determine dust concentration, harmful gas and physical factors in worksites. Routine physical examination, pulmonary function, hearing tests and nervous system test were performed in workers for 2 consecutive years. Urine lead, cadmium and mercury contents were detected. The comet assay was use to measure DNA damage in peripheral blood lymphocytes among workers. RESULT: The main occupational hazard factors in this solid landfill are dust, harmful gas, high temperature and noise. The oxides, carbon monoxide, and noise and high temperatures in summer at some work sites exceeded the national occupational exposure limits. The prevalence of respiratory inflammation and rate of pulmonary function decrease among front-line workers and on-site technical managers are 21.2% and 11.5%, which are significantly higher than those among administrative staff (7.1% and 0) (P < 0.05). Nervous system abnormalities rate of front-line workers and on-site technical managers was 50.0%, which is significantly higher than that (26.7%) of administrative staff (P < 0.05). Because of long-term exposure to high intensity noice, hearing loss rate of bulldozer drivers was 10.3%. In addition, about 75% of workers with DNA damage in peripheral blood lymphocyte are front-line workers. CONCLUSION: Adverse health effects from occupational hazards were observed among workers in this solid waste landfill.
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Doenças Profissionais/epidemiologia , Exposição Ocupacional , Eliminação de Resíduos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/epidemiologia , Fatores de Risco , Local de TrabalhoRESUMO
OBJECTIVES: To study the relationship between the clinical presentation, endocrinal findings and pathological types in patients with pituitary microadenomas, so as to improve the accuracy of clinical diagnosis and choose the best therapy strategy before the operation. METHODS: From January 2007 to June 2009, the clinical data of 94 patients who were surgically removed pituitary microadenomas were obtained, including the clinical presentation, endocrinal findings and pathological diagnosis. The analysis was accomplished with Chi-square test. RESULTS: Hormonal symptoms were found in 86 patients (91.5%), it occurred more frequently in immunopositive patients (85/92, 92.4%) than in immunonegative patients (1/2, 50.0%) (P < 0.05). The coincidence of hormonal symptoms and immunohistochemistry diagnosis was 71.7%; 88.9% patients had the symptoms of amenorrhea, galactorrhea and sexual function diseases in prolactin (PRL) positive group and 28.1% patients had the symptoms of gigantism or acromegaly in growth hormone (GH) positive group. The coincidence of endocrinal findings and immunohistochemistry diagnosis was 69.0%; 87.7% patients had high level of blood PRL in PRL positive group and 21.9% patients had high level of blood GH in GH positive group. CONCLUSIONS: There is an obvious relationship between the clinical presentation, endocrinal findings and pathological diagnosis in patients with pituitary microadenomas, which may contribute to the clinical diagnosis and treatment of pituitary secreting microadenomas.
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Adenoma/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Adenoma/metabolismo , Adenoma/patologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/metabolismo , Neoplasias Hipofisárias/patologia , Adulto JovemRESUMO
OBJECTIVE: To study the digestive system manifestations in children infected with novel influenza A (H1N1) virus. METHODS: A prospective study of 153 children infected with novel influenza A (H1N1) virus in Shenzhen Children's Hospital from November 2009 to January 2010 was conducted. The clinical features and outcomes of 69 children with digestive system manifestations were analyzed. RESULTS: The children presenting with digestive system manifestations accounted for 45% (69 cases) in the 153 hospitalized children with novel influenza A (H1N1) infection. Gastrointestinal manifestations were observed in 50 cases (33%) and liver function abnormality in 19 cases (12%). The incidence rate of coma, neurological complications, increase in creative kinase level, ICU admission, and death in the patients with digestive system manifestations were significantly higher than those without digestive system manifestations (P<0.05). In the 69 patients with digestive system manifestations, 5 died from severe complications and 64 recovered fully. Gastrointestinal manifestations disappeared through 1 to 3 days and abnormal liver function recovered through 4 to 7 days. CONCLUSIONS: Digestive system manifestations are common in children infected with novel influenza A (H1N1) virus. Neurological system involvements are more common in the patients with digestive system manifestations than those without.
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Doenças do Sistema Digestório/etiologia , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/complicações , Adolescente , Criança , Pré-Escolar , Doenças do Sistema Digestório/terapia , Feminino , Humanos , Lactente , Masculino , Estudos ProspectivosRESUMO
OBJECTIVE: In order to sum up the experience of diagnosis and treatment, the clinical information, diagnostic approach and treatment strategies from 23 patients with hematogenous pyogenic discitis and vertebral osteomyelitis (PDVO) in adults were reviewed. METHODS: A retrospective record review was conducted of all cases of hematogenous PDVO from July 1999 to October 2006, the diagnostic approach and the treatment strategies were discussed. RESULTS: The average age was 55.4 years. The average delayed diagnosis time was 4.4 months (range, 4 weeks to 11 months). Of these, 17 had underlying diseases such as diabetes mellitus, chronic alcoholism, liver cirrhosis, rheumatic disease, and the use of corticosteroids. All percent had elevated erythrocyte sedimentation rates and C-reactive proteins, while white blood cell counts were less reliably elevated. Imaging studies included radiographs and MRI. Seven patients were treated with immobilization and intravenous antibiotic drugs. Because of a delay in diagnosis, 16 patients underwent operative treatment for hematogenous PDVO using staged anterior debridement and Bone grafting with iliac crest or rib strut, anterior spinal instrumentation in 3 patients, posterior instrumentation was placed in 7 patients at a second procedure 10 days to 2 weeks following initial operation. Twenty-three patients were followed-up for an average period of 27 months, with a minimum of 6 months and the longest for 7 years. The patients return to their preoperative everyday activity. No patient had a recurrence of osteomyelitis. All their symptoms improved after surgery, bony fusion occurred in 87.5% of cases. CONCLUSIONS: Adult hematogenous PDVO is a disease that affects mainly older patients suffering underlying medical illnesses. Positive blood cultures is valuable for the diagnosis. Hematogenous PDVO may require surgery in case of a development of biomechanical instability and/or a vertebral collapse with progressive deformity. In experienced hands, surgical debridement, interbody fusion, and anterior or posterior instrumentation is a safe and effective treatment.
