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Implanted brain-computer interface (iBCI) is a system that establishes a direct communication channel between human brain and computer or an external devices by implanted neural electrode. Because of the good functional extensibility, iBCI devices as a platform technology have the potential to bring benefit to people with nervous system disease and progress rapidly from fundamental neuroscience discoveries to translational applications and market access. In this report, the industrialization process of implanted neural regulation medical devices is reviewed, and the translational pathway of iBCI in clinical application is proposed. However, the Food and Drug Administration (FDA) regulations and guidances for iBCI were expounded as a breakthrough medical device. Furthermore, several iBCI products in the process of applying for medical device registration certificate were briefly introduced and compared recently. Due to the complexity of iBCI in clinical application, the translational applications and industrialization of iBCI as a medical device need the closely cooperation between regulatory departments, companies, universities, institutes and hospitals in the future.
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Humans , Brain-Computer Interfaces , Brain/physiology , Electrodes, ImplantedABSTRACT
Objective:To investigate the risk factors for retrograde type A dissection (RTAD) associated with thoracic endovascular aortic repair (TEVAR) which provided the basis for clinical risk stratification and treatment decision.Methods:The clinical data of 1 688 patients with thoracic aortic disease who underwent TEVAR in our center from January 2004 to December 2019 were retrospectively analyzed. The pathological classification included aortic dissection (1 592 cases) and other thoracic aortic diseases (96 cases). Univariate analysis and categorical multiple logistic regression analysis were used to explore the risk factors for the development of RTAD during or after TEVAR.Results:A total of 18 cases of RTAD were found, with an overall incidence of 1.1% (18/1 688), all of which occurred in aortic dissection group. After adjusting for confounding factors, multivariate logistic regression analysis showed that the incidence of RTAD was significantly decreased(OR=0.27,95%CI 0.07-0.96, P=0.043) when the oversize of stentgraft was 11%-20%, the oversize of stentgraft was ≤10% as the control group, and the difference was statistically significant( P<0.05). The ascending aorta diameter was <40 mm as the control group, and there was no significant difference in the incidence of RTAD between the ≥40 mm group and the control group(OR=2.71,95%CI 0.94-7.84, P=0.065). Conclusions:Aortic dissection is more likely to develop RTAD than other thoracic aortic diseases. A proper stentgraft oversizing ratio could reduce the probability of RTAD. That is to say that a too low stentgraft oversizing ratio is not recommended.
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Objective@#To explore age, gender, and regional differences in physical activity among children and adolescents in China, and to provide a scientific reference for enhancing physical activity promotion.@*Methods@#A total of 4 269 children and adolescents aged 7 to 18 years were selected from six administrative regions of China (East China, Northwest China, North China, Central China, Southwest China and South China) using a stratified random cluster sampling method from September to December 2018. A questionnaire was administered to evaluate the physical activity level of Chinese children and adolescents aged 7 to 18.@*Results@#The overall detection rate of MVPA insufficiency in children and adolescents in China was 53.8%, of which the detection rate of MVPA insufficiency was 50.8% among boys and 57.1% among girls. Gender differences were statistically significant ( χ 2= 17.10 , P <0.05). Among the different age groups, the lowest detection rate of MVPA among 10-12 year olds was 43.6%, whereas the highest rate among 16-18 year olds was 63.0%, with significant differences between gender ( χ 2=4.33, 30.79, P <0.05). The P 50 values of total physical activity(TPA), light intensity physical activity(LPA), moderate intensity physical activity(MPA), vigorous intensity physical activity(VPA), moderate to vigorous physical activity(MVPA) were 92.9,24.3,41.4,7.1 and 55.7 min/d , respectively. The P 50 values of physical exercise, housework activities, entertainment activities and transportation activities were 34.3 , 2.1, 2.3 and 30.0 min/d, respectively, and the difference in age groups was statistically significant( H =95.03, 74.99, 300.26 , 64.16, P <0.05). There was a statistically significant difference in the detection rate of insufficient MVPA among children and adolescents in different regions ( χ 2=83.91, P <0.05). The lowest rate was 44.0% in North China, and the highest was 65.9% in East China.@*Conclusion@#The detection rate of MVPA insufficiency among Chinese children and adolescents firstly decreased and then increased with age. Boys participated in higher levels of physical activity than girls.
