Humans ; Osteogenesis ; Mesentery/surgery* ; Ossification, Heterotopic/surgery*

OBJECTIVEFor heart functional parameters, we commonly used normal range. The reference values and predict formulas of heart functional parameters and their relationships with individual characteristics are still lack.

METHODSLeft ventricular (LV) volumes (end-diastolic volume and end-systolic volume), stroke volume (SV), ejection fraction (EF) and cardiac output (CO) were measured by cardiac CT angiography (CAT) in 1 200 healthy Caucasian volunteers, men 807 and women 393, and age 20-90yr. The results are analyzed by high-accuracy three-dimensional imaging technology, and then measured the dynamic changes of the volumes of each atriam and ventricule during their contractions and relaxations. The gender, age, height and weight were analyzed by multiple linear regression to predict LV functional parameters.

RESULTSExcept the LVEF was lower in man than in women (P < 0.001), all other LV functional parameters of EDV, ESV, SV, FE and CO were higher in man (P < 0.001). Multiple linear regression indicated that age, gender, height and weight are all independent factors of EDV, ESV and SV (P < 0.001). CO could be significantly predicted by age, gender and weight (P < 0.001), but not height (P > 0.05). The predict equation for CO (L x min(-1)) = 6.963+0.446 (Male) -0.037 x age (yr) +0.013 x weight (kg).

CONCLUSIONAge, gender, height and weight are predictors of heart functions. The reference values and predict equations are important for noninvasive and accurate evaluation of cardiovascular disease and individualized treatment.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Body Height ; Body Weight ; Cardiac Output ; Female ; Heart ; physiology ; Humans ; Male ; Middle Aged ; Reference Values ; Sex Factors ; Stroke Volume ; Ventricular Function, Left ; Young Adult

Facial scar and deformation caused by burn injury severely affect physical and psychological well-being of pediatric burn patients, which needs medical workers and pediatric burn patients′ family members to pay much attention to and to perform early rehabilitation treatment. Pressure therapy is an important rehabilitative strategy for pediatric burn patients with facial scar, mainly including wearing headgears and transparent pressure facemasks, which have their own features. To achieve better treatment results, pressure therapy should be chosen according to specific condition of pediatric burn patients and combined with other assistant therapies. Successful rehabilitation for pediatric burn patients relies on cooperation of both family members of pediatric burn patients and society. Rehabilitation knowledge should be provided to parents of pediatric burn patients to acquire their full support and cooperation in order to achieve best therapeutic effects and ultimately to rebuild physical and psychological well-being of pediatric burn patients.

OBJECTIVE This study aimed to determine the relationship between individual allergens with current wheezing and bronchial hyperresponsiveness (BHR) in schoolchildren from three chinese cities: Beijing, Guangzhou and Hong Kong. METHODS Community-based random samples of 10-yr-old schoolchildren from the 3 cities were recruited for study using the International Study of Asthma and Allergies in Childhood (ISAAC) Phase II protocol. The subjects were studied by parental questionnaires (n = 10,902), skin-prick tests (n = 3478), and methacholine challenge tests (n = 608). RESULTS The highest prevalence rates of wheezing in the past 12 months (Beijing, 3.8%; Guangzhou, 3.4%; Hong Kong, 5.8%) and atopy (Beijing, 23.9%; Guangzhou, 30.8%; Hong Kong, 41.2%, defined as having Allergens ; classification ; immunology ; Asthma ; etiology ; immunology ; Bronchial Hyperreactivity ; etiology ; immunology ; Child ; China ; Hong Kong ; Humans ; Risk Factors ; Skin Tests ; Surveys and Questionnaires

A systematic phylogenetic footprinting approach was performed to identify conserved transcription factor binding sites (TFBSs) in mammalian promoter regions using human, mouse and rat sequence alignments. We found that the score distributions of most binding site models did not follow the Gaussian distribution required by many statistical methods. Therefore, we performed an empirical test to establish the optimal threshold for each model. We gauged our computational predictions by comparing with previously known TFBSs in the PCK1 gene promoter of the cytosolic isoform of phosphoenolpyruvate carboxykinase, and achieved a sensitivity of 75% and a specificity of approximately 32%. Almost all known sites overlapped with predicted sites, and several new putative TFBSs were also identified. We validated a predicted SP1 binding site in the control of PCK1 transcription using gel shift and reporter assays. Finally, we applied our computational approach to the prediction of putative TFBSs within the promoter regions of all available RefSeq genes. Our full set of TFBS predictions is freely available at http://bfgl.anri.barc.usda.gov/tfbsConsSites.

