Objective To study the clinic value of digital three-dimensional shaping titanium mesh in repairing skull defects and reconstructing temporal muscle attachment points. Methods Eighty-two patients with skull defects from December 2013 to January 2016 were enrolled in this study. They were divided into two groups according to patients' will with 41 patients in each group. The patients in control group received traditional hand-shaping titanium mesh repair, the patients in observation group received individual digital forming technology to produce titanium mesh repair and reconstruct the temporal muscle attachment points at the titanium mesh temporal corresponding position. The rate of appearance satisfaction, operation time, the number of titanium nail and the rate of postsurgery adverse reaction was compared between the two groups. Results The rate of appearance satisfaction in observation group was significantly higher than that in control group: 97.56%(40/41) vs. 80.49%(33/41), P<0.05. The operation time and the number of titanium nail and in observation group was significantly lower than that in control group:(8.9 ± 1.6) h vs. (12.4 ± 2.4) h, (10.3 ± 0.9) pieces vs. (11.8 ± 1.8) pieces, P < 0.01. The rate of postsurgery adverse reaction in observation group was significantly lower than that in control group: 0 vs. 9.8%(4/41), χ2 = 4.21, P < 0.05. Conclusions The operation of repairing skull defects and reconstructing temporal muscle attachment points with digital three-dimensional shaping titanium mesh is simple. It can shorten the operation time, decrease the postsurgery adverse reaction, and increase the appearance satisfaction.

Objective To investigate the clinical value of digital three-dimensional shaping titanium mesh and traditional hand-shaping titanium mesh in the repairing of skull defect surgery.Methods The clinical data of 78 patients with skull defect were retrospectively analyzed,they were divided into digital three-dimensional shaping titanium mesh group (41 cases) and traditional hand-shaping titanium mesh group (37 cases) according to the different titanium net,then the hospital stay,operative time,hospital costs,shaping satisfaction and postoperative complications between two groups were compared.Results The hospital costs and shaping satisfaction in digital three-dimensional shaping titanium mesh group were significantly higher than those in traditional hand-shaping titanium mesh group [(12 978.1 ± 4 765.7) yuan vs.(9 436.6 ±3 798.7) yuan,(9.87 ±0.13) scores vs.(9.41 ±0.09) scores],the complication rate was significantly lower than that in traditional hand-shaping titanium mesh group [4.9％ (2/41) vs.29.7％ (11/37)],there was significant difference (P ＜ 0.05).The hospital stay and operative time between two groups had no significant difference (P ＞ 0.05).Conclusion The digital three-dimensional shaping titanium mesh repair is convenient to operate,it can largely reduce the risks and complications of surgery,and can also achieve a high standard of modeling results,so is worthy of promotion.

Brassinosteroids, a group of plant steroid hormones, regulate many aspects of plant growth and development. We and other have previously solved the crystal structures of BRI1(LRR) in complex with brassinolide, the most active brassinosteroid identified thus far. Although these studies provide a structural basis for the recognition of brassinolide by its receptor BRI1, it still remains poorly understood how the hormone differentiates among its conserved receptors. Here we present the crystal structure of the BRI1 homolog BRL1 in complex with brassinolide. The structure shows that subtle differences around the brassinolide binding site can generate a striking effect on its recognition by the BRI1 family of receptors. Structural comparison of BRL1 and BRI1 in their brassinolide-bound forms reveals the molecular basis for differential binding of brassinolide to its different receptors, which can be used for more efficient design of plant growth regulators for agricultural practice. On the basis of our structural studies and others' data, we also suggest possible mechanisms for the activation of BRI1 family receptors.
Amino Acid Sequence ; Arabidopsis ; metabolism ; Arabidopsis Proteins ; chemistry ; metabolism ; Binding Sites ; Brassinosteroids ; chemistry ; Crystallography, X-Ray ; Molecular Sequence Data ; Protein Kinases ; chemistry ; metabolism ; Protein Structure, Tertiary ; Recombinant Proteins ; genetics ; Sequence Alignment ; Steroids, Heterocyclic ; chemistry

OBJECTIVETo investigate the clinical effect of acellular dermal matrix (ADM) combined with auto-skin grafting on deep burn wound ,and the result of long-term follow-up and histological examination.

METHODSOne hundred and fifty-two patients with deep burn hospitalized from February 2000 to July 2003 were repaired with porcine ADM and auto split-thickness graft. Wound healing rate was assessed 1 week after operation. Degree of cicatricial hyperplasia was examined 1, 3, 6, 12 months after operation. Wound samples from 5 patients were harvested for histological examination 72 months after operation, for which transmission electron microscopy were employed in 2 cases.

