BACKGROUND:Moderate to severe burn and trauma, treatment of which has been paid equal attention to wound surface, is always a difficulty of clinical systemic treatment and has a poor prognosis. Anabolic hormones have acquired secure and good results in the treatment of burns in both animals and clinical patients. Although use of anabolic hormones is restricted by the doping management, but its androgen receptor and nuclear receptor coregulators are the newly emerging areas of interests in the field of gene regulation mechanism in recent years. OBJECTIVE:To investigate the effect of nandrolone phenylpropionate on androgen receptor-mediated transcriptional regulation of target gene in rat scald models. METHODS: Thirty-six rats were randomly divided into nandrolone phenylpropionate, model and control groups. In the nandrolone phenylpropionate and model groups, rats were subjected to a 20% total body surface area second-degree scald injury by hot water. Two days after model preparation, rats in these two groups were intramuscularly injected with nandrolone phenylpropionate and saline, once every other day, for a total of 21 days. RESULTS AND CONCLUSION:The gene expression levels of steroid receptor coactivator-1 and insulin-like growth factor 1 in the rat livers and gonads (testes, ovaries) were significantly different between the nandrolone phenylpropionate and model groups (P < 0.05), except steroid receptor coactivator-1 in the liver. There were no significant differences in steroid receptor coactivator-1, c-myc and insulin-like growth factor 1 in the rat livers and gonads (testes, ovaries) between model and control groups (P < 0.05). The results demonstrate that nandrolone phenylpropionate has different effects on the gene expression of steroid receptor coactivator-1, c-myc and insulin-like growth factor 1 in different tissues under different physiological and pathological conditions.

BACKGROUND: Ginsenoside Rb1 has been extensively used in the protection and treatment of heart, encephalon, lung, kidney and liver damage. However, its application in skin flap is rare.OBJECTIVE: To investigate the effects of intraperitoneal injection of ginsenoside Rb1 on the survival of the dorsal random-pattern skin flap with large length-to-width ratio in rats.METHODS: Healthy adult SD rats were randomly divided into experimental and control groups. A caudally based dorsal random pattern skin flap, 80 mmx20 mm (length: width = 4:1), was symmetrically made. Ginsenoside Rb1 (2 mg/kg) was intraperitoneally injected into the experimental group rats, and the same volume of normal saline was injected into the control group. Malonyl dialdehyde (MDA) and nitric oxide (NO) level of the flaps were tested 1 day after operation; the amount of viable tissues of the flaps were examined by planimetry 10 days after operation. Specimens from the proximal, middle and distal flaps were harvested for HE staining to examine the microstructure.RESULTS AND CONCLUSION: At the first day after operation, NO level was higher in the experimental group than the control group (P< 0.01), while MDA level was lower than the control group (P< 0.01). At the 10th day after operation, the survival rate of the flap was significantly greater in the experimental group than the control group (P < 0.001). Histological observation showed that compared with the control group, the edema and inflammatory cells infiltration were less, while the fiber hyperplasia and the microvascular growth were more obvious in the experimental group. Results show that intraperitoneal injection of ginsenoside Rb1 can enhance the blood supply of the flaps and improve the survival of the random-pattern skin flaps with large length-to-width ratio in rats. This may involve its effects of improving NO activity, decreasing lipid peroxidation, and promoting angiogenesis of skin flaps.

ObjectiveTo analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. MethodsFrom October 2008 to August 2010,nine patients with twelve fingertip defects,including 5 thumbs,2 index fingers,3 middle fingers,2 ring fingers,underwent repair with lateral homodigital flaps based on digital artery perforator.The size of the flaps ranged from 2.7 cm× 1.4 cm to 3.1 cm× 1.8 cm.The donor site were covered by skin graft. ResultsEleven flaps survived.One case met with partial necrosis.The follow-up time ranged from 3 to 6 months(average of 4.5 months).The finges had good appearance.Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation.ConclusionUsing the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects.

In order to study the changes of main oxidase and antioxidase in the pathological scars,the tissues of hypertrophic scar(10 cases),keloid(10 cases)and normal skin(8 cases)were obtained.The concentration of malonaldehyde(MDA)and the activities of xanthine oxidase(XO),copper,zinc-superoxide dismutase(CuZn-SOD),catalase(CAT)as well as glutathione peroxidase(GPX)were detected by spectrophotometric method.Compared with normal skin tissues,the concentration of malonaldehyde and xanthine oxidase activity were significantly higer in pathological scars(P

