OBJECTIVETo enlarge the ratio of length to width of a prefabricated random skin flap in a short period, in order to meet a special clinical need.

METHODSA white rat and a white mini-pig was chosen for an animal model for the experiment. They were divided into the experimental group and the control. The prefabricated flap was formed as the planned design. In the experimental group, the flaps were treated with a desired pressure in certain intervals at the planned part of the flap. We estimated and inspected the digitized perfusion of flap microcirculation, and made overcong and wide random skin flap survive within 24 hours, and this technique was finally used for the clinical wound treatment.

RESULTSAs expected, the survival area of the flap in the experimental group was significantly larger than the control. This technique was successfully used to repair the defects of the special sites in plastic and reconstructive surgery.

CONCLUSIONThe method of quickly prefabricated random flap could enlarge the ratio of length to width of the flap and put the flap in shape in short time. With the digitized estimating and inspecting, this method could obviously improve the survival area of the random flap and could also be very useful for the clinical treatment.

Adult ; Animals ; Dermatologic Surgical Procedures ; Female ; Humans ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Skin ; metabolism ; pathology ; Skin Transplantation ; methods ; Surgical Flaps ; supply & distribution ; Time Factors ; Transplantation, Heterologous ; Treatment Outcome

OBJECTIVETo investigate the possibility and the limit in increasing the survival area of the random skin flap by extremely increasing the ratio of its length and width within 24 hours.

METHODSSD rats (n = 20) were chosen for this study. The rats were randomly divided into: subject group and control one. Pre-made skin flap was prepared as design. The subject group was carried out rapid pre-fabricated skin flap formation training. No training was performed in control group. The changes in perfusion value of micro-circulation inside skin flap were monitored during the whole process, and micro-circulation parameters of the skin flap were used to evaluate whether its blood circulation network was mature or not.

RESULTSTraining of pre-made skin flap at 18th hour, the perfusion value of its micro-circulation was basically stable, Skin flap formation was finished at 24th hour. Survival area in control group was (68.25 +/- 0.18)% and in subject group was (97.25 +/- 0.24)% (P < 0.01). There was a significant difference between the two groups.

CONCLUSIONSWithin short time, it is possible to establish micro-circulation in skin flap which exceeds the limit set by traditional theory. Digitalized judgment can be used to monitor the fast formation of super-big skin flap. This method is reliable and can increase the survival rate of random skin flap.

Animals ; Female ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Skin ; blood supply ; metabolism ; Skin Transplantation ; Surgical Flaps ; Time Factors

Objective To explore the effect of olfactory ensheathing cells (OECs) on the proliferation and differentiation of neural stem cells (NSCs). Methods The cells from the embryonic rat brain were primarily cultured and identified by immunofluorescence and immunocytochemistry. NSCs in the experimental group shared medium with OECs were cultured and induced to differentiate. Simultaneously, NSCs in the control group were cultured alone. The effect of OECs on the proliferation and differentiation of NSCs was observed by immunocytochemistry. Results Nerve growth factor receptor (P75NGFR) was observed in the primarily cultured OECs; nestin was expressed in the primarily cultured neurosphere and the cells differentiated from the neurosphere expressed neurofilament 200 (NF200) and glial fibrillary acidic protein (GFAP). Compared with that in the control group, the number of NSCs in the experimental group was significantly increased (P<0.05). On the 4~(th) and 7~(th) day of differentiation, the percentage of NF200-positive cell was higher in the experimental group than that in the control group (P<0.05), indicating that the appearance of OECs increased the differentiation of NSCs into NF200-positive cells. Conclusion OECs can promote the proliferation of NSCs and induce the differentiation of NSCs into neurons.

OBJECTIVETo summarize the experience of early treatment of high-voltage electric burn wounds in the limbs.

METHODSFifty-four patients (50 males and 4 females, aged from 10 to 56 years) with high-voltage electric burn wounds in 97 limbs (67 upper limbs and 30 lower limbs) were hospitalized in our burn wards from January 2003 to December 2010. A total of 119 burn wounds in wrist-forearm, forearm-elbow-upper arm, shoulder-axillary region, ankle-foot, lower leg, around the knee, thigh-inguinal region were treated with incision for decompression within 10 days after burn. Under the premise of relatively stable systemic condition of the patients, certain surgical operations were performed as follows. (1) Sixteen limbs with 16 wounds were amputated, among them forearm amputation was performed for 5 upper limbs with necrosis, with preservation of elbow joints, and the residual wounds of the elbow and upper arm were repaired with pedicled latissimus dorsi musculo-cutaneous flaps; 1 upper limb with upper arm amputated, with preservation of shoulder joint, was repaired with pedicled latissimus dorsi musculo-cutaneous flap. (2) Ninety-five wounds were covered with various tissue flaps with abundant blood supply after early debridement, in which 3 brachial arteries, 1 vein, 1 brachial artery and vein were reconstructed in 5 wrist wounds, artery reconstruction was performed in elbow wound of 1 case with injured brachial artery. (3) Eight wounds were treated with free skin grafting. Wound healing conditions were observed and followed up.