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Objective:To investigate the treatment strategies for the thoracic endovascular aortic repair (TEVAR) of Stanford type B aortic dissection (TBAD) accompanied with intra-or post-operational retrograde type A aortic dissection (RAAD).Methods:TBAD patients who underwent TEVAR in Henan Provincial People′s Hospital from February 2004 to January 2020 were retrospectively analyzed. Among 1 176 cases, 14 cases (1.2%) were accompanied with RAAD. Another 9 patients who received TEVAR at other hospitals with TBAD accompanied with RAAD were also collected. In total 23 patients [18 males and 5 females, age as (54±12) years old , ranging from 38 to 79] were included in this study. There were 15 cases of typical dissection, 7 cases of intramural haematoma, and 1 case of penetrating aortic ulcer. Sixteen patients received surgical operation, 1 received hybrid surgery, and the remaining 6 patients underwent conventional therapies. The clinical data and followed up data were collected and analyzed.Results:Among 23 cases, 2 RAAD cases were discovered during the TEVAR, 8 cases were discovered during the perioperative period, 5 cases were discovered within 3 months after discharge, and 8 cases were discovered at more than 1 year after TEVAR, with the longest time point of 120 months after TEVAR. The RAAD rupture was located on the greater curvature side of the aorta in 21 cases, and on the minor curvature side in 2 cases. In 13 cases, the rupture was close to the stent head, and in 10 cases, the rupture was located on the ascending aorta and more than 2 cm from the stent head. Followed up data were collected in 21 cases, with the mean follow-up time as (59±40) months, ranging from 1 to 134 months. Six patients died, with 3 cases of all-reason death and 3 cases of cardiac-reason death. Among the 16 patients receiving surgical operation, one patient died during the perioperative period, and 1 patient suffered from the cerebral infarction and mediastinal infection. Well recovery was found in 1 patient received the hybrid operation. Five of 6 patients who received the conventional treatment died.Conclusions:RAAD is a serious complication related to TEVAR, with low incidence and high mortality rate. RAAD can occur in the early or late stages of TEVAR. TEVAR-associated RAAD has poor therapeutic outcomes, and the surgical operation should be recommended as the preferred treatment for RAAD in clinical practice.
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OBJECTIVE@#To delineate the serological and molecular profiles of a patient with A(w)37B subtype.@*METHODS@#The ABO bloodtypes of the proband, his wife and daughter were determined with a standard serological method. Their ABO genotypes were determined by sequence-specific primer polymerase chain reaction (PCR-SSP). All exons of the ABO gene were directly sequenced. Exons 6 and 7 of the ABO gene were further analyzed by cloning and sequencing.@*RESULTS@#The red blood cells of the proband showed a weak B phenotype. His serum sample contained weak reactive anti-A antibody, which was defined as A(w)B blood group based on the serological characteristics. The A and B alleles were detected by blood group genotyping. Gene cloning and sequencing have identified a characteristic c.940A>G variant (ABO*AW.37) in exon 7 of the ABO gene, which resulted in substitution of Lysine by Glutamate at position 314. The proband's daughter has inherited the ABO*AW.37 allele.@*CONCLUSION@#The c.940A>G variant in exon 7 of the ABO gene probably underlay the decreased activity of GTA transferase and resulted in the Aw37 phenotype.
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Humans , ABO Blood-Group System/genetics , Alleles , Genotype , Pedigree , PhenotypeABSTRACT
OBJECTIVE@#To explore the genetic basis for a Chinese pedigree with a novel ABO subtype.@*METHODS@#The proband and his family members were subjected to serological analysis, and their genotypes were determined by fluorescence PCR and direct sequencing of the coding regions of the ABO gene. Exons 6 to 7 of the ABO gene were also subjected to clone sequencing for haplotype analysis.@*RESULTS@#The proband was determined as an AxB subtype. By fluorescence PCR, he was typed as A/B. Clone sequencing has revealed a insertional mutation c.797_798 insT in exon 7 of the ABO gene, which yielded a novel allele. Pedigree analysis confirmed that the novel ABO*A1.02 allele carried by the proband and his sister was inherited from their father. The c.797_798insT mutation has been submitted to GenBank with an accession number of MK125137.@*CONCLUSION@#The c.797_798insT mutation of exon 7 of the ABO gene probably has led to weakened expression of A antigen.
