BACKGROUNDThe cytotoxicity of dermal substitutes may be increased by the very processes used to deplete the cells. The present research aimed to investigate the method for monitoring the cytotoxicity of cell-free dermal substitutes using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) method.

METHODSThe cytotoxicity of four dermal substitutes was evaluated using the MTT method according to the standards set by the Chinese State Food and Drug Administration (SFDA). Swine acellular dermal matrix (SADM) and goat acellular dermal matrix (GADM) were produced using a repeated freeze-thaw method. Human dermal matrix glutaraldehyde composite (HADM-G) and SADM cross-linked with glutaraldehyde (SADM-G) were produced using conventional methods.

RESULTSThe cytotoxicity of all dermal substitutes ranged from Grade 0 to Grade 1, meeting the standards of the Chinese FDA. The OD(490) of both SADM and GADM was higher than that of either HADM-G or SADM-G (P < 0.05).

CONCLUSIONDermal substitutes produced by the freeze-thaw method are less cytotoxic than those produced using conventional methods.

Cell Line ; Humans ; Skin, Artificial ; adverse effects ; Tetrazolium Salts ; chemistry ; Toxicity Tests ; methods

Animals ; Collagen ; chemistry ; Goats ; Humans ; Mice ; Skin ; cytology ; immunology ; Skin, Artificial ; Swine

OBJECTIVETo explore the method for repairing circumferential wound in the wrist region due to high-voltage electrical burn.

METHODSSix patients with circumferential wound in the wrist region after high-voltage electrical burn were admitted to our hospital from January 2009 to December 2011. After debridement, wounds in the wrist were repaired with combined abdominal axial pattern flaps. The wound of wrist on the flexor aspect was repaired with paraumbilical flap carrying a portion of rectus abdominis that filled the wound cavity of the wrist on the flexor aspect. The wound of wrist on the dorsal aspect was repaired with lower abdominal flap. Pedicle division was performed 4 - 5 weeks post surgery. Some donor sites were sutured directly, and the others were closed by skin grafting after the suture of anterior sheath.

RESULTSThree flaps survived. Liquefaction necrosis of tissue was observed under two flaps, and they were healed after debridement. Radial artery embolism of wrist occurred in one flap when pedicle division was performed 5 weeks post surgery, and it was healed by a transplantation of a segment of the great saphenous vein to reconstruct radial artery right after debridement. Patients were followed up for 6 - 12 months, and satisfactory appearance and function of the flaps were observed.

CONCLUSIONSIt is a feasible option to repair circumferential wound in the wrist region due to high-voltage electrical burn by using paraumbilical flap carrying a portion of rectus abdominis muscle combined with lower abdominal flap.

Adult ; Burns, Electric ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Rectus Abdominis ; transplantation ; Skin Transplantation ; Surgical Flaps ; Wrist Injuries ; surgery

BACKGROUNDInfection due to pandrug-resistant Pseudomonas aeruginosa (PDRPA) has become a challenge in clinical practice. The aim of this research was to summarize the treatment of large-area burns (60% - 80%) with PDRPA infection and respiratory failure in our hospital over the last two years, and to explore a feasible treatment protocol for such patients.

METHODSWe retrospectively analyzed the treatment of five patients with large-area burns accompanied by PDRPA infection and respiratory failure transferred to our hospital from burn units in hospitals in other Chinese cities from January 2008 to February 2010. Before PDRPA infection occurred, all five patients had open wounds with large areas of granulation because of the failure of surgery and dissolving of scar tissue; they had also undergone long-term administration of carbapenems. This therapy included ventilatory support, rigorous repair of wounds, and combined antibiotic therapy targeted at drug-resistance mechanisms, including carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors.

RESULTSFour patients recovered from burns and one died after therapy.

