From September 2002 to May 2006, five patients ( age range, 24 to 46; mean, 32) with tibial defect underwent transplantation of free latissmus dorsi osteocutaneous flap using bridge-like vascular anastomosis. All the osteocutaneous flaps survived without any serious complications, and tibial defects were improved completely. After 1.5 to 4.5 years' follow-up ( mean, 2.6), no remarkable dysfunction was found at donor sites, and local injury was reduced. This study indicates that transplantation of free latissmus dorsi osteocutaneous flap using bridge-like vascular anastomosis might be useful in leg reconstructive surgery if only one vessel is remained.

Objective To develop the Assessment Scale for Patient Safety Culture in ICU and do psychometric test.Methods The Assessment Scale for Patient Safety Culture in ICU was developed based on literature review,qualitative interview,and two-round Delphi consultation.The reliability and validity were tested among 235 chnical nurses and doctors in ICU.Results A 45-item questionnaire was originally developed and eleven of them were deleted after subjective screening,project analysis and exploratory factor analysis.Seven factors were extracted with cumulative contribution rate of 59.347％.The scale of total Cronbach's alpha coefficient was 0.909; the split half reliability was 0.832.Each dimension of Cronbach's alpha coefficient was between 0.481～0.909,and the split half reliability was 0.481～0.866.All had significance in statistics above.Conclusions The Assessment Scale for Patient Safety Culture in ICU has good reliability and validity,which can be used to evaluate the ICU patient safety culture atmosphere domestically.

OBJECTIVETo examine the effect of acute incisional pain on the expression of connexin 43 in rat spinal cord dorsal horn.

METHODSEighty rats were assigned into control group without any treatment and incisional pain group with incision surgery. For paw incisions, a 1-cm longitudinal incision was made through the skin and fascia of the plantar aspect of the right hind paw. After surgery, the 50% paw withdrawal threshold (PWT) was assessed in response to a tactile stimulus with calibrated von Frey monofilaments at 1, 2, 4 and 24 h, respectively. The spinal cord dorsal horn of rats was isolated at 1, 2, and 4 h after the surgery to assess the expression of connexin 43 using Western blotting and immunofluorescence assay.

RESULTSThe 50% PWT of the rats was significantly decreased after the incision surgery, and this decrement was the most obvious at 2 and 4 h. Western blotting and immunofluorescence assay showed that the expression of connexin 43 in the spinal cord dorsal horn was significantly increased in rats receiving the surgery especially at 2 and 4 h after the surgery.

CONCLUSIONIncision surgery induces an significant increase in connexin 43 expression in rat spinal cord dorsal horn, suggestting an potential role of connexin43 in postoperative incisional pain.

Animals ; Connexin 43 ; metabolism ; Pain, Postoperative ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Dorsal Horn ; metabolism

OBJECTIVETo observe the immune reaction in the mixed culture of host lymphocytes with allogenic and host endothelial cells.

METHODSThe host epithelial cells and lymphocytes from burn patients and allogenic epithelial cells were mix-cultured in different ratios, so as to simulate the local immune micro-environment of host skin island in intermingled skin grafting. In addition, the cells from normal human subjects were also mix-cultured as control. The lymphocyte cpm values were detected by (3)H-TdR and HLA molecules and T cell subgroup were determined by immunohistological technique.

RESULTS(1) The lymphocyte proliferation reaction could be effectively inhibited by the epithelial cells from burn patients but not from normal control. (2) The inhibition of host lymphocyte proliferation could not be mediated by the HLA-DQ molecules of epithelium from burn patients. (3) The positive expression rate of HLA-DR of epithelia from burn patients was evidently higher that that from normal control (P < 0.05), (4) The CD8 expression of lymphocyte in burn patients was significantly higher than that in normal control (P < 0.01), while the CD4 expression in burn patients was lower than that in normal control (P < 0.01). But there was no obvious difference of the CD3 expression between patients and normal subjects (P > 0.05).

CONCLUSIONThe lymphocyte proliferation reaction could be obviously inhibited by the host epithelium, which might be related to the specific immune state of the host lymphocytes and epithelium of burn patients.

Cell Communication ; immunology ; physiology ; Cell Culture Techniques ; Cell Division ; Epithelial Cells ; immunology ; physiology ; Humans ; Lymphocytes ; immunology ; physiology ; Skin Transplantation ; immunology

Objective:To explore the changes of blood viscosity in high-intensity alternating magnetic field and the mechanisms.Methods:Five adult sheep were randomly selected and the blood samples were placed in highintensity alternating magnetic field.Before and after exposure,the blood samples were taken and divided into 2 groups:a control group and a magnetic field group.The blood rheology and transmission electron microscopy (TEM) were performed.Results:Compared to the control group,the high shear viscosity of whole blood was decreased in the magnetic field group (P＜0.05);the whole blood low shear viscosity and plasma viscosity were also decreased (both P＜0.01).TEM showed the changes in red blood cell morphology and the double concave disc curvature.The radian of double concave disc and cell volume in the magnetic field group was larger than those in the control group.Conclusion:The high intensity alternating magnetic field may affect the distribution of surface charge and molecular current in blood cells,which in turn decrease the aggregation of cells and the blood viscosity.

