Objective To study the mechanism of nandrolone phenylpropionate (NP) on hepatic albumin mRNA and androgen receptor(AR) in burned rats. Methods Thirty-two Wistar rats with a deep second-degree cutaneous burn of 20% total body surface area were randomly divided into two groups:NP group (experimental group, 5 mg/kg NP) and normal saline as control group every other day. The expression copy quantity of albumin-mRNA and mean integrated absorbency(mIA) of AR in liver tissue were measured by quantitative fluorescent RT-PCR and immunohistochemistry respectively on the 4th, 7 th, 14th and 21st days of post-burned. Result The expression levels of ablumin-mRNA and AR in liver tissue in HP grouop were much higher than those in control group. The ablumin-mRNA and AR expression increased significantly(P lt; 0.05) after 7 and 14 days, whole the expression had no significant difference between NP group and control group on the 4th day. A positive correlation occurred between the expression level of albumin-mRNA and the quantity of AR in liver tissue(r=0.936, P lt; 0.05). Conclusion Nadrolone phenylpropionate up-regulated respectively the expression of albumin-mRNA and the density of AR in liver tissue.
Objective
To evaluate the mid-long term results of application research of artificial Gore-Tex chordate in mitral valvuloplasty in patients with mitral insufficiency caused by endocarditis.
Methods
We retrospectively analyzed the clinical data of 28 consecutive infective endocarditis(IE) patients who received mitral valve repair with Gore-Tex in our hospital between January 2012 and December 2015. There were 17 males and 11 females. The age of these patients ranged from 18 to 69 (52.0±15.4) years. Echocardiography before operation showed the degree of mitral regurgitation (MR) was severe in 19 patients, moderate in 9 patients. Six patients were in New York Heart Association (NYHA) class Ⅱ, 14 in class Ⅲ, 8 in class Ⅳ. There were 26 selective surgeries and 2 emergent surgeries. One patient had concomitant coronary artery bypass graft. Six patients had aortic valve replacement. Five patients had aortic valve repair. Twenty patients had tricuspid valve repair. Five patients had Maze procedure.
Results
Follow-up was done to all the patients for 6 months to 55 (30.5±6.4) months. During the follow-up, the echocardiography showed that postoperative left atrium diameter (36.64±8.50 mm vs. 51.78±17.50 mm, P<0.05) and left ventricular end-diastolic dimension (49.30±5.05 mmvs. 57.70±7.49 mm, P<0.05) were significantly smaller than those before operation. The left ventricular ejection fraction (EF) increased from 53.86%±8.16% to 59.14%±4.23% (P<0.05). No MR was found in 16 patients, mild MR in 8 patients, mild to moderate MR in 2 patients, moderate MR in 1 patient. One patient required reoperation for recurrent infection. No death or complications related to thrombosis and embolism occurred after operation.
Conclusion
Application research of artificial Gore-Tex chordate in mitral valve repair is feasible for treating mitral valve lesions caused by endocarditis, and may provide a long-term outcome to the patients.
Objective To explore the effect of nandrolone phenylpropionate (NP) on rats’ fibroblasts after injury. Methods After being isolated from granulation tissue of a onemonth wistar rat,the fibroblasts(FB) were grouped into 5 groups and cultured in RPMI1640 and 5%FBS culturing liquid with 0.5,1.0,5.0,10.0,and 15.0 μg/ml NP respectively. The control group was cultured in RPMI1640 and 5% FBS culturing liquid Fibroblasts were isolated from granulation tissue of a onemonth Wistar rat and cultured with RPMI1640 culturing liquid with 5% FBS added different doses of NP from 0.5～15.0 μg/ml in NPgroup, but only 5% FBS for the control group. Cell validity of fibroblasts was measured by MTT. The proliferetive index(PI) of the most effected group was measured by flow cytometry. Results Compared with control group, higher FB validity occured in every NP group (P＜0.05) The PI of FB in every NP group measured by flow cytometry was significantly higher than that in controlgroup(Plt;0.01). Conclusion NP can promote the replication and proliferation of FB.
