Objective To observe the effect of lung protective ventilation strategy on oxygenation and pulmonary inflammatory response in dogs with severe smoke inhalation injury.Methods Twelve local healthy male dogs were selected and anesthetized underwent endotracheal intubation, the time controlled smoke was applied to replicate the model of severe smoke inhalation injury, and they were divided into two groups according to the random number table: conventional ventilation group (CV group) and protective ventilation group (PV group), each receiving corresponding ventilation mode for 8 hours respectively. The blood gas analyses were detected before injury, immediately after injury and at ventilation for 2, 4, 6, 8 hours. The contents of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) in serum were detected by the enzyme-linked immunosorbent assay (ELISA) at each time point. Animals were killed after 8-hour ventilation, and different parts of the lung tissues were obtained for pathological examinations of lung tissues and evaluation of injury scores. The levels of inflammatory factors as TNF-α and IL-10 in lung homogenates were measured by ELISA.Results The arterial partial pressure (PaO2) levels in CV and PV groups were significantly decreased after injury compared with those before injury [mmHg (1 mmHg = 0.133 kPa): 57±19 vs. 128±31, 58±15 vs. 126±22, bothP < 0.01]. Compared with those before injury, the pH values and arterial carbon dioxide partial pressure (PaCO2) levels after injury in two groups had no statistically significant differences at each time point (bothP > 0.05). At 6 hours ventilation, PaO2 level in PV group was significantly higher than that in CV group (mmHg: 121±11 vs. 105±11,P < 0.05). The comparisons of PaO2 levels, pH values and PaCO2 levels at 2, 4, 8 hours of ventilation between the two groups showed no statistically significant differences (allP > 0.05). The histopathological changes revealed that there were alveolar tissue edema and inflammatory cells infiltration in both groups, the degree of severity in CV group was more prominent and its pulmonary tissue injury score was higher than that in PV group (3.68±0.22 vs. 3.27±0.35, P < 0.05). The serum levels of TNF-α and IL-10 after smoke injury were significantly increased in CV and PV groups [TNF-α (μg/L): 4.32±1.13 vs. 0.35±0.11, 4.51±2.02 vs. 0.41±0.08; IL-10 (ng/L): 16.73±2.31 vs. 4.27±0.56, 18.39±3.15 vs. 4.03±1.07, allP < 0.01]. Compared with CV group, the levels of TNF-α were significantly lower at 6 hours and 8 hours of ventilation [6 hours (μg/L): 2.62±0.34 vs. 3.65±1.08, 8 hours (μg/L): 3.02±0.31 vs. 4.21±1.27, bothP < 0.05), while the contents of IL-10 were obviously increased in PV group [6 hours (ng/L): 21.07±2.95 vs. 16.11±3.02, 8 hours (ng/L): 23.57±2.69 vs. 18.28±3.21, bothP < 0.05]. The content of TNF-α in lung homogenate in CV group was significantly higher than that in PV group (μg/L: 5.85±2.57 vs. 3.08±1.17,P < 0.05), but the content of IL-10 in lung homogenate of CV group was markedly lower than that in CP group (ng/L: 19.64±3.16 vs. 24.05±2.09, P < 0.05).Conclusion Lung protective ventilation strategy can effectively improve oxygenation and pulmonary inflammatory response in dogs with severe smoke inhalation injury, thus the lung injury is alleviated and the strategy has protective effect on damaged lung tissues.

Objective To evaluate the advantage and clinical value of javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma. Method Randomized controlled trials (RCTs) concerning javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma were made on electronic databases of CBM, CNKI, Wangfang, VIP and PubMed from 1990 to February 28, 2015. Quality of the included RCTs was assessed by Jadad scoring , and Meta-analyses were performed by RevMan5.3 software. Results Seven RCTs involving 575 patients were included in Meta-analysis. All studies were in low quality. The results of Meta-analyses showed that Javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma, compared with control groups, could increase the recent curative effect (P < 0.000 01) and improve the quality of live (P = 0.000 8), decrease the hematologic toxicities (P = 0.03) and the incidence rate of radioaction esophagitis (P = 0.02), but not enough evidence was found to prove that it can enhance survival rate (P = 0.25). Conclusions The results of Meta-analysis indicate that javanica oil emulsion injection may have therapeutic effects on the treatment of esophageal carcinoma. Yet the effects of javanica oil emulsion injection still need to be confirmed by large multi-center randomized controlled trials.

