In order to explore the influence of purified donor regulatory T cells (T(Reg) cells) infused after allogeneic bone marrow transplantation (allo-BMT) on GVHD and hematopoietic reconstitution of mice, an allo-BMT model of C(57)BL/6-->BALB/c mice was established. CD4(+)CD25(+)T(Reg) cells were purified through bead-magnetic activated cells separated from donor mice peripheral blood. The recipient mice were randomly divided into three groups: CD4(+)CD25(+) T cells, CD4(+)CD25(-) T cells and RPMI 1640 culture medium. These cells and RPMI 1640 were infused into recipient mice by caudal veins at about 6 to 8 hours after allo-BMT respectively. Incidence of GVHD, pathological lesion of liver, spleen, small intestine, survival time and hematopoietic reconstitution in the recipients were observed after allo-BMT. The results showed that the time for WBC > 1.0 x 10(9)/L was (8.14 +/- 3.26) days, (17.62 +/- 5.71) days, (19.81 +/- 6.77) days and the time for Plt > 20.0 x 10(9)/L was (5.29 +/- 1.34) days, (8.97 +/- 3.44) days, (9.52 +/- 3.92) days in T(Reg) positive cell group, T(Reg) negative cell group and the blank control group respectively, and the recovery times of WBC and Plt in T(Reg) positive cell group were faster than that in T(Reg) negative cell group and the blank control group (P < 0.05). The scores of GVHD were (1.33 +/- 0.58), (1.80 +/- 0.27), (1.93 +/- 0.45) in three groups of mice at about 15 days after allo-BMT, respectively, the GVHD in T(Reg) positive cell group was slighter than that in T(Reg) negative cell group and the blank control group (P < 0.05). It was found that GVHD pathologic manifestations of the liver, spleen and small intestine in T(Reg) positive cell group were slighter in a certain extent than those in other two groups at about (25 - 30) days after allo-BMT. The mean survival time in three groups was (41.45 +/- 17.88) days, (18.75 +/- 14.39) days and (25.67 +/- 16.84) days after allo-BMT, respectively, which in the T(Reg) positive cell group was significantly longer than that in other two groups (P < 0.05). It is concluded that donor-T(Reg) cell infusion can mitigate the GVHD so as to reach hematopoietic reconstitution and prolong survival time after allo-BMT in mice.
Animals ; Female ; Graft vs Host Disease ; immunology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Random Allocation ; T-Lymphocytes, Regulatory ; immunology ; transplantation

Objective To investigate the distribution of water-borne fluoride and the current situation of endemic fluorosis in Yan'an city in 2006, and to evaluate the effect of water defluoridation project by improving driking water quality. Method In 2006 in Yan'an city, 5 samples from water source were collected in each selected village that was chosen according to 5 directions of East, West, South, North, and Central. Meanwhile, 1 sample from water source, 1 sample from water processing factory and 2 tap water samples were collected from each water defluoridation project. Water fluoride was determined by spectrophotometric method, teeth and skeletal fluorosis examination were performed by Dean method and "national criteria of endemic skeletal fluorosis diagnosis of China" in children aged 8-12 year and adults, respectively if water fluoride level > 1.00 mg/L Results Of 726 water samples from 293 villages tested, samples from 25 villages had higher fluoride( > 1.00 mg/L), and these villages covered a population of 11 610 people and most of these people were in Wuqi and Yanchuan counties. Water fluoride ranged from 0.10 mg/L to 3.50 mg/L, with median being 0.59 mg/L. Of 100 water samples from 25 water defluoridation projects, only 1 sample exceeded the national criteria in Yanchuan, and Wuqi counties, respectively,with fluoride level being 1.85 mg/L and 1.60 mg/L, respectively, and population exposed was 3083 and 708, respectively, with water fluoride ranged 0.30 - 2.00 mg/L In the examination of 1281 children aged 8 - 12, we detected 238 cases of dental fluorosis, and the detection rate reached 18.58%; 13 900 adults were checked, and 375 cases were confirmed of skeletal fluorosis, a detection rate reached 2.70%. Conclusions Yan'an has a wide range of water with high fluoride and severe fluorosis people. The water defluoridation projects need to be further improved. The task of prevention of endemic fluorosis is still arduous, and we should speed up the implementation of comprehensive water defluoridation measures.

