Objective To introduce the research progress in the immune of composite tissue allotransplantation. Methods The related articles were reviewed to summarize the immune characteristics, experimental developments, and cl inical experiences of composite tissue allotransplantation. Results Composite allogeneic tissue is on the body surface, including the composition of the complex with high antigenicity. There are a lot of differences in the immune responsesbetween composite tissue allotransplantation and organ transplantation, such as immunosuppressant protocol, rejectiondiagnosis, and chronic rejection. Conclusion In the next study, it is urgently needed to learn these experiences and toestabl ish the special standard of composite tissue allotransplantation in induction of immune tolerance, local medication, and rejection diagnosis.
Objective To explore the protective effects of liver X receptor-αactivator ( LXRα)T0901317 on rats with acute lung injury ( ALI) . Methods Seventy-two male Wistar rats were randomly divided into three goups, ie. a control group, a LPS group, and a T0901317 group. Artery blood gas analysis,lung tissue wet/dry weight ratio,myeloperoxidase activity, and lung histopathological changes were measured.The expressions of LXRαand TNF-αmRNA in lung tissue were detected by RT-PCR. The protein levels ofTNF-αand LXRαwere examined with ELISA and immunohistochemistry, respectively. Results In the ALI rats, PaO2 decreased, lung W/D weight ratio and myeloperoxidase activity increased significantly compared with the control group ( P lt; 0. 05) . Histopathological examination also revealed obvious lung injury. In theLPS group, the expression of TNF-αmRNA in lung tissue and the level of TNF-αprotein in lung homogenate and serum increased markedly( all P lt; 0. 05) while the expression of LXR-αmRNA declined significantly ( P lt; 0. 05) . Immunohistochemical staining showed that lung tissues of the normal rats expressed LXRαsignificantly but in the LPS group the expression of TNF-αand LXR-αin lung tissue decreased markedly ( P lt;0. 05) . After the treatment with T0901317, the expressions of LXR-αin lung tissues were significantly higher than those in the LPS group both at the mRNA and the protein level ( P lt; 0. 05) . Conclusion T0901317 plays an anti-inflammatory effect through up-regulating the expression of LXR-αand suppressing the expression of TNF-α, thus reduces the infiltration and aggregation of inflammatory cells in lung tissue.
Objective To investigate the influence of enamel matrix proteins (EMPs) on the attachment, prol iferation and pre-mRNA of type I collagen synthesis of cultured human dermal fibroblast cells. Methods Human dermal fibroblast cells were obtained from human acrobystia and cultured in DMEM medium with 10% FBS. The 3rd to 6th passage cells were used. Ninety-six-well plates and 6-well plates were pre-coated with different concentrations of EMPs (50, 100, 150 and200 μg/ mL). ① The cell attachment experiment: 0.2 mL cells suspension at the concentration of 1 × 106/mL was added to the pre-coated 96-well plates as the experimental groups (groups A, B, C and D based on different concentrations of EMPs). At 1.5, 3.0, and 4.5 hours after inoculation, the attached cells were measured by MTT method. ② The cell prol iferation experiment: 0.2 mL cells suspension at the concentration of 5 × 104/mL was added to the pre-coated 96-well plates as the experimental groups (groups A1, B1, C1 and D1 based on the different concentrations of EMPs). At 2, 4, 6 and 8 days after inoculation, the cells were measured by MTT method. ③ The synthesis experiment of pre-mRNA: 2 mL cells at the concentration of 1 × 106/mL was added to the pre-coated 6-well plates as the experimental groups (groups A2, B2, C2 and D2 based on different concentrations of EMPs). At 5 days after inoculation, the synthesis of pre-mRNA was measured by RT-PCR method. Human dermal fibroblast cells were added to the un-coated plates as the control groups. Results ① The cell attachment experiment: There were significant differences in attachment cells between the control group, group A and the groups B, C and D (P lt; 0.05). There were no significant difference between group A and control group (P lt; 0.05). ② The cell prol iferation experiment: At 2 days, there were no significant differences in absorbance between the control group and the experimental groups (P gt; 0.05); at 4 days and 6 days, the absorbance of groups B1 (0.598 ± 0.020 and 0.639 ± 0.016 ), C1 (0.582 ± 0.017 and 0.641 ± 0.020) and D1 (0.574 ± 0.021and 0.635 ± 0.021) was significantly higher than that of the control group (0.548 ± 0.021 and 0.605 ± 0.019, P lt; 0.05); at 8 days, the absorbance of group B1 (0.629 ± 0.012) and group C1 (0.631 ± 0.014) was significantly higher than that of the control group (0.606 ± 0.031, P lt; 0.05). ③ The synthesis experiment of pre-mRNA: The synthesis of type I collage pre-mRNA of groups B2, C2 and D2 was significantly higher than that of the control group. Conclusion EMPs stimulate human dermal fibroblast cell attachment, prol iferation and synthesis of type I collage pre-mRNA, and its maximal effect can be achieved at the concentration of 100 μg /mL.
