This paper reviews the clinical application characteristics of artificial skin for external used in the treatment of burn wound at recent years. Skin is the important organ to protect the environmental stability in vivo, resist the outside invasion, evacuate moisture and regulate body temperature, as well as one component of immunity system. Subsequent to the burn injury, various damages of the organism may be related to the loss of skin barrier. Epidermal substitutes comprise the epidermal cells growing on the degradable matrix or polymer film; While dermal substitutes are shaped as a matrix with active bacterium or without cells, and they can induce the migration and proliferation of fibroblasts, together with the secretion of extracellular matrix; Full skin substitutes include both epidermal ones and dermal ones. With the progress on the biomedicines and the materials, the research regarding artificial skin also develops. However, it is still a key problem to construct an ideal artificial skin, which contains vessels and innervation, skin accessory structure and physiological function of normal skin.

Objective To study the relationship between angiotensin Ⅱ type 2 receptor (AGTR2) gene single nucleotide polymorphisms and hypertension in patients with essential hypertension and renal hypertension.Methods Direct DNA sequencing was performed to detect the single nucleotide polymorphisms (SNP) in eighty patients with essential hypertension,eighty patients with renal hypertension and forty normal blood pressure controls.Results There was significant difference on A allele frequencies between essential hypertension group and control group ( 56.88％ [ 91/160 ] vs 30.00％ [ 24/80 ],x2 =15.44,P ＜ 0.001 ).A allele frequency had no correlation with renal hypertension (42.50％ [ 68/160 ] vs 30.00％ [ 24/80 ],x2 =3.52,P ＞0.05).There was no significant difference on SNP between essential hypertension group and renal hypertension group ( P ＞ 0.05 ).Conclusion A1675G signal nucleotide polymorphisms of AGTR2 may be associated with the development of essential hypertension,but has nothing to do with renal hypertension.

Objective To compare the diagnostic values of magnetic resonance elastography (MRE) and T1ρ imaging in staging hepatic fibrosis (HF) in a rabbit model.Methods The institutional animal care and use committee approved all experiments.Sixty healthy rabbits were divided into HF group (n=44) and control group (n=16).Each eight rabbits in the HF group and 4 rabbits in the control group were randomly selected at the 4th,5th,6th week and the remaining rabbits at the 10th week after subcutaneous injection with 0.1 ml 50％ CCl4 oily solution per kilogram of body respectively,to undergo liver MR scan including axial liver MRE and T1ρ imaging.The values of liver stiffness (LS) and T1ρ were measured.Masson trichrome staining of liver tissue was used.According to the Scheuer scoring system,rabbits were classified into F0 to F4 group based on the percentage of hepatic fibrosis.The difference of LS values and Tip values among stage F0 to F4 were compared by the one-way ANOVA analysis.The correlations between pathological staging and LS,T1ρ values were performed by the Spearman correlation analysis.ROC curve analysis was performed to compare the value of MRE with T1ρ imaging.Results Forty three rabbits were included,there were 10,8,8,8,9 rabbits in F0,F1,F2,F3 and F4 stage,respectively.LS values were (1.051±0.155),(1.335±0.235),(1.401±0.163),(2.001±0.499) and (2.981±0.714) kPa in F0,F1,F2,F3 and F4,respectively,while T1 p values were (23.20±4.02),(24.28±2.93),(25.40± 1.82),(24.69± 1.85) and (31.54±3.39) ms (all P＜0.05).The correlation of LS values with hepatic fibrosis staging measured on MRE was stronger than T19 values (r values were 0.916 and 0.608,all P＜0.01).Area under ROC curve of LS value for differentiating hepatic fibrosis stage were 0.938 to 0.989,while the areas of T1ρ were 0.771 to 0.954.Conclusion MR elastography is an accurate technique for quantitatively staging hepatic fibrosis and superior to T1ρ imaging.