OBJECTIVETo observe and compare the effects of two kinds of lung recruitment maneuvers, namely sustained inflation (SI) and incremental positive end-expiratory pressure (PEEP) (IP) on oxygenation, respiratory mechanics, and hemodynamics of dogs with severe smoke inhalation injury.

METHODSAfter being treated with conventional mechanical ventilation, 12 dogs were inflicted with severe smoke inhalation injury. They were divided into group SI and group IP according to the random number table, with 6 dogs in each group. Dogs in group SI were subjected to continuous positive airway pressure ventilation, with inspiratory pressure of 25 cmH2O (1 cmH2o = 0. 098 kPa), and it was sustained for 20 s. PEEP level in group IP was gradually increased by 5 cmH2O every 5 min up to 25 cmH2O, and then it was decreased by 5 cmH2O every 5 min until reaching 2-3 cmH2O. Then the previous ventilation mode was resumed in both groups for 8 hours. Blood gas analysis (pH value, PaO2, and PaCO2), oxygenation index (OI), respiratory mechanics parameters [peak inspiratory pressure (PIP), mean airway pressure, and dynamic lung compliance], and hemodynamic parameters [heart rate, mean arterial pressure (MAP), pulmonary arterial pressure (PAP), and cardiac output (CO)] were recorded or calculated before injury, immediately after injury, and at post ventilation hour (PVH) 2, 4, 6, 8. Data were processed with analysis of variance of repeated measurement and LSD-t test.

RESULTS(1) At PVH 6 and 8, pH values of dogs in group SI were significantly lower than those in group IP (with t values respectively 2. 431 and 2. 261, P values below 0.05); PaO2 levels in group SI [(87 ± 24), (78 ± 14) mmHg, 1 mmHg =0. 133 kPa] were lower than those in group IP [ (114 ± 18) , (111 ± 17) mmHg, with t values respectively 2. 249 and 3.671, P <0.05 or P <0.01]; OI values in group SI were significantly higher than those in group IP (with t values respectively 2.363 and 5.010, P <0.05 or P <0.01). No significant differences were observed in PaCO2 level within each group or between the two groups (with t values from 0. 119 to 1. 042, P values above 0.05). Compared with those observed immediately after injury, the pH values were significantly lowered (except for dogs in group IP at PVH 6 and 8, with t values from 2.292 to 3.222, P <0.05 or P <0.01), PaO2 levels were significantly elevated (with t values from 4. 443 to 6.315, P <0.05 or P <0.01), and OI values were significantly lowered (with t values from 2.773 to 9.789, P <0.05 orP <0.01) in both groups at all the treatment time points. (2) The PIP level at each time point showed no significant differences between two groups (with t values from 0. 399 to 1. 167, P values above 0. 05). At PVH 4 and 8, the mean airway .pressure values of dogs in group SI were significantly higher than those in group IP (with t values respectively 1.926 and 1. 190, P values below 0.05). At PVH 4, 6, and 8, the dynamic lung compliance levels of dogs in group SI [(9.5 ± 1.9), (12.8 ± 2. 1), (13. 1 ± 1.8) mL/cmH2O] were significantly lower than those in group IP [(11.6 ± 1.2), (15.4 ± 1.8), (14.9 ± 0.8) mL/cmH2O], with t values respectively 2. 289, 2. 303, 2. 238, P values below 0.05. Compared with those observed immediately after injury, PIP and the mean airway pressure values of dogs in two groups were significantly lowered at each treatment time point (with t values from 2. 271 to 7. 436, P <0. 05 or P < 0.01); the dynamic lung compliance levels were significantly elevated in both groups at PVH 6 and 8 (with t values from 2. 207 to 4. 195, P < 0.05 or P <0.01). (3) Heart rate, MAP, and PAP levels at each time point between two groups showed no significant differences (with t values from 0. 001 to 1. 170, P values above 0. 05). At PVH 4, 6, and 8, CO levels in group IP [(0. 6 + 0. 3), (0. 6 + 0. 4), (0. 5 + 0. 7) L/min] were significantly lower than those in group SI [(1.5 0.7), (1.8 + 1.1), (1.6 +0.9) L/min], with t values respectively 3. 028, 2.511, 2.363, P values below 0.05. Compared with that observed immediately after injury, CO level in group IP was significantly lowered at PVH 4, 6, or 8 (with t values respectively 2. 363, 2. 302, 2. 254, P values below 0. 05).