RESULTSWounds in 16 limbs healed after amputation and repair. Blood supply and (or) venous return of hands were restored in 5 wrist wounds after vessel reconstruction. After artery reconstruction, abundant blood supply was observed in 1 case with injured brachial artery and amputation was avoided. Necrosis occurred in distal parts of tissue flaps in 5 wounds after grafting, in which 2 wounds healed after removal of necrotic tissue followed by closure with suture, and 3 wounds healed after debridement and free skin grafting. Tissue flap infection occurred in wrist (5 wounds), elbow (1 wound), ankle-foot (2 wounds), and healed after debridement and suture. The other tissue flaps survived after grafting. Six wounds healed after skin grafting. Partial necrosis occurred in 2 wounds after skin grafting, and they were healed after second skin grafting. Thirty-seven patients were followed up for 6 to 12 months, the skin flaps survived with satisfactory appearance and texture.

CONCLUSIONSEarly extensive compartment release through fasciectomies and escharectomies, early debridement, early vascular grafting, early wound coverage with contemporary reparative and reconstructive surgical techniques are rational options for the treatment of high-voltage electric burns in the limbs.

Adolescent ; Adult ; Burns, Electric ; therapy ; Child ; Extremities ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Skin Care ; Surgical Flaps ; Wound Healing ; Young Adult

OBJECTIVEThe severe acute respiratory syndrome (SARS) is a highly contagious infection caused by a newly discovered strain of coronavirus (SARS-CoV). During the outbreak of SARS in the first half of 2003, children appeared to be less susceptible to the SARS coronavirus and pediatric patients presented with a less aggressive clinical course than adult patients did, demonstrating the traits which were rarely observed in other viral contagious disease. The present study aimed to preliminarily examine the presence of serum specific antibodies against severe acute respiratory syndrome (SARS)-associated coronavirus virus (SARS-CoV) in pediatric SARS patients and explore the possibility of subclinical infection in children/adults through close association with SARS cases.

METHODS(1) Clinicians and nurses visited families and collected general and epidemiological information about the subjects using a standard questionnaire and took serum specimens. (2) Specific antibodies against SARS-CoV were assayed with two methods, indirect immunofluorescence assay (IFA) for detecting IgG antibodies and enzyme linked immunosorbent assay (ELISA) for mixed antibodies. Serum specimens tested included those from 21 clinically confirmed pediatric SARS cases (aged from 8 months to 14 years, 11 male and 10 female) and their 23 parents who had close contact with the children, 36 adult patients in convalescence stage of SARS, 24 children (aged 1.5 to 14 years) and other 34 adults who had close contact with infected adults.

RESULTS(1) The positive rates of specific IgG and mixed antibodies against SARS-CoV were 38% (8/21) and 33% (7/21) in pediatric cases; whereas the rates were 75% (27/36) and 69% (25/36) in adult patients. (2) The proportion of the patients who had close contact to SARS patients was 7/8 among the antibody-positive group vs. 1/13 for the antibody-negative group (P < 0.05). (3) The IgG antibody emerged in one of 24 children, whose mother, a nurse, had suffered from SARS (4%). (4) Among 23 parents of children with SARS, one was positive for IgG and the mixed antibodies, whose grandson and husband suffered from SARS; The IgG antibody and the mixed antibodies were also positive in another adult who had close contact with adult SARS cases (3%).

CONCLUSIONS(1) SARS-CoV infection was confirmed by serological methods in 38.1% of clinically diagnosed pediatric SARS cases, which leads to the assumption that correct diagnosis of pediatric SARS requires more accurate and efficient ways, for example, screening for antigen or gene of SARS-CoV. (2) The proportion of the patients who had close contact to SARS patients among antibody-positive cases was higher than that in antibody-negative cases. (3) It is possible that subclinical SARS CoV infection exists in children and adults, although the rate of occurrence is low. The data of the present study did not confirm that SARS had subclinical infection among adults who had close contact to pediatric SARS cases.

Adolescent ; Adult ; Antibodies, Viral ; blood ; immunology ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin G ; blood ; immunology ; Infant ; Male ; SARS Virus ; immunology ; Severe Acute Respiratory Syndrome ; blood ; epidemiology ; immunology

OBJECTIVETo investigate the prevalence of influenza virus infections in children in 2006 using the real-time PCR method.