Objective
To investigate the prevalence and risk factors of isolated nocturnal oxygen desaturation (INOD) in pre-discharge inpatients with chronic obstructive pulmonary disease (COPD).
Methods
Totally 431 inpatients with COPD in this department were screened during January to June in 2017, in which pre-discharge inpatients without daytime hypoxia were enrolled in this study. Portable and wearable oximeter was used to record whole night oxygen saturation, pulse, hand movement of the inpatients within two days before being discharged. The clinical characters and symptoms, resting daytime artery gas analysis results, spirometry results, Epworth Sleepiness Score (ESS), Pittsburgh Sleep Quality Index (PSQI) were recorded and compared between INOD and non-INOD patients. Moreover, these data were furtherly compared between patients with or without suspected COPD-SAHS overlap syndrome (OS) to reveal the differences in clinical features. Logistics regression was used to find out independent predictors.
Results
One hundred and six pre-discharge inpatients without daytime hypoxia were screened out and out of them, 44 patients (41.5%) were proven with INOD. Patients with INOD presented lower daytime SaO2 [(91.8±1.1)% vs. (94.4±1.5)%, P<0.05], moreover, the patients with suspected OS had a higher yearly exacerbation frequency (2.1±0.6 per yearvs. 1.4±0.4 per year, P<0.05), higher ESS score (10.5±2.7vs. 5.1±2.5, P<0.05) and PSQI (12.8±4.4vs. 7.4±3.1, P<0.05).
Conclusions
Even in pre-discharge COPD inpatients without daytime hypoxia, there is 41.5% of them suffering from unrevealed INOD. Lower daytime oxygen saturation and higher ESS indicate probable INOD and with higher exacerbation risk in OS patients. To screen out INOD in pre-discharge COPD is of clinical value and in need of attention.
Objective?To compare the double dorsal phalangeal flap (DDPF) with the combination of digital neurovascular island flap (NVIF) and first dorsal metacarpal artery flap (FDMA) in terms of repairing digit degloving injury.?Methods?From October 2005 to March 2008, DDPF was used to repair 9 patients (9 fingers) with degloving injury of the thumb and index finger and completely amputated thumb and index finger (group A). From August 1996 to June 2007, NVIF and FDMA were used to repair 13 patients (13 fingers) with the thumb degloving injury and completely amputated or necrotic thumb (group B). In group A, there were 7 males and 2 females aged 19-48 years old, there were 4 cases of thumb and index finger degloving injury repair and 5 cases of completely amputated thumb and index finger reconstruction, the skin defect ranged from 6.0 cm × 3.5 cm to 7.0 cm × 4.5 cm, and the interval between injury and operation was 3-10 hours. The size of DDPF harvested during operation was 4.0 cm × 3.5 cm-5.0 cm × 4.0 cm. In group B, there were 10 males and 3 females aged 18-50 years old, there were 5 cases of thumb degloving injury repair and 8 cases of completely amputated or necrotic thumb reconstruction, the skin defect ranged from 6.0 cm × 3.0 cm to 7.0 cm × 4.5 cm, and the interval between injury and operation was 3 hours-5 days, and the size of NVIF and FDMA harvested during operation was 3.5 cm × 3.0 cm-5.0 cm × 4.0 cm. The donor site was repaired with the full-thickness skin graft.?Results?All the flaps survived uneventfully except for 1 case in group A suffering from venous crisis 1 day after operation and 2 cases in group B suffering from FDMA artery crisis 4-12 hours after operation. Those flaps survived after symptomatic treatment. All the wounds healed by first intention. All patients in two groups were followed up for 1-12 years (average 3.2 years). All the donor sites were normal except for 3 cases in group B suffering from flexion contracture deformity of the proximal interphalangeal joint due to the scar contracture in the margin of NVIF donor site. According to Allen test, the skin temperature and color of the donor fingers in two groups were normal under room temperature; 1 case of group A and 6 NVIF donor fingers of group B were pale and cold under ice water. According to sensory recovery evaluation system, 16 fingers in group A were graded as S4, 1 as S3+, and 1 as S2; while