CONCLUSIONSBoth lung recruitment maneuvers can effectively improve oxygenation and lung compliance of dogs with severe smoke inhalation injury. IP is more effective in improving lung compliance, while SI shows less impact on the hemodynamic parameters.

Animals ; Blood Gas Analysis ; veterinary ; Dogs ; Hemodynamics ; Lung Compliance ; physiology ; Oxygen ; blood ; Oxygen Consumption ; physiology ; Positive-Pressure Respiration ; methods ; Respiration, Artificial ; Respiratory Mechanics ; Severity of Illness Index ; Smoke ; adverse effects ; Smoke Inhalation Injury ; physiopathology ; therapy

Objective:To study the significance of H19 gene in the progress from normal mucosa through oral submucous fibrosis (OSF) to carcinogenesis.Methods:Real-time fluorescent quantitative PCR technique was used to detect LncRNA H19 expression level in 12 cases of normal buccal mucosa tissue,33 cases of OSF buccal mucosa tissue and 31 cases of buccal carcinoma with OSF.Results:The relative expression levels of LncRNA H19 in normal buccal mucosa tissues,OSF buccal mucosa tissue and buccal carcinoma with OSF tissue were 1.17 ±0.37,3.44 ± 1.08 and 8.88 ± 1.78 respectively(between each 2 groups,P ＜ 0.01).Conclusion:H19 may involve the occurrence and canceration of OSF.

Objective To evaluate the functional features of motor function area in patients with meningioma by blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI).Methods fMRI were obtained from 10 patients who suffered from meningioma which was adjacent to the motor function cortex.Probabilistic independent component analysis method was used for data analysis.Preoperative and postoperative line Karnofsky Performance Scale (KPS)score was used to assess the patient’s condition.Re-sults Contralateral primary motor cortex and the supplementary motor cortex motor functions were observed in all the activation clusters,in which one side activation area compared with the contralateral activation zone was symmetrical in 6 cases,and significant shift in 4 cases.In 4 patients with the movement function activated,tumor extrusion function shift forward or backwardwith tensile deforma-tion were found.Conclusion BOLD-fMRI imaging technology can effectively locate motor functional area for patients with meningi-oma,which can provide preoperative surgical planning.

