Accurate area assessment of a burn injury and its treatment according to its depth of injury are the foundation of burn treatment due to its complexity, and various techniques and methods have been employed to solve these problems for many years. As the demand of modern medicine calls for individualized and precise therapeutic measures, it is clear that the traditional diagnostic and treatment measures are insufficient. The flourishing development of three-dimensional (3D) technology seems to provide new research approaches and technical opporturities for burn surgery. A series of techniques such as 3D model, 3D scanning, and 3D printing may be promising in advancing burn surgery through basic research to achieve rational clinical applications in the future. In this paper, the applications and achievements of 3D technology in burn surgery in recent years are summarized.
Body Surface Area ; Burns ; diagnosis ; pathology ; therapy ; Humans ; Image Processing, Computer-Assisted ; methods ; Therapy, Computer-Assisted

Objective To compare treatment response according to the PERCIST1.0,RECIST1.1,EORTC,and WHO criteria in patients with colorectal liver metastases (CLM) who received neoadjuvant chemotherapy.Methods A total of 41 CLM patients (27 males,average age 68.48 years;14 females,average age 62.43 years) from January 2010 to September 2013 were included in this retrospective study.PET/CT scan was performed before chemotherapy and after 4-6 cycles′ chemotherapy.The baseline and the sequential follow-up 18F-FDG PET/CT of each patient were evaluated according to the PERCIST1.0,RECIST1.1,EORTC,and WHO criteria.The response was categorized into 4 levels including CR,PR,SD,PD.PET/CT images were used for both metabolic and anatomic evaluation.The concurrent diagnostic CT or MRI images (performed within 1 week of PET/CT) were also utilized when needed.The agreements of criteria were analyzed using Kappa test.The response rate (RR) and disease control rate (DCR) were compared using χ2 test.Results The RR and DCR according to the PERCIST1.0,EORTC and RECIST1.1 criteria were 31.71％(13/41) and 63.41％(26/41),31.71％(13/41) and 60.98％(25/41),17.07％(7/41) and 68.29％(28/41),respectively.The general comparison of PERCIST1.0 and RECIST1.1,EORTC and RECIST1.1 criteria showed good agreements (κ values: 0.711,0.689).Significant difference was not found in the DCR(χ2=2.000,P>0.05) but found in the RR(χ2=6.000,P<0.05) between PERCIST1.0 and RECIST1.1.Difference of DCR between EORTC and RECIST1.1 was not significant(χ2=3.000,P>0.05),while the RR had significant difference(χ2=6.000,P<0.05).The RR and DCR according to WHO criterion were 12.20％(5/41) and 70.73％(29/41),which had a good consistency with those according to PERCIST1.0 criteria (κ=0.629).Significant statistical difference was not found in the DCR(χ2=3.000,P>0.05) but found in the RR(χ2=8.000,P<0.05) between PERCIST1.0 and WHO criteria.Conclusions In evaluating CLM treatment response,anatomical criteria and metabolic criteria have a good consistency.But metabolic criteria are more sensitive for RR evaluating.

Fibromyalgia syndrome (FS) is a rheumatic and immunologic disease and the disease incidence is ranked at the third in the rheumatic diseases, characterized by whole-body myalgia, and with mental and nervous symptoms and signs. At present, there is no ideal therapy for it. Based on TCM theories, this article tries to analyze the pathogenesis of FS from the angle of meridian and collateral science, and according to location of pain of the patient, TCM syndrome differentiation for corresponding channels and collaterals is made and FS possible relation with dysfunction of qi is raised, which is used to guide the treatment, so as to provide a better physical treatment way.
Diagnosis, Differential ; Fibromyalgia ; diagnosis ; etiology ; pathology ; therapy ; Humans ; Medicine, Chinese Traditional ; Meridians

