Inhalation injury seriously threatens the survival and quality of life in burn and trauma patients. So far there is no breakthrough in the treatment of inhalation injury. A significant advance has been witnessed in the experimental study of the use of stem cells in the treatment of lung injury in recent years. In this paper, according to the results of our study in the systemic transplantation of bone marrow mesenchymal stem cells for the treatment of inhalation injury, the effect of mesenchymal stem cells on anti-inflammatory process and repair of lung tissues in inhalation injury, and its possible mechanisms are reviewed.
Humans ; Lung ; Lung Injury ; blood ; surgery ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Quality of Life ; Smoke Inhalation Injury ; blood ; surgery ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood

Hemodynamic monitoring is a very important measure for critically ill patients with burn and trauma, and it should be carried out throughout the course of treatment. Functional hemodynamic monitoring consists of the assessment of the dynamic interactions of hemodynamic variables in response to a defined volume change. Accordingly, response of fluid volume can be assessed in a quantitative fashion by measuring variation of both arterial pulse pressure and left ventricular stroke volunime during positive pressure breathing, or the change in cardiac output response to passive leg raising maneuver. Functional hemodynamic monitoring, contrary to that of static condition in order to realize dynamic and individual monitoring, is related to response to treatment, and it is a useful complement to static (routine) hemodynamic monitoring. At present, in the care of sepsis, shock, and mechanical ventilation, etc. related to burn injury and trauma, functional hemodynamic monitoring is more and more accepted and applied by medical personnel of ICU in burn and trauma departments. Therefore, further study on functional hemodynamic monitoring should be emphasized and practised.
Blood Pressure ; Burns ; therapy ; Critical Care ; Critical Illness ; Fluid Therapy ; Hemodynamics ; physiology ; Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; Sepsis ; diagnosis ; therapy ; Shock ; diagnosis ; therapy ; Stroke Volume ; Systole

Purpose:To evaluate the effect of metallic stent in the treatment of malignant stricture in esophagus and cardia.Materials and Methods:Treated by metallic stent:14patients with malignant stricture in esophagus and cardia,13 males and 1 female aged ranged from 57 to 81,were discussed in this article.Among 12 patients,8 were proved as esophageal squamous carcinoma,4 as esophagus adenocarcinoma,and 1 was complicated with esophagotrachial fistula,l0 of the pa- tients could take fluid food and 4 only water.After catheterizing from mouth,the strictured portions dilated with hallon catheter,15 selfmade Z stents coveted with dacron and 1 strecker stent were in 13 and 1 patients respectively.Results:All stems were successfully placed.Patients could eat more easily after the operations.The esophogotrachial fistula was completely sealed.The average lifetime after the operation was 5.5 months.Conclusions:Metallic stent prosthesis is an effective method to treat malignant stricture in esophagus and cardia,and could elevate the life quality of patients sig- nifieantly.

ObjectiveTo observe the efficacy of rehabilitation therapy for patients and experimental animals with short bowel syndrome.MethodsThirty SD rats were randomly divided into control group,short bowel group and growth hormone (GH) treatment group.Short bowel was produced by resecting 80% of the rats′ small intestine, growth hormone at a dosage of 1?U/kg?d was delivered to the rats from POD1 to POD28.Nine patients with short bowel syndrome were enrolled in the study,the average length of the small intestine was (44?24)?cm, 3 cases had also suffered a short colon.ResultsIncreased ratio of S phase cells, proliferation index and expression of proliferative cell nucleus antigen (PCNA) were observed, indicating the putative effects of exogenous GH on residual small intestinal mucosa. The mechanism of action was probably through the alteration of protooncogene C-jun. The nutritional state of the patients and the absorptive capacity of the residual intestine improved markedly. Follow up were made to 8 patients,75% of the patients have weaned TPN,25% of them need intermittent TPN supplementation.ConclusionsRehabilitation therapy provides a new and effective alternative for short bowel patients.

Objectives To observe the clinical efficacy and safety of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemia.Methods 29 older patients with acute myeloid leukemia treated from June 2010 to December 2016 were randomly divided into observation group and control group.Observation group(n=14)were treated with decitabine combined with half of CAG(aclacinomycin,cytarabine,granulocyte colony-stimulating factor)regimen.The control group(n=15)were treated with CAG regimen.Results The overall effective rate was higher in observation group(78.6%)than in control group(53.5%),but there was no statistically significant difference(χ2=2.042,P=0.153).The rate of lung infections was significantly lower in observation group(28.6%)than in control group(73.3%),(χ2=5.811,P=0.016).The survival time of patients was significantly longer in observation group(17.5±5.7 months)than in control group(12.6±6.2 months),the difference was statistically significant(t=2.211,P=0.018).Conclusions The treatment program of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemiais is safe and effective,which is worthy of clinical promotion.