Objective: To investigate the effect of recombinant human keratinocyte growth factor 2 (rhKGF-2) on lung tissue of rabbits with severe smoke inhalation injury. Methods: A total of 120 New Zealand rabbits were divided into 5 groups by random number table after being inflicted with severe smoke inhalation injury, with 24 rats in each group. Rabbits in the simple injury group inhaled air, while rabbits in the injury+phosphate buffer solution (PBS) group inhaled 5 mL PBS once daily for 7 d. Rabbits in injury+1 mg/kg rhKGF-2 group, injury+2 mg/kg rhKGF-2 group, and injury+5 mg/kg rhKGF-2 group received aerosol inhalation of 1 mg/kg, 2 mg/kg, and 5 mg/kg rhKGF-2 (all dissolved in 5 mL PBS) once daily for 7 d, respectively. On treatment day 1, 3, 5, and 7, blood samples were taken from the ear central artery of 6 rabbits in each group. After the blood was taken, the rabbits were sacrificed, and the tracheal carina tissue and lung were collected. Blood pH value, arterial oxygen partial pressure (PaO₂), arterial blood carbon dioxide pressure (PaCO₂), and bicarbonate ion were detected by handheld blood analyzer. The expressions of pulmonary surfactant-associated protein A (SP-A) and vascular endothelial growth factor (VEGF) in lung tissue were detected by Western blotting. Pathomorphology of lung tissue and trachea was observed by hematoxylin-eosin staining. Data were processed with analysis of variance of two-way factorial design and Tukey test. Results: (1) Compared with those in simple injury group, the blood pH values of rabbits in the latter groups on treatment day 1-7 had no obvious change (P>0.05). The PaO₂ of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 5 and 7 were (75.0±2.4) and (71.0±4.5) mmHg (1 mmHg=0.133 kPa), respectively, which were significantly higher than (62.0±6.8) and (63.0±3.0) mmHg in simple injury group (q=4.265, 8.202, P<0.05 or P<0.01). The PaO₂ of rabbits in injury+5 mg/kg rhKGF-2 group on treatment day 7 was (82.0±4.9) mmHg, which was significantly higher than that in simple injury group (q=6.234, P<0.01). Compared with that in simple injury group, the PaCO₂ of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 3 was significantly decreased (q=4.876, P<0.01) and significantly increased on treatment day 5 (q=5.562, P<0.01); the PaCO₂ of rabbits in injury+5 mg/kg rhKGF-2 group was significantly increased on treatment day 5 and 7 (q=5.013, 4.601, P<0.05 or P<0.01). Compared with that in simple injury group, the serum bicarbonate ion of rabbits in injury+1 mg/kg rhKGF-2 group on treatment day 7 was significantly increased (q=5.142, P<0.01); the serum bicarbonate ion of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 5 and 7 were significantly increased (q=4.830, 6.934, P<0.01); the serum bicarbonate ion of rabbits in injury+5 mg/kg rhKGF-2 group on treatment day 5 were significantly increased (q=3.973, P<0.05). (2) The expressions of SP-A in lung tissue of rabbits in simple injury group and injury+PBS group in each treatment time point were close (P>0.05). The expressions of SP-A in lung tissue of rabbits in injury+2 mg/kg rhKGF-2 group and injury+5 mg/kg rhKGF-2 group on treatment day 3 were 0.091±0.007 and 0.101±0.009, respectively, significantly higher than 0.069±0.009 in simple injury group (q=10.800, 13.580, P<0.01). The expressions of SP-A in lung tissue of rabbits in injury+1 mg/kg rhKGF-2 group, injury+2 mg/kg rhKGF-2 group, and injury+5 mg/kg rhKGF-2 group on treatment day 5 and 7 were 0.127±0.008, 0.132±0.006, 0.194±0.006, 0.152±0.017, 0.166±0.004, 0.240±0.008, significantly higher than 0.092±0.003 and 0.108±0.005 in simple injury group (q=6.789, 12.340, 17.900, 9.875, 31.480, 40.740, P<0.01). (3) On treatment day 1 and 5, there was no significant difference in the expression of VEGF in lung tissue of rabbits among the 5 groups (P>0.05). Compared with those in simple injury group, the expressions of VEGF in lung tissue of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 3 and 7 were significantly increased (q=4.243, 8.000, P<0.05 or P<0.01), and the expression of VEGF in lung tissue of rabbits in injury+5 mg/kg rhKGF-2 group on treatment day 7 was significantly increased (q=20.720, P<0.01). (4) On treatment day 1, the injury of rabbits in each group was similar, with a large number of neutrophils infiltrated and abscess formed in the alveolar and interstitial tissue, thickened alveolar septum, some collapsed alveolar and atelectasis; large area of tracheal mucosa was degenerated and necrotic, with a large amount of inflammatory exudates blocking in the cavity. On treatment day 3, the inflammation of lung tissue and trachea in each group were improved, but the inflammation in simple injury group and injury+PBS group was also serious. On treatment day 5, the inflammation in lung tissue and trachea of rabbits in injury+2 mg/kg rhKGF-2 group and injury+5 mg/kg rhKGF-2 group were improved much obviously than those in the other groups. On treatment day 7, the inflammation in lung tissue of rabbits in injury+5 mg/kg rhKGF-2 group alleviated obviously than those in the other groups, most alveoli had no obvious exudative fluid, the alveolar cavity was intact and clear, the local alveolar dilated like a cyst, and the alveolar septum thinning; the improvement of inflammation of trachea was more obvious than the other groups, the tracheal mucosa tended to be more complete, and few neutrophils were infiltrated in the endotracheal cavity. Conclusions Atomization inhalation of rhKGF-2 can improve the PaO₂ level of rabbits with severe smoke inhalation injury, reduce airway inflammation, increase the expression of SP-A and VEGF in lung tissue, thus promoting the repair of lung tissue.