Objective To examine the effect of acute incisional pain on the expression of connexin 43 in rat spinal cord dorsal horn. Methods Eighty rats were assigned into control group without any treatment and incisional pain group with incision surgery. For paw incisions, a 1-cm longitudinal incision was made through the skin and fascia of the plantar aspect of the right hind paw. After surgery, the 50% paw withdrawal threshold (PWT) was assessed in response to a tactile stimulus with calibrated von Frey monofilaments at 1, 2, 4 and 24 h, respectively. The spinal cord dorsal horn of rats was isolated at 1, 2, and 4 h after the surgery to assess the expression of connexin 43 using Western blotting and immunofluorescence assay. Results The 50%PWT of the rats was significantly decreased after the incision surgery, and this decrement was the most obvious at 2 and 4 h. Western blotting and immunofluorescence assay showed that the expression of connexin 43 in the spinal cord dorsal horn was significantly increased in rats receiving the surgery especially at 2 and 4 h after the surgery. Conclusion Incision surgery induces an significant increase in connexin 43 expression in rat spinal cord dorsal horn, suggestting an potential role of connexin43 in postoperative incisional pain.

Objective To examine the effect of acute incisional pain on the expression of connexin 43 in rat spinal cord dorsal horn. Methods Eighty rats were assigned into control group without any treatment and incisional pain group with incision surgery. For paw incisions, a 1-cm longitudinal incision was made through the skin and fascia of the plantar aspect of the right hind paw. After surgery, the 50% paw withdrawal threshold (PWT) was assessed in response to a tactile stimulus with calibrated von Frey monofilaments at 1, 2, 4 and 24 h, respectively. The spinal cord dorsal horn of rats was isolated at 1, 2, and 4 h after the surgery to assess the expression of connexin 43 using Western blotting and immunofluorescence assay. Results The 50%PWT of the rats was significantly decreased after the incision surgery, and this decrement was the most obvious at 2 and 4 h. Western blotting and immunofluorescence assay showed that the expression of connexin 43 in the spinal cord dorsal horn was significantly increased in rats receiving the surgery especially at 2 and 4 h after the surgery. Conclusion Incision surgery induces an significant increase in connexin 43 expression in rat spinal cord dorsal horn, suggestting an potential role of connexin43 in postoperative incisional pain.

Objective:To investigate the clinicpathological characteristics of post-transplant lymphoproliferative disorders (PTLD) in transplanted lung, and to improve its diagnosis and treatment.Methods:The clinicopathological characteristics of PTLD in three transplanted lungs were evaluated at Wuxi People′s Hospital Affiliated to Nanjing Medical University from 2014 to 2019. HE, immunohistochemical staining and in situ hybridization were performed. The relevant literature of PTLD was reviewed.Results:All three patients had chronic obstructive pulmonary disease (COPD) before lung transplantation. After receiving both lung transplants, they were all treated with anti-rejection drugs tacrolimus or mycophenolate mofetil, and combined with antiviral and/or rituximab. The time from transplantation to diagnosis of PTLD was four years, seven months, and five months, respectively. Two patients died one month and five months after initial diagnosis, and one patient was alive with no disease after one year. Histologically, all cases were monomorphic B-cell PTLD (diffuse large B-cell lymphoma, unspecified), and the tumor cells were positive for Epstein-Barr virus by in situ hybridization; one of the late-onset patients had herpes simplex virus infection.Conclusions:PTLD in the post-transplant lung tissue shows unique morphology and clinical characteristics, and is closely related to Epstein-Barr virus infection. Patients who receive lung transplantation due to COPD are more susceptible to develop PTLD, while late-onset ones occur more commonly in the hilum of lungs, and the prognosis is relatively poor.

Objective:To investigate the relationship between plasma factor VIII (FVIII) level and the clinical indicators and prognosis in IgA nephropathy (IgAN) patients.Methods:The clinical data of IgAN patients diagnosed from the Second Xiangya Hospital of Central South University from January 2016 to December 2016 were collected. Patients were divided into high FVIII group (FVIII>140.50%) and low FVIII group (FVIII≤140.50%) according to the time-dependent receiver operating characteristic curve analysis. The baseline clinical parameters at the time of renal biopsy between two groups of patients were compared. Taking the estimated glomerular filtration rate (eGFR) reduction ≥30% or entering end-stage renal disease (ESRD) as the endpoint event, Kaplan-Meier analysis and Cox proportional hazards models were used to explore the association between plasma FVIII level and prognosis in IgAN patients.Results:A total of 93 patients were ultimately retained for this study, with a median follow-up of 35.15(33.77, 36.76) months. Twelve (12.90%) patients reached the endpoint event. The levels of serum creatinine, urea nitrogen, triglyceride, total cholesterol, plasma fibrinogen, D-dimer, 24-hour urinary protein, protein C, protein S, slope of eGFR and age in the high FVIII group were higher than those in the low FVIII group (all P<0.05). The levels of eGFR, serum albumin and follow-up time in the high FVIII group were lower than those in the low FVIII group (all P<0.05). The renal cumulative survival rate was significantly lower in the high FVIII group than that in the low FVIII group ( χ2=5.635, P=0.018) according to the Kaplan-Meier analysis. After adjusting for variables such as systolic blood pressure, eGFR, urinary protein, and renal tubular atrophy/interstitial fibrosis, multivariate Cox proportional hazards models analysis showed that high level of plasma FVIII was an independent risk factor for poor prognosis in IgAN patients ( HR=4.147, 95% CI 1.055-16.308, P=0.042). Conclusions:The level of plasma FVIII is associated with clinical indicators and prognosis in IgAN patients. The higher level of plasma FVIII can be identified as an independent risk factor for poor prognosis in IgAN patients.