Objective To evaluate the levels of neutrophil gelatinase associated lipocalin (NGAL) in prediction of acute kidney injury (AKI) in children with burn. Methods Forty seven children with burn were selected in this study and thirty healthy children were enrolled as a control group. Levels of blood routine, urine routine, serum creatinine (Scr), serum NGAL (SNGAL), urine NGAL (UNGAL), blood urea nitrogen (BUN) and C-reactive protein (CRP) were measured. Receiver operating characteristic (ROC) curve were used to estimate the AKI diagnostic value of serum NGAL, urine NGAL and Scr. Results On the day of admission, serum NGAL and urine NGAL were significantly increased in patients with AKI , while Scr did not change significantly as compared with those in non-AKI patients and the healthy controls. In AKI group, serum NGAL and urine NGAL were positively correlated with WBC and CRP on the day of admission , and positively related with Scr on the seventh day. ROC analysis showed the AUC of serum NGAL, urine NGAL and Scr on admission were 0.737(95%CI: 0.653 ~ 0.779, P < 0.05), 0.772(95%CI: 0.632 ~ 0.793, P < 0.05), and 0.508(95%CI: 0.454~0.618, P < 0.05) respectively. The cut-off value of serum NGAL and urine NGAL were 318 μg/L (sensitivity of 72.8% and specificity of 81.6%) and 105 μg/L (sensitivity of 75.6% and specificity of 83.7%). Conclusions Elevation in levels of serum NGAL and urine NGAL occurs earlier than that in Scr level in children with burn. Both serum and urine NGAL level can be used as a biomarker for early prediction of AKI.

OBJECTIVETo investigate methods and short-term effects on tantalum metal block for reconstruction of Paprosky type III severe acetabulum bone defect.

METHODSTwelve patients (12 hips) with Paprosky type III severe acetabulum bone defect,treated with tantalum metal block in revision of total hip arthroplasty, were retrospectively analyzed from March 2009 to December 2012. Among the patients, there were 5 males and 7 females aged from 45 to 78 years old with an average of 64 years old; the courses of disease ranged from 3 to 32 months with an average of 16 months. According to classification of Paprosky, all patients were Paprosky type III acetabulum bone defect. All patients were used tantalum metal block in revision of total hip arthroplasty, and large diameter biological acetabulum cups were used in combination. Operative time,blood loss and postoperative complications were recorded and compared, Harris score were used to evaluate clinical effects.

RESULTSEleven patients ( 11 hips) were followed up from 9 to 36 months with an average of 25 months, 1 case was lost to follow-up for dying in car accident. The incisions were healed at stage I . Operative time ranged from 2 to 6 h with an average of 3 h; blood loss was 300 to 1 600 ml with an average of 900 ml. No deep venous thrombosis, periprosthetic femoral fracture and infection, sciatic nerve injury occurred after operation. Harris score were improved from (46.25 ± 8.99) before operation to (83.75 ± 6.76) after operation. There was significant difference in Harris score before and after operation (t = 3.14, P = 0.00 < 0.05), and 7 cases got excellent results, 2 good and 2 moderate. CONCLUCSION: Tantalum metal block is suitable for revision of Paprosky III acetabulum bone defect, could repair different kinds of acetabulum cup defect, could fill up inclusive defect of inner wall combined with particulate bone graft, induce bone growth pressured between metal block and metal cup, provide a new further choose for the treatment of Paprosky type III severe acetabulum bone defect.

Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Tantalum

Objective:To analyze the preliminary effects of subxiphoid video-assisted thoracoscopic extended thymectomy.Methods:We retrospectively analyzed the clinical data of six patients who underwent subxiphoid video-assisted thoracoscopic extended thymectomy in Peking University International Hospital from August 2018 to June 2020.Results:All six patients underwent successful subxiphoid video-assisted thoracoscopic extended thymectomy without conversion to thoracotomy. The rate of R0 resection was 100%. Operative time was (175.50 ± 67.78) minutes, intraoperative blood loss was (40.83 ± 31.37) mL, and postoperative drainage time was (7.17 ± 3.55) days. The total amount of postoperative drainage was (1781.67 ± 1293.53) mL. Postoperative hospital stay was (10.67 ± 6.35) days. The length of hospital stay was (19.67 ± 5.65) days. The Visual Analog Scale score measured after surgery was (2.12 ± 0.48) points. Three patients had grade 1 complications, with an incidence of complications of 50.00%. Grade 3-5 compilations did not occur in any patient. No patient died during the perioperative period.Conclusion:Subxiphoid video-assisted thoracoscopic extended thymectomy is safe and effective and provides a good visual field. The surgical method allows bilateral thoracic surgery, reduces surgical trauma, and has a broad application prospect.

OBJECTIVETo investigate the feasibility of constructing scaffold for tissue engineering with human extracellular matrix from adipose tissue.

METHODSFresh human adipose tissue was obtained by liposuction in 7 women who undergone liposuction. One part of the fat was used to isolate the adipose-derived stem cells (ADSCs), the other part was used to extract human extracellular matrix powder. After removing blood and oil components, the tissue was homogenized, centrifuged, freeze-dried, and crushed to powder by instrument. The structure of human ECM powder was observed with electron microscopy. The ADSCs were seeded and attached to the human extracellular matrix powder before and after labeled with fluorescent DiI, respectively. The adhesion rate was detected. The adhesion and growth of ADSCs were observed with Fluorescence microscope. The adhesion rate before and after DiI labeling was analyzed statistically with two-sample test of SPSS 13.0.