Subject(s)
Humans , Male , ABO Blood-Group System/genetics , Alleles , China , Genotype , Mutation , N-Acetylgalactosaminyltransferases/genetics , PedigreeABSTRACT
Objective@#To analyze the causes of complication of early acute kidney injury (AKI) in four severely burned patients, and to explore the related treatment methods.@*Methods@#The clinical data of 4 patients with severe burn complicated with early AKI admitted to Guangzhou Red Cross Hospital Affiliated to Medical College of Jinan University (hereinafter referred to as our hospital) from June 2014 to December 2017 were retrospectively analyzed. All the patients were male, aged 23-33 (30±5) years old, with depth of burns ranged from deep partial-thickness to full-thickness, complicated with myofascial compartment syndrome of extremities and varying degrees of striated muscle injury, and treated in other hospitals before transfer to our hospital. The patients were numbered from small to large according to the total burn area. The total burn area of patients No. 1, 2, 3, and 4 was 10%, 80%, 90%, and 95% total body surface area respectively, their occurrence time of early AKI was 48, 11, 29, and 48 hours after injury respectively, and their time of arriving our hospital was 60, 11, 29, and 144 hours after injury respectively. Hypovolemic shock occurred in patients No. 2 and 3 at admission to our hospital. All the patients received continuous renal replacement therapy (CRRT) after admission to our hospital. Under the support of hemodynamic monitoring and organ function monitoring, the limbs complicated with myofascial compartment syndrome were incised, thorough decompression exploration was performed, and necrotic muscle tissue was removed or amputation was performed. After escharectomy and decompression of limbs, fresh granulation wounds were formed by temporarily covering wounds with Jieya dressing skin or pig skin, multiple debridements, and vacuum sealing drainage. Fresh granulation wounds and other wounds underwent staged eschar excision and shaving were covered with autologous Meek skin graft, particulate skin graft, reticular skin graft and small skin graft respectively. The treatment outcome, CRRT time, operation times, time of recovery of serum creatinine and myoglobin, length of hospital stay, and follow-up were recorded.@*Results@#All the 4 patients were cured after transfer to our hospital. Among them, totally 5 limbs of patients No. 1 and No. 4 underwent amputation because of complication of myofascial compartment syndrome and a large amount of necrotic muscle which could not be preserved. Patients No. 1, 2, 3, and 4 were treated with CRRT for 19, 35, 14, and 25 days respectively and performed with operation for 5, 6, 10, 8 times respectively. Serum creatinine of patients No. 1, 2, 3, and 4 returned to normal on 22, 35, 37, and 48 days after transfer respectively, and their serum myoglobin returned to normal on 18, 28, 25, and 30 days after transfer respectively. Patients No. 1, 2, 3, and 4 were hospitalized for 52, 105, 148, and 156 days and discharged after basic wound healing. Follow-up for 1 to 36 months showed no abnormal renal function in 4 patients.@*Conclusions@#The early AKI in patients No. 1 and 4 was caused by rhabdomyolysis after severe burn complicated with myofascial compartment syndrome, while that of the other 2 cases were also related to hypovolemic shock and poor renal perfusion. The success rate of early AKI treatment in severely burned patients can be effectively improved by removing the causes of diseases at the same time of CRRT and actively treating burn wounds under the support of organ function and hemodynamic monitoring.
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Objective@#This paper analyses the secular trend in physical growth among Japanese children and adolescents from 1900 to 2016, and to provide scientific reference for growth and development in Chinese adolescents.@*Methods@#Data of height and weight of Japanese children and adolescents aged 6-17 years from 1900 to 2016 included in the Survey of School Health Care were used to illustrate growth rate and range of height, weight and BMI during different periods by using one-way ANOVA. Longitudinal correlation between height, weight and BMI was analyzed by using longitudinal analysis method.@*Results@#During 1900 to 2016, height growth ranged between 9.5-19.9 cm in boys and 10.8-18.9 cm in girls aged 6-17 years and the weight growth ranged between 4.0-15.9 kg in boys and 3.9-14.2 kg in girls, with males significantly higher than females; Peak height and weight growth rate of Japanese children and adolescents occurred between 1950 and 1960 (boys: 4.8 cm and 2.7 kg; girls: 3.9 cm and 2.4 kg). On the contrary, from 1939 to 1950, height and weight of Japanese children and adolescents showed a significant decreasing trend (boys: -1.8 cm and -1.2 kg per 10 years; girls: -0.8 cm and -0.4 kg per 10 years); During 2000-2016, the growth rates of height of boys and girls in all age groups in Japan were -0.2 to 0 cm in boys and -0.2 to -0.1 cm in girls per 10 years, respectively.@*Conclusion@#The long-term growth trend of Japanese children and adolescents shows an increasing trend before and after World War II; During World War II and the early post-war period, Japanese children and adolescents showed long-term decreasing trend. In the 21st century, the slow decreasing trend in growth among Japanese children and adolescents is observed, which might associate with absence of favorable environment.
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Objective@#To analyze and compare the correlation between body mass index (BMI) and cardiopulmonary fitness of children and adolescents aged 7 to 18 years in China and Japan, and to provide important reference for healthy development promotion of children and adolescents in China.@*Methods@#A total of 9 594 children and adolescents aged 7-18 years in China and Japan were selected and examined for height, weight and 20 meters shuttle run test (20mSRT), 4 800 of whom were randomly selected and included for analysis. Independent sample t test was used to compare the differences of BMI and 20mSRT between Chinese and Japanese children and adolescents of different sex and age. Logistic regression was used to compare the odds ratio of high cardiopulmonary fitness among children and adolescents of different nutritional status. Pearson correlation and linear regression were used to analyze the correlation between BMI and 20mSRT.@*Results@#Odds ratios of high cardiopulmonary fitness were 0.57, 0.52 and 0.33 in wasting, overweight and obese children and adolescents in China, and 0.49, 0.36 and 0.16 in Japan, respectively, with significant differences(P<0.05). The BMI-Z scores of Chinese and Japanese children and adolescents ranged from - 2.72 to 8.76. There were significant differences in 20mSRT-z between different BMI-Z groups(P<0.05). The 20mSRT-z score of Chinese and Japanese children and adolescents initially increased with BMI-Z score and then decreased with the increase of BMI-z score. With the decrease of BMI-Z score, 20mSRT performance in Chinese boys decreased significantly.@*Conclusion@#Compared with the normal weight peers in China and Japan, the proportion of wasting, overweight and obese children and adolescents with high cardiopulmonary fitness is lower. The BMI-Z score and 20mSRT-z score shows a general inverted "U-shaped" trend. The effect of wasting on cardiopulmonary fitness is greater in Chinese boys.
