Management of Fournier gangrene in perineal region by negative-pressure wound therapy combined with delayed repair / 中华烧伤杂志

Objective@#To explore the effects of negative pressure wound therapy (NPWT) combined with delayed repair on Fournier gangrene in perineal region.@*Methods@#During July 2010 to September 2018, 16 patients with Fournier gangrene in perineal region were admitted to our center, with 13 males and 3 females, aged 30 to 76 years. In the first stage, the necrotic tissue of the wound was completely removed according to the scope of the lesion, and NPWT was applied. After the operation, general anti-infection and nutritional support were performed. In the second stage, the local flaps, free flaps, or skin grafts were chosen to repair the wounds according to the specific condition of wounds. The average length of stay and pathological diagnosis were recorded, and the survival and follow-up of skin grafts and flaps were recorded.@*Results@#All the 16 patients were cured and discharged, with an average of 29.6 days in hospital. The pathological diagnosis of biopsies were necrotizing inflammation. The wound of 1 patient was healed directly after only NPWT, the skin grafts of 5 patients, local flaps of 9 patients, and anterolateral thigh island flap of 1 patient who had NPWT combined with delayed repair survived well. Sixteen patients were followed up for 1 to 2 years after discharge, and no recurrence of Fournier gangrene was found. Among them, 5 patients with wounds involved perineum and scrotum had good appearance and function of scrotum and mons pubis.@*Conclusions@#NPWT combined with delayed plastic repair have great effects on Fournier gangrene.

Autologous granular adipose transplantation for augmentation mammoplasty : report of a case with follow up for 18 years and review of literature / 中华医学美学美容杂志

Objective To analyze the long-term follow-up result of mammaplasty by autologous granular adipose transplantation.Methods In combination with literature review,the late result was studied by means of a 18 years follow-up in a case of mammaplasty with autologous granular adipose transplantation.Results In this case,2 cm thickness of adipose tissue was formed in submammary space,it lacked lobule structure,adipose cells appearred in different size in some region,and nerve fiber was not observed.Under the same observing condition,capillary quantity in this adipose tissue was more than that in normal subcutanous fat,and the difference was significant (P ＜0.05).Conclusions If appropriate operation is carried out,the autologous granular adipose transplantation would be a safe and effective mammaplasty.The tranplanted fat might form new adipose tissue,which could survive for a long time.

PAHs exposure and occupational health risk assessment of workers in coal tar pitch factory / 中华劳动卫生职业病杂志

Objective@#To Investigation of industrial sites involving coal tar pitch to detect PAHs in the occupational environment and to assess their occupational health risks to workers.@*Methods@#Taking coal tar pitch enterprises as the research object, and making the occupational health field investigation and inspection. Detecting the 16 PAHs in the samples by high performance liquid chromatography (HPLC) , analyze the PAHs exposed dose of the workers in the place, and using cumulative toxic equivalent quantity method, loss of life expectancy method and carcinogenic risk factor method to assessment worker's occupational health risk.@*Results@#In the 15 posts involved, Some workers' exposed to the total concentration of PAHs is higher than others, the maximum exposure concentration is 1931.45ng/m3. There are different hazard risk levels in different working post due to different processes.The lifetime risk of workers is significantly higher than the acceptable range. Some workers has higher carcinogenic risk and workers' life expectancy loss is up to 1033.95 hours.@*Conclusion@#Part of the coal tar pitch workers exposed to higher concentrations of PAHs, and beyond the occupational exposure limits.And there is a high occupational health risk due to high exposure to PAHs.