Objective To explore the effect of short-term low-frequency electrical stimulation (SLES) during operation on nerve regeneration in delayed peripheral nerve injury with long gap. Methods Thirty female adult Sprague Dawley rats, weighing 160-180 g, were used to prepare 13-mm defect model by trimming the nerve stumps. Then all rats were randomly divided into 2 groups, 15 rats in each group. After nerve defect was bridged by the contralateral normal sciatic nerve, SLES was applied in the experimental group, but was not in the control group. The spinal cords and dorsal root ganglions (DRGs) were harvested to carry out immunofluorescence histochemistry double staining for growth-associated proteins 43 (GAP-43) and brain-derived neurotrophic factor (BDNF) at 1, 2, and 7 days after repair. Fluorogold (FG) retrograde tracing was performed at 3 months after repair. The mid-portion regenerated segments were harvested to perform Meyer’s trichrome staining, immunofluorescence double staining for neurofilament (NF) and soluble protein 100 (S-100) on the transversely or longitudinal sections at 3 months after repair. The segment of the distal sciatic nerve trunk was harvested for electron microscopy and morphometric analyses to measure the diameter of the myelinated axons, thickness of myelin sheaths, the G ratio, and the density of the myelinated nerve fibers. The gastrocnemius muscles of the operated sides were harvested to measure the relative wet weight ratios. Karnovsky-Root cholinesterase staining of the motor endplate was carried out. Results In the experimental group, the expressions of GAP-43 and BDNF were higher than those in the control group at 1 and 2 days after repair. The number of labeled neurons in the anterior horn of gray matter in the spinal cord and DRGs at the operated side from the experimental group was more than that from the control group. Meyer’s trichrome staining, immunofluorescence double staining, and the electron microscopy observation showed that the regenerated nerves were observed to develop better in the experimental group than the control group. The relative wet weight ratio of experimental group was significantly higher than that of the control group (t=4.633,P=0.000). The size and the shape of the motor endplates in the experimental group were better than those in the control group. Conclusion SLES can promote the regeneration ability of the short-term (1 month) delayed nerve injury with long gap to a certain extent.
Objective To observe the expression of Twist in esophageal squamous cell carcinoma (ESCC) and analyze the relationship between positive expression of Twist and disease-free survival, and to provide clinical evidence for reducing tumor recurrence, prolonging disease-free survival and improving prognosis. Methods Retrospective analysis of 70 ESCC patients receiving thoracic surgery from June 2010 to June 2012 in the Department of Thoracic Surgery, Sichuan Cancer Hospital was done, including 39 males and 31 females with an average age of 63.6 years. The expression of Twist in normal esophageal tissue, tumor tissue and vascular tumor emboli was observed by immunohistochemical staining of paraffin specimens. Results The positive rate of Twist in normal esophageal tissues was 42.9%, and in tumor tissue was 77.1% (P<0.05). The positive expression rate of Twist in tumor cells was 74.3% in patients with vascular tumor emboli and 80.0% in patients without vascular tumor emboli (P>0.05). The positive expression rate of Twist in tumor cells and in vascular tumor emboli was 74.3% and 71.4%, respectively (P>0.05). The expression of Twist in lymphatic vessels and blood vessels of patients with vascular tumor emboli was 56.0% and 72.0%, respectively (P>0.05). Conclusion Twist expression in esophageal cancer tissues is significantly higher than that in normal tissues, but there is no significant difference in the positive expression of Twist between tumor cells and the mean disease-free survival (P>0.05). At present, Twist expression can not be used as a prognostic indicator of esophageal cancer, and more researches need be further implemented.