METHODS(1) Consulting the most conserved sequence NP gene of influenza virus, after comparing with the NP gene sequences of influenza virus in GenBank, one pair of specific primers and one TaqMan probe were designed for each subtype of influenza virus by the software Primer Express. The sensitivity of influenza was evaluated by testing known positive samples which had been two-fold diluted. The specificity of real-time PCR for influenza virus detection was assessed by cross testing 60 isolates of influenza A, 16 isolates of influenza B, and by testing a variety of other respiratory viruses positive samples; (2) 281 nasopharyngeal aspirate samples were detected by real-time PCR and virus isolation; (3) the 12 301 specimens from the patients of Guangzhou Children's Hospital were tested by using the real-time PCR method. Furthermore, the real-time PCR reagent was evaluated by comparing with the result of virus isolation.

RESULTS(1) The sensitivity of real-time PCR developed in this study for influenza A detection was 1:2(22) and for influenza B was 1:2(20) in two-fold serially diluted way. (2) No positive results were found in cross testing of other viruses positive specimens. (3) Influenza virus was detected from 1687 cases (13.71%) out of the 12 301 cases, including 773 cases (45.8%) positive for subtype A and 914 cases (54.2%) positive for subtype B; 455 out of 525 (86.7%) of influenza B positive specimens and 70 out of 525 (13.3%) of influenza A (H1N1) positive specimens were from patients seen during January to April; 419 out of 1118 (37.5%) specimens positive for influenza B and 699 out of 1118 (62.5%) specimens positive for influenza A (H1N1) were from patients seen from May to August. Influenza virus could be identified from 1380 samples by the methods of virus isolation, accounting for 81.80% of the 1687 positive samples detected by real-time PCR. All the influenza virus subtype A was H1N1.

CONCLUSIONThe real-time PCR method developed in this study was sensitive and specific for detecting influenza A and B in clinical specimens. During 2006, influenza A and influenza B co-circulated. The predominant virus was influenza B from January to April, peaking in April. Influenza A (H1N1) prevailed from May to August, with the peak in June.

Child ; China ; epidemiology ; Epidemics ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; epidemiology ; virology ; Polymerase Chain Reaction ; methods ; Prevalence ; RNA, Viral ; isolation & purification ; Sensitivity and Specificity

The study was purposed to investigate the expression of CD73 on bone marrow nucleated cells (BMMNC) in various leukemia subtypes and its relationship with cell differentiation of leukemia. Immunocytochemistry staining and Wright-Giemsa staining of BMMNC from 75 cases of leukemia, 11 cases of myelodysplastic syndrome (MDS), 13 cases of non-leukemic patients and 9 healthy adults were performed, and the CD73(+) ratio in BMMNC and its relationship with differentiation of leukemia cells were analyzed. The results showed that the ratios of CD73(+) in BMMNC of com-B ALL, pre-B ALL and PLL were significantly higher than those in B-CLL (p < 0.05). CD73(+) ratios in AML subtypes of M(1), M(2a), t (8; 21), t (15; 17), M(4) and M(5) were markedly higher than those in MDS respectively, but in M(6) and MDS were lower and had no statistical difference between them. CD73(+) ratios in T-ALL, B-CLL, M(6), MDS, non-leukemia patients and healthy adults were close to each other and all of them were lower than those in B-ALL and other AML subtypes. It is concluded that the expression of CD73 is associated with leukemia subtype, differentiation and development. The higher differentiation of leukemia cells, the lower of CD73 expression in myeloid and B lymphoid leukemia, but T-ALL does not meet this pattern.
5'-Nucleotidase ; metabolism ; Adolescent ; Adult ; Cell Differentiation ; Humans ; Leukemia ; metabolism ; pathology ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; Leukemia, Myeloid, Acute ; metabolism ; Myelodysplastic Syndromes ; metabolism ; Young Adult

OBJECTIVETo probe into the mechanism of electroacupuncture intervention for lipid metabolism of metabolic syndrome patients.

METHODSEighty cases of metabolic syndrome were randomly divided into an electroacupuncture combined with western medicine group (observation group) and a simple western medicine group (control group), 40 cases in each group. The observation group was treated with electroacupuncture at Back shu points, Zusanli (ST 36),Zhongwan (CV 12),Sanyinjiao (SP 6) etc. as main combined with oral administration of Simvastatin, Glipizide XL, and Felodipine sustained-release tablets for lipid-lowering, glucose-lowering and antihypertensive treatment; the control group was treated with oral administration of western medicine only (the medicine was the same with observation group). The Body Mass Index (BMI) and the blood lipid of the patients were detected respectively before and after treatment.

RESULTSThe BMI, Three Acids Glyceride (TG), Total Cholesterol(TC), Low Density Lipoprotein Cholesterol (LDL-C) and High Density Lipoprotein Cholesterol (HDL-C) were compared respectively before and after treatment, there were significant differences between them in observation group (all P < 0.01); while in control group, there were significant differences of TG,TC,LDL-C and HDL-C before and after treatment (all P < 0.01), and with no significant difference in BMI before and after treatment. There were significant differences of BMI,TG,TC,LDL-C and HDL-C between two groups after treatment (P < 0.01, P < 0.05).

