Burns ; complications ; diagnosis ; prevention & control ; Humans ; Sepsis ; diagnosis ; etiology ; prevention & control

Objective To investigate the brain mechanism elicted by multiple conflict.Methods This study integrated different types of conflict,including Flanker,Stroop and Simon conflict,by using the event-related potential(ERP) technique.Results The behavioral data showed that there were the congruency effect and the conflict adaptation effect in all types of the conflict.ERP data showed that the congruency effects of P300,N450 and SP component were found in all types of conflict.Conclusion The conflict monitoring theory is still available for various types of conflict in multiple conflict conditions and the human brain uses local control mechanism to resolve the conflict.In addition,the human brain resolves the conflict based on the flexibility of cognitive control system driven by multiple conflict and the conflict-specific control mechanisms.These mechanisms are independent and free from any interference with each other.

ObjectiveTo assess the diagnostic value of dual-energy dual-source CT in detecting the enhancement ofhepatocellularcancer( HCC )aftertransarterialchemoembolization( TACE )treatment.Methods Twenty-seven patients with HCC underwent dual-energy dual-source CT including nonenhanced,arterial,portal,and delayed phases scanning after TACE treatment.Arterial phases were acquired with the dual-energy mode for reconstruction of virtual nonenhanced images and color overlay images.DSAs were performed in all these patients.Two blinded and independent readers evaluated the data in 2 reading sessions:standard nonenhanced,arterial phase,portal phase,and delayed phase images were read in session A,and virtual nonenhanced,arterial phase,portal phase,and delayed phase images in session B.Sensitivity and specificity were calculated,with the DSA data set as the reference standard.The sensitivity and specificity were compared with Chi-square test.Results DSA revealed 63 lesions in 27 patients,and 39 of them had blood supply.Overall sensitivity and specificity were 74.4％ (29/39) and 83.3％ (20/24) for session A,and 94.9％ (37/39),95.8％ (23/24) for session B,respectively.The sensitivity of the two reading sessions was significantly different (x2 =6.303,P ＜ 0.05 ),while the specificity was insignificantly different ( x2 =2.009,P ＞ 0.05 ).Conclusion Compared with standard dynamic protocols,an arterial dual-energy dual-source CT scan with reconstruction of virtual nonenhanced and color overlay images enables detection of relapse and intrahepatic metastasis of HCC after TACE treatment with higher accuracy.

Most of the major advances in burn treatment were made within the last five decades. However, hypermetabolic response after severe burn remains a problem in the treatment of patients with massive burn. As skeletal muscle accounts for over 50% of body cell dry weight, its catabolism exerts profound effect on body metabolism as a whole. Main mechanisms underlying skeletal muscle wasting induced by severe burn include activation of ubiquitin-proteasome pathway, bringing about breakdown of muscle protein, and myonuclear apoptosis. Therapeutic strategies for skeletal muscle wasting after burn mainly include maintenance of room temperature at (31.5 +/- 0.7) degrees C, early active and passive exercise of skeletal muscles, administration of beta adrenergic receptor blocker such as Propranolol, recombinant growth hormone, androgen, and insulin, which has lately been proven to possess the effect of suppressing myonuclear apoptosis after burn. Combination of multiple therapeutic strategies is beneficial in reducing complications of burn patients, particularly wide ranged skeletal muscle atrophy, to achieve a better clinical outcome.
Apoptosis ; Burns ; drug therapy ; metabolism ; pathology ; Humans ; Muscle, Skeletal ; metabolism

Calpains are intracellular nonlysosomal Ca(2+-) regulated cysteine proteases, widely located in the tissues of most mammals. Skeletal muscle tissue mainly expresses m-calpain, µ-caplain, n-calpain, and their endogenous inhibitor calpastatin. They are closely related to the cell apoptosis, cytoskeleton formation, cell cycles, etc. Calpains are also considered to be participating in the protein degradation process. Severe burns are typically followed by hypermetabolic responses that are characterized by hyperdynamic circulatory responses with increased proteolysis and cell apoptosis. Recently, overloading of Ca(2+) in skeletal muscle cells, which activates the calpains is observed after a serious burn. This paper aims to review the current research of the relationship between calpains and post-burn skeletal muscle wasting from the perspectives of structure, function, and physiological activities.
Animals ; Burns ; metabolism ; pathology ; Calpain ; metabolism ; Muscle, Skeletal ; metabolism ; pathology

Sepsis induced by invasive infection is a challenging problem and the major cause of death after severe burn. With the increasing understanding of sepsis, diagnostic criteria of sepsis were proposed and revised consecutively so that they could be consistent with the clinical practice. Being different from other trauma and critical diseases, diagnostic criteria of sepsis after severe burn were also proposed, and they need further clinical verification. It is believed that comprehensive measures for the treatment of severe sepsis after burn should be advocated. These measures include rapid and effective resuscitation of burn shock, early escharotomy and closure of burn wound, metabolic support, immunoregulation and anti-inflammation, reinforcement of organ support, etc. Although a number of advances have been achieved in the past decades, the mechanism of sepsis need further elucidation, diagnostic criteria of sepsis need further revision, and novel therapeutic measures for burn sepsis should be developed.
Burns ; complications ; Humans ; Sepsis ; diagnosis ; etiology ; therapy

OBJECTIVETo investigate the mechanism and the effects of intravenously injected tumor necrosis factor alpha (TNFalpha) on skeletal muscle protein degradation in rats and its relationship with glucocorticoid.