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Objective@#To determine the relationship between body mass index (BMI) and physical fitness index (PFI) in Chinese and Japanese children and adolescents and to provide theoretical support for physical fitness improvement in Chinese children and adolescents.@*Methods@#A total of 9 594 children and adolescents aged 7-18 years were tested in China and Japan, 4 800 of which with various BMI were randomly selected for analyzing and comparing PFI between the two countries. The relationship between different BMI-Z scores and PFI was analyzed.@*Results@#In general, the PFI of wasting, normal weight, overweight and obesity in Chinese boys was -1.17, -0.03, 0.04 and 0.26, the figures were -2.59, -0.34, -1.46 and -2.44 for Japanese boys, significant differences were found in overweight and obese group (P<0.01). the PFI of wasting, normal weight, overweight and obesity in Chinese girls was -1.18, -0.08, 0.01 and 1.03, the figures were -1.21, 0.51, 0.11 and -1.30 for Japanese girls, significant differences were found in normal weight and obese group(P<0.05). Significant differences in PFI were found within Chinese boys, Chinese children, Japanese boys, Japanese girls and Japanese children with different BMI-Z levels(F=2.89, 3.05, 4.81, 2.33,5.34,P<0.01).@*Conclusion@#There is an inverted "U" curve relationship between BMI and PFI in Chinese and Japanese children and adolescents. With the increase of BMI-Z score, decreasing rate of PFI in Chinese boys is higher than Japanese boys. Practical and effective intervention measures should be taken to improve physical fitness of children and adolescents in China.
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Objective@#To investigate the effect and regulatory mechanism of Smurf2 on the negative regulator Smad7 of TGF-β1/Smad signaling pathway in hypertrophic scar fibroblasts.@*Methods@#From January to October 2014, 8 patients with hypertrophic scar after burn were admitted. The age of patients ranged from 1 year 8 months to 7 years, and the time of scar hyperplasia ranged from 2 to 12 months. The residual normal skin of the same patient was used as the control. The fibroblasts were isolated from hypertrophic scar and normal skin respectively and cultured. The third to fifth passage cells were used for the experiments. ① The protein expression of Smad7 in the two groups was detected by Western Blot. ② Hypertrophic scar fibroblasts and normal skin fibroblasts were treated with exogenous TGF-β1 at concentration of 10 ng/ml for 0 min, 5 min, 15 min, 30 min, 1 h, 2 h and 12 h. The expression of Smad7 protein and mRNA were detected by Western Blot and RT-PCR, respectively. ③ The cell lysates of the two groups were collected and incubated with the ubiquitin mixture for 1 h, 2 h and 6 h at 37℃, respectively. The degradation level of Smad7 protein was detected by Western Blot. ④ The cell lysate of hypertrophic scar fibroblasts was collected and incubated with ubiquitin mixture with or without proteasome inhibitor (MG132: MG115=1: 1) to study its inhibitory effect on the degradation of Smad7 in vitro. ⑤ Immunoprecipitation (IP) technique was used to detect the interaction between Smad 7 and E3 ubiquitin ligase Smurf2 in hypertrophic scar fibroblasts. ⑥ The expression of Smad7 protein in hypertrophic scar fibroblasts stimulated by TGF-β1 after Smurf2 silencing by small interference RNA (siRNA) technique were detected by Western blot.@*Results@#① There was no significant difference in the expression level of Smad7 protein between hypertrophic scar and normal skin fibroblasts(t=0.76, P=0.46). ② Expressions of Smad7 mRNA and protein in normal skin fibroblasts stimulated by exogenous TGF-β1 gradually increased in a time-dependent manner(P<0.05). The expression of Smad7 mRNA in the hypertrophic scar fibroblasts increased at all-time points except at 5min , (P<0.05), while there was no significant difference in the expression level of Smad7 protein at all-time points with or without TGF-β1 stimulation(P>0.05). ③ Degradation of Smad7 protein was enhanced in hypertrophic scar fibroblasts (the expression level of Smad 7 protein at each time point was compared with that of the control group and the last time point, P<0.05), while there was no significant difference in Smad7 protein degradation in normal skin fibroblasts(P=0.162). ④ Enhanced degradation of Smad7 in hypertrophic scar fibroblasts was blocked by the addition of the proteasome inhibitors MG132/MG115. ⑤ In hypertrophic scar fibroblasts, the Smurf2-Smad7 complex was detected, which indicated the interaction between Smurf2 and Smad7 in hypertrophic scar fibroblasts. ⑥ The expression of Smad7 protein was not increased in the hypertrophic scar fibroblasts stimulated by TGF-β1, whereas the stimulation of TGF-β1 increased the expression of Smad7 protein after silencing of Smurf2 gene expression.@*Conclusions@#In the hypertrophic scar fibroblasts, Smurf 2 attenuates the inhibitory effect of Smad 7 on TGF-β1 signaling pathway through the degradation of Smad7 by ubiquitination, which may be involved in the formation of hypertrophic scar.