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Discite/diagnóstico , Discite/terapia , Osteomielite/diagnóstico , Osteomielite/terapia , Adulto , Idoso , Discite/microbiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/microbiologia , Prognóstico , Estudos RetrospectivosRESUMO
OBJECTIVE: To investigate the association of changes in immune function with enterovirus 71 (EV71) cases with different severity of the disease. METHOD: Forty-six EV71-infected patients and 12 age-matched healthy children were enrolled in this study. The patients were divided into four groups according to critical degree of enterovirus 71 infection: hand-foot-and-mouth disease (HFMD); central nervous system disease (CNSD); autonomic nervous system dysregulation (ANSD) and pulmonary edema (PE). We analyzed CD14+ monocyte HLA-DR expression, lymphocyte immunophenotypes, the proportion of CD4+CD25+ Foxp3high regulatory T cells (Treg cells) and Th17 cells, cytokines (IL-1beta, TNF-alpha, IL-10, TGF-beta, IL-6, IL-17A), evaluated the mRNA levels of Foxp3 and ROR-gammat, and serum immunoglobulin and complements. RESULT: (1) Serum concentrations of IL-1beta and TNF-alpha elevated in mild cases, while declined in severe cases, and were lower in PE group (P<0.05). Serum concentrations of IL-10 and IL-10/TNF-alpha ratio gradually raised with the aggravation of the disease, and higher in PE group (P<0.05). (2) Circulating CD14+ monocyte HLA-DR expression, CD3+T cells, CD4+T cells, CD8+T cells, and NK cells gradually decreased, and lower in PE group (P<0.05). There was no significant difference in B cells, immunoglobulin and complement among the four groups. (3) The proportion of CD4+CD25+ Foxp3high Treg cells, mRNA level of Foxp, and serum concentrations of TGF-beta gradually decreased with the aggravation of the disease, while the proportion of Th17 cells, serum concentrations of IL-17A, mRNA level of ROR-gammat, and IL-6 gradually increased with the aggravation. CONCLUSION: Immune function changed with different illness phases. The mild cases presented systemic inflammatory response syndrome status, while critically ill cases presented compensatory anti-inflammatory response syndrome or mixed antagonist response status. Immunoregulatory treatment of patients with EV71 infection should emphasize different methods at different stage and individualization.
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Infecções por Enterovirus/imunologia , Infecções por Enterovirus/patologia , Adolescente , Linfócitos T CD4-Positivos/imunologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Enterovirus Humano A , Infecções por Enterovirus/metabolismo , Feminino , Antígenos HLA-DR/imunologia , Humanos , Inflamação , Interleucina-10/metabolismo , Contagem de Linfócitos , Masculino , Fator de Necrose Tumoral alfa/metabolismoRESUMO
OBJECTIVE: This study attempted to reconstruct engineered uterine tissues (EUTs) containing smooth muscle layer, akin to the normal uterine wall. METHODS: EUTs were reconstructed by seeding epithelial cells on top of the constructed stromal layer over smooth muscle layer. A self-made mold was used to keep the EUTs from contraction. At the same time, it provided static stretch to the EUTs. After 14 days of culture, the structure of the EUTs was analyzed histologically and immunohistochemically, or by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The expression of integrin beta3 subunit, heparin-binding epidermal growth factor (EGF)-like growth factor (HB-EGF), and HOXA-10 was detected by reverse transcription-polymerase chain reaction (RT-PCR). The ability of the EUTs supporting the development of embryos was estimated by coculturing embryos on the EUTs. We also tried a new method to reconstruct EUTs by mixing epithelial cell and stromal cells (1:2) in collagen/Matrigel to form an endometrial layer and putting it on top of the smooth muscle layer. The self-assembling ability of the endometrial epithelial cells and stromal cells in the reconstructed EUTs was analyzed histologically and immunohistochemically. RESULTS: The results found that the constructed EUTs with the first and the second method showed three-layered structures. The epithelial layer, stromal layer, and smooth muscle layer were stained by cytokeratin 18, vimentin, and alpha-actin, respectively. TEM showed that the cells in the EUTs reconstructed by the first method were attached to each other by apical tight junctions and rivet-like desmosomes. SEM showed protruded pinopodes, microvilli, and cilium of epithelial cells. The RT-PCR analysis showed that integrin beta3 subunit, HB-EGF, and HOXA-10 were expressed in EUTs. The coculture system of EUTs improved the development rate and quality of murine embryo significantly in comparison with those of control Chatot Ziomek Bavister culture. In the EUTs reconstructed by the second method, the epithelial cells demonstrated self-assembling ability and formed epithelial cell layer on top of the stromal layer and glandular tube-like structures in the stromal layer. Columnar epithelial cells existed in some parts of the epithelial layer. CONCLUSION: We engineered EUTs containing smooth muscle layer by two methods. The reconstructed EUTs could support the development of embryos. The epithelial cells showed self-assembling ability in the EUTs.