CONCLUSIONSFirst, compromised immunity caused by delayed healing of burn wounds in patients with large-area burns and long-term administration of carbapenems may be the important factors in the initiation and progression of PDRPA infection. Second, if targeted at drug-resistance mechanisms, combined antibiotic therapy using carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors could effectively control PDRPA infection. Third, although patients with large-area burns suffered respiratory failure and had high risks from anesthesia and surgery, only aggressive skin grafting with ventilatory support could control the infection and save lives. Patients may not be able to tolerate a long surgical procedure, so the duration of surgery should be minimized, and the frequency of surgery increased.

Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Burns ; drug therapy ; microbiology ; Carbapenems ; therapeutic use ; Ciprofloxacin ; therapeutic use ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Macrolides ; therapeutic use ; Male ; Middle Aged ; Pseudomonas Infections ; drug therapy ; Pseudomonas aeruginosa ; drug effects ; pathogenicity ; Respiratory Insufficiency ; drug therapy ; microbiology ; Retrospective Studies ; Young Adult

Biomechanical Phenomena ; Humans ; Skin Physiological Phenomena ; Skin, Artificial ; Stress, Mechanical ; Tensile Strength

OBJECTIVETo quantify the content of type I, III collagen and their ratio in normal human skin of different age, and to explore the regulation of changes.

METHODSThe normal human skin specimens were obtained from 6 spontaneously aborted fetus and 56 burn patients of different ages, including infants (newborn -3 years), pre-school group ( > 3, < or =7 years), adolescent group ( >7, < or = 18 years), youth and middle age group ( > 18, < or = 50 years), and elderly group ( > 50 years), were studied. The total collagen content were determined by hydroxyproline method. The contents of type I, Ill collagen and their ratio were examined by immunohistochemistry.

RESULTSThe total collagen content decreased along with increase in age, and it was highest in fetus [(543 +/- 13) microg/g]. The ratio between type I and Ill collagen increased along with increase in age. The content of type III collagen was highest in fetus [(278 +/- 7) microg/g], and it decreased along with increase in age. The content of type I collagen content was [(265 +/- 7) microg/g] in fetus, and it was increased slightly in infant and pre-school groups, then decreased along with advance in age.

CONCLUSIONDecomposition of type III collagen in normal human skin may exceed its synthesis after birth immediately, leading to its reduction. Synthesis of type I collagen in normal human skin is dominant before 8 years old, and it shows an opposite tendency afterwards.

Aborted Fetus ; cytology ; metabolism ; Adolescent ; Adult ; Child ; Child, Preschool ; Collagen Type I ; analysis ; metabolism ; Collagen Type III ; analysis ; metabolism ; Female ; Humans ; Infant ; Male ; Middle Aged ; Skin ; chemistry ; metabolism ; Young Adult

OBJECTIVE:To evaluate therapeutic efficacy and safety of romethamine for assisted prevention of intraoperative and postoperative hemorrhage in placenta previa puerperal during caesarean section,and to provide evidence-based reference in clinic. METHODS:Retrieved from CNKI,Wanfang database,VIP,CBM and PubMed,randomized controlled trials(RCT)about romethamine(trial group)vs. routine therapy alone,or routine therapy combined(with)misoprostol(control group)for assisted prevention of intraoperative and postoperative hemorrhage in placenta previa puerperal during caesarean section were collected. Meta-analysis was conducted by using Rev Man 5.2 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.2.0. RESULTS:A total of 18 RCTs were included finally,involving 1 824 patients. Results of Meta-analysis showed that intraoperative bleeding amount[MD=-138.16,95%CI(-162.97,-113.35),P<0.001],bleeding amount 2 h after surgery[MD=-134.33,95%CI(-149.87,-118.79),P<0.001],bleeding amount 24 h after surgery[MD=-150.78,95%CI(-171.20,-130.37),P<0.001] and the incidence of postoperative hemorrhage [OR=0.22,95%CI(0.10,0.47),P<0.001] in trial group were significantly lower than control group,with statistical significance. The incidence of ADR in trial group was significantly lower than control group [OR=2.37,95% CI(1.09,5.17),P=0.03],with statistical significance. CONCLUSIONS:Romethamine can reduce intraoperative and postoperative bleeding amount in placenta previa puerperal during caesarean section, and do not increase the occurrence of ADR.