in group B, 3 NVIF fingers were graded as S3, 6 NVIF fingers as S2, 4 NVIF fingers as S1, and 13 FDMA fingers as S4. The appearance of the recipient flap was satisfactory and the color was similar to the surrounding skin. The skin temperature and color of the flaps in two groups were normal under room temperature; 2 cases of group A and 4 recipient fingers of group B were pale and cold under ice water. In group A, all the palmar flap of the recipient finger achieved the reorientation of the recipient flap sensation; while in group B, 8 cases achieved the reorientation of the recipient flap sensation, and 5 cases had double sensation. For the two-point discrimination of the flap, group B was superior to that of group A in terms of the palmar aspect (P lt; 0.05), no significant difference was evident between two groups in terms of the dorsal aspect (P gt; 0.05), and the palmar aspect of each group was superior to the dorsal flap (P lt; 0.05).?Conclusion?DDPF is less invasive to donor finger, easy to be operated, able to partially restore the sensory of the injured finger, and suitable for the repair of the degloving injury of the thumb and the index finger. Combination of NVIF and FDMA can restore the fine sensory of recipient palmar flap better and is applicable for those patients suffering from digital nerve defects from the proximal phalanx and with high demand for the recovery of thumb sensory.
Inconsistency, impracticability and non-standardization of the selection, measurement and reporting of outcomes are three primary existing issues in clinical trials. These problems pose a threat to huge research waste when the results of similar studies are not able to be combined or compared. The key for resolution will be to standardize outcomes in traditional Chinese medicine (TCM) clinical trials and to establish a core outcome set (COS), which is a set of outcomes to be reported as a minimum in all TCM clinical trials of similar healthcare system and syndromes. The first step in the development of COS is to collect all existing outcomes, that is, to build a pool of outcomes for clinical trials of TCM. A pool of outcome is the basis of developing COS, which is important to follow strict and scientific methodology. This paper aims to construct an outcome pool from published literature, clinical trial registration protocols, and clinicians, and patients questionnaires were used to form a list of outcomes. In addition, the influencing factors of constructing an outcome pool and considerations for each problem are summarized in order to provide guidance and reference for the development of COS in clinical trials for TCM.
To investigate the computed tomography (CT) characteristics and differential diagnosis of high altitude pulmonary edema (HAPE) and COVID-19, CT findings of 52 cases of HAPE confirmed in Medical Station of Sanshili Barracks, PLA 950 Hospital from May 1, 2020 to May 30, 2020 were collected retrospectively. The size, number, location, distribution, density and morphology of the pulmonary lesions of these CT data were analyzed and compared with some already existed COVID-19 CT images which come from two files, “Radiological diagnosis of COVID-19: expert recommendation from the Chinese Society of Radiology (First edition)” and “A rapid advice guideline for the diagnosis and treatment of 2019 novel corona-virus (2019-nCoV) infected pneumonia (standard version)”. The simple or multiple ground-glass opacity (GGO) lesions are located both in the HAPE and COVID-19 at the early stage, but only the thickening of interlobular septa, called “crazy paving pattern” belongs to COVID-19. At the next period, some increased cloudy shadows are located in HAPE, while lesions of COVID-19 are more likely to develop parallel to the direction of the pleura, and some of the lesions show the bronchial inflation. At the most serious stage, both the shadows in HAPE and COVID-19 become white, but the lesions of HAPE in the right lung are more serious than that of left lung. In summary, some cloudy shadows are the feature of HAPE CT image, and “crazy paving pattern” and “pleural parallel sign” belong to the COVID-19 CT, which can be used for differential diagnosis.