OBJECTIVES: Based on peripheral blood lymphocyte subsets and common laboratory test indexes, this study aimed to construct a predictive scoring system for intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD). METHODS: Children hospitalized in Tianjin Children's Hospital from January 2021 to March 2023 were included in the study (185 cases of IVIG-sensitive KD and 41 cases of IVIG -resistant KD). Forty-six healthy children matched for age and gender were selected as controls. The relative percentage and absolute counts of peripheral lymphocyte subsets were measured by flow cytometry. Multivariate logistic regression was used to identify the predictive factors for IVIG-resistant KD and to construct a predictive scoring system for predicting IVIG-resistant KD. RESULTS: The multivariate logistic regression analysis showed that CD4⁺ T cell absolute count, natural killer cell absolute count, serum sodium level, globulin level, and total bilirubin level were identified as predictive factors for IVIG-resistant KD (P<0.05). The predictive scoring system based on these factors achieved a sensitivity of 70.7% and a specificity of 83.8% in predicting IVIG-resistant KD. CONCLUSIONS Peripheral blood lymphocyte subsets can serve as predictive indicators for IVIG-resistant KD in children. The introduction of this indicator and the establishment of a scoring system based on it can provide a higher accuracy in predicting IVIG-resistant KD in children.
Child ; Humans ; Infant ; Immunoglobulins, Intravenous/therapeutic use* ; Mucocutaneous Lymph Node Syndrome/drug therapy* ; Lymphocyte Count ; Lymphocyte Subsets ; Retrospective Studies

OBJECTIVETo investigate the mechanisms of pressure intervention, and to explore the most effective regime for pressure therapy.

METHODSSeveral trials were carried out to study the efficacy and mechanism of pressure therapy, and the development and application efficacy of a smart pressure monitored suit (SPMS) for scar management. (1) Effectiveness of pressure therapy. Forty-five patients suffered burn on extremities were divided into pressure treatment group (n = 36) and control group (n = 9) according to the random number table. Patients in pressure treatment group were prescribed with a regime of wearing custom pressure garment (10% strain rate of pressure + 9 mm thick local pressure padding) more than 23 hours per day, while no active intervention was conducted on patients in control group. Scar conditions were assessed using the Vancouver Scar Scale (VSS), spectrocolorimeter, and tissue palpation ultrasound system. Data were processed with t test or paired t test. (2) Changes in fibroblasts growth rate under pressure. Fibroblasts extracted from scar tissue excised during surgery were loaded with 0, 1.1, 2.8, 5.6 mm Hg (1 mm Hg = 0.133 kPa) pressure respectively to observe the growth rate of fibroblasts. Data were processed with Fisher LSD post-hoc analysis. (3) Scar thickness upon pressure. The changes in scar thickness upon 0, 5, 15, 25, 35 mm Hg pressure were measured at early stage (1 - 6 months), mid-stage (7 - 12 months), and late stage (more than 12 months) using the high frequency ultrasound imaging system. Data were processed with correlation analysis and regression analysis. (4) Study on application of SPMS. Thirty-six patients with hypertrophic scars once treated with the conventional garment were recruited and they were prescribed with the regime of wearing SPMS for one month. Feedback from all participants in rating conventional garment and SPMS was obtained using self-reported questionnaire. The interface pressure of pressure garment was measured using the Pliance X system. Data were processed with Wilcoxon Sign-Ranks test.

RESULTS(1) Scar thickness, color, and VSS score were significantly improved in pressure treatment group after two-month of pressure intervention. VSS score of the scars in pressure treatment group was lower than that in control group two months after treatment. (2) The growth rate of scar fibroblasts under 5.6 mm Hg pressure was obviously lower than that under 0 mm Hg pressure 2 days after pressure loading (mean deviation = 0.086, P = 0.001). Growth rates of fibroblasts under 2.8 and 5.6 mm Hg pressure were obviously lower than that under 0 mm Hg pressure 3 days after pressure loading (with mean deviation respectively 0.060 and 0.118, P = 0.003, P < 0.001). (3) Scar thickness was significantly reduced upon pressure, and a negative relationship between scar thickness and pressure level was observed (r = -0.96, P < 0.01). (4) The results of SPMS study showed a reduction in both static pressure (19.5%) and dynamic pressure (11.9%) after one month of usage; while there was nearly 50.0% reduction in pressure in conventional garment. SPMS was rated significantly higher than conventional garment in terms of comfort, permeability and clinical efficacy (P ≤ 0.001).

CONCLUSIONSPressure therapy can effectively inhibit the growth of hypertrophic scar, while its exact mechanism needs further study for verification. SPMS is convenient to apply for patients. It takes less time to fabricate and adjust when compared to the conventional garment. Its clinical effect is positive and it may expand its application to other medical conditions.