CONCLUSIONThe electroacupuncture has an obvious effect to reduce body mass, and acupuncture combined with medication has a better effect of improving the lipid metabolism than simple medication.

Acupuncture Points ; Adult ; Body Mass Index ; Electroacupuncture ; Female ; Humans ; Hypolipidemic Agents ; administration & dosage ; Lipid Metabolism ; Lipids ; blood ; Male ; Metabolic Syndrome ; drug therapy ; metabolism ; therapy ; Middle Aged

The purpose of study was to investigate the ultrastructural features of leukemic megakarocyte (LMK) in patients with acute megakaryocytic leukemia (M(7)). Analyzing the ultrastructure characteristics of LMK and positive ratio of platelet peroxides (PPO) in 11 patients with M(7) were analyzed on basis of transmission electron microscopic observation retrospectively. The results showed that the diameter of LMK in 7 out of 11 cases was less than 20 microm, in 2 cases of them, the LMK diameter was from 10 to 15 microm and their PPO positive ratio was more than 50%, most LMK displayed regular shape, less protrusions, irregular nucleus, high nuclear/cytoplasm ratio, tiny granules, undeveloped demarcation membrane system (DMS) and irregular tubules in cytoplasm; in 5 out of those 7 cases the diameter of LMK was about 20 microm, PPO positive cell count was from 8% to 22%, most showing round or horseshoe nuclei, more or less heterochromatin, no DMS and granules were found in LMK in 3 cases and 2 cases occasionally. In other 5 out of 11 cases, the diameter of LMK was from 20 to 40 microm and PPO positive ratio was from 16% to 80%, in which smaller LMKs were similar to those in former cases in shape, and the larger LMK had irregular protrusions, varied nuclear/cytoplasm ratio, more heterochromatin, prominent nucleolus, some of them contained developed DMS, tubules and alpha-granules. It is concluded that most patients with M(7) are predominant of LMK in stage-I and minority contained LMK in II or III stage simultaneously. The differentiation degrees of LMK are different in individual and various cases.
Adult ; Blood Platelets ; enzymology ; Child, Preschool ; Female ; Humans ; Infant ; Leukemia, Megakaryoblastic, Acute ; pathology ; Male ; Megakaryocytes ; ultrastructure ; Middle Aged ; Peroxidase ; blood ; Retrospective Studies ; Young Adult

OBJECTIVETo explore the treatment options for younger than 60 years old adults with Ph /BCR-ABL positive acute lymphoblastic leukemia (Ph⁺ ALL).

METHODSFrom January 2001 to June 2012, 42 adult patients were enrolled in the study. All patients received standard VDCP±L ±imatinb (IM) as induction therapy followed by intensive consolidation of modified Hyper-CVAD/MA±IM. At complete remission 1 (CR1), patients with appropriate donor received allogeneic hematopoietic stem cell transplantation (allo-HSCT), the others sequentially received intensive consolidation ±IM and autologous HSCT (ASCT) at molecular CR (MCR), then MM±VP±IM as maintenance therapy. Overall survival (OS), disease free survival (DFS) and relapse rate (RR) were analyzed.

RESULTSCR rate after 1 cycle of induction chemotherapy was 83.3%. 39(92.9%) patients achieved CR. The median DFS and OS were (22.0±3.5) and (37.0±5.3) months respectively, with cumulative RR of (43.7±9.7)% during a median follow-up of 26.5(8-75) months. All 7 patients in CT group relapsed. Two patients received IM pre- and post-ASCT maintained MCR for 35 and 12 months after ASCT. But the other 3 ASCT recipients without IM died of relapse within 1 year. The transplant-related mortality rate in allo-HSCT group was 12.5%. The estimated 3-year OS in allo-HSCT (n=16), ASCT (n=5) and CT (n=7) groups were (66.7±12.2)%, (25.0±21.7)% and (16.7±15.2)%, respectively (P=0.014); meanwhile, the estimated 3-year DFS in those groups were of (56.3±12.4)%, (26.7±22.6)% and 0, respectively (P=0.002).

CONCLUSIONIM combined with intensive chemotherapy significantly increased the CR rate with the improved quality of CR, which highlighted the feasibility of SCT. Allo-HSCT could decrease relapse to produce favorable OS and DFS in CR1 of young adults with Ph⁺ ALL. ASCT combined IM might be the treatment of choice for those achieved MCR but without donors.

Adolescent ; Adult ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy ; Prospective Studies ; Recurrence ; Remission Induction ; Survival Rate ; Treatment Outcome ; Young Adult