AIM:Researches have shown that musculocutaneous flap or fascial flap could well treat refractory bedsore in a long term. This study observed the clinical experience in the treatment of sacrococcygeal ulcers. METHODS:From January 2000 to January 2006,19 patients with sacrococcygeal ulcers,who received myocutaneous flap transposition in Department of Burns and Plastic Surgery,West China Hospital of Sichuan University,were selected. The informed consent was obtained from all patients. The surgery included two stages. At the first stage,debridement and eschar excision were performed. At the second stage,the surgery was undergone after selecting the myocutaneous flap type according to the patients' age,ulcer position,and ulcer extent. Twenty-one wounds were repaired by gluteus maximus myocutaneous flaps,and the flap size was 13 cm ?11 cm-17 cm?14 cm;8 by long-head of biceps femoris flaps of 10 cm?6 cm-13 cm?6 cm. After operation,the patients were placed on turn-over bed for 14 days and followed regularly. RESULTS:All flaps survived and the wounds in 18 cases healed at the first stage. Hematocele underlying flap occurred in one patient with urinemia,and healed by dressing exchange. After a follow-up of 5 months to 3 years,no patient had a recurrence;the color and texture of the flaps were good,and he appearance was satisfactory. CONCLUSION:The technique of two period operation treatment of myocutaneous flap transposition can accelerate the healing of sacrococcygeal ulcers and improves the success rate of operation.

The interventional treatment of lung cancer is tightly related with hemodynamic situation of artery.To study hemodynamics of the interventional treatment of lung cancer can significantly improve curative effect and decrease complications.Through simulation experiment,the ratio of drug injection around the entrance of bronchial artery is obtained and the definition of natural perfusion region is given.The evidence for interventional treatment of lung cancer and the principle avoiding high-level paraplegia in clinical interventional treatment of lung cancer are also presented.

Objective To compare the rates of clearance of different solutes during continuous veno-venous haemodiafiltration (CVVHDF) between pre-dilution and post-dilution.Methods A study in vitro was carried out using model CRRT system with AN69 filter used,which was applied to perform CVVHDF for solutes clearance.The removed amounts of different solutes including potassium ion (K +),creatinine (Cr),vancomycin,insulin,and interleukin-6 (IL-6) were determined in the groups of control (without dilution),pre-dilution and post-dilution during CVVHDF at the same substitution fluid amount.Each group was repeated 4 times (n =4).Results Post-dilution mode increased K +,Cr,vancomycin and insulin clearances significantly.There was no difference in clearance of IL-6 between the pre-and post-dilution groups.In the control group,insulin and IL-6 levels were decreased extremely.Conclusions In general,the rate of clearance using post-dilution of CVVHDF is higher than that using pre-dilution.Among high molecular weight solutes,the difference in clearance is not significant.The control group demonstrates insulin and IL-6 adsorbed by the filter.

Objective To investigate the influencing factors of the controlled virtual touch tissue quantification (VTQ) in liver of patients with type 2 diabetes mellitus (T2DM) complicated withnon-alcoholic fatty liver disease (NAFLD). Methods Two hundred and twenty-seven patients with T2DM complicated with NAFLD were enrolled in this study,and the shear wave speed of the liver was measured by VTQ. Levels of the fasting plasma glucose, glycated hemoglobin,total cholesterol three acids glyceride, low density lipoprotein, high density lipoprotein , aspertate aminotransferase , alanine aminotransferase , gamma glutamyl transpeptidase and uric acid were measured. The relationships among VTQ and the severity of NAFLD , and those quantitative indexes were analyzed. Results Univariate analysis showed that the value of shear wave speed was negatively correlated with age,duration of diabetes,INS and HDL-C,while was positively correlated with HbA1c and AST. Conclusion Age, sex and levels of serum HbA1c,INS,AST and HLD-C might affect the values of shear wave speed in patients with T2DM complicated with NAFLD.

A laboratory scale combination process of anaerobic baffled reactor(ABR) with sequencing batch reactor(SBR) for treatment of real dyeing wastewater was studied.The effects of operational conditions were investigated.The results demonstrated that removal rates of COD,colour and aniline were 32%~95%,89%~99% and 50%~98%,respectively,the effluents of COD were 30.0 ~97.1mg/L,colour were 8 ~40 times dilution ratio,concentration of aniline were 0.20 ~0.95 mg/L,which could meet the National Discharge Criteria(GradeⅠ) under the operational conditions of HRTs of 24~36 h,organic loading rates of 0.43 ~2.46 kg COD/(m~(3)?d),the influent pH values of 6.5~8.0,ambient temperatures of 20℃~35℃ at the ABR stage and DOs of 2 mg/L,reaction times of 3~10h,settle times of 2 h at the SBR stage.

Objective To evaluate transport efficiency and safety by process management during the handover of patients with tracheal intubation post-operation. Methods Prospective studies were performed between patients with or without process management during the handover. The time of handover were recorded and compared. The difference between systolic and diastolic blood pressure, heart rate, and arterial oxygen saturation were also recorded and compared. The adverse events during the handover were also investigated. Results It costed less time in the handover of patients under process management with significant difference[(4.75±0.54) min vs. (7.05±0.88) min, t=-17.21, P<0.01]. The incidence rate of harmful cases in the handover of patients under process management was significantly declined than that without process management[ 1.67%(1/60) vs. 13.33%(8/60),Χ2=4.324 3,P<0.05 ]. Conclusions Process management may facilitate the handover of patients with tracheal intubation post-operation and improve its safety.