RESULTSGrafts completely survived was seen in 116 patients (accounting for 76.3% of cases), survival rate over 95% were observed in 23.7% of cases. One hundred and twenty-seven patients were followed up 1 month after operation, in whom mild local contraction, cord like scar was seen along its junction with skin, its texture was soft ,and there was no pruritus or blister formation. One hundred and one patients were followed up 3 months after operation, and the graft showed mild contraction less marked when compared with that of the site where auto split-thickness skin grafting was used. Articular function was good. Eighty-two patients were followed up 6 months after operation,color and texture of grafts were similar to normal skin with no obvious cicatricial hyperplasia. Fifty-eight patients were followed up 12 months after operation, the texture of grafts was similar to normal skin without obvious reject reaction. Sixteen patients were followed up over 72 months after operation, the grafts appeared dry compared with normal skin. Histological examination showed: tissue structure of grafts was similar to normal skin, intact small sweat gland and sweat gland cells were not found in dermal layer.

CONCLUSIONHeterologous ADM combined with auto split-thickness graft can survive in human body without obvious immune rejection reaction for a long time. No intact small sweat gland or sweat gland cells in dermis is a problem worth of study in regeneration of skin function.

Adolescent ; Adult ; Aged ; Burns ; surgery ; Dermis ; transplantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Skin, Artificial ; Transplantation, Autologous ; Young Adult

OBJECTIVE: To review the clinical data of pathological morphology, diagnosis, surgical treatment of cor triatriatum in 15 patients. METHODS: Fifteen patients with a mean age of (14.6+/-10.3) years (range from 6 months to 40 years) were performed operations under extracorporeal circulation. Fourteen of the patients had cor triatriatum sinister, and 1 had cor triatriatum dexter; 12 of the 15 patients had other cardiac abnormalities. The excision of the fibromuscular membrane was accomplished through a right atrial incision in all of the 14 cases, and the associated abnormalities were corrected at the same time. RESULTS: One patient died after the operation, and the other survivors had good outcome. CONCLUSION Operation is necessary if the diagnosis is clear. The patients generally have good prognosis. Surgical results of cor triatriatum depend on the complexity of associated defects and the adequacy of the repair.
Adolescent ; Adult ; Child ; Child, Preschool ; Cor Triatriatum ; surgery ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Young Adult

Objective To explore the application of UW solution in the replantation of the rat limb,and to explore a simple method for the ideal preservation of the amputated limbs.Methods From September,2017 to Janurary,2018,one hundred and twenty healthy adult male SD rats,weight 320-350 g,were randomly divided into 8 groups:A,B,C,D,E,F,G,H group.The isolated limbs of the control group A,C,E,G were cryopreserved in refrigerator at 4 ℃,while those of the experiment group B,D,F,H were preserved under the same condition after being perfused with UW solution.All the severed limbs were replanted back to the rats after different time length of cry opreservation:A,B 12 hours,C,D 20 hours,E,F 28 hours and G,H 36 hours.During the operations the femoral artery and venous patency were detected immediately after anastomosis.And after the operations the survival rates of limb replantation were observed.On the third day after the limb replantation,the tibial posterior muscle tissue was examined for pathology.The cell areas in pathological photographs were compared with Image analysis software Image-pro Plus 6.0 and the ultra structural changes of skeletal muscle tissue were observed.Results The femoral artery and venous patency in experiment group A,C,E and control group B,D,F were all 100 percent.However,in the group G,H the severed limb vessels changed obviously,the patency dropped markedly and the survival rates of limb replantation turned out to be 0.The experiment groups perfused with UW solutions,had relatively higher survival rates compared with the control groups (12 h:93.33％ vs.53.33％,20 h:80.00％ vs.40.00％,28 h:53.33％ vs.13.33％) and the skeletal muscles edema was lighter than that of the control group,with a larger proportion of cell areas(12 h:69.49±8.57 vs.44.75±6.34,20 h:56.34±7.73 vs.36.69±5.74,28 h:45.76±8.23 vs.31.49±7.72).There was a significantly difference (P＜0.05).Electron microscope observation showed that the experiment group bore a lighter damage of myofibril,interstitial tissue and mitochondria compared with the control group.Conclusion The combination of UW solution and cryopreservation of organs is an ideal and proper way to preserve the amputation limb,to extend the time limit for replantation,and to achieve a better recovery effect of postoperative limb function.Besides,UW solution is easy to be promoted in the treatment of isolated limb in clinical work.

