Objective To explore the diagnosis and topical treatment of diabetic foot in patients with burns.Methods Sixty-five patients with burns complicated with diabetic foot were admitted from Jan.2002 to Dec.2006.Bacterial culture of wound excretion,peripheral nerve electromyography and vascular ultrasonography of both lower extremities were performed in a part of patients.Twenty-four patients received topical treatment,including immersion bath with hypertonic saline solution and the application of epidermal growth factor,fibroblast growth factor and complex lysozyme disinfectant.Forty-one patients underwent surgical treatment.The operation methods,surgical treatment included debridement followed by direct closure,split-thickness skin grafting,repair with local skin flap or cross leg skin flap,or amputation of foot,as determined according to the condition of the wound.Results The positive rate of bacterial culture of wound excretion was 88.7%(47/53)on admission and 30.2%(16/53)one week after topical treatment.There were abnormal findings of peripheral nerve electromyography in all 31 cases.Vascular ultrasonography revealed pathological findings in both lower extremities of all 12 patients with vascular lesion,and 9 in 16 cases without vascular lesion.The lesions in all patients except 2,who were discharged in advance,healed and the cure rate was 96.9%.Conclusion Peripheral nerve electromyography and vascular ultrasonography of both lower extremities are promising auxiliary examinations for the diagnosis of diabetic foot in patients with burns.Topical treatment,which includes immersion bath with hypertonic saline solution and the application of growth factors and complex lysozyme disinfectant,as well as appropriate surgical management,plays an important role in the wound healing.

Objective: To analyze the prognosis of neonates with severe asphyxia, so as to provide insights into improvements of prognosis among neonates with severe asphyxia. Methods: Neonates with severe asphyxia born in Hangzhou Women's Hospital from 2016 to 2021 were recruited, and neonates' birth weight, gender, Apgar score, arterial blood pH value within 30 minutes after birth and maternal delivery data were collected. Outpatient follow-up was performed among neonates one year after birth, and the prognosis was evaluated with the Gesell Developmental Scale. Death or development quotient (DQ) of <75 was defined poor prognosis, and the clinical characteristics were compared between the good prognosis group and the poor prognosis group. Results: A total of 55 neonates with severe asphyxia were enrolled, including 26 boys and 29 girls, with a median birth weight of 2 845.00 g (interquartile range, 1 948.00 g). There were 52 lying-in women (3 women had twins), with a mean age of (30.56±4.08) years, including 35 women with dystocia (67.31%) and 37 primiparas (71.15%). Of 55 neonates with severe asphyxia, there were 40 neonates with good prognosis (72.73%) and 15 neonates with poor prognosis (27.27%), including 13 deaths and 2 cases with DQ of <75. The incidence of abnormal fetal position was higher in the good prognosis group than in the poor prognosis group (36.84% vs. 0%; P<0.05), and the incidence of uterine torsion or uterine rupture was higher in the poor prognosis group than in the good prognosis group (21.43% vs. 0%; P<0.05). The median Apgar score at 5 min after birth and arterial blood pH within 30 min after birth were lower in the poor prognosis group [3.00 (interquartile range, 4.00) points and (6.93±0.23)] than in the good prognosis group [6.00 (interquartile range, 4.00) points and (7.23±0.15)] (P<0.05). Conclusion Maternal uterine torsion or uterine rupture, low Apgar score at 5 min after birth, and low arterial blood pH within 30 min after birth may aggravate the poor prognosis among neonates with severe asphyxia.

