Effect of low-magnitude whole-body vibration combined with alendronate in ovariectomized rats: a random controlled osteoporosis prevention study.

BACKGROUND: Alendronate (ALE) is a conventional drug used to treat osteoporosis. Low-magnitude whole-body vibration (WBV) exercise has been developed as a potential treatment for osteoporosis. The aim of this study was to investigate whether low-magnitude WBV could enhance the protective effect of ALE on bone properties in ovariectomized rats. METHODS: A total of 128 Sprague-Dawley rats were randomly divided into five groups (SHAM, OVX+VEH, OVX+WBV, OVX + ALE, OVX+WBV+ALE). The level of WBV applied was 0.3 g at 45-55 Hz for 20 min/day, 5 day/week and for 3 months. ALE was administered in dose of 1 mg/Kg once a week. Every four weeks eight rats from each group were sacrificed and their blood and both tibiae were harvested. The expression of osteocalcin and CTX in serum was measured by enzyme-linked immunosorbent assay (ELISA) and the tibiae were subjected to metaphyseal three-point bending and µCT analysis. RESULTS: Osteocalcin rose after ovariectomy and was not appreciably changed by either alendronate or WBV alone or in combination. Alendronate treatment significantly prevented an increase in CTX. WBV alone treatment did not alter this effect. Compared with the OVX+WBV group, nearly all tested indices such as the BV/TV, TV apparent, Tb.N, Tb.Th, and Conn.D were higher in the OVX+ALE group at week 12.Compared with the OVX+WBV group, certain tested indices such as BV/TV, TV apparent, Tb.N, and Con.D, were higher in the OVX+WBV+ALE group at week 12. At week 12, tibiae treated with WBV+ALE exhibited a significantly higher Fmax compared to the OVX+VEH group, and a significant difference was also found in energy absorption between the OVX+WBV+ALE and OVX+VEH groups. CONCLUSIONS: Compared with the WBV, ALE was more effective at preventing bone loss and improved the trabecular architecture. However, WBV enhanced the effect of alendronate in ovariectomized rats by inducing further improvements in trabecular architecture.

Effect of heparin on prevention of flap loss in microsurgical free flap transfer: a meta-analysis.

The effectiveness of heparin for thromboprophylaxis during microvascular free flap transfer is uncertain. The purpose of this meta-analysis was to determine the effect of heparin on the prevention of flap loss in microsurgical free flap transfer.A search of PubMed, Cochrane databases, and Google Scholar using combinations of the search terms heparin, free flap, flap loss, free tissue transfer was conducted on March 15, 2013. Inclusion criteria were: 1) Prospective randomized trials. 2) Retrospective, non-randomized studies. 3) Patients received free tissue transfer. Flap loss rate was used to evaluate treatment efficacy. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated and compared between therapies. Four studies meet the criteria for analysis and were included. Two studiescompared aspirin and heparin, and the ORs of the 2 studies were 1.688 and 2.087. The combined OR of 2.003 (95% CI 0.976-4.109, p = 0.058) did not indicate any significant difference between heparin and aspirin therapies. Two studiescompared high and low doses of dalteparin/heparin therapies, and the ORs of the 2 studies were 4.691 and 11.00. The combined OR of 7.810 (95% CI 1.859-32.808, p = 0.005) revealed a significant difference indicating that high dose dalteparin or heparin therapy is associated with a greater flap loss rate than low dose therapy. Heparin and aspirin prophylaxis are associated with similar flap loss rates after free flap transfer, and high dose dalteparin or heparin therapy is associated with a greater flap loss rate than low dose therapy.

Advanced oxidation protein products induce inflammatory response in fibroblast-like synoviocytes through NADPH oxidase -dependent activation of NF-κB.