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The treatment of critically burned patients has benefited from the development of knowledge and technologies that we got in critical care medicine of our country in the past ten years. The close-ended management model of general intensive care unit (ICU) and the idea of general ICU doctors who treat the monitoring of organ function and alternative therapy of organs as their primary tasks would affect the treatments for special critical patients hospitalized in general ICU, especially for those patients who were severely burned. If the burn wounds of patients are not treated timely, properly or in effective manner, the final treatment outcome would be affected. Therefore, the establishment of burn ICU is necessary. The development and close-ended management of burn specialty ICU has significantly improved the success rates, reduced complications, shortened hospitalization time, and increased the quality of wound healing of severe burn patients in the past more than 10 years in our unit. With the reducing of burn, especially severe burn accidents, the construction of regional burn center and burn specialty ICU locating in burn center is necessary. It can not only reduce the waste of medical resource, but also ensure timely and professional treatments for the patients in sudden fire accidents. At present, there is no consensus on the establishment and management model of burn specialty ICU, and further discussion is needed in practice.
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The 2018 Academic Annual Meeting of the Society of Burn Surgery of Chinese Medical Doctor Association, sponsored by the Chinese Medical Doctor Association, was successfully held in Guangzhou, Guangdong province from November 16th to 18th, 2018. More than 300 representatives of burn surgery attended the meeting. The content of the meeting included academician lectures, special reports, seminar, difficult and complex case discussions, which were closely related to clinical needs. In response to the development status and challenges of burn specialty and the status and problems of the training of burn specialist in China, special experts were invited to make special reports and discussions. During the meeting, a general election meeting of the Society of Burn Surgery of Chinese Medical Doctor Association was held, the fourth committee was elected, and professor Peng Yizhi was elected as the president.
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Objective: To investigate the effectiveness of the arthroscopic lateral retinacular release combined with medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation.
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Objective@#To investigate the expression of SnoN in human hypertrophic scar fibroblasts and the mechanism of its participation in hypertrophic scar formation.@*Methods@#Eight patients with hypertrophic scar after burn in need of surgery were admitted in our unit from January to October 2013, and then hypertrophic scar tissue and normal skin tissue of full-thickness skin donor site resected by surgery of the patients were collected. Hypertrophic scar fibroblasts and normal skin fibroblasts of patients were isolated with method of explant culture and then sub-cultured. Cells of the third to fifth passage were used in the following experiments. (1) The protein expressions of SnoN of hypertrophic scar fibroblasts and normal skin fibroblasts were assessed with Western blotting. (2) The mRNA expressions of SnoN of another batch of hypertrophic scar fibroblasts and normal skin fibroblasts were determined with reverse transcription polymerase chain reaction. (3) Another batch of hypertrophic scar fibroblasts and normal skin fibroblasts were treated with 10 ng/mL transforming growth factor beta1 (TGF-β1) for 30 min, 1 h, 2 h, and 6 h, respectively, and then the protein expressions and mRNA expressions of SnoN of untreated cells and treated cells were detected as above. Data were processed with one way analysis of variance and independent sample t test.@*Results@#(1) The protein expression of SnoN of hypertrophic scar fibroblasts was 0.020±0.003, significantly lower than that of normal skin fibroblasts (0.032±0.005, t=7.19, P<0.05). (2) The mRNA expression of SnoN of hypertrophic scar fibroblasts was 0.407±0.157, with no significant difference from that of normal skin fibroblasts (0.339±0.095, t=-1.29, P>0.05). (3) The protein expression of SnoN of normal skin fibroblasts was increased in a time-dependent fashion with the TGF-β1 stimulation, and the protein expressions of SnoN of cells treated with TGF-β1 for 30 min, 1 h, 2 h, and 6 h were significantly higher than those of untreated cells (with t values from 2.27 to 27.89, P values below 0.05). The protein expression of SnoN of hypertrophic scar fibroblasts was decreased in a time-dependent fashion with the TGF-β1 stimulation, and the protein expressions of SnoN of cells treated with TGF-β1 for 30 min, 1 h, 2 h, and 6 h were obviously lower than those of untreated cells (with t values from 10.80 to 13.85, P values below 0.05). (4) The mRNA expressions of SnoN of normal skin fibroblasts and hypertrophic scar fibroblasts were both increased in a time-dependent fashion with the TGF-β1 stimulation, and the mRNA expressions of SnoN of the two types of cells treated with TGF-β1 for 30 min, 1 h, 2 h, and 6 h were both significantly higher than those of untreated cells (with t values from 18.16 to 58.22, P values below 0.05).@*Conclusions@#The protein expression of SnoN in hypertrophic scar fibroblasts is reduced, which weakens its inhibitory effect on TGF-β1 signal, thus amplifying the TGF-β1 signal, and it may participate in the formation of hypertrophic scar.