RESULTSThe ADSCs and human extracellular matrix powder were obtained successfully from adipose tissue. The ADSCs could be differentiated into adipose cells, bone cells and chondrocytes. SEM images showed that the power had both rugged and smooth surface with a porous structure characteristics. ADSCs could adhere to the scaffold easily, and the adhesion rate was (88.81 +/- 4.81)% and (86.48 +/- 4.58)% before and after DiI labeling. There was no difference between two groups. DiI labeled ADSCs were adhered to extracellular matrix scaffold and could grow in good condition.

CONCLUSIONSHuman adipose tissue extracellular matrix powder was easy to obtain, with diversity in size and shape which provided excellent substrates for cell adhesion and growth. It could be an ideal adipose tissue engineering scaffold.

Adipocytes ; cytology ; Adipose Tissue ; cytology ; Adolescent ; Adult ; Cell Culture Techniques ; Cells, Cultured ; Extracellular Matrix ; Female ; Humans ; Tissue Engineering ; methods ; Tissue Scaffolds ; Young Adult

Objective:To compare the effects of unilateral thoracic paravertebal block with lidocaine on hemodynamic and the level of consciousness during double lumen endotracheal intubation.Methods:From June to october 2021,a total of 40 patients American Society of Anesthesiologists(ASA)physical status Ⅰ-Ⅱ,aged 19-65 years,scheduled for elective thoracic sugeries in Peking University Interna-tional Hospital block with under general anesthesia requiring orotracheal intubation were recruited and di-vided into two groups:The double-lumen endobronchial intubation(group C)and double-lumen endo-bronchial intubation after thoracic paravertebal block with lidocaine(group P).After an intravenous an-esthetic induction,the orotracheal double-lumen intubation was performed using a Macintosh direct laryn-goscopy,respectively.Invasive blood pressure(BP)and heart rate(HR)were recorded before and after anesthetic induction,immediately after intubation and 5 min after intubation with 1-minute interval and the intubation time was also noted.Rate-pressure product(RPP)were calculated.Results:After anes-thetic induction,BP and RPP in the two groups decreased significantly compared with their preinduction values.As comparison with their postinduction values,the orotracheal intubation in the two groups caused significant increases in BP,HR and RPP.Diastolic blood pressure(DBP)and mean arterial pressure(MAP)increased significantly and lasted for 1-minute in group C compared with the baseline values.Systolic blood pressure(SBP)was not significant change and DBP increased significantly immediately af-ter intubation in group P.HR of both groups after intubation were significantly higher than their baseline values and lasted for 4 min in group C,HR increased significantly immediately after intubation in group P.SBP,DBP,MAP,HR and RPP after intubation in group P were significantly lower than those of group C during the observation period.The value of BIS was similar between the two groups.Compared with group C,the incidence of SBP greater than 30％and RPP greater than 22 000 was significantly lower in group P in the observation period,and no patient in group P developed RPP greater than 22 000.At the end of the incidence of SBP less than 30％of the basal value and HR less than 30％of the baseline,no severe bradycardia occurred in both groups.Conclusion:During double-lumen endobronchial intubation,unilateral thoracic paravertebal block with lidocaine can provide less hemodynamic response and level of conscionsness.

BACKGROUNDClinical observations have shown that the complex fractionated atrial electrogram (CFAE) associates with ganglionated plexus activity in the cardiac autonomic nervous system. This study aimed to investigate the impact of CFAE ablation on vagal modulation to atria and vulnerability to develop atrial fibrillation (AF).

METHODSTen adult mongrel dogs were involved. Cervical sympathovagal trunks were decentralized and sympathetic effects were blocked. CFAE was color tagged on the atrial 3-dimensional image and ablated during AF induced by S1S2 programmed stimulation plus sympathovagal trunk stimulation. Atrial effective refractory period (ERP) and vulnerability window (VW) of AF were measured on baseline and at vagal stimulation at 4 atrium sites. Serial tissue sections from ablative and control specimens received hematoxylin and eosin staining for microscopic examination.

RESULTSMost CFAE areas were localized at the right superior pulmonary quadrant, distal coronary sinus (CS(d)) quadrant, and proximal coronary sinus (CS(p)) quadrant (21.74%, separately). Sinus rhythm cycle length (SCL) shortening did not decrease significantly after ablation at the sites, including right atrial appendage, left atrial appendage, CS(d), and CS(p) (P > 0.05). ERP shortening during vagal stimulation significantly decreased after ablation (P < 0.01); the VW to vagal stimulation significantly decreased after ablation (P < 0.05). The architecture of individual ganglia altered after ablation.

CONCLUSIONSCFAE has an autonomic basis in dogs. The decreased SCL and ERP shortening to vagal stimulation after CFAE ablation demonstrate that CFAE ablation attenuates vagal modulation to the atria, thereby suppressing AF mediated by enhanced vagal activity. CFAE ablation could suppress AF mediated by enhanced vagal activity.

Animals ; Atrial Fibrillation ; therapy ; Autonomic Nervous System ; Catheter Ablation ; methods ; Dogs ; Electrophysiologic Techniques, Cardiac ; methods ; Electrophysiology ; Female ; Male