Autologous fat is commonly used filling material in plastic surgery for filling and shaping of soft tissue, which has the advantages of simple material obtaining,quick operation and good shaping.The paper has reviewed the theoretical basis of facial fat filling,autologous fat survival research,transplantation of stem cells,fat compartment, autologous fat transplantation,complications and treatment measures of fat transplantation in order to provide the basis for further development and application of autologous fat transplantation.

Objective　To study the effect of acute serious smoke inhalation injury to unilateral lung on contralateral lung and the therapeutic efficacy of massive bronchoscopic lavage with saline to the primary injured bronchoalveolus at early stage after smoke inhalation on mitigating the secondary damage of the other lung and so as to confirm the therapeutic validity of lung lavage to smoke inhalation injury. Methods　Fifteen mongrel dogs were insufflated with sawdust smoke into left lung and then randomized into 2 groups. The dogs in group A were maintained intravenous glucose saline transfusion and breathed air freely for 24 h after injury. Those in group B received a massive bronchoscopic lavage with 250 ml of saline to injured lung at 1 hour after injury and then were administrated similarly to those in group A. Gas exchange function of bilateral lungs in the process were observed and pathologic and phyiopathologic changes of the lung specimen were examined after the process. Results　While the total lavaging volume was kept to 250 ml, the liquid volume remained in left lung after each operating was from 90 ml to 140 ml. All animals had a significant decline in pulmonary function after smoke inhalation injury. PaO2 in group B decreased significantly soon after the lavage and then increased gradually to exceeding that in group A. The left lung showed serious edema similarly in two groups but in right lung the water content was less, dynamic and static compliance was more in group B than in group A. Conclusion　Bronchoalveolar massive lavage at early post-injury stage to injured lung after unilateral lung smoke inhalation injury can mitigate secondary damage of the non-injured lung. Lung lavage can decrease the intensity of secondary systemic inflammatory reaction and show a therapeutic validity to smoke inhalation injury.

Objective　To investigate the existence, intensit y and persisting time of biologic activity of bronchoalveolar lavage fluid (BALF ) collected from dogs with acute severe smoke inhalation injury in early post-i njury stage. Methods　BALF was collected 1 h after the est ablishment of acute severe sawdust smoke inhalation injury in 5 dogs, and the fl uid was perfused into the lungs of Wistar rats in the amount of 5 ml/kg (gro up C). Normal saline (group A) and BALF from normal dog (group B) were perfused into the lungs of rats and served as control. The respiratory rate, PaO2, lung water content and the expanding stability of lungs in all rats were determ ined at the time points of 4,12 and 24 h after the purfusion. Results　 Compared with the rats in group A and B, the rats in group C had higher mortality, wider range in RR, higher lung water content, PaO2 decreased obviou sly and lower lung expanding stability. The rats in control groups showed sl i ght mechanic obstruction in their airways in the course of experiment. Meanwhile ，the rats in group C showed higher oxidative activities and lower total anti-o xidative activities in lung tissues. Conclusion　It is certai n that the BALF collected from dogs with acute severe smoke inhalation injury in early post-injury stage could induce obvious injury in lung structure of norma l rats, showing certain mechanic obstruction in small airways. The injuring act ivity of the BALF can be alleviated ultimately 24 h after the perfusion of the B ALF.

OBJECTIVETo analyze the incidence and the risk factors of late-onset non-infectious pulmonary complications (LONIPC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSClinical data from 144 patients who underwent allo-HSCT and survived more than 3 months at our institution between January 2003 and August 2006 were collected, and the incidence and its risk factors of LONIPC were reviewed retrospectively.

RESULTSWith a median follow-up time of 1149 (103 - 2151) d, 24 patients (16.7%) fulfilled the diagnostic criteria for LONIPC. The median time to diagnosis of LONIPC was 235 days after transplantation (range, 116 - 950 days). Three variables were associated with LONIPC on univariate analysis: CMV antigenaemia (P = 0.000), grade II-IV aGVHD (P = 0.026) and cGVHD (P = 0.002). By using a Binary Logistic regression model for multivariate analysis, cGVHD (OR = 18.804, P = 0.004) and CMV antigenaemia (OR = 14.376, P = 0.000) were the risk factors of LONIPC.