Objective To investigate the value of 11C-choline PET-CT imaging in the diagnosis of benign and malignant prostate lesions with high PSA.Methods A retrospective analysis of 11C-choline PET-CT imaging results of 43 prostate lesions cases with high PSA, including 21 cases of benign prostatic hyperplasia, 22 cases of prostate cancer, all cases were diagnosed by histopathology , data was accessed 5min after injection of 11C-choline , if suspected of metastasis, whole body 11C-choline PET-CT imaging was done.Standardized uptake value ( SUV) of prostatic hyperplasia and prostate cancer were calculated and analysed.Results More uniform uptake of the imaging agent showed in benign prostatic hyperplasia, uptake in the mild metabolic or nodular prostate symmetry slightly increased, the average SUV value 1.70 ± 1.09;focal asymmetry abnormal imaging agent uptake or diffuse abnormal uptake of the imaging agent of prostate cancer manifested in 11C-choline PET/CT imaging for prostate heterogeneity were increased, the average SUV values 3.29 ±1.55;The two groups had statistically significant.Four pelvic and retroperitone-al lymph node metastasis cases ,nine cases of bone metastasis and three cases of lung metastases was found in 11C-choline PET/CT imaging.Conclusions 11C-choline PET-CT imaging is not only a better differ-ential noninvasive imaging diagnosis method of benign and malignant prostate lesions with high PSA, but al-so has contribution to accurate preoperative staging of prostate cancer.

Objective To prepare porcine acellular dermal matrix(PADM) without cytotoxicity,to evaluate its biological safety,and investigate its end result in vivo.Methods A piece of porcine split-thickness skin of 0.3-0.4mm was obtained,the epidermis was removed by hypertonic saline immersion,and then the skin was immersed in sodium hydroxide solution,and dermal cells were removed by shaking water bath at normal temperature to harvest PADM.After cross-linking and sterilization,bacteria and porcine virus were examined in the PADM.The PADM were embedded beneath the Sprague-Dawley(SD) rat's skin,and then the general and histological changes were observed after transplantation.Result The obtained PADM was soft and elastic,easy to be moulded,and convenient for operation.No cellular component was found in PADM,the collagen was regularly arranged and elastic fibers were abundant.Bacteria and virus examination of all specimens was negative.No immunologic rejection of PADM was found after being embedded beneath the skin of SD rat.The PADM adhered to the wound firmly,and it was difficult to detach 3 weeks after implantation,and the general structures of PADM beneath rat skin were discernible 24 weeks after implantation.The PADM was infiltrated by inflammatory cells in the early stage,fibroblasts and capillary vessels increased in number along with the time,and collagen fibers gradually gained a regular and compact arrangement in PADM.Conclusions The PADM prepared by hypertonic saline/sodium hydroxide method is a simple preparation process,and there is no cytotoxicity.It has a high biological safety and can be used as dermal scaffold with long-term existence in vivo.

Objective To evaluate the postoperative efficacy and safety of dexmedetomidine for cardiac surgery patients in intensive care unit. Methods A total of 90 cardiac surgery patients in the intensive care unit (ICU)were randomly assigned into dexmedetomidine group(D group,45 cases)and propofol group(P group,45 cases)to receive dexmedetomidine or propofol respectively for post-operative sedation. The ratio of sedation satisfac-tion was evaluated and calculated by Riker sedation-agitation scale(SAS),and the duration of mechanical ventila-tion,24-hour consumption of sufentanil,ICU staying time,and the incidences of side-effects(such as hypoten-sion,bradycardia,delirium etc)were recorded during the observation period. Results No significant differences were found in the ratio of sedation satisfaction and the incidences of bradycardia and delirium between the two groups (P > 0.05). The duration of mechanical ventilation and ICU staying time were significantly shorter in D group than that in P group(P<0.01),while the 24-hour consumption of sufentanil and the incidences of hypoten-sion and delirium were significantly lower than that in P group(P<0.05). Conclusion Using the dexmedetomi-dine as a postoperative sedation drug for post cardiac surgical patients in ICU is clinically effective and safe ,and the postoperative recovery of patients may be enhanced by the drug using.

