Objective To observe the epidermal width, the amount variation and distribution character of epidermal stem cells(ESCs) and the wound healing rate at different periods of diabetes mellitus(DM) rats after trauma, thento study the correlation of them. Methods Forty-eight Wistarrats were divided into DM group and normal control group randomly(n=24).TheDM rats were induced by streptozocin (STZ) and then made chronic healing wound by special perforex.At the 3rd, 4th, 7th,14th and 21st days after trauma, the healing rate was calculated, the wound edge and granulation tissue were obtained for haematoxylin-eosin (HE) staining and immunohistochemical staining of keratin 19(K19) and β1 integrin. Then the epidermal width, the area and the gradation value of positive unit(PU) were measured. Results At the 3rd, 7th,14th and 21st days after trauma, the wound healing rates of normal rats were 24.48%±3.37%, 50.46%±1.26%, 92.82%±2.12% and 99.41%±0.66% respectively, while those of DM rats were 2.43%±1.02%, 40.59%±1.65%, 80.77%±3.57% and 85.40%±0.94% respectively, showing significant differences (Plt;0.01). Before trauma, there was no significant difference in the epidermal width between normal rats and DM rats (Pgt;0.05). However, at the 3rd, 7th, 14th and 21st days after trauma, the epidermal widths of normal rats were 26.43±3.21, 33.29±3.52, 31.53±3.35 and 26.01±3.19 μm respectively, while those of DM rats were23.58±2.33, 31.02±3.38, 33.72±5.49 and 21.80±4.02 μm respectively,the epidermal widths in DM rats were significantly lower than those in normal rats(Plt;0.01). The average PU value of K19 in normal rats were 91.68%, 93.14%, 72.27% and 70.31% respectively, while those in DM rats were 40.29%, 40.79%, 29.94% and 10.37% respectively. The average PU value of β1 integrin in normal rats were 49.6%, 91.16%, 77.13% and 57.17% respectively, while those inDM rats were 38.94%, 24.16%, 61.36% and 38.83%. The results indicated that the average PU values of K19 and β1 integrin in DM rats were significantly lower than those in normal rats(Plt;0.05). Conclusion The amountand activity decrease of ESCs may be one of the important mechanisms of difficult recovering wounds of DM rats.
Objective To explore the effectiveness of conservative dressing change method in treating skin necrosis after open reduction with internal fixation (ORIF) of calcaneal fracture. Methods Between November 2007 and June 2010, 21 cases of skin necrosis after ORIF of calcaneal fracture were treated, including 18 cases of Sanders type II and 3 cases ofSanders type III. There were 20 males and 1 female with an average age of 33.1 years (range, 23-60 years). All fractures were close fractures and were treated by ORIF with plate. Skin necrosis occurred at 3-5 days (mean, 4 days) after internal fixation. The interval of internal fixation and conservative dressing change was 3-10 days (mean, 6 days). Of 21 cases, 10 cases had superfacial skin necrosis with a size range of 1-10 cm in length and 0.5-1.5 cm in width, and 11 cases had deep skin necrosis with a size range of 1-8 cm in length and 0.5-1.5 cm in width. The conservative dressing change method was performed. Alcohol (75%) was used at the edge of the zone of skin necrosis, whereas sal ine in the central of the wound every 2-3 days. The necrosed tissue in the wound was reserved as more as possible. No patient was given antibiotic. Results Scab formed and subcrust heal ing was observed after 6-30 days (mean, 16 days) in 20 patients, 1 patient failed for discontinue treatment. No case had deep infection or osteomyl itis. The mean treatment time was 7.8 days (range, 6-14 days) in 10 cases of superfacial skin necrosis, and was 23.1 days (range, 14-30 days) in 10 cases of deep skin necrosis. All cases were followed up 92 days on average (range, 54-123 days). The scar was usually dark red and hard, protruding from the normal skin. No patient had difficulty in weight bearing or walking. Conclusion Skin necrosis after ORIF of calcaneal fracture can be cured by the conservative dressing change method, and this conservative method is effective and economic.
ObjectiveTo investigate the correlation between tumor-vessel signs on 64-slice spiral CT (MSCT) and malignant change of tubulovillous adenoma in the colon and rectum. MethodsA retrospective study of the image and the clinical data of 16 patients with tubulovillous adenoma or malignant change proved by pathologies from February 2010 to October 2012 was conducted. The tumor-vessel signs were analyzed by multiplanar reformation (MPR) and maximum intensity projection (MIP) on picture archiving and communication systems workstation. ResultsAmong the 16 cases of tubulovillous adenoma or malignant change, 2 cases of tumor diameter≤2 cm had no tumor-vessel sign; and in the 14 cases of tumor diameter >2 cm, 13 were observed to bear tumor-vessel signs. The size of the tumor and tumor-vessel signs showed a certain correlation (r=0.618, P=0.002). And the manifestation of tumor-vessel signs had obvious differences between benign and malignant tumor. For the adenoma group, it showed venous blood vessel involvement, and downy and natural contour; for the adenocarcinoma group, it showed arterial blood vessel involvement, blood vessels with uneven thickness, visible expansion and irregular defect manifestations. No obvious difference was detected among tumor-vessel signs of adenocarcinoma with different malignant degree. ConclusionMSCT combined with image reconstruction techniques (such as MPR and MIP) can clearly demonstrate tumor blood supply, and tumor-vessel in the arterial phase may suggest a high risk of malignant change of tubulovillous adenoma in the colon and rectum.
