Objective To explore the clinical manifestations of toxic epidermal necrolysis(TEN) and its rare pulmonary complications.Methods Clinical symptoms,treatment and prognosis of 1 child with TEN caused by carbamazepine were analyzed.Radiological images were reviewed to evaluate the manifestations and the outcome of chronic pulmonary complications associated with TEN.Results The patient had high fever shortly after a dosage increment of carbamazepine.A confluent erythematous exanthema developed rapidly into painful blistering with skin erosion,denudation and involvement of conjunctive and oropharyngeal mucosa.The diagnosis of TEN was made.The mucocutaneous damage was gradually recovered with steroid plus intravenous immunoglobulin for 3 weeks.However,the patient presented with respiratory failure in the recovery phase of TEN.The computer tomography revealed pulmonary bullae and pneumothorax in the right lung.Lung parenchyma was squeezed and pulmonary bullae ruptured with pneumothorax and atelectasis,which were absorbed gradually through thoracic drainages.The patient′s lung function and pulmonary bullae were partly improved during a 7-month follow-up.Conclusions TEN is a severe form of blistering skin di-sease which is characterized by an extensive loss of epidermis and mucous membrane.Chronic pulmonary complications may occur in recovery phase of TEN.Pulmonary bullae,which might be caused by mucous damage and respiratory obstruction,is a rare complication of TEN.

Objective To establish an effective and stable rat model of skin-infection for evaluating the therapeutic effects of topical anti-infection drugs.Methods SD rats were subcutaneously injected with cyclophosphamide to induce immunosuppression,and then surgical incisions were made on both sides of the spine.The rat model of skin-infection was established by applying methicillin-resistant Staphylococcus aureas suspension to the incisions for two consecutive days,and evaluated by analyzing infection status,pathological changes and healing time.Results The development of pyogenic infection was detected in all of the rats.Compared with the non-cyclophosphamide treated group,the cyclophosphamide treated group showed a more severe infection both from the visual inspection and the microscopic observation,moreover,its healing time was delayed more than 10 days.Conclusion The skin-infection model was successfully established in immunosuppressed rats induced by cyclophosphamide,which could be applicable to the efficacy evaluation of anti-infection drugs for external use on skin infection.

Objective To develop an interlocking-style vascular shunt device for the treatment of distal limb ischemia resulting from vascular disconnection and defect.Methods A one-way interlocking buckle was designed with the space between the clamping teeth being 0.5 mm,which prevented the device from moving backwards and fixed the vessel and shunt tube conveniently.The interlocking buckle combined with silicone tube was used to connect the two ends of the defected vessel,which was compared with conventional method by suture ligation and silicone tube by the tests on vessel bursting pressure and tensile biomechanics.Results The vessel repaired with the developed device behaved better than that by the conventional method in the tests on vessel bursting pressure and tensile biomechanics (P＜0.05).Conclusion The vascular shunt device can be used for the treatment of distal limb ischemia resulting from vascular disconnection and defect,and thus facilitates the vascular graft in rear hospital after evacuation.

APOBEC(apolipoprotein B mRNA-editing enzyme catalytic-polypeptide) family members were reported as innate immune molecules with anti-viral activity for many viruses, such as HIV and HBV.In order to understand the function of APOBEC, the APOBEC-3F and-3G were cloned, expressed, and the sub-cellular localization of them was detected.The genes of APBEC-3F and-3G were cloned from PHA-stimulated PMBC and expressed in the MDCK cell by transfection.The sub-cellular localization of APOBEC-3F and-3G were detected by immunofluorescence.APOBEC-3F and-3G were cloned by RT-PCR and confirmed by DNA sequencing.The immunofluorescence indicated APOBEC-3F and-3G were located in the cytosal.APOBEC-3F and-3G could inhibit HBV replication effectively in HepG2.2.15 cell.APOBEC-3F and-3G could not be trans-located into nuclear by nuclear location signal(NLS) or bi-NLS(B-NLS).These results will help the future research on the function of APOBEC.

OBJECTIVETo explore the clinical effects of vacuum sealing drainage (VSD) in treating wound disunion after operation of fracture of calcaneus.