BACKGROUND:Despite tissue repair with a kind of stem cels has achieved great outcomes, but the combination of two or more kinds of stem cels to construct tissue-engineered bone is stil rare.
OBJECTIVE:To evaluate the efficacy of tissue-engineered bone constructed based on combining adipose-derived stem cels with bone marrow mesenchymal stem cels and alogenic bone in rabbit posterior intertransverse lumbar interbody fusion models.
METHODS:Seventy-five New Zealand rabbits were randomly divided into five groups. L5,6 interbody fusion models were made in each group. Then, these five groups were respectively treated as folows (1) group A: bone marrow mesenchymal stem cels/alograft iliac bone with adipose-derived stem cels; (2) group B: bone marrow mesenchymal stem cels/alograft iliac bone with normal saline; (3) group C: alograft iliac bone with adipose-derived stem cels; (4) group D: alograft iliac bone with normal saline; group E: autologous iliac bone alone. Each group was detected by PET/CT to contrast the standard uptake value at 1, 3, 5 weeks postoperatively.
RESULTS AND CONCLUSION: PET/CT images showed varying degrees of bone fusion and bone metabolism enhancement in the five groups. With time, the standard uptake value was increased in each group, and except the group D, the standard uptake value was higher in al the groups at 3, 5 weeks than at 1 week (P < 0.05). There was no difference in the standard uptake value of al the five groups at weeks 3 and 5 after operation (P > 0.05). The standard uptake value of the group A was better than that in the group B and group E (P < 0.05). Taken together, the combination of adipose-derived stem cels and bone marrow mesenchymal stem cels for rapid production of tissue-engineered bone has good osteogenesis and vascularization.

This paper is to introduce our experiences in treating 2 batches of 13 burn victims transferred from remote areas on postburn days 3 and 4. Methods Thirteen burn victims of 2 mass casualties were transferred to our burns institute from remote areas on postburn days 3 and 4 on June 27, 2001 and June 2, 2002, respectively. There were 4 males and 9 females, age ranged from 20 to 43 years, with a mean age of 31.1±6.2 years. The mean total burn area was 74.3%±24.7% TBSA (range, 25% to 97%). Among them, 10 patients suffered from serious burn with mean total burn area involving 86.0%±11.5% TBSA (range, 60% to 97%), and mean full-thickness burn of 63.9%±26.3% TBSA. Four patients also manifested signs of severe inhalation injury, and 6 patients with moderate inhalation injury. In three patients with mean total burn area covering 35.5%±10.0% TBSA (range, 25% to 45%), with mean full-thickness burn of 15.3%±5.0%, were al having moderate inhalation injuries. Among these 13 patients, 3 were having high body temperature (39℃), while 3 manifested hypothermia. The heart rate was 140-160/min, and respiratory rate 26 to 32/min in 6 patients. Abdominal distension or loss of bowel sound were found in 4 patients. Low white cell and platelet count were found in some patients. In 13 cases, liver function, renal function, myocardiac enzyme, and coagulation function were abnormal. Results Among 13 burn victims, one patient died of myocarditis on postburn day 29, and another one died of hepatic failure (history of chronic hepatitis B) on postburn day 45 with only 2% TBSA of burn wound remained open. Conclusion Burns victims occurred in mass casualties who were transferred from remote areas to our Burns Institute were all in critical condition, usually with multiple complications, demanding most meticulous care. Our strategies in this regard consisted of dispatch of experienced surgeons and nurses to the referring hospitals and the airport to receive the patients to offer appropriate care to them during the journey,organization of the medical staff so that each of them was ordained specific function, thus conditions of the patients were evaluated immediately and appropriate treatment started expeditiously for those lethal complications on arrival. Timely and exact comprehensive treatments were prerequisite to save the patients’ life. Adequate metabolic support should be emphasized, and coagulant of anticoagulant treatment should be carried out when indicated.

OBJECTIVETo investigate the mechanism of β-amyloid protein (Aβ) in regulating the expression of the receptor for advanced glycation end products (RAGE).

METHODSAβ1-40 was injected into the bilateral hippocampus of rats, and 3 weeks later, the levels of reactive oxygen species (ROS) production were detected by flow cytometry. The expressions of RAGE, reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (gp9l(phox) and p47(phox)), nuclear factor-κB (NF-κB), and inhibitor of κB (IκB) were measured by Western blotting.

