Arginine ; therapeutic use ; Burns ; immunology ; therapy ; Humans ; Nutrition Therapy ; methods

Arginine ; therapeutic use ; Burns ; drug therapy ; immunology ; Critical Care ; methods ; Critical Illness ; therapy ; Glutamine ; therapeutic use ; Humans ; Linolenic Acids ; therapeutic use ; Nutritional Support ; methods ; Wounds and Injuries ; drug therapy ; immunology

OBJECTIVE:To prepare chloramphenicol and ephedrine nasal gel and establish its quality control method.METHODS:Gel was prepared with chloramphenicol and ephedrine hydrochloride as principal agents and with carbomer-940 as base.The contents of the principal agents were determined by HPLC and the stability of the gel was investigated as well.RESULTS:The preparation was transparent colloid.The linear ranges of chloramphenicol and ephedrine hydrochloride were 62.5～1 000 and 31.25～500 ?g?L-1(r=0.999 9),respectively,with average recovery rates at 99.64%(RSD=0.5%)and 99.57%(RSD=0.7%),respectively.Storing under room temperature,no obvious change was noted for the property of the sample at 12 months.CONCLUSION:The preparation technique of the gel is simple and feasible,and its quality is stable and controllable.

Objective To define a suitable threshold setting for gross tumor volume (GTV)when using 18F-fluoro-deoxyglucose positron emission tomography and computed tomogram (PET/CT) for radiotherapy planning in Nasopharyngeal carcinoma(NPC).Methods Sixteen NPC patients respectively received PET/CT and MRI scan before their radiation treatment.All of the images were transferred to the radiotherapy planning system (TPS).MRI/CT-based primary GTV was defined as GTVf.Biological target volumes (BTVs) were derived from PET/CT-based GTVs of primary tumors.The BTVs were defined as the volumes when adjusting different percentage of the maximal standardized uptake value (SUVmax).GTVfs were compared with BTVs.The suitable threshold level (sTL) could be determined when BTV value and its morphology using a certain threshold level were observed to be the fittest GTVf.The suitable standardized uptake value (sSUV) was calculated as the sTL multiplied by the SUVmax.Results Our result demonstrated no single sTL or sSUV method could achieve an optimized volumetric match with the GTVf.The sTL was [20.93％±6.51％(15％-40％)],whereas the sSUV was [2.27±0.48(1.56-3.25)].The sTL was inversely correlated with the SUVmax sTL =-0.144ln(SUVmax) + 0.5548 (R2 =0.85,F =78.57,P＜0.01.The sSUV showed a linear correlation with the SUVmax sSUV =0.104(SUVmax) + 1.0398,(R2=0.75,F=41.88,P＜0.01).The sTL was not associated with the value of GTVf.Conclusions In PET/CT-based BTV for NPC,SUVmax threshold method is feasible.sTL is not a fixed value,which is correlated with the SUVmax instead of the value of tumor.

BACKGROUND: Bone marrow stem cells can be induced to differentiate into vascular endothelial cells and facilitate establishment of compensatory circulation, so as so improve blood supply of ischemic tissues. OBJECTIVE: To observe the clinical efficacy of autologous peripheral blood stem cells (PBSCs) transplantation in the treatment of diabetic vascular disorder in the lower extremities and diabetic feet. DESIGN: Wuhan Central Hospital, Wuban, Hubei Province, China. PARTICIPANTS: A total of 89 patients with type 2 diabetic vascular disorder in the lower extremity were enrolled from Department of Endocrinology in Wuhan Central Hospital from July 2005 to may 2007. All cases matched the criteria of diabetes by WHO in 1999, and complicated with diabetic peripheral angiopathy and diabetic feet. They included 61 males and 28 females, aged 45-90 years, with an average age of 67. Lesion was mainly located in lower extremities, 54 patients with foot ulcers while 8 patients with gangrene. All the patients signed the informed consents, and the experiment was approved by the hospital ethics committee. Recombinant human granulocyte colony stimulating factor was purchased from China Kunpeng Bio-Pharmaceutical Co., Ltd.METHODS: Stem cell mobilization: 89 patients all received recombinant human granulocyte colony stimulating factor, 500-600 μg per day by hypodermic injection for 5 days to mobilize stem cells. On the fifth day. PBSCs were collected with a total amount of 83-103mL. The number of mononuclear cells was (1.86-3.39)×1011L-1,while the proportion of CD34 positive cells was 0.55%-1.36%. PBSCs transplantation: After patients were treated with intravenous anesthesia, PBSCs were injected into the ischemic lower extremity and foot intramuscularly at 3cm×3cm distance. The clinical and laboratory findings were monitored from the first day to the sixth month.MAIN OUTCOME MEASURES: The patients were evaluated before transplantation, and in the first, third and sixth months after transplantation, including affected limb pain, cool feeling, intermittent claudication, ankle brachial index (ABI), limb skin temperature and deep feeling. Color Doppler. CT and digital subtraction angiography were applied to detect lower extremities morphous.RESULTS: All 89 included patients were involved in the result analysis. Scores of clinical symptom: The affected limb pain, cool feeling, and intermittent claudication were all improved significantly after PBSCs transplantation (P<0.05),and the improvement was more evident with time extension. ABI: After PBSCs transplantation, ABI in patients increased significantly by different degrees with the time extension(P0.05). Skin temperature and deep feeling: Limb skin temperature increased significantly after transplantation (P<0.05), and deep feeling seemed to be improved, but the change was not significant(P0.05). Imaging determination: There was no obvious change after transplantation checking of lower extremity by color Doppler. But CT and digital subtraction angiography results showed lower extremities in 23 patients had new collateral vessels formation with different degrees.CONCLUSION: Autologous PBSCs transplantation can increase blood flow of lower extremities in patients with diabetic vascular disorder in the lower extremities and diabetic feet, and promote the angiogenesis in lower extremity of partial patients.