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Objective@#To explore the effects of silencing Smad ubiquitination regulatory factor 2 (Smurf2) on the secretion of transforming growth factor beta 1 (TGF-β1), alpha-smooth muscle actin (α-SMA), and collagen type Ⅰ by human hypertrophic scar-derived fibroblasts.@*Methods@#The human normal skin-derived fibroblasts and hypertrophic scar-derived fibroblasts were cultured with explant culture technique from the normal skin and hypertrophic scar tissue, which was obtained from 9 patients with hypertrophic scars after burn. Two kinds of fibroblasts of the third passage were both divided into 6 groups according to the random number table, with 9 wells in each group. Fibroblasts in blank control group were cultured for 72 h without transfection of any small interfering RNA (siRNA), fibroblasts in negative control group were for cultured for 72 h after transfected with non-target siRNA, fibroblasts in Smurf2 siRNA group were cultured for 72 h after transfected with 100 nmol/L Smurf2 siRNA, fibroblasts in blank control+ TGF-β1 group were cultured for 72 h without transfection of any siRNA and then treated with 10 ng/mL TGF-β1 for 6 h, fibroblasts in negative control+ TGF-β1 group were cultured for 72 h after transfected with non-target siRNA and then treated with 10 ng/mL TGF-β1 for 6 h, fibroblasts in Smurf2 siRNA+ TGF-β1 group were cultured for 72 h after transfected with Smurf2 siRNA and then treated with 10 ng/mL TGF-β1 for 6 h. (1) The protein and mRNA expression levels of Smurf2 of the two kinds of cells in blank control group, negative control group, and Smurf2 siRNA group were assessed by Western blotting and reverse transcription-polymerase chain reaction (RT-PCR), respectively. (2) The content of TGF-β1 in the cell culture supernatant of the two kinds of cells in blank control group and Smurf2 siRNA group was determined by enzyme-linked immunosorbent assay (ELISA). (3) The protein expression levels of α-SMA of the two kinds of cells in the 6 groups were assessed by Western blotting. The content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in the 6 groups was determined by ELISA. (4) The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in the 6 groups were assessed by RT-PCR. The sample numbers of each group in the above experiments were all 9. Data were processed with analysis of variance of factorial design and Bonferroni test.@*Results@#(1) The protein and mRNA expression levels of Smurf2 of the two kinds of cells in Smurf2 siRNA group were significantly lower than those in blank control group and negative control group (with P values below 0.05). The protein and mRNA expression levels of Smurf2 of the two kinds of cells in blank control group and negative control group were close (with P values above 0.05). (2) The content of TGF-β1 in the cell culture supernatant of hypertrophic scar-derived fibroblasts in blank control group and Smurf2 siRNA group was respectively (4.34±0.56) and (2.14±0.28) pg/mL, which was significantly higher than (1.52±0.20) and (1.41±0.18) pg/mL of normal skin-derived fibroblasts respectively (with P values below 0.05). In hypertrophic scar-derived fibroblasts, the content of TGF-β1 in the cell culture supernatant in Smurf2 siRNA group was significantly lower than that in blank control group (P<0.05). In normal skin-derived fibroblasts, the content of TGF-β1 in the cell culture supernatant in Smurf2 siRNA group was close to that in blank control group (P>0.05). (3) The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in blank control+ TGF-β1 group were significantly higher than those in blank control group (with P values below 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in negative control+ TGF-β1 group were significantly higher than those in negative control group (with P values below 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in Smurf2 siRNA group were close to those in blank control group and negative control group (with P values above 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in Smurf2 siRNA+ TGF-β1 group were significantly lower than those in blank control+ TGF-β1 group and negative control+ TGF-β1 group (with P values below 0.05). (4) The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in blank control+ TGF-β1 group were significantly higher than those in blank control group (with P values below 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in negative control+ TGF-β1 group were significantly higher than those in negative control group (with P values below 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in Smurf2 siRNA group were close to those in blank control group and negative control group (with P values above 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in Smurf2 siRNA+ TGF-β1 group were significantly lower than those in blank control+ TGF-β1 group and negative control+ TGF-β1 group (with P values below 0.05).@*Conclusions@#Silencing Smurf2 in human hypertrophic scar-derived fibroblasts can reduce the autocrine of TGF-β1 and inhibit the TGF-β1-induced α-SMA expression and collagen type Ⅰ synthesis.
