Objective This study is to identify long-term functional recovery and maturity of regenerated nerve fibers after repairing mouse nerve defects with chitosan/polylactide-co-polyglycolide artificial nerve grafts ( CPANGs ) . Methods Mouse sciatic nerve defects, 2mm in length, were bridged by CPANGs (n=6), with nerve autograft (n=6) and nerve defect (n=6) as controls.Plantar test, electrophysiological examination and laser Doppler perfusion imaging following nerve crush were carried out at 1 year after repair to assess nerve function recovery , while muscle wet weight ratio, histological assessment and transmission electron microscopy were performed to evaluate nerve re -innervation and maturity of regenerated nerve fibers .Results When compared to the autograft group , the CPANG group did not show statistically significant difference in functional recovery in terms of paw withdrawal latency , neurogenic vasodilatation , amplitude and latency of compound muscle action potentials ( CMAPs ) , wet weight ratio of gastrocnemius and tibialis cranialis muscles , number of myelinated nerve fibers and density of unmyelinated axons .However , both these two repair groups exhibited significantly longer CMAPs latency , thinner myelin sheath and a lag-behind shift of diameter distribution of myelinated axons as compared to the normal control .Conclusion At 1 year after the mouse sciatic nerve defect was repaired by CPANGs , sensory and autonomic nerve function , number of regenerated axons and muscle re-innervation degree were recovered to the same extent as nerve autografting , but the regenerated nerve fibers were in a state of immaturity .

Objective: To investigate the clinical characteristics of extremely severe burn patients complicated with severe inhalation injury caused by dust explosion. Methods: The medical records of 13 extremely severe burn patients complicated with severe inhalation injury in August 2nd Kunshan factory aluminum dust explosion accident, who were admitted to the First Affiliated Hospital of Soochow University on August 2nd, 2014, were retrospectively analyzed. The following indicators were collected: (1) Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at post admission hour (PAH) 24. (2) Prognosis, death time, causes of death, and the mortality of patients with different sexes. (3) The number of times of airway electronic bronchoscopy, airway characteristics, and the corresponding onset time. (4) The number and result of microorganism culture of lesion tissue during the leukoplakia formation stage. Detection of Pseudomonas aeruginosa in patients with and without leukoplakia in airway mucosa. Fisher′s exact probability test was used to detect the mortality of patients with different sexes. Kappa test was used to detect the relevancy between leukoplakia and Pseudomonas aeruginosa. Results: (1) The APACHE Ⅱ score of patients of this group at PAH 24 was (19±3) points, and the SOFA score was (12±3) points. (2) Eight patients survived, while 5 patients died, and the time of death was 19-46 (34±10) d after injury. The main cause of death was multiple organ dysfunction syndrome, which was secondary to severe infection. One of the 7 male patients and 4 of the 6 female patients died, but there was no significantly statistical difference in mortality between patients of the two sexes (P>0.05). (3) Airway electronic bronchoscopy was performed 4-25 (10±5) times among patients of this group. Hyperemia and edema were found in the airway mucosa of all the 13 patients 2-3 weeks after injury; ulcer was found in the airway mucosa of 5 patients 2-4 weeks after injury; leukoplakia was found in the airway mucosa of 7 patients 4-14 weeks after injury; granulation formed in the airway mucosa of 7 patients 10-15 weeks after injury, and airway patency was affected, which was solved after local clamping or replacement of lengthened tracheal cannula. (4) During the leukoplakia formation stage, 19 cases of microorganism culture were performed basing on airway lesion tissue, and the results were 15 cases of Pseudomonas aeruginosa, 5 cases of Acinetobacter baumannii, 2 cases of Serratia marcescens, as well as 1 case of Stenotrophomonas maltophilia, Burkholderia cepacia, and Proteus mirabilis each. Among 7 patients with airway mucosa leukoplakia, 6 patients were detected with Pseudomonas aeruginosa. Among 6 patients without airway mucosa leukoplakia, 1 patient was detected with Pseudomonas aeruginosa. The appearance of leukoplakia was consistent with the detection of Pseudomonas aeruginosa (Kappa=0.69, P<0.05). Conclusions Most of these extremely severe burn patients complicated with severe inhalation injury caused by dust explosion survived, and there was no significant gender difference in mortality. Electronic bronchoscopy showed that the early manifestations of airway mucosa were hyperemia and edema, followed by varying degrees of erosion, ulcer, leukoplakia, and granulation formation, etc. Leukoplakia may be relevant to Pseudomonas aeruginosa infection.