Objective To discuss the clinical effects of transverse screw fixation of double columns in crescent pelvic fractures.Methods Twenty patients with crescent pelvic fractures hospitalized from December 2012 to December 2015 were reviewed retrospectively.There were thirteen male and seven female patients with the age ranging from 22 to 72 years (mean,39.5 years).Causes of injury were traffic accidents in fifteen patients,falling from high places in three and hitting by heavy objects in two.Time interval between injury and operation was 3-14 d.According to the Orthopedic Trauma Association (OTA) classification,all were classified as 61-B2 type.Reconstruct plate was used to stabilize the supperior pubic ramus fractures,and transverse double-column fixation with anterograde or retrograde screws was used for the posterior iliac crescent fractures.Duration of inserting screws,operation time,intraoperative blood loss and frequency of C-arm X-ray were recorded.Radiological and clinical outcomes were evaluated after operation.Results Duration of inserting screws ranged from 3 to 16 min (mean,5 min).Operation time ranged from 50 to 130 min (mean,80 min) and the intraoperative blood loss ranged from 200 to 550 ml (mean,280 ml).Frequency of C-arm X-ray in the surgery ranged from 1 to 5 times (mean,2 times).All screws were in the expected location,without any piercing out of the iliac bone dependent on the confirmation of X-ray and CT-scan after operation.According to the Matta and Tornetta radiological evaluation,the reduction was rated excellent in sixteen patients and good in four,with the excellent-good rate of 100％.There was no death,wound infection,sciatic nerve or superior gluteal nerve injury or deep venous thrombosis of lower extremities.At the followup,no nonunion,loss of reduction,and breakage of internal fixation occurred.Nineteen patients were followed up,and mean follow-up time was 19.6 months (range,3 to 36 months).Union was obtained in all patients in a period of 8-17 months (mean,11.2 months).According to the Majeed functional evaluation at the final follow-up,the outcome was rated excellent in seventeen patients and good in two,with the excellent-good rate of 100％.Conclusion Transverse screw fixation of double columns in crescent pelvic fracture of 61-B2 type can reduce the operation injury,decrease complications,and have good clinical results.

ObjectiveTo investigate the clinical effect and safety of sofosbuvir (SOF)-ledipasvir (LDV) in the treatment of patients with HCV genotype 6a chronic hepatitis C (CHC). MethodsA total of 63 patients with HCV genotype 6a CHC who visited Department of Infectious Diseases, Henan Provincial People’s Hospital and Nanfang Hospital, from October 2014 to December 2016 were enrolled in this prospective observational study. They were divided into SOF-LDV group (treated with SOF-LDV for 12 weeks) and PR group (treated with pegylated interferon combined with ribavirin for 24 weeks). HCV RNA was measured during treatment and follow-up, and virologic response was evaluated. The chi-square test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of continuous data between two groups. ResultsThere were no significant differences between the PR group and the SOF-LDV group in rapid virologic response rate (85.3% vs 100%, P＞0.05) and virologic response rate at the end of treatment (94.1% vs 100%, P＞005). The SOF-LDV group had a significantly higher sustained virologic response rate than the PR group (96.4% vs 73.5%, χ2=438, P=0.036). The PR group had a significantly higher incidence rate of adverse events than the SOF-LDV group(χ2=754,P=0006). During follow-up, one patient with liver cirrhosis in the SOF-LDV group developed small hepatocellular carcinoma, while no patient in the PR group developed liver cancer at the end of follow-up. ConclusionSOF-LDV for 12 weeks is safe and effective in the treatment of HCV genotype 6a CHC, but liver cancer should be closely monitored in patients with liver cirrhosis.

OBJECTIVETo investigate the effects of adefovir dipivoxil (ADV) on blood phosphorus metabolism in patients with chronic hepatitis B (CHB).