METHODSFrom June 2008 to December 2011, 11 patients with fracture of calcaneus complicated with wound ischemic necrosis and disunion after operation. There were 10 males and 1 female, aged from 21 to 55 years with an average of 39 years, and the course of disease in range from 7 to 9 weeks. These patients were treated with surgical debridement and VSD technique. According to calcaneal intraarticular fracture standard of ZHANG Tie-liang to evaulate the effects.

RESULTSWound area and autogeneic skin grafts healed after operation. All patients were followed up from 6 to 18 months with an average of 11 months. No wound infection and chronic osteomyelitis were found. According to above standard, 6 cases got excellent results, 4 good and 1 fair.

CONCLUSIONVSD technique in treating postoperative wound disunion of fracture of calcaneus can obtain satisfactory effects.

Adult ; Calcaneus ; injuries ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Postoperative Complications ; therapy ; Vacuum ; Wound Healing

Qigui Tongfeng tablet (QLTFT) is a traditional Chinese medicine with good effect for treating gout. Here, network pharmacology method and molecular similarity analysis were utilized to study the effective substance basis and molecular mechanism of the QLTFT on the gout. The similarity to the medicinal compounds is reflected in the Tanimoto coefficient that gives the structural similarity of two compounds. Operationally, similar modifiers were described as pairs of concepts with a similarity score of 0. 500. The results of the molecular similarity analysis suggested that the flavonoids in QLTFT could be new leads for gout. Furthermore, complex biological systems may be represented and analyzed as computable networks. Two important properties of a network were degree and betweenness. Nodes with high degree or high betweenness may play important roles in the overall composition of a network. And the results of network analysis showed that dongbeinine, verticinone-N-oxide, verticine N-oxide, peimine, peiminine, isobaimonidine, dongbeirine, peimisine and simi-arenol which with high degree acted on xanthine dehydrogenase/oxidase, matrix metalloproteinase-9, an arachidonate 5-lipoxygenase-activating protein, tyrosine-protein kinase and etc. Inhibition of these targets can prevent the formation of uric acid, reduce inflammation by uric acid and regulate the body's immune response. Thus, these compounds may be the main effective substance basis. The research results not only reveals its molecular mechanism, but also provide a theoretical basis for the quality control of drugs and clinical application.
Gout ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Pharmacology ; methods ; Tablets ; Technology, Pharmaceutical ; methods

OBJECTIVEAs a new kind of reinforcing filler, ultrafine diamond (UFD) is added into photocurable composite core materials. The properties of the materials are then measured to see if there is any improvement.

METHODSDifferent content of barium glass and UFD were added into resin matrix to fabricate six groups of photocurable composite core materials. For each group of the materials, the flexural strength, Vicker's micro-hardness and depth of cure were measured. Data of the flexural strength and Vicker's micro-hardness was then collected and analyzed by One-Way ANOVA.

RESULTSFor the two kinds of composites with barium glass of 60% and 70%, only a small quantity of modified UFD with 0.2% weight percentage could improve the flexural strength of the composites by 34% and 21% respectively, the microhardness was improved by 23% and 30% respectively. The depth of cure of the composite core materials were more than 2 mm, which had reached the demand of the corresponding ISO criteria. The addition of UFD could make the composite core materials darker and grayer.

CONCLUSIONMicro-quantity of UFD can improve the mechanical properties of composite resins notably, and it will not affect the curability of the materials, but the defect in the color need to be reformed.

Barium Compounds ; Composite Resins ; Diamond ; Hardness ; Materials Testing ; Methacrylates ; Pliability ; Silicon Dioxide

OBJECTIVETo generate a refined staging system of fibrosis in chronic viral hepatitis and to assess its accuracy and sensitivity for evaluating therapeutic efficacy of anti-fibrosis drug treatments.

METHODSA refined fibrosis staging system was established according to the detailed characteristics of progressive fibrosis. A total of 396 liver puncture biopsy specimens were collected from patients before and after anti-fibrosis therapy and used to evaluate the refined staging system. According to the original fibrosis staging system and refined fibrosis staging system, fibrosis staging differences from before and after treatment were analyzed by Chi-squared test and paired-samples t-test respectively.