Humans ; Spinal Diseases/surgery* ; Spine/surgery*

Phytochemical investigation on Ilex asprella stems by using various chromatographic techniques led to the isolation of 18 phenolic constituents. Based on spectroscopic data analyses and/or comparison of the spectroscopic data with those in literature, these constituents were identified, including two lignans (1, 2), five phenylpropanes (3-7), six chlorogenic analogues (8-13), and five benzoic analogues (14-18). Among them, compounds 3-7, 9, 11, 13, 14, 17, and 18 were isolated from genus Ilex for the first time, and 2, 8, 10, 15, and 16 were isolated from this species for the first time. The in vitro anti-inflammatory assay results showed that compounds 8, 9, 11, 13, and 15 possessed moderate inhibition on the NO production in RAW264.7 cells with IC₅₀ values of 51.1-85.8 μmol·L⁻¹. The present study brought preliminary reference for the clarification of therapeutic ingredients of I. asprella with anti-inflammatory efficacy and its quality evaluation.
Animals ; Anti-Inflammatory Agents ; isolation & purification ; pharmacology ; Ilex ; chemistry ; Mice ; Nitric Oxide ; metabolism ; Phenols ; chemistry ; Phytochemicals ; isolation & purification ; pharmacology ; Plant Stems ; chemistry ; RAW 264.7 Cells

Phytochemical investigation on the stems of Ilex asprella by using various chromatographic techniques led to the isolation of 13 compounds. By spectroscopic analyses and comparisons the spectral data with those in literatures, these compounds were identified as salicifoneoliganol(1), rel-(7R,8S)-3,3',5-trimethoxy-4',7-epoxy-8,5'-neolignan-4,9,9'-triol 9-β-D-glucopyranoside(2),(+)-cycloolivil(3),(+)-syringaresinol-4'-O-β-D-monoglucoside(4), liriodendrin(5), caffeic acid (6), 3,4-dihydroxy-5-methoxybenzaldehyde(7), benzene-1,2,4-triol(8), 3,4,5-trimethoxyphenyl-1-O-β-D-apiofuranosyl(1″→6')-glucopyranoside(9), aeculetin(10), cryptochlorogenic acid ethyl ester(11), chlorogenic acid ethyl ester(12), and rel-5-(3S,8S-dihydroxy-1R,5S-dimethyl-7-oxa-6-oxobicyclo [3,2,1]oct-8-yl)-3-methyl-2Z,4E-pentadienoic acid(13). Among them, compounds 7, 8, 11, and 13 were isolated from genus Ilex for the first time, and 1-3, 9, 10, and 12 were isolated from this speciesfor the first time. The anti-inflammatory assay results of these compounds showed that compounds 1 and 9 showed moderate inhibitory effect against NO production in RAW 267. 4 cells with IC₅₀ values of 35.7 and 50.6 μmol•L⁻¹, in vitro respectively, whereas compound 10 showed weak inhibition(IC₅₀ value 98.7 μmol•L⁻¹).

[摘 要] 目的：探究炎症标志物对晚期非小细胞肺癌（NSCLC）患者抗PD-1治疗疗效及安全性的预测价值。方法：动态监测2018年1月至2020年12月在海军军医大学第一附属医院接受抗PD-1治疗的222例晚期NSCLC患者的血清炎症标志物，应用ROC曲线计算最佳截断值并将炎症指标分为高和低水平两组。以Log-Rank检验和Kaplan-Meier法分析患者临床病理特征及各炎症标志物水平与患者预后的关系，单因素和多因素Cox回归分析估算PFS和OS的风险比。Fisher精确检验分析各炎症标志物基线水平高和低两组与免疫相关不良反应（irAE）的相关性，Wilcoxon秩和检验比较治疗前（基线）与首次PR、PD时及发生irAE时各炎症标志物水平的差异。结果：血清炎症标志物NLR、MLR、PLR、LDH、CRP和IL-6基线水平升高与患者的PFS和OS显著缩短有关（圴P<0.01）。多因素分析结果显示，基线升高的PLR、MLR和LDH是PFS和OS的独立危险因素（P<0.05或P<0.01）。NLR、LDH、CRP和IL-6水平在患者首次获得PR时显著降低（P<0.05或P<0.01），LDH、CRP、IL-6和TNF-α水平在出现PD时显著升高（P<0.05或P<0.01）。发生irAE时，LDH、CRP、IL-6、IL-10和TNF-α水平与基线水平相比显著升高（P<0.05或P<0.01）。结论：晚期NSCLC抗PD-1治疗中炎症标志物水平的下降提示患者病情改善，其水平的上升则提示病情进展且与irAE的发生相关，动态监测炎症标志物可以预测抗PD-1治疗的疗效及安全性，有助于筛选抗PD-1治疗的最佳晚期NSCLC人群。