BACKGROUND: Advanced oxidation protein products (AOPPs), a marker of oxidative stress, are prevalent in many kinds of disorders. Rheumatoid arthritis (RA), mainly resulting from the dysfunction of fibroblast-like synoviocytes (FLSs), is related to oxidative stress. Although the increased levels of AOPPs in RA patients were reported, the effect of AOPPs on FLSs function still remains unclear. Therefore, our study aims to investigate whether AOPPs have an effect on the inflammatory response of FLSs in vitro. METHODS: FLSs obtained from both knees of rats were treated with or without AOPPs-modified rat serum albumin (AOPPs-RSA) in vitro. The mRNA and protein expression of tumor necrosis factor (TNF)-α, interleukin(IL)-1ß, matrix metalloproteinases(MMP)-3, MMP-13 and vascular endothelial growth factor (VEGF) were measured by real-time quantitative polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA), respectively. Reactive oxygen species (ROS) generation was detected by fluorescent microscope and fluorescence microplate reader. Immunoprecipitation, Co-Immunoprecipitation and western blot were performed to examine the activity of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and nuclear factor kappa B (NF-κB). RESULTS: Exposure of FLSs to AOPPs upregulated the mRNA and protein expression of TNF-α, IL-1ß, MMP-3, MMP-13 and VEGF in a concentration dependent manner. AOPPs treatment triggered ROS production in FLSs, which was significantly abolished by ROS scavenger N-acetyl-L-cysteine (NAC), superoxide dismutase (SOD), NADPH oxidase inhibitors diphenyleneiodonium (DPI) and apocynin. Challenged AOPPs induced phosphorylation of p47(phox), triggered an interaction between p47(phox), p22(phox) and gp91(phox), and significantly upregulated expression of NADPH oxidase subunits p47(phox), p22(phox) and gp91(phox). IκB degradation and nuclear translocation of NF-κB p65 induced by AOPPs were significantly blocked by SOD, NAC, DPI and apocynin. CONCLUSIONS: These data indicate that AOPPs induce inflammatory response in FLSs is medicated through NADPH oxidase-dependent activation of NF-κB.

[Probe into construction mode of wound care center].

Relevant data including diagnosis and treatment model, operation situation, etc. are analyzed in our wound care center and compared with abroad based-on literature retrieval, to find out a suitable way for setting up wound care centers in our country. Wound care center with mode of multidisciplinary cooperation that is "specialist-oriented" was established in our hospital, mirroring the experience of foreign wound care centers. The investigation showed the demands of patients could be met, their psychological and economic pressures as well as social burden might be greatly relieved in our center. For an example, we achieved our purpose readily by setting up a clinical pathway of diabetic foot according to the features of our hospital. The model of multidisciplinary cooperation, with minor adjustments, may be applicable for wound care centers at home and abroad. Our wound care center will establish better system of diagnosis and treatment to conform to the situation in our country.

[Influence of recombinant human growth hormone on body fluid compartments and water-sodium retention in severe burn patients].

OBJECTIVE: To investigate the influence of recombinant human growth hormone (rhGH) on body fluid compartments and water-sodium retention in severe burn patients. METHODS: Thirty adult patients with severe burn were divided into treatment (T) and control (C) groups by block randomized design. Patients in both groups were subcutaneously injected with same amount of rhGH (12 IU/d) or isotonic saline during 7 - 21 post burn day (PBD). The total body water (TBW), intracellular water (ICW), extracellular water (ECW) were measured by bioelectrical impedance analysis (BIA) on 7, 14, 21 PBD. The 24 h urinary output of Na+ was determined by ion selective electrode method (ISE). RESULTS: There were no significant difference in levels of TBW, ICW, ECW and 24 h urinary output of Na+ between two groups on 7, 14, 21 PBD (P > 0.05). No difference in results was found between groups at different time points (P > 0.05). After the data were analyzed, the level of TBW (36 +/- 6 L), ICW (21 +/- 4 L) on 21 PBD were evidently lower than those on 7 PBD (38 +/- 6 L, 23 +/- 7 L, P < 0.01). CONCLUSION: The level of ICW and TBW in severe burn patients decreased along with the time. Proper dosage of rhGH has no significant effect on body fluid compartments and water-sodium retention.

[Retrospective survey of nutritional support therapy in adult patients after severe burn].

OBJECTIVE: To investigate the status of nutritional support therapy in moderate and severe burn patients. METHODS: The burn patients with age over 16 y and burn area larger than 20% TBSA were enrolled in the retrospective study. According to length of stay, all patients were divided into the first period (271 cases, was from 1994 to 2001 year), and second period (273 cases, from 2002 to 2007 year), and they were subdivided into a (20% - 30% TBSA), b (31% - 50% TBSA), c (51% - 70% TBSA), d (larger than 70% TBSA) groups. The death rate and ratio of nutritional support therapy were compared. The change in albumin and other indices (including side-effects, complication, etc) were analyzed in each group in second period. RESULTS: There were similar in general conditions in both groups, however, some were obvious difference in two periods between nutritional support therapy rate (74.17% in first period vs 85.35% in second period, P < 0.01), and the ratio of parenteral nutrition to enteral nutrition (1.5:1.0 in first period, 1.0:1.5 in second period, P < 0.01). There were also significant differences in albumin levels among each group in second period on 4, 7, 14 days after burn (P < 0.05). In the second period, parenteral nutrition preparation was mostly delivered through central vein in the form of "all-in-one", among them 62 cases of positive catheter cultures were found. Enteral nutrition was delivered by oral route in 108 cases, naso-gastric or naso-enteric tubes with pump in 165 cases. 27 cases with severe gastrointestinal complications and 2 cases with inhalation pneumonia occurred. CONCLUSION: The ratio of parenteral nutrition and enteral nutrition in burn patients was higher in our ward than average level in China. There is still a long way ahead to optimize nutritional therapy.