Burns ; complications ; Cicatrix, Hypertrophic ; etiology ; therapy ; Compression Bandages ; Humans ; Pressure

Objective: To analyze the correlation between integrin β₁, focal adhesion kinase (FAK), extracellular signal-regulated kinase 1/2 (ERK1/2) of hypertrophic scar (HS) and post injury time in burn patients in scar remodeling stage. Methods: Thirty-four patients with 34 HS specimens admitted to Department of Burns and Plastic Surgery of Chengdu No.2 Hospital and Institute of Burn Research of the First Affiliated Hospital of Army Medical University (originally the Third Military Medical University) from May 2013 to April 2016 were recruited by convenient sampling method, and normal skin specimens were obtained from donor sites of another 6 patients from the above-mentioned departments who had scar resection and skin grafting for this cross-sectional and observational study. Vancouver Scar Scale (VSS) was used to assess the height, vascularity, pigmentation, and pliability of scars. Diasonograph was used to assess scar thickness. Immunohistochemical method was used to observe the expressions of integrin β₁, FAK, and ERK1/2 in dermis and epidermis of scar and normal skin. Correlations between the post injury time and the scar thickness, the post injury time and the expressions of integrin β₁, FAK, and ERK1/2 in epidermis of scar, the post injury time and the expressions of integrin β₁, FAK, and ERK1/2 in dermis of scar, the expressions of integrin β₁, FAK, and ERK1/2 in dermis and those in epidermis of scar were analyzed by Pearson correlation analysis. Locally estimated scatterplot smoothing curve fitting line was used to demonstrate the non-linear regression relationship between the expressions of integrin β₁, FAK, and ERK1/2 in dermis and those in epidermis of scar, the scar thickness and the post injury time. Results: (1) The total VSS score of scars of patients was (8.3±2.3) points, with height scored (2.2±0.7) points, vascularity scored (2.0±0.8) points, pigmentation scored (2.3±0.7) points, and pliability scored (1.9±0.7) points. The thickness of scar was (2.8±1.1) mm. (2) The expressions of integrin β₁, FAK, and ERK1/2 in dermis and epidermis of scar were more than those in normal skin. (3) There was significantly positive correlation between the scar thickness and the post injury time (r=0.39, P<0.05). There was significantly positive correlation between the expression of integrin β₁ in epidermis of scar and the post injury time (r=0.33, P<0.05). There were no significantly correlations between the expressions of FAK and ERK1/2 in epidermis of scar and the post injury time (r=-0.03, -0.04, P>0.05). There was significantly negative correlation between the expression of FAK in dermis of scar and the post injury time (r=-0.34, P<0.05). There were no significantly correlations between the expressions of integrin β₁ and ERK1/2 in dermis of scar and the post injury time (r=0.07, -0.23, P>0.05). There were significantly positive correlation between the expressions of integrin β₁, FAK, and ERK1/2 in dermis and those in epidermis of scar (r=0.70, 0.60, 0.64, P<0.01). (4) The expressions of integrin β₁, FAK, and ERK1/2 in dermis and epidermis of scar were changed from downtrend in 1 to 2 months post injury to uptrend in 2 to 3 months post injury, which reached the peak around 3 to 4 months post injury. Hereafter the expressions of mechanical signaling molecules in epidermis of scar were gradually declined, while the expressions of mechanical signaling molecules in dermis of scar were at a quite high level within half a year post injury. Scar thickness was steadily increased after 1 month post injury. Conclusions In scar remodeling stage of burn patients, the HS thickness increases continuously along with the increasing post injury time in the early stage of scar formation. The vulnerability of integrin β₁, FAK, and ERK1/2 of HS to external mechanical stimuli increases gradually within 4 months post injury.

INTRODUCTIONInjecting drug abusers are vulnerable to many infectious complications. We describe a case of tetanus in a Singaporean who regularly abused buprenorphine.

CLINICAL PICTUREA 49-year-old male was hospitalised for progressive generalised spasms associated with dysarthria and opisthotonus. Tetanus was diagnosed clinically.

TREATMENTSupportive management was instituted in the intensive care unit (ICU). Toxicology samples tested positive for buprenorphine.

OUTCOMEHe recovered rapidly and was transferred out of the ICU after 8 days. Retrospective questioning confirmed parenteral abuse of buprenorphine.

CONCLUSIONThis case highlights an uncommon and potentially lethal complication of parenteral drug abuse.

Buprenorphine ; Disease Progression ; Dysarthria ; Humans ; Male ; Middle Aged ; Singapore ; Substance Abuse, Intravenous ; Substance-Related Disorders ; complications ; Tetanus ; diagnosis ; etiology ; therapy

INTRODUCTIONSporadic clinical episodes of malignant hyperthermia (MH) that develop during general anaesthesia (GA) have been reported in Singapore. However, there is no published local report of a confirmed case of MH susceptibility (MHS) by skeletal muscle contracture tests and/or molecular tests.

MATERIALS AND METHODSWe report 2 patients from an extended family who developed signs of clinical MH while under GA. The MH episodes were successfully treated with intravenous dantrolene sodium. Sequence analysis of the entirecoding gene was carried out in an index patient.

RESULTSThe index patient was found to carry a c.7373G>A (p.Arg2458His) mutation in exon 46. This particular mutation satisfies the criteria for a MHS causative mutation. Hence, the index patient was considered to be MHS and did not need to undergo further muscle contracture testing. The same mutation was also found in 3 other members of his extended family.

CONCLUSIONThis is the first report of a Singaporean family with at least 4 members carrying a MH-causative mutation ingene. This report serves to highlight the existence of the putative gene for MH in Singapore, and the need for clinical vigilance during anaesthesia involving the use of triggering agents.