Objective To investigate the pathological changes in the neuromuscular junction during ischemiareperfusion(IR) in the skeletal muscle. Methods Forty-eight healthy adult Wistar rats (24 male, 24 female) were equally randomised into the following 6 groups: Group A (control group): no ischemiareperfusion; Group B: ischemia by clamping the blood vessels of the right hindlimb for 3 hours; Group C: ischemia by clamping for 4.5 hours;Group D: ischemia by the clamping for 4.5 hours followed by reperfusion for 1.5hours; Group E: ischemia for 4.5 hours followed by reperfusion for 24 hours; and Group F: ischemia for 4.5 hours followed by reperfusion for 2 weeks. Then, the medial head of the gastrocnemius muscle flap model was applied to the right hindlimb of each rat. The medial head of the gastrocnemius muscle was isolated completely,leaving only the major vascular pedicle, nerve and tendons intact.The proximal and distal ends (tendons) were ligated while the vessel pedicle was clamped. And then, Parameters of the muscle (performance,contraction index,colour,edema,bleeding) were observed. The muscle harvested was stained with gold chloride(AuCl3) and the enzymhistochemistry assay (succinate dehydrogenase combined with acetylcholine esterase) was performed. Morphology and configuration of the neuromuscular junction were observed during the ischemiareperfusion injury by means of the AuCl-3 staining. The result of the enzymhistochemical reactions was quantitatively analyzed with the computer imageanalysis system. And then, additional 5 rats were prepared for 3 different models identical with those in Groups A, C and E separately. The specimens were harvested from each rat and were stained with HE and AuCl-3, and they were examined under the light microscope. Results During the period of ischemia, the skeletal muscle of Group B showed the colour of purple and edema.The colour and edema became worse in Group ,while dysfunction of elasticity and contraction appeared obviously with plenty of dark red hemorrhagic effusion at the same time.After reperfusion,the color and edema of muscle in Group D became improved while the elasticity and function of contraction was not improved. Hemorrhagic effusion of Group D turned clearer and less than Group C.Group E was similar to Group D in these aspects of muscle except for much less hemorrhagic effusion. Skeletal muscle in Group F showed colour of red alternating with white, adhesion,contracture of muscle, exposure of necrotic yellow tissue and almost lost all its functions. The AuCl3 staining showed that during IR, necrosis of the myocytes was followed by degeneration of their neuromuscular junctions, and finally the nerve fibers attached to these neuromuscular junctions were disrupted like the withering of leaves. The enzymhistochemistry assay showed thatthere was no significant difference in the level of acetylcholine esterase between the ischemic group (Groups B and C) and the control group (Group A) (Pgt;0.05). However, the level of acetylcholine esterase in all the reperfused groups (Groups D, E and F) decreased significantly when compared with the control group（Group A）and the ischemic groups (Groups B and C) (Plt;0.01). Conclusion The distribution of the nerve fibers and the neuromuscular junctions in the mass of the muscles is almost like the shape of a tree. The neuromuscular junction seems to be more tolerant for ischemia than the myocyte. Survival ofthe neuromuscular junction depends on its myocytes alive. Therefore, an ischemiareperfusion injury will not be controlled unless an extensive debridement of the necrotic muscle is performed.
Objective To investigate the phenotypic change and proliferation of fibroblasts in human inflammatory strictured bile duct wall. Methods We observed the density and ultrastructure of fibroblasts, and the histologic structure in human normal bile duct wall and inflammatory strictured bile duct wall by light and electron microscope.Results The results showed that fibroblasts were the main source of extracellular matrix production in bile duct wall. The phenotype of fibroblasts in inflammatory strictured bile duct wall changed obviously, quiescent fibroblasts were activated and transformed to myofibroblasts, with massive proliferation. Conclusion These data suggest that massive proliferation of activated fibroblasts and myofibroblasts is the main source of extracellular matrix overproduction which results in inflammatory bile duct stricture.
In the clinical practice, the mechanical ventilation is a very important assisting method to improve the patients' breath. Whether or not the parameters set for the ventilator are correct would affect the pulmonary gas exchange. In this study, we try to build an advisory system based on the gas exchange model for mechanical ventilation using fuzzy logic. The gas exchange mathematic model can simulate the individual patient's pulmonary gas exchange, and can help doctors to learn the patient's exact situation. With the fuzzy logic algorithm, the system can generate ventilator settings respond to individual patient, and provide advice to the doctors. It was evaluated in 10 intensive care patient cases, with mathematic models fitted to the retrospective data and then used to simulate patient response to changes in therapy. Compared to the ventilator set only as part of routine clinical care, the present system could reduce the inspired oxygen fraction, reduce the respiratory work, and improve gas exchange with the model simulated outcome.