[Influence of recombinant human growth hormone on the prognosis of patients with severe burns a prospective multi-center clinical trial].

OBJECTIVE: To investigate the influence of recombinant human growth hormone (rhGH) on the mortality of the patients with severe burns. METHODS: In a prospective multi-center randomized clinical trial, 207 adult patients with severe burns were enrolled in the study, and they were randomly divided into treatment (T, with subcutaneous injection of rhGH) and placebo control (C, with subcutaneous injection of same amount of isotonic saline) groups. The mortality, incidence of hyperglycemia and sepsis in the two groups were observed. RESULTS: The mortality rate in T group was 0.89% as compared with 5.26% in the C group (P >0.05). Hyperglycemia (blood glucose level over 10 mmol/L) was present in 36.61% of patients in T group but 18.95% in C group (P <0.01). There was no difference in the incidence of sepsis between the two groups (P > 0.05). CONCLUSION: The application of rhGH in appropriate dosage in adult patients with severe burns could be safe, but blood glucose level should be monitored during the administration.

The binding of MBL to common bacteria in infectious diseases of children.

OBJECTIVE: To purify Mannan-binding lectin (MBL) from human serum and detect its binding ability to several kinds of bacteria common in infectious diseases of children. METHODS: MBL was purified from human serum by affinity chromatography on mannan-Sepharose 4B column. Its binding ability to eight species, 97 strains of bacteria was detected by enzyme-linked lectin assay (ELLA). RESULTS: MBL has different binding ability to bacteria and shows strong binding ability to Klebsiella ornithinolytica and Escherichia coli, but shows relatively lower binding ability to Staphylococcus haemolyticus, Enterobacter cloacae and Staphylococcus epidermidis. To different isolates of Klebsiella pneumoniae, Haemophilus influenzae and Staphylococcus aureus, MBL shows quite different binding ability. CONCLUSIONS: MBL has different binding ability to different bacteria, and has relatively stronger binding ability to Gram-negative bacteria. Its binding ability to different isolates of certain kinds of bacteria is quite different.

[Optimal time for the administration of rhGH in severely burned patients--analysis of the dynamic changes of IGF axis and blood sugar].

OBJECTIVE: To investigate the effects of recombinant human growth hormone (rhGH) on the changes in serum insulin-like growth factor-I (IGF-I), IGF binding protein 3 (IGFBP-3) and blood sugar in severely burned patients, so as to validate the optimal time of rhGH administration. METHODS: Forty severely burned patients were enrolled in the study and were randomly divided into control (C), treatment 1 (rhGH given from 7 - 9 PBD, T1) and treatment 2 (rhGH from 10 - 14 PBD, T2) groups. The dynamic changes in serum IGF-I, IGFBP-3 and blood sugar on the 1, 3, 5, 7, 10, 14 and 21 PBDs in all 3 groups of burn patients were determined, analyzed and compared with one another. RESULTS: The serum IGF-I, IGFBP-3 and blood sugar levels in T1 and T2 groups were higher than those in C group after the use of rhGH, especially the IGFBP-3 and blood sugar (P < 0.05). There was no difference of all the indices between T1 and T2 groups. CONCLUSION: It might be optimal to give rhGH to severely burned patients during 7-9 PBDs.

[Treatment of partial thickness burn wound with herb plaster Tangshangxiaobogao]

OBJECTIVE: To evaluate the therapeutic effect of the herbal plaster Tangshangxiaobagao on partial thickness burn wound. METHODS: A randomized controlled trial was conducted with two herbal plasters: Tangshang-xiaobagao and Jingwanhong in 57 hospitalized burn patients. Both the effect and safety of two herbal plasters were noted in patients with partial thickness burns. RESTULTS: In superficial second degree burns, the 7 d healing rate of both groups was (61.35+/-36.26)%and (51.21+/-37.24)% and the healing time (10.56+/-3.43)d and (11.98+/-4.13)d P<0.05 respectively. While in deep second degree burns, the 14 d healing rate of both groups was (62.9+/-36.0) % and (53.9+/-32.2) % and the healing time (19.4+/-4.9)d and (21.5+/-5.5)d, respectively. Study group had lower VAS(visual analogue scale)score than control group. No obvious side effects were observed in study group. CONCLUSION: Tangshangxiaobagao is safe and may be an effective adjunct for treatment of partial thickness burn wounds.