CONCLUSIONLONIPC is one of the major complications after allo-HSCT and cGVHD and CMV antigenaemia are the risk factors for developing LONIPC.

Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Incidence ; Retrospective Studies ; Risk Factors

OBJECTIVETo evaluate the impact of luteinizing hormone-releasing hormone (LHRH) on the protection of thymic function after allogenic hematopoietic stem cell transplantation (allo-HSCT).

METHODSMurine model of MHC mismatched allogeneic HSCT (C57BL/6-->BALB/c) was established. The severity of acute graft-versus-host-disease (GVHD) was assessed according to a clinical scoring system. The intra-cellular levels of IFN gamma, TNFalpha and IL-1 beta in thymocyte were analyzed by protein array and thymic function by quantification of signal-joint TCR rearrangement excision circles (sjTRECs).

RESULTSAll recipients in group A (allogeneic mice), B (allogeneic LHRH castrated-mice) and C (syngenic mice) achieved hematopoietic reconstitution. White blood cell (WBC) over 1.0 x 10(9)/L in groups A, B and C were on day (11.2 +/- 1.4), day (9.8 +/- 0.6) and day (9.7 +/- 0.7), respectively (P = 0.003, 0.002). The onset of acute GVHD in group B was (14.1 +/- 0.7) d and in group A was (11.4 +/- 1.2) d (P = 0.000). All mice in groups A and B developed acute GVHD. No mice occurred aGVHD in group C. The average scores of acute GVHD in groups A and B were (9.1 +/- 0.7) and (5.1 +/- 1.0), respectively (P = 0.000). The levels of IFN gamma, TNFalpha and IL-1 beta in control group were (2.3 +/- 2.5) ng/ml, (1.7 +/- 1.1) pg/ml and (1.8 +/- 1.2) pg/ml, respectively. The IFN gamma levels in groups A, B and C were (10.5 +/- 2.1) ng/ml, (6.7 +/- 2.1) ng/ml and (5.2 +/- 3.3) ng/ml, TNFalpha levels were (7.0 +/- 2.6) pg/ml, (4.3 +/- 0.8) pg/ml and (3.0 +/- 1.8) pg/ml, and IL-1 beta levels were (24.9 +/- 9.0) pg/ml, (17.4 +/- 3.9) pg/ml and (10.8 +/- 3.1) pg/ml, respectively. There were significant differences in the levels of cytokines between group A and the control group (P = 0.000, 0.000, 0.000). The levels of cytokines in group B were significantly higher than those in control group (P = 0.000, 0.003, 0.000). The levels of IFN gamma and IL-beta in group C were significantly higher than those of in control group (P = 0.015, 0.013), and so did in group A than in group B (P = 0.002, 0.002, 0.004), and in group A than in group C (P = 0.000, 0.000, 0.000). The analysis of linear regression showed that the average levels of IFN gamma and TNFalpha paralleled with aGVHD scores (r(2) = 0.359, P = 0.045; r(2) = 0.228, P = 0.019). The average sjTRECs copies/1000 PBMNCs were (39.4 +/- 44.7) in the control group and (12.3 +/- 13.0), (58.0 +/- 71.8) and (19.6 +/- 14.6) in groups A, B and C, respectively. There was no significant difference in the multiple comparisons of peripheral blood levels of sjTRECs among these four groups (P = 0.468).

CONCLUSIONIFN gamma, TNFalpha and IL-1 beta might be involved in the damage to the thymus by acute GVHD. Sex steroid inhibitor can not only reduce the severity of thymic damage after allo-HSCT, but also reduce the severity of aGVHD and the mechanism might be associated with the reduction of intra-cellular levels of IFN gamma in thymocyte.