ObjectiveTo summarize the therapeutic targets of pancreatic cancer (PC). MethodsThe related literatures about the therapeutic targets of PC were reviewed. ResultsPC was one of the most challenging tumor in worldwide, and was characterized as a highly aggressive disease with poor overall prognosis and a high mortality rate. The hallmark of PC was its poor response to radio-and chemo-therapy. Current chemotherapeutic regimens could not provide substantial survival benefit with a clear increase in overall survival. Recently, several new approaches which could significantly improve the clinical outcome of PC had been described, involving signal-transduction pathways, immune response, stroma reaction, and epigenetic changes. ConclusionsMany therapeutic targets are involved in the treatment of PC. As current therapies failed to significantly improve the progression and the survival of PC, new therapeutic approaches and clinical studies are strongly required.
Out of 4500 patients with gastro-intesinal disorders coming to our department from January 1970 to May 1994,31 of them were fund to be suffering from gastric adenomotous polyps(GAP).The detective rat of GAP was 0.7% with two malignant adenomatous polyps detected and 13 percent of GAP cases complicated with adenocarcinoma of the stomach(4/31).The size of the polyps is closely relevant to the malignant change.Twelve patients underwent surgical therapy and 19 gastrocopic polypectomy.On follow up.2 cases of recurrence were detected in both surgical and endoscopic removal proups.
【Abstract】ObjectiveTo investigate the effects of CO2 pneumoperitoneum on blood flow of carotid arteries in atherosclerosis rabbits.MethodsFifty Japan white rabbits were randomly divided into control group and three atherosclerosis groups. In atherosclerosis group, the rabbits were randomly subjected to CO2 pneumoperitoneum with an intraabdominal pressure of 0 mm Hg, 10 mm Hg or 15 mm Hg for 2 hours, after the model were created by feeding the rabbits with high fatty diet. The blood flow of the common carotid arteries were measured by electromagnetic blood flowmeter. Artery blood samples were collected for blood gas analysis at 30 minute intervals. ResultsHigher insufflation pressures and longer duration of CO2 pneumoperitoneum were associated with greater increase in blood flow of common carotid arteries. Compared with those in control group and atherosclerosis group with 0 mm Hg CO2 pneumoperitoneum, there were statistically significant increases in blood flow of the common carotid arteries during CO2 pneumoperitoneum in 10 mm Hg and 15 mm Hg pneumoperitoneum group, the changes in 15 mm Hg pneumoperitoneum group were more significant than those in 10 mm Hg pneumoperitoneum group (Plt;0.05). When compared with the blood flow before insufflation, those in 10 mm Hg and 15 mm Hg pneumoperitoneum group also increased significantly during CO2 pneumoperitoneum, even at 30 minute after desufflation (Plt;0.05). However, those in control group and 0 mm Hg pneumoperitoneum group did not change significantly (Pgt;0.05). There were significant decrease in pH and significant increase in PCO2 in both 10 mm Hg and 15 mm Hg groups, when compared with presufflation values or those in control group and 0 mm Hg pneumoperitoneum group(Plt;0.05). The changes in pH and PCO2, however, were no significant at any time point in control group and 0 mm Hg pneumoperitoneum group (Pgt;0.05). HCO3- did not change significantly in either group(Pgt;0.05).ConclusionUnder atherosclerosis conditions, CO2 pneumoperitoneum has an adverse influence on the blood flow of the common carotid arteries which may be associated with increased intrabdominal pressure,absorbed CO2 gas.
ObjectiveTo understand the clinical distribution and drug resistance of Klebsiella pneumoniae in Yibin during 2011 to 2014 so as to provide evidence for clinical rational use of antimicrobial drugs. MethodsKlebsiella pneumoniae isolated from all types of clinical specimens were collected from the First People's Hospital and the Second People's Hospital of Yibin during 2011 to 2014. VITEK2 Compact and its supporting identification card GP and drug sensitivity test card AST-GP67 were used for detection, and the results were analyzed and summarized. ResultsMost Klebsiella pneumoniae were detected from the Department of Respiratory Medicine, the proportion for each year was 48.15%, 46.24%, 45.44%, and 44.97% during 2011 to 2014. Klebsiella pneumoniae isolated were mainly from sputum samples, the proportion for each year was 81.01%, 89.18%, 87.80%, and 83.52% between 2011 and 2014. Imipenem and piperacillin/tazobactam resistance rates were lower, but the overall trend was rising. Ampicillin/sulbactam, and sulfamethoxazole resistance rates were higher. Levofloxacin, ciprofloxacin increased year by year. Aztreonam, cefepime, and amikacin rate declined. ConclusionKlebsiella pneumoniae is one of the main infection pathogen in the Department of Respiratory Medicine. Klebsiella pneumoniae resistance rates are higher. Klebsiella pneumoniae were sensitive to enzyme inhibitors β-lactam antimicrobial agents and carbapenem antibiotics.