OBJECTIVE: To analyze the characteristics soft tissue profile in Hunan Han adults with normal occlusion and to explore the differences of the soft tissue profile in gender, region and race. METHODS: Lateral cephalometric radiographs were performed for 323 volunteers (164 females and 159 males) from Hunan Province. The digital cephalometric radiographs were imported into the WinCeph8.0 measurement and analysis system in a same computer. According to the Holdaway analysis method, the mean and standard deviation were calculated. Then the results were compared to the data from Liaoning, Nepalese, Japanese, North American Caucasians. RESULTS: The normal value of cephalometric facial soft tissue profile in Han population adults with normal occlusion in Hunan Province were obtained. There were significant differences in subnasale to H line (Sn-H), upper lip tension, lower lip sulcus depth (Si-PgsLs), and soft tissue chin thickness (Pg-Pgs) between males and females (all P<0.05). Compared with Liaoning Province, significant regional differences in soft tissue facial angle (FH-NsPgs), upper lip sulcus depth (Ss-Ls), Sn-H, lower lip thickness, upper lip thickness, H angle, lower lip to H line (Li-PgsLs), Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Japan, significant regional differences in FH-NsPgs, nose prominence (Sn-Pn), lower lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Nepalese, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, skeletal profile convexity (A-NPs), basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the North America, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, A-NPs, basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). CONCLUSION There are both similarities and differences in facial soft tissue profile between males and females with normal occlusion in Hunan Province. The characteristics of facial soft tissue profile in Hunan Province are different from that in Liaoning area, Nepal, Japan and North America.
Adult ; Asian Continental Ancestry Group ; Cephalometry ; European Continental Ancestry Group ; Face ; anatomy & histology ; Female ; Humans ; Lip ; anatomy & histology ; Male ; Reference Values