OBJECTIVETo screen the potential protein biomarkers in minimal residual disease (MRD) of the acute promyelocytic leukemia (APL) by comparison of differentially expressed serum protein between APL patients at diagnosis and after complete remission (CR) and healthy controls, and to establish and verify a diagnostic model.

METHODSSerum proteins from 36 cases of primary APL, 29 cases of APL during complete remission and 32 healthy controls were purified by magnetic beads and then analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The spectra were analyzed statistically using FlexAnalysis(TM) and ClinProt(TM) software.

RESULTSTwo prediction model of primary APL/healthy control, primary APL/APL CR were developed. Thirty four statistically significant peptide peaks were obtained with the m/z value ranging from 1000 to 10 000 (P < 0.001) in primary APL/healthy control model. Seven statistically significant peptide peaks were obtained in primary APL/APL CR model (P < 0.001). Comparison of the protein profiles between the two models, three peptides with m/z 4642, 7764 and 9289 were considered as the protein biomarker of APL MRD. A diagnostic pattern for APL CR using m/z 4642 and 9289 was established. Blind validation yielded correct classification of 6 out of 8 cases.

CONCLUSIONSThe MALDI-TOF MS analysis of APL patients serum protein can be used as a promising dynamic method for MRD detection and the two peptides with m/z 4642 and 9289 may be better biomarkers.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; Humans ; Leukemia, Promyelocytic, Acute ; classification ; diagnosis ; Male ; Middle Aged ; Neoplasm, Residual ; classification ; diagnosis ; Prognosis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods ; Young Adult

OBJECTIVESTo investigate the mechanisms for human telomerase reverse transcriptase (hTERT) RNA interference (RNAi) in increasing hepatocellular carcinoma cell apoptosis induced by TNF-related apoptosis-inducing ligand (TRAIL).

METHODSCell apoptosis was identified by flow cytometry analysis after annexin V/PI double staining. Expression of apoptosis-related proteins, procaspase-8, -9, -3, Bax, Bcl-2 and hTERT, were identified by Western blotting analysis; telomerase activity and telomere length were detected by telomeric repeat amplification protocol (TRAP) and telomere amount and length assay (TALA) methods.

RESULTSHepatocellular carcinoma cell apoptosis induced by TRAIL were all significantly increased by hTERT RNAi (P less than 0.05). For example, apoptosis rates were enhanced from 5.53% (untransformed) to 10.35% (transformed) in HepG 2 cells and from 14.73% to 77.24% in SMMC 7721 cells after being treated by 100 ng/ml TRAIL for 24 h. Moreover, activation of procaspase-8, -9 and -3 in transformed cells after being treated by TRAIL were all significantly raised (P less than 0.05) in a dose-dependent manner. The expression of procaspase-8, -9 and Bcl-2 were effectively augmented (P less than 0.05), but expressions of Bax and hTERT were strikingly decreased (P less than 0.05). Meanwhile, telomerase activity was apparently suppressed and telomere length was markedly shortened (P less than 0.05). There were no remarkable differences in these effects between control cells and the untransformed cells (P more than 0.05).

CONCLUSIONEnhanced cell apoptosis induced by TRAIL through hTERT RNAi may be related to up-regulation of procaspase-8 and -9 expressions. However the down-regulation of hTERT expression, reduced telomerase activity and shortened telomere length may not be related to expressions of Bcl-2 and Bax.

Apoptosis ; Carcinoma, Hepatocellular ; pathology ; Caspase 8 ; metabolism ; Caspase 9 ; metabolism ; Cell Line, Tumor ; Humans ; Liver Neoplasms ; pathology ; RNA Interference ; TNF-Related Apoptosis-Inducing Ligand ; pharmacology ; Telomerase ; genetics ; metabolism

China ; Clinical Trials as Topic ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Kidney Diseases ; drug therapy ; Prospective Studies ; Retrospective Studies ; Tripterygium