Objective To explore the method of fabricating larynx-shape tissue engineered cartilage by means of filling together with wrapping with pedicle myofascial flap.Methods Serial steps of solution casting,extrusion molding and particulate leaching were used to make larynx-shape[poly(3-hydroxybutyrate-co-3-hydroxyhexanoate),PHBHH]biomaterial models.The chondrocytes were seeded onto PHBHH models to form cell-PHBHH composites for culture in vitro for one week and then to fill and wrap larynx-shape composites with pedicle myofascial flap.After that to implant larynx-shape composites in situ on the back of adult New Zealan white rabbits(experimental groups n =9).Control groups(n =3)were the same measure as experimental groups but without chondrocytes on PHBHH models.Finally,morphological observation,HE & special staining and immunohistochemical test were conducted to evaluate the cartilage regeneration and its shape at 6,8 and 12 weeks following implantation.Results The PHBHH models appeared to be hollow half-trumpet with edges and comers of larynx-shape and its porosity ＞ 90％.Pedicle myofascial flap using fascia as lining presented rich blood supply and had enough to fill and wrap larynxshape composites.Tissue engineered larynx-shape cartilage specimens could be harvested at different period.It was demonstrated that the cartilaginous tissue formed in 6 weeks after implantation through histological and immunohistochemical examination and further maturity in 12 weeks and 18 weeks.But no cartilaginous tissue showed without chondrocytes on PHBHH as control groups to implant at the same time.Conclusion It seems that pedicled myofascial flap showed sufficient blood supply and that the filling together with wrapping method with pedicled myofascial flap is appropriate for fabricating larynx-shape tissue engineered cartilage.

Objective To investigate the methods and efficacy of microscopic surgical treatment in patients with anterior communicating artery aneurysm. Methods The clinical data of 35 patients with ruptured anterior communicating artery aneurysm, admitted to our hospital from January 2008 to January 2011 and performed microneurosurgical treatment via pterional approch, were retrospective analyzed; their surgical techniques and efficacy were concluded. Results All the aneurysms in 35 patients were successfully clipped. Follow-up was performed for 3-6 months: complete recovery was achieved in 19 patients, good recovery in 11, and mild disability in 3 (including 1 with psychiatric symptom); death appeared in 2 patients. Conclusion The microsurgery via pterional approach is an effective method in treating anterior communicating artery aneurysms,resulting from its full exposure of aneurysms and few complications; adequate dissection and exposure of the entire H shaped complex body of anterior communicating artery are the keys to a successful clipping of aneurysm neck; and the selection of aneurysm clip suitable for the aneurysm and the preservation of the perforating arteries should be specially emphasized.

BACKGROUNDAnxiety appears to be more common in patients with coronary artery disease (CHD) than in the general population, and anxiety symptoms may precede onset of CHD and play an important role in development of CHD. Little is known about the prevalence of anxiety symptoms in Chinese patients with premature ventricular contractions (PVCs). Our objective was to study anxiety symptoms and potential risk factors in a Chinese population with PVCs but without structural heart disease.

METHODSThe Zung self-rating anxiety scale (ZSAS) was used to assess anxiety symptoms. Correlation between anxiety symptoms and socio-demographics and medical factors were analyzed by Logistic regression.

RESULTSOf 1144 patients with PVCs (487 males and 657 females), age (53 ± 23) years old, disease duration 1 month to 24 years, a total of 381 (33.3%) patients were categorized as having anxiety symptoms. Anxiety symptoms increased with age, low income, low education level, nationality, PVC count/24 hours, bad social support, village settlement type (P < 0.05). Multivariate Logistic regression indicated that six variables-education level, ethnic minorities, dwelling place, age, PVC count/24 hours, and social support-significantly and independently related with anxiety symptoms (P < 0.05).

CONCLUSIONSIn the Chinese population, anxiety symptoms in subjects with PVCs were frequent. Education level, ethnic minorities, dwelling place, age, PVC count/24 hours, and social support were independent risk factors for anxiety symptoms. Further research on the relationship between PVCs and anxiety symptoms in China is necessary.

Adult ; Aged ; Anxiety ; epidemiology ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Female ; Heart Diseases ; psychology ; Humans ; Male ; Middle Aged ; Ventricular Premature Complexes ; psychology

BACKGROUNDRecent studies have shown that T helper type-2 (Th2) cells can induce the apoptosis of CD4+CD25+ Treg cells or resist the immunosuppressive effect of Treg cells. We hypothesize that an imbalance of Th2/Treg is present in patients with allergic asthma.

METHODSTwenty-two patients with mild asthma, 17 patients with moderate to severe asthma, and 20 healthy donors were enrolled. All patients were allergic to house dust mites. The proportion of peripheral blood CD4+CD25+ Treg cells and Th2 cells were determined by flow cytometry. The concentration of interleukin (IL)-10, transforming growth factor (TGF)-β and IL-4 in plasma was determined by enzyme linked immunosorbent assay. In these subjects, peripheral blood mononuclear cells from 17 mild asthmatic patients, 13 moderate to severe asthmatic patients and 14 healthy donors were acquired and expression of forkhead box P3 (Foxp3) and GATA-3 mRNA was detected by reverse-transcriptase polymerase chain reaction.