Objective To analyze the Podoplanin expression in patients with esophageal squamous cell carcinoma and to find out the relationship between Podoplanin expression and tumor embolus, lymph node metastasis, tumor differentiation as well as prognosis, and to provide clinical evidence for reducing the recurrence of esophageal squamous cell carcinoma and prolonging the disease-free survival and overall survival. Methods A retrospective analysis of 70 patients with esophageal squamous cell carcinoma in our hospital from June 2010 to June 2012 was conducted, including 39 males and 31 females, with a mean age of 63.6 years. Positive diagnosis of tumor thrombus was achieved in 35 patients and negative in 35 patients. Postoperative pathological specimens were examined and normal esophageal tissues (esophageal tissue more than 5 cm from the edge of the tumor) of patients were excised as a control group. Results The positive rate of Podoplanin was 34.2% in normal esophageal tissues and 62.8% in tumor tissues. The positive rate of Podoplanin expression was 77.1% and 48.6% in esophageal squamous cell carcinoma patients with or without tumor embolus, respectively. The positive rate of Podoplanin expression in tumor cells of patients with positive and negative lymph node metastasis was 71.9% and 23.1%, respectively (P<0.05). The mean disease-free survival of patients with Podoplanin expression-negative esophageal squamous cell carcinoma was 15.2 months, which was significantly longer than that of patients with Podoplanin expression-positive esophageal squamous cell carcinoma (P<0.05). Conclusion Podoplanin expression in the tumor cells and vessels can be an important reference index to the prognosis of patients with esophageal squamous cell carcinoma.
Objective To investigate the feasibility and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using unilateral incision and internal fixation of pedicle screws and a translaminar facet screw for dural-level lumbar degenerative disease. Methods Between January 2010 and January 2012, 19 patients with dural-level lumbar degenerative disease was treated, including 7 males and 12 females with an average age of 50.4 years (range, 22-68 years) and a median disease duration of 37 months (range, 8 months to 15 years). The operated segments included L3-5 in 6 cases and L4-S1 in 13 cases. MIS-TLIF was performed by unilateral incision, and then pedicle screws and a translaminar facet screw were used for internal fixation. Results Operations were successfully performed in all cases. The mean operation time was 158 minutes; the mean intraoperative blood loss was 156 mL; the mean length of incision was 42 mm; the mean postoperative ambulation time was 35 hours; the mean hospitalization time was 4.1 days; and the mean length of translaminar facet screw was 51 mm. All the wounds healed by first intention. No complication occurred in the others except 1 case of dural tear. The patients were followed up 12-24 months (mean, 17.1 months). The visual analogue scale (VAS) scores for back and leg pain and Oswestry disability index (ODI) scores at postoperation were significantly improved when compared with preoperative ones (P lt; 0.05). The symptom disappeared gradually. The postoperative X-ray images showed that the internal fixations were in good position; all facets screws penetrated through the base of spinous process, laminar, and facets joint; of the screws, 2 (5.3%) facets screws penetrated lateral laminar, and 1 (1.8%) pedicle screw penetrated out of pedicle of vertebral arch, but no symptom of nerve injury was seen. The CT scan and three-dimensional reconstruction at postoperative 12th month showed good interbody fusion; and based on the Bridwell’s interbody fusion grading system, 11 cases were rated as grade I, and 8 cases as grade II. Conclusions MIS-TLIF by unilateral incision and internal fixation is a safe and reliable method to treat dural-level lumbar degenerative disease, and it has the advantages of short operation time, less invasion, less blood loss, and fast recovery.