RESULTSInjection of Aβ1-40 caused a significant increase in the expressions of RAGE, gp9l(phox), p47(phox), phospho-p47(phox), phospho-IκBα, NF-κB and phospho-NF-κB in rat hippocampus but decreased the level of IκBα. Aβ1-40 injection also resulted in a significantly increased content of ROS in the hippocampus of the rats.

CONCLUSIONAβ up-regulates the expression of RAGE in rat hippocampus via NADPH/ ROS/NF-κB signaling pathway.

Amyloid beta-Peptides ; adverse effects ; Animals ; Hippocampus ; metabolism ; Male ; Membrane Glycoproteins ; metabolism ; NADP ; metabolism ; NADPH Oxidase 2 ; NADPH Oxidases ; metabolism ; NF-kappa B ; metabolism ; Oxidative Stress ; Peptide Fragments ; adverse effects ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic ; metabolism ; Signal Transduction ; Up-Regulation

Objective:To investigate the risk factors of diabetes mellitus complicated by pulmonary tuberculosis.Methods:The clinical data of 83 patients with diabetes mellitus complicated by pulmonary tuberculosis who received treatment in Taiyuan Fourth People's Hospital from March 2020 to March 2022 were collected. These patients were divided into sensitive group ( n = 45) and resistant group ( n = 38 ) according to the results of drug sensitivity test. Univariate and multivariate non-conditional logistic regression was performed to analyze the influential factors of drug resistance. Results:Univariate logistic regression results revealed that there were significant differences in blood CD4 +T lymphocyte count ( χ2 = 11.73, P = 0.001) and diabetic complications ( χ2 = 4.94, P = 0.026). Multivariate non-conditional logistic regression analysis was performed taking whether blood CD4 +T lymphocyte count was lower than the average level and whether patients with diabetes mellitus had complications as independent variables, and taking whether drug resistance was a dependent variable. The results showed that the OR (95% CI) value of the decreased blood CD4 +T lymphocyte count was 4.909 (1.926-12.514). It is a risk factor for drug resistance of diabetes mellitus complicated by pulmonary tuberculosis. Conclusion:The decrease of blood CD4 +T lymphocyte count is a risk factor of drug resistance in diabetes mellitus complicated by pulmonary tuberculosis, and it should be intervened early in the clinic.

Objective:To investigate the correlation between radiation dose of the pelvic bone marrow of different anatomical bony sites and the incidence of neutrophil toxicity during the three-dimensional radiotherapy concurrent chemotherapy for cervical cancer.Methods:Clinical data of 117 cervical cancer patients who received three-dimensional radiotherapy concurrent chemotherapy from 2016 to 2018 were retrospectively analyzed. The dosimetric parameters included D mean, V 5Gy, V 10Gy, V 20Gy, V 30Gy, V 40Gy and V 50Gy. The correlation between the dosimetric parameters and the lowest neutrophil count was analyzed by linear regression analysis. Clinicopathological features and dosimetric parameters were included into the multivariate regression analysis model. Results:The incidence rates of neutrophil toxicity (grade 1-4) were 10.3%, 27.4%, 11.1% and 10.3%, respectively. The linear regression analysis showed that the D mean and V 50Gy of lumbosacral vertebrae (LS), the D mean, V 5Gy, V 10Gy, V 20Gy, V 30Gy, V 40Gy and V 50Gy of the ilium were significantly correlated with the grade 2-4 neutrophil toxicity ( P=0.035、<0.001、<0.001、=0.001、=0.003、=0.001、<0.001、<0.001、<0.001). Multivariate analysis demonstrated that the V 20Gy, V 30Gy and V 50Gy of the LS, the D mean, V 5Gy, V 10Gy, V 20Gy and V 30Gy of the ilium were significantly correlated with the grade 2-4 neutrophil toxicity ( P=0.046、0.038、0.049、0.041、0.039、0.029、0.036、0.029). Conclusion:During the process of three-dimensional radiotherapy concurrent chemotherapy for cervical cancer, the volume of medium-and high-dose of LS and the volume of low-and medium-dose of ilium are significantly correlated with the risk of neutrophil toxicity.