Objective To detect the small molecular metabolite profiles of urine from patients with acute pancreatitis (AP) in different severity,and screen the differential metabolites that have potential diagnostic value for AP and its severity.Methods Urine samples were collected from 65 AP patients (MSAP and SAP 29,MAP 36) in the First Affiliated Hospital of Soochow University,and 25 healthy volunteers served as controls.The liquid chromatograph mass spectrometer (LC-MS) combined method was used to detect urine small molecule metabolites of AP patients and healthy controls.Multivariate statistical analysis was used to establish and validate the principal component analysis (PCA) model and partial least squares discriminate analysis (PLS-DA) model to select the differential metabolites.Results PCA model had a good degree of interpretation (R2X ＞0.5),and each group of urine samples showed a good distinction between clustering trends,and good classification models were obtained.In the PLS-DA model,the differences among groups were further highlighted,and samples of each group showed distinct differentiation between clusters,with high predictability (Q2 ＞ 0.7).The model was reliable and effective indicated by the PLS-DA permutation test.17 differential metabolites were screened out by comparing AP with control.A diagnostic model constructed with 7 differential metabolites including nonanedioic acid,succinic acid semialdehyde,D-beta-hydroxy butyric acid,acetylcarnitine,angelic acid,sebacic acid and hippuric acid had a high diagnostic value for AP,with the sensitivity of 100％ and the specificity of 94％.Then control,MAP and MSAP + SAP group were compared with each other,and it was found that the model integrating urine succinic acid semialdehyde,angelic acid,D (-)-beta-hydroxy butyric acid,malic acid and acetylcarnitine had a good diagnostic value for SAP,with the sensitivity and specificity of both 90％.Conclusions LC-MS metabolomics can effectively identify the changes of urine metabolism in patients with different severity of AP.The screened differential metabolites have the potential clinical value in the diagnosis and classification of AP.

Objective To analyze the changes in serum procalcitonin (PCT) in patients with extremely severe burn and sepsis,and to evaluate its clinical significance in the prognosis of patients.Methods Thirteen patients with extremely severe burn and sepsis injured in the aluminum dust explosion accident,which occurred in Kunshan of Jiangsu province,were admitted to our unit on August 2nd,2014.They were involved in this retrospective study and divided into death group (n =5) and survival group (n =8) according to the outcome.Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score and Sequential Organ Failure Assessment (SOFA) score at post admission hour (PAH) 24 were compared among the patients between two groups.Serum level of PCT,serum level of C-reactive protein (CRP),white cell count,neutrophils,platelet count,level of aspartate transaminase (AST),level of prealbumin (PA),level of creatinine,level of urea nitrogen,and level of blood sodium were compared among the patients between two groups in post admission week (PAW) 1,2,3,and 4.Data were processed with Fisher's exact test,analysis of variance for repeated measurement,t test,and Mann-Whitney test.Receiver operating characteristic (ROC) curves of serum PCT values were plotted to evaluate the predictive value for death of 13 patients in PAW 3 and 4.Results The differences in APACHE Ⅱ score and SOFA score at PAH 24 and serum level of CRP,white cell count,level of AST,level of creatinine,level of urea nitrogen,and level of blood sodium from PAW 1 to 4 of the patients between two groups were not statistically significant (with t values from-1.164 to0.587,Zvalues from-1.872 to-0.442,Pvalues above0.05).The serum levels of PCT in patients of death group in PAW 3 and 4 were respectively (15.8 ± 14.9) and (13.6 ± 5.6) ng/mL,which were significantly higher than those of survival group [(2.4 ± 1.8) and (4.9 ± 6.1) ng/mL,with Z values respectively-2.635 and-2.208,P ＜ 0.05 or P ＜0.01].The serum levels of PCT of patients in death group and survival group in PAW 1 and 2 were close (with Z values respectively-0.732 and -1.025,P values above 0.05).Compared with those of survival group,neutrophils in PAW 4 was significantly increased (t =-3.690,P ＜ 0.01),the platelet count in PAW 4 was significantly decreased (t =4.858,P ＜ 0.01),and the level of PA in PAW 2 was significantly increased in patients of death group (t =-2.320,P ＜ 0.05).There were no statistically significant differences in neutrophils,platelet count,and the level of PA at the other time points of patients between death group and survival group (with t values from-1.562 to 1.904,P values above 0.05).The total areas under ROC curves of serum level of PCT for predicting death of 13 patients with extremely severe burn and sepsis in PAW 3 and 4 were respectively 0.938 and 0.906,and 7.45 ng/mL and 8.77 ng/mL were respectively chosen as the optimal threshold values,with sensitivity of 75.0％ and 100.0％ and specificity of 100.0％ and 87.5％.Conclusions Serum level of PCT in PAW 3 and 4 can be used as the vital prognostic indicators for patients with extremely severe burn and sepsis,and it can be considered as a guide for rational treatment in clinic.