Trilobed buttocks perforator pedicled propeller flaps for reparing sacrococcygeal wounds / 中华整形外科杂志

Objective@#To explore the clinical effect of reparing sacrococcygeal wounds with trilobed buttocks perforator pedicled propeller flap.@*Methods@#From February 2015 to October 2017, 9 patients with sacrococcygeal wounds were received and cured, including 7 cases of pressure ulcers and 2 cases of squamous cell carcinomas, and the sizes of the wounds ranged from 4 cm×6 cm to 6 cm×12 cm after debridement or extended resection.@*Results@#In 2 cases, inadequate drainage led to congestion under the flaps and healed in 14 days with dressing changing and drainage. The other cases were all primary healing in 10 to 12 days, and the appearances and functions were satisfied.@*Conclusions@#Trilobed buttocks perforator pedicled propeller flap was an excellent method for reparing sacrococcygeal wound. It was simple to design and caused small injury and could restore satisfied appearance and function.

Revisiting ovarian cancer microenvironment: a friend or a foe?

Development of ovarian cancer involves the co-evolution of neoplastic cells together with the adjacent microenvironment. Steps of malignant progression including primary tumor outgrowth, therapeutic resistance, and distant metastasis are not determined solely by genetic alterations in ovarian cancer cells, but considerably shaped by the fitness advantage conferred by benign components in the ovarian stroma. As the dynamic cancer topography varies drastically during disease progression, heterologous cell types within the tumor microenvironment (TME) can actively determine the pathological track of ovarian cancer. Resembling many other solid tumor types, ovarian malignancy is nurtured by a TME whose dark side may have been overlooked, rather than overestimated. Further, harnessing breakthrough and targeting cures in human ovarian cancer requires insightful understanding of the merits and drawbacks of current treatment modalities, which mainly target transformed cells. Thus, designing novel and precise strategies that both eliminate cancer cells and manipulate the TME is increasingly recognized as a rational avenue to improve therapeutic outcome and prevent disease deterioration of ovarian cancer patients.

A association of genetic polymorphisms of XRCC1 and damage levels in workers exposed to coal tar pitch / 中华劳动卫生职业病杂志

Objective@#To study the relationship between XRCC1 gene polymorphism and DNA damage in peripheral blood lymphocytes of workers exposed to coal tar pitch.@*Methods@#203 coal tar asphalt device operation area workers (exposure group) and 76 logistics management personnel (control group) as the research ob-ject, determination of 1-hydroxypyrene concentrations in the urine as polycyclic aromatic hydrocarbons expo-sure dose, using the alkaline comet assay evaluation a peripheral blood lymphocyte DNA damage degree, using TaqMan MGB real time PCR method to detect XRCC1 gene 3 loci (XRCC1-194, XRCC1-280 and XRCC1-399) single nucleotide polymorphism.@*Results@#No significant differences was observed in age, sex, smoking and alco-hol consumption between the two groups (P>0.05). The level of 1-OHP in the exposed group was significantly higher than that in the control group (1.27±0.93 μg/g creatinine) (P<0.05). The comet Olive tail moment level (3.21±0.93) in the peripheral blood lymphocytes of the exposed group was significantly higher than that in the control group (0.94 ± 0.39) (P<0.05). There was no significant difference in genotype distribution of XRCC1-194, XRCC1-280 and XRCC1-399 between the two groups (P>0.05). There was a significant correlation be-tween the XRCC1-280 locus gene polymorphism and comet Olive tail moment in the exposure group (P<0.05) af-ter adjustment for sex, age, smoking rate, drinking rate, length of service and urinary 1-OHP concentration. The comet Olive tail moment level of GG individuals carrying wild homozygous genotype was significantly lower than that of individuals carrying heterozygous genotype GA and carrying mutant homozygous genotype AA (P< 0.05) , and the difference was statistically significant (P<0.05) The comet Olive tail moment level of heterozy-gous genotype GA was significantly lower than that of genotype AA with mutational homozygous genotype AA (P<0.05) , and the difference was statistically significant (P<0.05).@*Conclusion@#Arg280His locus polymor-phism of XRCC1 gene may influence the DNA damage level of peripheral blood lymphocytes induced by occupational exposure to coal tar pitch.