RESULTSThe refined fibrosis staging system detected significant changes in fibrosis stage that occurred in response to treatment (before treatment: 6.55 +/- 2.93 vs. after treatment: 6.19 +/- 2.945, P less than 0.01). However, the original (unrefined) staging system was unable to differentiate therapy-related changes in fibrosis stage (x2= 3.144, P = 0.534).

CONCLUSIONThe newly-developed refined fibrosis staging system was able to effectively evaluate the therapeutic efficacy of anti-fibrosis drug treatment and performed better than the original staging system.

Biopsy, Needle ; Hepatitis, Chronic ; Hepatitis, Viral, Human ; Humans ; Liver Cirrhosis

OBJECTIVETo observe the role and mechanism of CO-releasing molecule (CORM)-2 in lung injury induced by ischemia-reperfusion (IR) of hind limbs in rats.

METHODSA rat model of lung injury induced by IR of hind limbs was established. A total of 40 Sprague Dawley (SD) rats were randomly divided into 5 groups (n equal to 8): sham, sham + CORM-2, IR, IR + CORM-2 and IR + dimethyl sulfoxide (DMSO). Rats in the IR group received hind limb ischemia for 2 hours and reperfusion for 2 hours, rats in the sham group underwent sham surgery without infrarenal aorta occlusion, rats in the IR+CORM-2 group and in the sham + CORM-2 group were given CORM-2 (10 micromol/kg intravenous bolus) 5 minutes before reperfusion or at the corresponding time points, while rats in the IR + DMSO group was treated with the same dose of vehicle (DMSO) at the same time. The lung tissue structure, polymorphonuclear neutrophil (PMN) count, wet-to-dry weight ratio (W/D), malondialdehyde (MDA) content, myeloperoxidase (MPO) activity, intercellular adhesion molecule-1 (ICAM-1) expression,IkBa degradation and nuclear factor (NF)-kB activity in the lungs were assessed.

RESULTSAs compared with the sham group, lung PMNs number, W/D, MDA content, MPO activity, ICAM-1 expression and NF-kB activity significantly increased in the IR group, but the level of IkBa decresed (P less than 0.01). Compared with the IR group, lung PMNs number, W/D, MDA content, MPO activity and ICAM-1 expression significantly decreased in the IR+COMR-2 group (P less than 0.01), while the level of IkBa increased.

CONCLUSIONSThese data demonstrate that CORM-2 attenuates limb IR-induced lung injury through inhibiting ICAM-1 protein expression, NF-kB pathway and the leukocytes sequestration in the lungs following limb IR in rats, suggesting that CORM-2 may be used as a therapeutic agent against lung injury induced by limb IR.

Animals ; Hindlimb ; blood supply ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; metabolism ; Lung Injury ; etiology ; metabolism ; Male ; NF-kappa B ; metabolism ; Neutrophils ; metabolism ; Organometallic Compounds ; pharmacology ; Rats ; Reperfusion Injury ; complications

OBJECTIVETo detect and compare the PD-1/PD-L1 (programmed death 1/programmed death 1 ligand) expressions in the liver tissues of chronic HBV infection patients in immune tolerant phase and those in immune clearance phase.

METHODSLiver biopsy samples were divided into two groups: 25 samples from patients in immune clearance phase and 19 samples from patients in immune tolerant phase. PD-1/PD-L1 expressions on T lymphocytes in these liver biopsy specimens were detected by immunohistochemistry method. Percentage of PD-1/PD-L1 positive cells among CD3 positive cells was calculated by semi-quantitative evaluation. Differences between the two groups were statistically analyzed.

RESULTSPD-1/PD-L1 expressions were significantly higher in the patients in immune tolerant phase as compared to that in immune active phase (P < 0.05). No statistical difference found between the two groups for PD-L1 expression in Kupffer cells (P > 0.05).

CONCLUSIONPD-1/PD-L1 expression level can reflect the immune functions of chronic hepatitis B patients.

Adult ; Antigens, CD ; metabolism ; B7-H1 Antigen ; metabolism ; CD8-Positive T-Lymphocytes ; metabolism ; Female ; Hepatitis B, Chronic ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Liver ; metabolism ; pathology ; Male ; Middle Aged ; Programmed Cell Death 1 Receptor ; metabolism