RESULTSCompared with healthy donors and patients with mild asthma, the percent of CD4+CD25+ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. There were no significant differences in Foxp3 mRNA expression among three groups, but a downward trend seen among patients with asthma. However, the percent of Th2 cells, IL-4 levels and expression of GATA-3 mRNA was markedly higher in patients with mild and moderate to severe asthma than in the control group. The ratio of Th2/Treg and their cytokines was increased in allergic asthma, especially for moderate to severe asthma. The ratio of GATA-3/Foxp3 mRNA was also increased in allergic asthma. In patients with moderate to severe asthma, the percentage of peripheral blood Treg cells was negatively correlated to the percentage of Th2 cells and IL-4 levels.

CONCLUSIONSThe decline of CD4+CD25+ Treg cells in patients with moderate to severe asthma may play an important role in progress of the disease. Furthermore, the deficiency of CD4+CD25+ Treg cells was associated with the over-expression of Th2 response.

Asthma ; etiology ; immunology ; Cytokines ; blood ; Forkhead Transcription Factors ; genetics ; GATA3 Transcription Factor ; genetics ; Humans ; RNA, Messenger ; analysis ; T-Lymphocytes, Regulatory ; immunology ; Th2 Cells ; immunology

To investigate the effects of classical swine fever virus (CSFV) virulent strain Shimen (SM) infection on piglets peripheral blood leucocytes, the 60-days weanling piglets were infected with the shinen strain and the peripheral blood samples of the piglets were collected to analyze the kinetics of the CSEV nucleic acid, the peripheral blood leucocytes subpopulation and SLA molecule expression on the peripheral blood leukocytes. The results showed that the piglets rectal temperature increased 48 hours after intramuscular injection of CSFV SM strain, the CSFV nucleic acid was detected in the peripheral blood at 2DPI, the content of CSFV nucleic acid increased and up-regulated to a peak at 6DPI as 10 (4.84 +/- 0.98 times as 2DPI. The amount of WBC, LYM and PLT significantly decreased, where in the amount of WBC decreased to 65.87% at 1DPI and 50% at 2DPI respectively; the amount of LYM decreased to 70.68%, 47.88% and 23.29% at 1DPI, 2DPI, and 3DPI, respectively; the amount of PLT decreased day by day and to 34.59% at 6DPI; the amount of NK, gammadeltaT, Tc, Th, CD3+ CD4+ CD8+ and CD3- CD4- CD8- cells decreased after infection; 78.49% of NK cells decreased at 1DPI and then there was no significant change from 2DPI to 6DPI. The amount of gammadeltaT, Tc, CD4- CD8- CD3-,CD4+ CD8+ CD3+ cells decreased to 41.74%, 43.83%, 15.87%, and 32.96% at 3DPI, respectively, However, the amount of T helper cells decreased continually to 42.95% at 6DPI; the amount of SLA I positive lymphocytes decreased significantly and the amount of SLA I positive CD3 cells decreased to 23.07% and 15.38% at 1DPI and 2DPI respectively; the SLA I positive granulocytes increased continually from 92.20% at 1DPI to 98.30% at 3DPI; the amount of CD3 SLA II + cells in lymphocytes decreased from 1.38% at 1DPI to 0.22% at 2DPI, while the SLA II + granulocytes increased continually to a peak at 3DPI and 53.76% of granulocytes expressed the SLA II molecule, but the percentage of the granulocytes expressing SLA II molecules decreased to 12.54% and 4.06% at 4DPI and 5DPI respectively. The study indicated that the CSFV SM strain infection could escape the immune surveillance and cause immunosuppression through inhibiting the host's innate antiviral immunity and the SLA molecule expression to affect the antigen presentation.
Animals ; Cells, Cultured ; Classical Swine Fever ; genetics ; immunology ; virology ; Classical swine fever virus ; pathogenicity ; physiology ; Gene Expression ; Histocompatibility Antigens Class I ; genetics ; immunology ; Histocompatibility Antigens Class II ; Leukocyte Count ; Leukocytes ; immunology ; virology ; Random Allocation ; Swine ; Virulence

OBJECTIVETo evaluate the long-term clinical outcomes between laparoscopic and open distal gastrectomy with D2 lymph dissection for advanced gastric cancer.