METHODSPatients with hepatitis B surface antigen (HBsAg)-positive CHB were treated with ADV alone, ADV combined with interferon (IFN), or ADV combined with lamivudine (LAM). Changes in levels of calcium, phosphate, urea, and creatinine were assessed at treatment weeks 4, 12, 24, 48, 72 and 96. Statistical analysis was carried out with SPSS 16 software; influential factors were analyzed by ANOVA and non-conditional logistic regression analysis.

RESULTSDuring the course of treatments, 32 (42.6%) of the patients presented with low phosphorus. The highest incidence of low phosphorus was found to have occurred at treatment week 24 (25.0%, 27.5% and 36.4% respectively, with no statistical difference between three groups, x2=0.225, P>0.225). Patients with hypophosphatemia did not show a significant difference in serum phosphorus levels from the other patients (F=1.853, P=0.169). Logistic regression showed a correlation between low phosphorus and sex (x2=7.876, P<0.05), age (t=2.479, P<0.05), and serum creatinine (t =-2.256, P<0.05), but not with blood urea nitrogen or blood calcium (P>0.05).

CONCLUSIONADV antiviral treatment can decrease the blood phosphorous levels of CHB patients, particularly over extended time of treatment, and the occurrence of low phosphorus is more common than of mild phosphorus decrease.Male and elderly patients may be at greater risk of this complication. The incidence and severity of low phosphorus is not significantly different for the different ADV-based treatment regimens.

Adenine ; analogs & derivatives ; Aged ; Antiviral Agents ; Creatinine ; Drug Therapy, Combination ; Hepatitis B, Chronic ; Humans ; Interferons ; Lamivudine ; Male ; Organophosphonates ; Phosphorus

Objective: To investigate the effect of hepatitis B core antigen (HBcAg) in promoting the invasion of hepatitis B virus (HBV)-related hepatocellular carcinoma cell line HepG2.2.15 and the role of Toll-like receptor 4 (TLR4) in the mechanism. Methods: TLR4 mRNA and protein expression in HepG2 cells and HepG2.2.15 cells was measured by reverse transcription real-time PCR and Western blot analysis, respectively. HepG2.2.15 cells were transfected with TLR4 specific small interfering RNA (siRNA) to silence TLR4 expression, and stimulated by recombinant HBcAg in culture. The invasion of cells was measured by Transwell invasion assay. The expression of TLR4 signaling pathway-related proteins in the cultured cells and proinflammatory cytokines in the supernatant was also determined. The student’s t-test, one-way ANOVA, and SNK-q test were used for statistical analysis. Results: TLR4 mRNA and protein expression in HepG2.2.15 cells was significantly higher than that in HepG2 cells. TLR4 siRNA transfection remarkably down-regulated TLR4 expression in HepG2.2.15 cells. Inhibiting TLR4 expression and/or HBcAg stimulation did not affect the proliferation of HepG2.2.15 cells. However, HBcAg stimulation significantly increased the invasion ability of HepG2.2.15 cells and the secretion of proinflammatory cytokines [including interferon (IFN)-γ, interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α]. Inhibiting TLR4 expression significantly reduced HBcAg-induced cellular invasion. Meanwhile, HBcAg stimulation elevated the expression of MyD88 and TRIF in HepG2.2.15 cells. TLR4 silencing inhibited HBcAg-induced increase in the expression of MyD88, while it showed no significant impact on TRIF expression. Conclusion HBcAg can promote the invasion of HepG2.2.15 cells. The TLR4/MyD88 signaling pathway may be involved in this process by inducing the expression of proinflammatory cytokines.