Investigation and analysis on occupational hazards in a carbon enterprise / 中华劳动卫生职业病杂志

Objective@#To explore occupational-disease-inductive in a carbon enterprise workplace and personnel occupational health examination, providing the basis for occupational disease prevention and control of the industry.@*Methods@#Field occupational health survey and inspection law were used to study the the situation and degree of occupational disease hazards in carbon enterprise from 2013 to 2015.Occupational health monitoring was used for workers, physical examination, detection of occupational hazard factors and physical examination results were analyzed comprehensive.@*Results@#Dust, coal tar pitch volatiles, and noise in carbon enterprise were more serious than others. Among them, the over standard rate of coal tar pitch volatiles was 76.67%, the maximum point detection was 1.06 mg/m3, and the maximum of the individual detection was 0.67 mg/m3. There was no statistical difference among the 3 years (P>0.05) . There were no significant differences in the incidence of occupation health examination, chest X-ray, skin audiometry, blood routine, blood pressure, electrocardiogram between 3 years (P>0.05) , in which the skin and audiometry abnormal rate was higher than 10% per year.@*Conclusion@#Dust, coal tar, and noise are the main occupational hazard factors of carbon enterprise, should strengthen the corresponding protection.

Research of relationship between occupational exposure to coal tar pitch workers and cytogenetic damage / 中华劳动卫生职业病杂志

Objective@#To investigate the effect of coal tar pitch occupational exposure on the cytogenetic damage.@*Methods@#In July 2015, 691 workers exposed to coal tar pitch were selected as contact group. The administrative and the support crew 201 cases were selected as control group. Detect the tail DNA% and tail moment in peripheral blood lymphocyte as DNA damage degree by single cell gel electrophoresis (SCGE) . Detect the concentration of the metabolic product in urine by HPLC/MC as exposure levels.@*Results@#The contact group were significantly higher than the control group in tail DNA% (contact group14.44%, control group 11.17%) and olive tail moment (contact group 2.85 μm, control group 1.95 μm) . The smoking one (contact group18.51%, control group13.43%) were significantly higher than the group not smoking (contact group12.69%, control group 11.71%) in tail DNA%. The coal tar pitch content in the air of workplace have correlation with worker, stail DNA% (rs=0.10) and olive tail moment (rs=0.11) .@*Conclusion@#Occupational exposure to coal tar pitch and smoking can cause cytogenetic damage to workers.

Gelatin sponge particlesversus chitosan/alpha, beta-glycerophosphate gel microspheres in hemoptysis of pulmonary tuberculosis / 中国组织工程研究

BACKGROUND:It is reported that gelatin sponge particles and chitosan/α, β-glycerophosphate gel microspheres have high application prospects in the treatment of hemoptysis of pulmonary tuberculosis.METHODS: Forty SPF Kunming mice were selected to make animal models of pulmonary tuberculosis hemoptysis using aerosolized inhalation device and randomly divided into two groups undergoing embolization for hemostasis using gelatin sponge particles and chitosan/α, β-glycerophosphate gel microspheres, respectively. Body mass changes, hemostasis time, effective rate of hemostasis, related indexes of myocardium and pathological changes of pulmonary tuberculosis were observed at 15 and 30 days after treatment.RESULTS AND CONCLUSION:(1) Mice in the chitosan/α, β-glycerophosphate gel microspheres group had higher body mass than those in the gelatin sponge group at 15 days after treatment (P 0.05). (4) The lymphocyte infiltration and necrotic lesions were found around the microspheres, necrotic lesions were found, and there were a lot of active cells on the microspheres. There were a few lymphocytes in the gelatin sponge group. These results show that that the chitosan/α, β-glycerophosphate gel microspheres have better hemostatic effects in comparison with gelatin sponge particles in a mouse model of pulmonary tuberculosis.