METHODSForty-five male Wistar rats were randomly divided into 3 groups as A (control), B (TNFalpha injection) and C (TNFalpha and glucocorticoid receptor antagonist injection) groups. TNFalpha in dose of 1x 10(6) units/kg was given to rats in B group intravenously. RU38486, a glucocorticoid receptor antagonist, was given by gavage in C group 2 hours before intravenous injection of TNFalpha in the same dose as in B group. the rat temperature was monitored 12 hours after the administration of the drugs. At the same time, the rat extensor digitorum longus muscles (EDL) were isolated, weighed and cultured under aerobic condition, and than the degradation rates of total and the myofibrillar proteins were determined with HPLC (high performance liquid chromatography), and the expression changes in C2 subunit mRNA and ubiquitin mRNA were detected by Northern blot.

RESULTSTwelve hours after the injection, the temperature of the rats in B and C group was much higher than that in A group (P < 0.01), while the weight of the extensor digitorum longus muscle in B and C groups was evidently lower than that in A group (P < 0.01) whereas that in C was higher than that in B groups (P < 0.05). The degradation rates of total and the myofibrillar proteins in B group were increased by 43% and 112%, respectively, when compared with those in A group (P < 0.01), while the rates in C group was decreased by 16% and 28%, respectively, when compared with those in B group (P < 0.01). In addition, the expressions of ubiquitin mRNA (2.4 kb) and C2 subunit mRNA in B group were increased 4.3 and 3.6 fold compared with those in A group, whereas those in C group were much lower than those in B group.

CONCLUSIONIntravenous injection of recombinant TNFalpha in large dose might enhance the activity of rat skeletal muscle ubiquitin-proteasome system pathway, which led to an increase in the degradation rate of rat total protein, especially the myofibrillar protein. Glucocorticoid was one of the mediating factors of that effect.

Animals ; In Vitro Techniques ; Male ; Muscle Proteins ; metabolism ; Muscle, Skeletal ; drug effects ; Rats ; Rats, Wistar ; Recombinant Proteins ; pharmacology ; Tumor Necrosis Factor-alpha ; pharmacology ; Ubiquitin ; metabolism

Objective To evaluate accuracy of cefoxitin disk testing for detecting oxacillin resistance coagulase-negative staphylococci (MRCNS). Methods 139 clinical coagulase-negative staphylococci (CNS) were detected with ID32 STAPH. Cefoxitin disk and oxacillin disk testing were used to detect MRCNS. PBP2a was tested by latex agglutination us a reference method. Results 139 CNS isolates were identified to 8 species: Staphylococcus haemolyticus , S. epidermidis , S. hominis , S. xylosus , S. saprophyticus , S. auricularis , S. simulans and S. warneri. The sensitivity and specificity for cefoxtin disk and oxacillin disk testing were 99.0% vs. 86.0% and 91.7% vs. 74.4%, respectively. One S. epidermidis strain was identified to affect the sensitivity of cefoxitin disk testing. S. xylosus, S. warned, and S. saprophyticus were major species related to the decrease of specificity of cefoxitin disk testing. S. haemolyticus, S. hominis, S. simulans and S. auricularis were major species related to the decrease of sensitivity of oxacillin disk testing. And the decrease of specificity of oxacillin disk testing were mainly related to S. hominis , S. simulans , S. xylosus , S. auricularis , S. saprophyticus and S. warneri. Conclusions The accuracy of MRCNS detection by cefoxitin disk testing is varied due to different CNS species. So it is necessary to test PBP2a or mecA gene according to CNS species, especially for S. xylosus, S. warned and S. saprophyticus.

Objective To evaluate the value of DWI in assessing the biological characteristics of breast invasive ductal carcinoma (IDC).Methods Eighty-seven IDC lesions confirmed by postoperative pathology were involved in this retrospective study.The ADC values of IDC were compared among different lymph node status,grades,and molecular subtype.The correlations of ADC value and lymph node status,grades,and molecular subtype were evaluated.Results The ADC value of IDC with positive lymph node was lower than that with negative lymph node (P=0.035),and the ADC value of the high grade IDC was lower than those of medium grade IDC and low grade IDC (P=0.021,0.002).There was no significant difference of ADC value between different molecular subtypes.There was low negative correlation of ADC value with grades (r.s =-0.357,P 0.001) and week negative correlation of ADC value lymph node status and nolecular subtype (rs =-0.227,P=0.034;rs-0.093,P＜0.001).Conclusion DWI can provide useful information in evaluating the biological characteristics of IDC.

OBJECTIVETo explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology.

METHODSThe patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation.

RESULTSThe distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved.

CONCLUSIONSRapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Face ; abnormalities ; surgery ; Facial Asymmetry ; congenital ; surgery ; Goldenhar Syndrome ; surgery ; Humans ; Hyperplasia ; surgery ; Mandible ; surgery ; Maxilla ; surgery ; Osteogenesis, Distraction ; methods ; Osteotomy ; methods ; Osteotomy, Le Fort