Animals ; Castration ; methods ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Graft vs Host Disease ; pathology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Interferon-gamma ; metabolism ; Interleukin-1beta ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Thymus Gland ; immunology ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Although guidelines and formulas have been developed through clinical practice to define infusion rate and volume, over- and under-resuscitation are still common, followed by increasing morbidity and mortality. In order to establish an effective management for early fluid resuscitation, the clinical decision support system (CDSS) has been established. The CDSS, by utilizing information systems coupled with decision support technology, could provide recommendations for the amount of fluid to be infused based on measured biological response. The results showed that patients treated with CDSS had a significantly lower mortality, increased ventilator-free days, and ICU-free days as compared with those treated with traditional fluid management. This article reviews the concepts as well as the result of recent clinical studies of CDSS for burn patients.
Burns ; therapy ; Decision Support Systems, Clinical ; Fluid Therapy ; Humans

BACKGROUNDAspirin and clopidogrel resistance plays a significant role in the development of cardiovascular ischemic events for ninety patients undergoing percutaneous coronary intervention. Recent studies have indicated that increasing the dose of antiplatelet drugs maybe a potent method to improve the inhibition of platelet aggregation.

METHODSThrombelastograph (TEG) determinations were used to evaluate the effect of antiplatelet therapy. According to the results, 90 patients were divided into three groups and given different doses of aspirin and clopidogrel. Thirty patients with both an inhibition rate of aspirin > 50% and an inhibition rate of clopidogrel > 50% were defined as the control group. Sixty patients with an inhibition rate for aspirin < 50% and an inhibition rate for clopidogrel < 50% were defined as the resistance group. Patients in resistance group were randomly assigned to be given a routine dose (100 mg aspirin plus 75 mg clopidogrel per day, which we called a resistance plus routine dose group, R + R) and a loading dose (200 mg aspirin and 150 mg clopidogrel per day, which we called resistance plus loading dose group, R + L) of antiplatelet therapy. A 12-month follow-up was observed to examine the change of inhibition rate of antiplatelet therapy and to estimate the relationship between inhibition rate and the occurrence of cardiovascular ischemic events.

RESULTSAfter 6 months of antiplatelet therapy, the inhibition rate of aspirin in the R + L group increased from (31.4 ± 3.7)% to (68.6 ± 7.1)%, which was significantly higher than that in R + R group, (51.9 ± 8.2)% (P < 0.01). The inhibition rate of clopidogrel in the R + L group increased from (22.1 ± 3.8)% to (60.2 ± 7.4)%, which was significantly higher than in the R + R group, (45.9 ± 4.3)% (P < 0.01). The occurrence rates of cardiovascular ischemic events, stent thrombosis, recurrent unstable angina and myocardial infarction in the R + R group were 20%, 36% and 17%, respectively. Occurrence was significantly increased compared with that in the control group, 3%, 10% and 1%, respectively (P < 0.01). In contrast, the occurrence rates in the R + L group (10%, 23% and 6%, respectively) were attenuated compared with those in the R + R group (P < 0.01), although still higher than in the control group (P < 0.01).

CONCLUSIONSAlmost all of the cardiovascular ischemic events occurred in the first six months after percutaneous coronary intervention. According to the result of TEG determinations, earlier application of a loading dose of aspirin and clopidogrel can decrease the rate of recurrent cardiovascular ischemic events.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Aspirin ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; prevention & control ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; administration & dosage ; therapeutic use ; Prospective Studies ; Thrombelastography ; Thrombosis ; prevention & control ; Ticlopidine ; analogs & derivatives ; therapeutic use

OBJECTIVETo investigate the internal fixation of sternum with titanium plate for the treatment of sternal wound infection after cardiac surgery.

METHODSA retrospective study of 26 patients from Jan 2009 to Dec 2011 was carried out. All the 26 cases with sternal wounds infection after cardiac surgery, were treated by internal fixation with titanium plates.

RESULTSAll the patients had chronic infection, lasting for more than 3 months. 3 patients received vacuum-assisted closure treatment after complete debridement. All the wounds were covered with pectoral major muscle flap. All the wounds healed completely with no recurrence of infection.

CONCLUSIONSInternal fixation of sternum with titanium plate can increase the stability. It helps to improve the treatment efficacy of sternal wound infection after cardiac surgery.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgical Wound Infection ; surgery ; Thoracic Surgical Procedures ; adverse effects ; Thoracic Wall ; surgery ; Titanium