The relation between vitamin D deficiency and susceptibility to spinal tuberculosis / 天津医药

Objective To explore the relation between vitamin D deficiency and susceptibility to spinal tuberculosis. Methods A total of 163 hospitalized patients with untreated spinal tuberculosis in Tianjin Haihe hospital were enrolled in this study from June 2013 to May 2016. A total of 170 individuals participated in health examination program at the same period were enrolled as the control group. The serum level of 25-hydroxyvitamin D [25(OH)D] was measured by enzyme linked immunosorbent assay. The 25(OH)D grading included serious deficiency group (0.05). In patient group, there were 107 cases of caseous necrosis type, 56 cases of hyperplasia type, and the proportion of caseous necrosis type was significantly higher in the severe deficiency group (79.17%, 76/96) than that of deficiency group (46.27%, 31/67, P<0.01). Conclusion Excluding the effect of season, vitamin D deficiency is associated with susceptibility to spinal tuberculosis and histopathologic classification.

Research progress on dexmedetomidine for the prevention of delirium in intensive care unit / 中华危重病急救医学

In the clinical practice,critically ill patients are in great risk of delirium because of the impact of psychological,surroundings,illness,and medications,with the incidence rate as high as 45％-87％.Delirium could result in bad prognosis and clinical consequences of cognitive function in late stage.Dexmedetomidine (DEX) is a novel and highly selective 2-adrenoceptor agonist.It offers beneficial pharmacological properties and has been widely used in intensive care unit (ICU).In order to provide scientific and effective references for clinical practice,this paper reviewed the development of DEX intervention for the prevention of delirium in ICU both in China and abroad refereed to the pharmacological characteristics and the efficiency in clinic and the influence factors ofthe efficiency;and also discussed the possible mechanisms,such as modulating the neurotransmitters,and attenuating stress response and inflammation.

Role ofα7 nicotinic acetylcholine receptor in attenuation of endotoxin induced delirium with dexmedetomidine in mice / 中华危重病急救医学

Objective To observe the role of α7 nicotinic acetylcholine receptor (α7nAChR) in the protection against delirium by the use of dexmedetomidine (DEX) in endotoxin derived delirium and its mechanism. Methods 100 male adult C57BL/6 mice were randomly divided into normal saline control group (NS group), DEX control group, lipopolysaccharide (LPS) induced endotoxemia model group (LPS group), DEX protection group (DEX+LPS group), and α-bungarotoxin antagonism group (α-BGT+DEX+LPS group), with 20 mice in each group. A model of endotoxemia was reproduced by intraperitoneal injection of LPS 20 mg/kg, and the mice in NS group and DEX control group were given equivalent sterile normal saline. The mice in DEX control group, DEX+LPS group, and α-BGT+DEX+LPS group were intraperitoneally injected with DEX 40 μg/kg 15 minutes before LPS injection. The mice in α-BGT+DEX+LPS group were intraperitoneally injected with α7nAChR inhibitor α-BGT 1 μg/kg 15 minutes before DEX injection. The mice in NS group were given equivalent sterile normal saline. Ten mice in each group were assigned for open field test before and 24 hours after model reproduction, and the mice were then sacrificed to obtain the specimens. The levels of tumor necrosis factor-α (TNF-α) and neuron-specific enolase (NSE) in serum were determined by enzyme-linked immune sorbent assay (ELISA). Western Blot method was used to determine the expression of choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) in hippocampus. Another 10 mice were subjected to new object recognition test to observe the total exploration time during training period and preference index at 3 hours and 24 hours after LPS challenge. Results There were no significant differences in all parameters between NS group and DEX control group. ① It was shown by the open field test results that there were no significant differences in all parameters of open field test before model reproduction among all the groups. Twenty-four hours after model reproduction, when compared with NS group, the mice in LPS group showed that they had the ability of cognition of new environment, but learning and memory abilities were lowered, and tension was increased. DEX could significantly attenuate the degree of delirium, however, the protection of DEX from the delirious syndrome was antagonized partly by α-BGT. ② The new object recognition test results showed that compared with NS group, the ability of exploring new object was decreased in LPS group. DEX could significantly improve the exploration ability. However, DEX failed to control the delirious syndrome in α-BGT+DEX+LPS group. ③ The results of ELISA showed that the levels of TNF-α and NSE in serum were significantly increased in LPS groups as compared with that in NS group, and the levels of TNF-α and NSE were significantly decreased in DEX+LPS group. However, α-BGT could antagonise the protective effect of DEX [TNF-α (ng/L) in NS, LPS, DEX+LPS and α-BGT+DEX+LPS groups was 23.72±3.13, 808.78±87.86, 192.96±31.47, 829.99±80.98, respectively, and NSE (μg/L) was 8.70±0.74, 25.90±3.03, 18.10±2.14, and 23.12±2.21, respectively, all P < 0.01]. ④ The results of Western Blot showed that compared with NS group, the protein expression of ChAT in LPS group was significantly declined, and the protein expression of AChE was significantly increased. DEX could reverse the expressions of ChAT and AChT, however, α-BGT could reverse the protective effect of DEX [ChAT (gray value) in NS, LPS, DEX+LPS and α-BGT+DEX+LPS groups was 1.536±0.150, 0.381±0.138, 0.914±0.173, 0.628±0.088, respectively, and AChE (gray value) was 0.382±0.201, 1.843±0.325, 0.898±0.155, and 1.470±0.220, respectively, P < 0.05 or P<0.01]. Conclusions Delirium syndrome may occur in mice with endotoxemia. DEX could attenuate endotoxemia-associated delirium syndrome through transforming central neurotransmitter, and its mechanism maybe related with α7nAChR.