Multiple organ dysfunction syndrome (MODS) is a serious complication with higher mortality in patients with burns and trauma. It is important to study the mechanism of MODS for prevention and control of it. Mesenteric lymph mechanism of MODS is a new viewpoint of gut-derived mechanism of MODS in recent years. In this review, we elucidate the mechanism of gut-derived origin of MODS and role of mesenteric lymph path in development of MODS after burns and trauma injury.
Burns ; complications ; pathology ; Humans ; Lymphatic System ; Mesentery ; Multiple Organ Failure ; etiology ; pathology

Animals ; Animals, Newborn ; Brain ; blood supply ; metabolism ; pathology ; Carrier Proteins ; genetics ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; genetics ; Gene Expression ; Hypoxia-Ischemia, Brain ; genetics ; pathology ; In Situ Hybridization ; Protein Tyrosine Phosphatase, Non-Receptor Type 13 ; Protein Tyrosine Phosphatases ; genetics ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo compare shear bond strength (SBS) between two types of silicone soft liner and polymethyl methacrylate (PMMA) under the condition of heat curing and room temperature curing.

METHODSA total of 48 PMMA specimens (50 mm x 10 mm x 3 mm) were made by water-bath heating method, and randomly divided into four groups. By using Ufi Gel P (UGP) as soft liner material, group A1 was prepared under heat curing, and group A2 was prepared under room temperature curing. To form the other two groups, Silagum-Comfort (SLC) as soft-liner material was used. Group B1 was prepared under heat curing, and group B2 was prepared under room temperature curing. Shear bond strength (SBS) was tested by using the electronic universal testing machine. The adhesives layer and surface of silastic and PMMA were observed by optical microscope and scanning electron microscopy (SEM).

RESULTSThe SBS of groups A1, A2, B1, B2 were (2.39 +/- 0.24), (1.74 +/- 0.27), (3.09 +/- 0.26), and (2.21 +/- 0.29) MPa, respectively. Significant differences were found between A1 and A2, B1 and B2, A1 and B1, and A2 and B2 (P < 0.05). Optical microscope showed numerous bubbles in the cured UGP, and no air bubbles in the SLC. The surface of PMMA was rough. SEM images showed that each group had continual consistent adhesive interface and a whisker hump on the adhesive layer of A2 and B2.

CONCLUSIONThe SBS ofUGP, SLC, and PMMA achieved minimum clinical standard of 0.44 MPa. The SBS of UGP and PMMA were higher than that of SLC and PMMA. The polymerization method of heat curing was higher than room temperature curing.

Parenteral nutrition support for burn injury in China began to develop in 1970s along with improvement in burn foundational research of burn injury and the marketing of parenteral nutrition solutions manufactured by Chinese amino acids pharmaceutical industry. Up to 1980s many kinds of parenteral nutrition products were used in clinical therapy, and they were proved to be effective and safe. Meanwhile the guide for parenteral nutrition support of China was drafted to ensure standardized administration. Some problems should be called for attention in present practice of parenteral nutrition support. First, immuno nutrients have been proved to possess synergistic effect on parenteral/enteral nutrition support. But for those critical patients in sepsis/MODS period, more attention should be paid to the use of immuno nutrients in time of administration and optimal dosage because of the complicate physiopathologic reactions. Secondly, the use of growth hormone has been proved to be effective for promoting healing in patients with burn in many cases. However, the indications of growth hormone should be strictly observed and the regime of a low dose and short course should be adopted 7 days after burn for ensuring safety. Thirdly, we should pay attention to the best path of giving nutrition, whether enteral or parenteral. Parenteral nutrition support should be adopted for critical burn patients in early period with intestinal dysfunction, and enteral nutrition support should be used when intestinal functions recover partially. For patients with burn hypermetabolism, the application of enteral and parenteral nutrition support is complimentary, and it is aptly called total nutrition.
Burns ; therapy ; Humans ; Parenteral Nutrition ; methods

Objective To explore the diagnostic value of Gap-ligase chain reaction(LCR)-enzyme linked immunosorbent assay(ELISA)for Chlamydia trachomatis(CT) pneumonia in infants(28 days-3 months old baby was 16.9%(27/160 cases),and the incidence in 3-6 months old baby was 8.1%(12/149 cases).The clinical symptoms included that 25 cases(51.0%) had fever,48 cases(98.0%) with paroxysmal cough,45 cases(91.8%) with rhinocleisis,45 cases(91.8%) with spitting foam,49 cases(100%) with tachypnea,28 cases(57.1%) with lips cyanosis,26 cases(53.1%) with medium and moist rales,24 cases(49.0%) with dry rales,18 cases(36.7%) with phlegm whimper,29 cases(59.2%) with rough breath sounds in both lungs and there were 13 cases(26.5%) with conjunctivitis.Chest film and paper capacitor showed that bilateral extensive interstitial and(or) alveolar infiltration,over-inflation 23 cases(46.9%) had no lobal consolidation or pleural effusion.The WBC counts were normal or slightly high.All children were treated with cephalothin or penicillin before confirmation with CT infection.Eleven cases were treated with azithromycin after diagnosis with CT pneumonia and were cured 9 days after treatment and the others were not treated with azithromycin so their course prolonged from 15 to 44 days,among them there were 11 out-patients who were treated many times because of repeated cough.Conclusions CT is important pathogenic organism to cause pneumonia in neonatal and small infants.It is important to pay attention to the possibility of pneumonia caused by CT and make the diagnosis in early period as soon as possible and treat them with sensitive drug to shorten the course.