Objective Toinvestigatethecharacteristicsofclinicalpathologyand MRIofintracranialsolitaryfibroustumor/hemangiopericytoma (SFT/HPC).Methods ThisstudyanalyzedtheMRIimages,pathologicalandclinicaldataof14SFT/HPCpatientsretrospectively. AllthecasesweresubjectedtoMRIplainscanandenhancementexamination.CharacteristicsofMRIofallcaseswerereviewedtogetherwith clinicopathologicchanges.Results AllSFT/HPClesionswerelocatedintheintracranialbutextra-cerebralspace.6werelocatedabovethe tentoriumofcerebellum,and2werelocatedbelowit.Lesionsof6patientswereacrossthetentoriumofcerebellumandspreadfrom supratentorialtosubtenorialspace.Amongalllesions,4wereroundinshape,10werelobulated,and3weresmallnodulesaroundthe edge.9ofthemexhibitednecrosisandcysticstructures.11lesionsshowedhypointensityand3casesshowedisointensityonT1WI.All thelesionswereheterogeneoushyperintensetyonT2WI,and5ofthemdisplayed"yin-yang"patternonT2WI.11casesexhibitededema.Signalof vascularvoidflow wasobservedin6cases.Thesolidpartsofthetumorsshowedsignificanthomogeneousenhancementon MRI. StrongpositiveSTAT6stainingwasobservedforthenuclearoftumorcells.Conclusion ItisdifficulttodifferentiateSFT/HPCfrom meningeoma.The"yin-yang"patternonT2WIisthecharacteristicofSFT/HPC.Inaddition,nuclearpositivestainingofSTAT6isalsospecific featureofSFT/HPCcell.

Objective To explore the MSCT features,diagnostic values and the misdiagnosis causes of gastric schwannomas.Methods T he CT images,pathological and clinical data of 9 misdiagnosis cases of gastric schwannomas were analyzed retrospectively,which were later confirmed by the operation and pathology.The study examined the CT findings in the following aspects:the lesion location, size,contour,border,growth pattern,enhanced pattern,hemorrhage,necrosis,calcification,and the presence and absence of perirenal lymph nodes.Results The gastric schwannomas were ovoid or round,with well-defined boundaries.Tumors were found in the gastric body in 6 cases(4 cases in the large gastric curvature and 2 in the small gastric curvature),the gastric antrum in 2 cases and the gastric fundus in 1 case.The largest lesion diameters ranged from 2.5 to 7.4 cm,with an average diameter of 3.2 cm.Extracavitary growth was found in 2 cases,intracavitary growth in 2 cases and both intracavitary and extracavitary growth in 5 cases.The density of the tumor was low and evenly distributed,without cystic change,necrosis or calcification.2 cases were found to have ulcer formation. Another 2 cases were found to have enlarged lymph nodes,which were pathologically confirmed to be reactive hyperplasia.In the CT contrast enhancement,mild homogeneous enhancement was found in 4 cases in the arterial phase,but no obvious enhancement was found in the other 5 cases.In the venous phase,all the cases were found to have moderate homogeneous enhancement.4 cases were found to have further enhancement in the delay phase.Conclusion The gastric schwannomas appears to be homogeneous soft tissue mass on the MSCT,with clear boundaries and low-density and without hemorrhagic necrosis or cystic lesions.MSCT examination can help to locate and characterize gastric schwannomas,and to observe the relationship between the tumor and the surrounding tissue structure.

Objective To explore the correlation between adiponectin and liver fibrosis in patients with chronic hepatitis B virus infection.Methods 60 patients with chronic hepatitis B were divided into mild liver fibrosis group (n =28),severe liver fibrosis group (n =17)and cirrho-sis group (n =15),and 20 healthy volunteers were designed as the control group.The serum adiponectin level was detected in all the groups.Results There were significant differences of serum adiponectin levels among the four groups (P <0.05),and there was a positive correlation be-tween serum adiponectin level and liver fibrosis grade (r =0.967,P <0.05).The expression rate of liver tissue adiponectin in cirrhosis group was 93.33%,which was significantly higher than the mild group (14.29%)and severe fibrosis group (41.18%)(P <0.05).Conclusion Adiponectin is closely related to the liver fibrosis in patients with chronic hepatitis B virus infection.