Biocompatibility of polymethylmethacrylate as a polymer material for dental implants / 中国组织工程研究

BACKGROUND:As a kind of dental implant material, the application of titanium has certain restrictions because of its higher probability of postoperative bleeding rate, infection and gingival hyperplasia. Studies have shown that polymethylmethacrylate has been used in artificial joints and artificial bones, but rarely reported to be used as dental implant material. OBJECTIVE:To explore the biocompatibility indexes such as cytotoxicity, cel adhesion rate, relative cel proliferation rate and post-implantation inflammatory response of human osteoblasts when pure titanium and polymethylmethacrylate are used as dental implant materials, so as to provide certain reference basis for the clinical usage of polymethylmethacrylate as the dental implant material. METHODS:Human osteoblasts were cultured in vitro. Three groups were divided as folows: control group (cels cultured normaly), pure titanium group (cels cultured with titanium extract) and polymethylmethacrylate group (cels cultured with polymethylmethacrylate extract). RESULTS AND CONCLUSION:Compared with the control group, the cel adhesion rate was significantly decreased after 2, 4, 8 and 16 hours of culture with pure titanium and polymethylmethacrylate extracts (P < 0.05); the cel adhesion rate in the polymethylmethacrylate group was higher than that in the pure titanium group (P < 0.05). Compared with the control group, the cels were sparse and grew slowly after 2 days of culture with pure titanium and polymethylmethacrylate extracts. Cels in the polymethylmethacrylate group grew faster with fusiform distribution and obvious drawing phenomenon. Compared with the control group, the relative cel proliferation rate was significantly decreased after 2 days of culture with pure titanium and polymethylmethacrylate extracts (P < 0.05); the relative cel proliferation rate of polymethylmethacrylate group was higher than that of the pure titanium group (P < 0.05). The expression of inflammatory factors in rat serum was significantly increased after 7 days of implantation of titanium and polymethylmethacrylate materials (P < 0.05), the expression of inflammatory factors in the polymethylmethacrylate group was less than that in the titanium group (P < 0.05). There was only one rat developing alergic reaction, but no pyrogen reaction and no death in the polymethylmethacrylate group; and three rats presented with alergic reaction, one rat present with pyrogen reaction and no death occurred in the pure titanium group. These results demonstrate that as the dental implant material, polymethylmethacrylate is superior to pure titanium in the cel toxicity, inflammatory response and biocompatibility.