Objective To study the relationship between chromosomal abnormalities of diffuse large B-cell lymphoma and its survival time.Methods Chromosome preparations were made by using modified method.Karyotypes were analyzed by stain of G-banding. And all patients were treated by chemotherapy. All patients' survival time was calculated.Results Mitotic cells that could be used for analysis were found in 28 cases.5 of 28 karyotypes were normal and 8 cases were polyploid.There were 4 cases with t(14,18)(q32;q21),5 cases with t(3; 14) (q27;q32),2 cases with t(2;3) (p11 ;q27),1 case with t(3 ;22) (q27 ;q11) respectively.There were 2 cases with ectopia between 7 chromosome and other chromosomes and 1 case with ectopia between 17 chromosome and other chromosomes.The survival time of patients with normal karyotype,t(14,18) (q32;q21)or 3q+ was longer than that of other groups.The survival time of group in Ⅰ, Ⅱ stages was longer than that in Ⅲ, Ⅳ stages. Conclusion The treatment, survival time and prognosis could be expected according to chromosomal abnormalities and its relevance to stages in diffuse large B-cell lymphoma.

Objective To summarize the experience in treating coronary artery fistula (CAF) by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was(2.33±1.38) coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients (30%) and blood flow was significantly decreased in 28 patients (70%). All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.

Objective:To explore the correlation among serum cardiac troponin I (cTnI),N terminal pro brain natri-uretic peptide (NT-proBNP)and main endpoint events of heart in patients with chronic stable heart failure.Meth-ods:The present study enrolled 95 patients with NYHA cardiac function class III~IV from Feb 2010 to Feb 2011.According to levels of cTnI and NT-proBNP,the patients were divided into cTnI negative group (n=60)and cTnI positive group (n=35);NT-proBNP negative group (n=40)and NT-proBNP positive group (n=55),all patients were followed up for two years,and the main endpoint events were cardiogenic sudden death and rehospitalization caused by acute aggravation of heart failure.Results:Compared with negative group,the hazard ratio (HR)of end-point events was 2.69 and confidence interval (CI)was 1.54~ 4.72,P = 0.002 in cTnI positive group;HR was 2.54 and CI was 1.35~4.78,P =0.003 in NT-proBNP positive group;further interclass crossover analysis found that,when patients'cTnI and NT-proBNP were both positive,the hazard ratio of cardiac endpoint events was the highest (HR=6.34,CI 2.26~17.9,P <0.001).Conclusion:In patients with chronic stable heart failure,serum elevated levels of cardiac troponin I and N terminal pro brain natriuretic peptide are important predictors reflecting prognosis of patients with heart failure.

Objective To understand the incidence.mortality and risk factors of ventilator -associated pneu-monia(VAP)in surgical intensive care unit among elderly patient,in order to direct the clinical prevention and treat-ment of VAP.Methods Retrospective analysis was used on 65 cases of mechanical ventilation elderly patients in our hospital nearly 3 years.Results The incidence of VAP was 66.2%.The mortality of VAP was 67.4%.The factors of long-term mechanical ventilation,high APACHE Ⅱ score,low Glasgow score and inappropriate initial antimicrobial therapy were influenced the prognosis of VAP.Conclusion The incidence of VAP can be decreased and the cure rate can be increased by some effective measures in SICU.

Objective To discuss the effects of bone marrow-derived mesenchymal stem cells (MSCs) on vascular endothelial growth factor (VEGF) in lung tissue and in plasma, and extra-vascular lung water at the early stage of smog inhalation injury. Method The rabbit model of smog inhalation injury was established by using home-made smog generator, and the rabbit models were randomly(random number) divided into control group (group S, n = 32) and MSCs treatment group (group M, n = 32). Ten mL phosphate-buffered saline (PBS) was injected into ear marginal vein immediately after injury in rabbits of group S. The third generation of MSCs 1/10/10 mL PBS was injected into ear marginal vein immediately after injury in rabbits of group M. The levels of VEGF in peripheral blood and lung tissue were neasured 0 h,2 h,4 h and 6 hours after injection respectively, and analyzed. The right lung of rabbits was taken out to measure and calculate lung water mass fraction after experiment.Results In lung tissue, the levels of VEGF decreased gradually in group S (P ＜ 0.05), and though the levels of VEGF in lung tissue appeared with significant decreasing trend in group M (P ＜ 0.05), they were still higher than those of group S at corresponding intervals ( P ＜ 0.05). In peripheral blood, the levels of VEGF increased gradually in group S ( P ＜ 0. 05), and the levels of VEGF in group M appeared with markedly increasing trend ( P ＜ 0.05),but they were lower significantly than those in group S at corresponding intervals ( P ＜ 0.05). Conclusions MSCs engraftment to the rabbits with smog inhalation injury could increase VEGF in lung tissue, decrease VEGF in plasma and reduce extra-vascular lung water, showing protective effect on smog inhalation injury to a certain extent.