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Objective To investigate the harmless biochemical indicators for early screening of populations at high risk of suicide .Methods Seven hundred and twenty-seven new recruits were investigated according to self-rating idea of suicide scale (SIOSS) in the first month of recruitment in 2014.Twenty-five recruits (originally 27 recruits, but 2 recruits were absent from biochemical tests ) whose SIOSS scores were less than 12 were recognized as the suicidal ideation group. Another 25 recruits whose SIOSS scores were more than 12 were randomly selected as the control group .Saliva samples of the 50 recruits were collected for biochemical analysis after one month and three months of training , respectively .After three months of training , the SIOSS was also used for evaluation of suicidal ideation .Results After one-month training , the concentrations of Ca , Mg, amylase ( Amy ) and salivary acid ( SA ) in saliva were demonstrated to be statistically different between the suicidal ideation group and the control group ( P 0.05).After three-month training, the concentrations of Ca, Mg, Amy and SA in saliva between the two groups showed no significant difference (P>0.05).Conclusion After the first month training , changes in the biochemical compositions were found in the saliva of the screened recruits with suicidal ideation, which may be associated with the stress response of the body .The biochemical indicators in saliva lack specificity for suicidal ideation .
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BACKGROUND:Studies have shown that cytokine inhibitor pirfenidone can inhibit biological activity of fibroblasts by regulating a variety of cytokines. It has made good progress in the research and application of anti-fibrosis of internal organs, but the effect and mechanism for hypertrophic scars and skin fibroblasts are unclear. OBJECTIVE:To investigate the effect of pirfenidone on human hypertrophic scar fibroblasts. METHODS:Human hypertrophic scar fibroblasts were cultured using tissue culture method. Passages 3-6 cel s grew wel in the logarithmic growth phase were col ected. Cel s were divided into the control group (0 g/L pirfenidone), 0.15, 0.3 and 1 g/L pirfenidone groups according to different mass concentrations. Cel s were intervened for 12, 36 and 48 hours. RESULTS AND CONCLUSION:MTT, reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay results demonstrated that compared with the control group, cel proliferation, transforming growth factorβ1 mRNA expression, types I and III col agen secretion were decreased in the 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05), and the decrease was most significant in the 1 g/L pirfenidone group (P<0.05). At 24, 48 and 72 hours after intervention, significant differences in inhibitory rate of cel proliferation and the secretion of types I and III col agen were detected among 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05). Results confirmed that pirfenidone apparently inhibited the secretion of col agen of hypertrophic scar fibroblasts cultured in vitro, transforming growth factorβ1 expression and cel proliferation and viability.
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<p><b>OBJECTIVE</b>To analyze the detection, drug resistance, and status of infection of Acinetobacter baumannii (AB) in burn ICU during 3 years.</p><p><b>METHODS</b>A total of 2 010 specimens of wound secretion, blood, venous catheter attachment, sputum, stool and urine were collected from 505 burn patients hospitalized in our burn ICU from January 2011 to December 2013, and bacterial culture was performed. Pathogens were identified by automatic microorganism identifying and drug sensitivity analyzer. Drug resistance of all the obtained AB to 16 antibiotics commonly used in clinic, including cefoperazone/sulbactam, polymyxin, etc., was tested with K-B paper disk diffusion method. Patients with AB infection were ascertained. The WHONET 5.6 software was used to analyze the distribution of pathogens during 3 years, the isolation of AB with different sources and the status of drug resistance of AB to 16 antibiotics each year, and the status of patients with AB infection, and their outcome.</p><p><b>RESULTS</b>A total of 961 strains of pathogens were isolated, among which 185 (19.25%) strains were Gram positive cocci, 728 (75.75%) strains were Gram negative bacilli, and 48 (4.99%) strains were fungi. A total of 172 strains of AB were isolated, ranking the second place among all the detected pathogens, with 67 (38.95%) strains from wound secretion, 11 (6.40%) strains from blood, 23 (13.37%) strains from venous catheter attachment, and 71 (41.28%) strains from sputum, no AB strain was isolated from feces or urine. The AB strains were found sensitive to polymyxin and with relatively low drug resistance rate to minocycline, while the drug resistance rates were over 80.0% to the other 14 antibiotics commonly used in clinic in 2013. AB culture of wound secretion was positive in 27 patients. Among them, 7 patients suffered from wound infection, and the wound infection was caused by AB in 1 out of the 7 patients. AB culture of blood was positive in 7 patients. Among them, 3 patients suffered from bloodstream infection, and the infection was due to AB invasion in 1 out of the 3 patients. AB culture of venous catheter attachment was positive in 20 patients. Among them, 8 patients suffered from bloodstream infection, and the infection was due to AB invasion in 1 out of the 8 patients. AB culture of sputum was positive in 35 patients. Among them, 13 patients suffered from ventilatory associated pneumonia, and 2 out of the 13 patients were diagnosed as AB infection. A total of 69 patients were AB culture positive, among them 64 patients were cured, 2 patients were transferred to other hospitals, and 3 patients died, with the mortality rate of 4.35%.</p><p><b>CONCLUSIONS</b>AB in our burn ICU has a high detection rate and extensive drug resistance in above-mentioned 3 years. However, AB was mainly colonized in patients with extensive burns with a low mortality rate.</p>