Objective To summarize and analyze the clinical and video-EEG (VEEG) characteristics of adult sleep-related epilepsy, so as to provide evidence for clinical diagnosis, differential diagnosis and treatment. Methods The clinical data, routine EEG and long-term VEEG of 187 adult patients with sleep-related epilepsy treated in Department of Neurology, Xiangya Hospital, Central South University from January 2017 to December 2017 were retrospectively analyzed by χ2 test. Results Clinical manifestations: The duration of sleep-related epilepsy in 187 adults was concentrated in 1～10 years (101 cases, 54.01%); the frequency of seizures was mainly from several to dozens of times a year (99 cases, 52.94%); 119 cases (63.64%) had two or more types of seizures. Among the patients, 121 cases (39.29%) had focal origin, 152 cases (49.35%) had bilateral tonic clonus and 110 cases (58.82%) were treated with two or more drugs. EEG results: ① The detection rate of epileptiform discharges in routine EEG was 22.78%, and that in long-term video EEG was 80.43%. There was significant difference between the two methods (P< 0.01); ② Eighteen epileptiform discharges were monitored by routine EEG during interparoxysmal period and 111 epileptiform discharges were monitored by video EEG; and ③ Fifty-six epileptic events were monitored and all occurred in the process of long-term VEEG monitoring, 50 of them occurred in sleep (89.29%) and 6 in awake (10.71%); 45 cases (80.36%) were diagnosed as epileptic seizures, 9 cases (16.07%) were diagnosed as non-epileptic seizures, and 2 cases (3.57%) could not be determined. ④ The detection rate of epileptic discharges during sleep was higher than that during awake period in long-term VEEG monitoring (P< 0.01). The detection rate of epileptiform discharges in NREM stage I–II was the highest in sleep stage. Conclusion Sleep-related epilepsy in adults has certain clinical features and EEG manifestations. Compared with conventional EEG, long-term video-EEG can improve the detection rate of epileptiform discharges, provide diagnostic basis for the qualitative analysis of sleep-related seizures, and reflect the relationship between epileptiform discharges and sleep, and provide basis for the clinical diagnosis and treatment of sleep-related epilepsy in adults.
Objective To explore the application methods and values of using health failure mode and effect analysis (HFMEA) to prevent surgical site infection (SSI) in patients undergoing bone fracture and craniotomy surgery with class Ⅰ incision. Methods Patients undergoing bone fracture and craniotomy surgery with class Ⅰ incision at the Chengdu Pidu District People’s Hospital between January 2020 to December 2021 were selected. Based on whether receiving HFMEA-based risk management or not, the patients were divided into conventional group and intervention group. The compliance rates with infection control measures, changes in risk priority numbers (RPN) at various stages (1 month and 10 months after intervention) of HFMEA implementation, and the incidence of SSI between the conventional group and the intervention group were compared. Results A total of 884 surgeries were included. Among them, there were 399 cases in the conventional group and 485 cases in the intervention group; 16 cases SSI occurred. A total of 7 SSI prevention and control measures had been formulated. Except for proper surgical attire (P＞0.05), there were statistically significant differences in the compliance rate of the other prevention and control measures between the two groups of patients (P＜0.05). In the intervention group, the RPN values of pre-operative, intra-operative, and post-operative risk factors at the 10th month after intervention were all lower than those at the 1st month after intervention (P<0.05). Except for the incidence of SSI during craniotomy surgery (6.1% vs. 1.8%, P=0.375), there were statistically significant differences in the total SSI incidence (3.3% vs. 0.6%) and bone fracture surgery SSI incidence (2.7% vs. 0.5%) between the conventional group and the intervention group (P>0.05). Conclusion Applying HFMEA-based risk management techniques to prospectively identify, assess, analyze, manage and track the risk of SSI in bone fracture and craniotomy surgery with class Ⅰ incision can effectively enhance the adherence of preventive measures and reduce the incidence rate of SSI.