METHODSClinical data of 377 cases of laparoscopic distal gastrectomy and 301 cases of open distal gastrectomy with D2 lymph dissection at the Southwest Hospital, the Third Military Medical University from January 2004 to June 2010 were retrospectively analyzed. Patients were followed up until September 2015. Surgical outcomes, postoperative complications and long-term survival were compared between the two groups.

RESULTSCompared with conventional open group, laparoscopic group was associated with lower intraoperative blood loss [(125±89) ml vs. (290±161) ml, t=-15.942, P=0.000], shorter time to oral intake [(2.9±0.7) days vs. (4.1±1.6) days, t=-12.120, P=0.000], quicker bowel function retum[(2.7±1.4) days vs. (3.6±1.6) days, t=-7.804, P=0.000], shorter postoperative hospital stay [(7.7±3.6) days vs. (10.1±4.1) days, t=-8.107, P=0.000]. In addition, there were no significant differences in the operative time[(207±57) minutes vs. (202±43) minutes, P>0.05], number of retrieved lymph nodes(33±13 vs. 31±15, P>0.05), resection margin length(P>0.05) between two groups. The postoperative complication morbidity in laparoscopic group was significantly lower than that in open group[7.2%(22/377) vs. 12.6%(38/301), χ(2)=5.762, P=0.016]. Within perioperative period, 7 patients underwent operation again due to complication and 1 case died of peritoneal bleeding in laparoscopic group; 6 patients underwent re-operation and 2 cases died of peritoneal infection with hepatic failure and lung infection with respiratory failure. During the median follow-up of 86 months (range from 3-140 months), relapse occurred in 171(45.4%) patients and 183(48.5%, among them, 156 cases died of primary disease) patients died in laparoscopic group; relapse occurred in 140(46.5%) patients and 151(50.2%, among them, 127 cases died of primary disease) patients died in open group. The difference in overall 5-year survival rate between two groups was not statistically significant (51.5% vs. 49.8%, χ(2)=0.142, P=0.706). No significant difference was seen in 5-year disease-free survival rate (49.1% vs. 47.8%, χ(2)=0.062, P=0.803). Stratified analysis based on TNM stage also showed no significant difference in 5-year overall or disease-free survival rate(both P>0.05).

CONCLUSIONLaparoscopic distal gastrectomy with D2 lymph dissection for advanced gastric cancer has better short-term efficacy and similar long-tern efficacy as compared to open surgery.

Blood Loss, Surgical ; Defecation ; Disease-Free Survival ; Gastrectomy ; methods ; Gastroenterostomy ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Neoplasm Recurrence, Local ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Survival Rate ; Treatment Outcome

Objective To compare the treatment outcomes,complications and histopathologic features between conventional parotidectomy and functional regional parotidectomy in the treatment for pleomorphic adenoma of parotid gland and to provide clinical,and pathological evidence for determining the safe surgical margin.Methods Of 109 patients,60 patients received conventional parotidectomy and 49 patients received functional regional parotidectomy.The rates of tumor recurrence and complications were compared between the groups of patients.Results There was no significant difference in the incidence of tumor recurrence,the facial paralysis and sialosyrinx between two groups.The rates of Frey's syndrome,numbness of auricular region,and facial asymmetry were 30.0％,61.7％,and 38.3％ in the patients with conventional parotidectomy respectively,while the rates were 6.1％,30.6％,and 8.2％ in the patients with functional regional parotidectomy,with significant statastically difference,respectively (P ＜ 0.05 ).Of 109 patients,33 with incomplete capsule,29 with capsule penetration,25 with pseudopodia,and 13 with satellite nodules.There was no significant difference in the depth of tumor infiltration between two groups of patients.For the tumor smaller than 2 cm,the depth of infiltration in conventional group was from 0.061 to 1.122 mm,functional group was from 0.442 to 3.127 mm (Z =- 1.093,P =0.057) ; for the tumors between 2 - 4 cm,the depth in conventional group was from 0.081 to 7.908 mm,functional group was from 0.082 to 6.632 mm ( Z =-0.214,P =0.831 ) ;for the tumor larger than 4 cm,the depth of infiltration was from 0.340 to 8.476 mm.Conclusions Compared with conventional parotidectomy,functional regional parotidectomy has good outcomes and less complications.The surgical margins of pleomorphic adenomas of the parotid gland should be determined by the size of tumor.The 1 cm-surgical margins are safe for the tumors less than 4 cm,and the tumors more than 4 cm should be treated with superficial parotidectomy.