Opportune time and method of reconstruction of penile defects caused by devastating electrical burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the timing and suitable method of reconstructing penile defects caused by devastating electrical burn.</p><p><b>METHODS</b>Thirteen patients with penile defects after devastating electrical burn, hospitalized from September 1998 to August 2013, were included in this study. After the necrotic tissues in the wounds were removed by dressing changes, a local or a hinge-like flap constructed from scrotum or abdominal wall, a prelaminated hinge-like flap from forearm, or a free forearm flap was selected, according to the injury degree of the penis, for the repair of the defect or reconstruction of penis respectively.</p><p><b>RESULTS</b>The flaps survived and the wounds healed well in 2 patients repaired with local flaps from scrotum or abdominal wall. Urethritis occurred in 2 patients 6 to 9 months after the transplantation of hinge-like flaps from scrotum, and they were cured by appropriate drugs. Functions of urination and erection of penis were recovered in these 4 patients. All flaps survived in the 5 patients repaired with hinge-like flaps from abdominal wall or prelaminated flaps from forearm. The wounds in 2 patients healed; wound dehiscence occurred in the other 3 patients in different degrees, and they healed after suturing for 2 or 3 times. The function of erection of penis recovered in these 5 patients, but with discontinuity of urinary stream during urination. Among them, 3 married patients enjoyed satisfactory sexual life. All free forearm flaps survived and the wounds healed well in 4 patients. Urinary fistula occurred in 1 patient, and it was repaired by a secondary operation. These 4 patients experienced normal urination function, but only 2 patients in whom corpus spongiosum partially remained retained the function of erection of penis to certain degree. All these 4 patients could not perform normal sexual intercourse. All patients were followed up for 6 to 13 months after surgery. Under ordinary state, the length of penis was 5.9-9.3 cm, and the circumference of penis was 8.4-10.0 cm. Wound scar was not obvious in all cases. Nine patients reported a restricted erection.</p><p><b>CONCLUSIONS</b>Penile defect caused by devastating electrical burn should be repaired with a suitable flap after necrotic tissues are removed with dressing change. To repair affected penis with necrosis of a small part of cavernous body and/or corpus spongiosum, or combined with urethra defects, local flaps from scrotum or abdominal wall or hinge-like flap from scrotum should be employed. To repair those with necrosis of a large part or the whole of corpus spongiosum combined with urethra defects, hinge-like skin flaps from abdominal wall or prelaminated flaps from forearm should be employed. In patients with necrosis of a large part of cavernous body and corpus spongiosum combined with urethra defect, or total loss of penis, free forearm flaps should be employed to reconstruct penis.</p>

Association study of ZNF804A gene polymorphism rs7597593 with schizophrenia and working memory / 中华行为医学与脑科学杂志

Objective To assess the association between rs7597593 polymorphism of ZNF804A gene and schizophrenia,and to assess the relationship between rs7597593 polymorphism and working memory.Methods Schizophrenia patients and healthy controls were diagnosed in accordance with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) ; 767 schizophrenia patients and 690 healthy controls were involved.Restriction fragment length polymorphism (RFLP) was carried out to genotype rs7597593 polymorphism.The cognitive function of working memory was assessed by the N-back task.Statistical analyses were carried out with SPSS19.0 software.Results The study found no significantly different genotype frequencies (x2=1.519,P=0.468) and allele frequencies(x2=1.263,P=0.261) of rs7597593 polymorphism between schizophrenia patients and healthy controls,however in the subgroup of higher IQ (IQ ≥ 110),there were significant different distributions of both genotype and allele (x2 =9.411 and 6.529; P=0.009 and 0.011 respectively).It was also found in this subgroup that risk T allele was associated with more error at 1-back task (F=6.854,P=0.009).Conclusion These results indicated that rs7597593 polymorphism was associated with individuals having spared cognitive function; carriers of T allele had worse cognitive function,which maybe a pathway that it contributes to schizophrenia.