Subject(s)
Humans , Acinetobacter Infections , Drug Therapy , Epidemiology , Microbiology , Acinetobacter baumannii , Anti-Bacterial Agents , Pharmacology , Burns , Microbiology , Cross Infection , Drug Resistance , Gram-Negative Bacteria , Intensive Care Units , Microbial Sensitivity TestsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of unified surgical scheme for wounds on the outcome of patients with extensive deep partial-thickness to full-thickness (briefly referred to as deep) burn.</p><p><b>METHODS</b>One hundred and thirty-seven patients with extensive deep burn hospitalized from July 2007 to November 2012 underwent unified surgery according to area of deep wound (unified scheme group, US). Among them, 57 patients with deep wound area less than 51% TBSA received escharectomy or tangential excision by stages followed by autologous mesh skin grafting; 52 patients with deep wound area from 51% to 80% TBSA underwent escharectomy or tangential excision by stages followed by autologous mesh skin grafting and/or small skin grafting, or escharectomy or tangential excision followed by large sheet of allogeneic skin covering plus autologous mesh skin grafting and/or small skin grafting after the removal of allogeneic skin; 28 patients with deep wound area larger than 80% TBSA received escharectomy or tangential excision by stages followed by autologous microskin grafting plus coverage of large sheet of allogeneic skin, or escharectomy or tangential excision followed by small autologous skin grafting and/or intermingled grafting with small autologous and/or allogeneic skin. Another 120 patients with extensive deep burn hospitalized from January 2002 to June 2007 who did not receive unified surgical scheme were included as control group (C). Except for the surgical methods in group US, in 53 patients with deep wound area less than 51% TBSA in group C escharectomy or tangential excision was performed followed by autologous small skin grafting; in 40 patients with deep wound area from 51% to 80% TBSA in group C escharectomy or tangential excision was performed followed by autologous microskin grafting plus large sheet of allogeneic skin covering, or escharectomy or tangential excision followed by large sheet of allogeneic skin embedded with stamp-like autologous skin; in 27 patients with deep wound area larger than 80% TBSA in group C escharectomy or tangential excision was performed followed by covering with large sheet of allogeneic skin embedded with stamp-like autologous skin without intermingled grafting with small autologous and allogeneic skin in group US. In group US, escharectomy of full-thickness wound in extremities was performed with the use of tourniquet in every patient; saline containing adrenaline was subcutaneously injected when performing escharectomy or tangential excision over the trunk and skin excision; normal skin and healed superficial-thickness wound were used as donor sites for several times of skin excision. The baseline condition of patients and their treatment in the aspects of fluid resuscitation, nutrition support, anti-inflammation, and organ function support were similar between the two groups. The mortality and incidence of complications of all patients and wound healing time and times of surgery of healed patients were compared between the two groups. Data were processed with independent sample t test, Mann-Whitney U test, and Fisher's exact test.</p><p><b>RESULTS</b>(1) Both the mortality and the incidence of complications of patients with deep wound area less than 51% TBSA in group US were 0, which were close to those of group C (with P values above 0.05). The number of times of surgery of healed patients with deep wound area less than 51% TBSA in group US was 2.4 ± 0.9, which was obviously fewer than that of group C (3.5 ± 1.8, U=-5.085, P<0.001), but with wound healing time close to that of group C (U=-1.480, P>0.05). (2) Both the mortality and the incidence of complications of patients with deep wound area from 51% to 80% TBSA in group US were 0, which were significantly lower than those of group C [both as 20.0% (8/40), with P values below 0.01]. The number of times of surgery and wound healing time of healed patients with deep wound area from 51% to 80% TBSA in group US were respectively 3.0 ± 1.0 and (43 ± 13) d, which were obviously fewer or shorter than those in group C [4.2 ± 2.3 and (61 ± 34) d, with U values respectively -2.491 and -2.186, P values below 0.05]. (3) Both the mortality and the incidence of complications of patients with deep wound area larger than 80% TBSA in group US were 25.0% (7/28), which were close to those of group C [both as 25.9% (7/27), with P values above 0.05]. The number of times of surgery and wound healing time of healed patients with deep wound area larger than 80% TBSA in group US were close to those of group C (with U values respectively -0.276 and -0.369, P values above 0.05).</p><p><b>CONCLUSIONS</b>Unified surgical scheme can indirectly decrease the mortality and the incidence of complications of burn patients with deep wound area from 51% to 80% TBSA; it can reduce times of surgery of healed patients of this type and shorten their wound healing time.</p>