Objective:To explore the mechanism of 14-3-3σgene in regulating inflammatory response of human pulmonary epithelial cells induced by endotoxin/lipopolysaccharide (LPS).Methods:(1) Cells of human normal pulmonary epithelial cell line BEAS-2B cultured in logarithmic growth period were collected and divided into control group and PCMV6-14-3-3σgroup using the random number table, with 3 wells in each group. Cells in control group were transfected with empty plasmid, and cells in PCMV6-14-3-3σgroup were transfected with PCMV6-14-3-3σplasmid. The protein expression of 14-3-3σin cell was detected by Western blotting at 48 hours after transfection. (2) Cells of human normal pulmonary epithelial cell line BEAS-2B cultured in logarithmic growth period were collected and divided into control group, PCMV6-14-3-3σgroup, PCMV6-14-3-3σ+ LPS group, and LPS group using the random number table, with 3 wells in each group. Cells in control group were transfected with empty plasmid for 42 hours. Cells in PCMV6-14-3-3σgroup were transfected with PCMV6-14-3-3σplasmid for 42 hours. Cells in PCMV6-14-3-3σ+ LPS group were stimulated with 1 μg/mL LPS (the same final mass concentration below) for 6 hours after being transfected with PCMV6-14-3-3σplasmid for 42 hours. Cells in LPS group were stimulated by LPS for 6 hours. The protein expressions of Bax and B-cell lymphoma-2 (Bcl-2) were detected by Western blotting, and the ratio of Bax to Bcl-2 was calculated. Apoptotic rate was detected by flow cytometry. The mRNA expressions of tumor necrosis factor alpha (TNF-α) and interleukin 1beta (IL-1β) in cells were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction technique. Content of TNF-α and IL-1β in cell culture supernatant was detected by enzyme-linked immunosorbent assay. Data were statistically analyzed with t test, one-way analysis of variance, and least significant difference test. Results:(1) At 48 hours after transfection, the protein expression of 14-3-3σin cells of PCMV6-14-3-3σgroup (1.05±0.03) was significantly higher than that in control group (0.78±0.04, t=5.41, P<0.01). (2) Compared with those in control group, the ratio of Bax to Bcl-2, apoptotic rate, mRNA expressions of TNF-α and IL-1β, and content of TNF-α and IL-1β in cell supernatant in PCMV6-14-3-3σgroup showed no significant difference ( P>0.05); the above-mentioned indexes of cells in LPS group were significantly higher or increased ( P<0.01). Compared with those in LPS group, the above-mentioned indexes of cells in PCMV6-14-3-3σ+ LPS group were significantly lower or decreased ( P<0.01). Conclusions:14-3-3σis a key factor in regulating apoptosis. It can alleviate the LPS-induced inflammatory responses by regulating the ratio of apoptotic regulators Bax to Bcl-2 and inhibiting apoptosis of human pulmonary epithelial cells.

Objective:The repair of small and medium-sized defects in the oral has always been a challenge,free skin flap and distal pedicled tissue flaps are difficult to meet clinical needs,and the traditional under-chin flap has the risk of donor-area injury.This study aims to investigate the efficacy of V-shaped folded submental flap in the repair of small-sized and medium-sized oral defects. Methods:The clinical data of 28 patients with oral defect lesions,who were hospitalized in the Department of Stomatology,Third Xiangya Hospital of Central South University from March 2019 to December 2022,were retrospectively analyzed.Patients were divided into a V-shaped folded group(17 cases)and a conventional group(11 cases)according to different surgical methods.The V-shaped folded group was treated with a V-shaped folded submental flap for postoperative soft tissue repair,while the conventional group was treated with a conventional submental flap for repair.The postoperative follow-up time was 6-48 months.The survival status,repair time,and repair effect of the 2 groups were compared. Results:There was no significant difference in flap survival rate,flap size,flap preparation time,repair surgery time,and postoperative hospital stay between the 2 groups(all P>0.05).At 6 months after the surgery,the V-shaped folded group had no difficulty in raising the head or everting the lower lip,no"cat ear"deformity in the submental skin.Scars in the V-shaped folding group were hidden at the lower edge of the mandible.The wound aesthetics and functional scores in the V-shaped folded group were significantly higher than those in the conventional group(both P<0.05). Conclusion:The V-shaped foldable submental flap has the advantages of flexible design,simple preparation,reliable blood supply,and protection of the donor area,which can effectively protect the appearance of the chin and avoid functional disorders.

This study presents a case of synchronous multiple primary cancers involving floor of mouth carcinoma with esophageal carcinoma. Literature was reviewed to summarize the incidence, location, diagnosis, treatment characteristics, and prognosis to improve understanding and awareness of the multiple primary cancer. As a result, early discovery, early diagnosis, and effective treatment can help prolong survival and improve the quality of life of patients.