To investigate the influence factors and effects of metal or dissolving microneedles on the formation and healing of skin microchannels, the pencil-shaped or conical stainless steel microneedles with different lengths, tip to tip space and base area, and the pencil-shaped dissolving microneedles with different tip to tip space were used. The microneedles were applied to the skin of epilatory mice and rats, and the effects of various microneedle parameters, application parameters, and animals on the microchannels were explored by the transepidermal water loss (TEWL) and methylene blue staining. Visually observe the skin local irritation caused by the microneedles. The animal experiments were approved by the Animal Experiments Welfare and Ethical Committee of Zhejiang University of Technology. The application time of the microneedle should be maintained at 30 s or more. When the insertion forces were 2, 4, 8 N, and the TEWL initial values of the formed microchannels were 12.9, 33.0, 40.4 g·m^-2·h^-1, respectively. When the length of metal microneedle were 400, 600, 800 μm, and the TEWL initial values of the formed microchannels were 37.1, 40.4, 49.5 g·m^-2·h^-1, respectively. When the tip to tip space of metal microneedle were 400, 600, 800 μm, and the TEWL initial values of the formed microchannels were 33.2, 40.4, 55.8 g·m^-2·h^-1, respectively. When the base area of metal microneedle were 0.16, 0.35, 0.62 cm², and the TEWL initial values of the formed microchannels were 35.1, 40.4, 67.1 g·m^-2·h^-1, respectively. The effects of conical and pencil-shaped microneedles are similar. When the tip to tip space of pencil shaped dissolving microneedle were 400, 600, 800 μm, and the TEWL initial values of the formed microchannels were 49.8, 60.5, 70.5 g·m^-2·h^-1, respectively. The TEWL baseline values of animal skins of different genders and series are different, but the tendency of microchannels formation and closure is similar. Visual inspection revealed that the slight erythema caused by the microneedles subsided within 24 h. Microneedles of different parameters have different effects on microchannels. The microchannels closed within 24 or 48 h, and the skin local irritation caused by microneedle was mild.

Objective To explore the alterations of protein phosphatase-2A (PP-2A) in lymphocytes in mild cognition impairment (MCI) and Alzheimer's disease (AD).Methods The activity PP-2A of was measured by ~(32)p liquid seintillography for incorporated radioactivity in control group(n=11) , the MCI group(n=11),and the AD group(n=11).The expression of PP-2A was determined by Western blot.Results In the control group,the activity of PP-2A (1.01?0.09) and the expression of PP-2A (0.96?0.07) were high while in the MCI group,the activity of PP-2A (0.71?0.12) and the expression of PP-2A (0.80?0.05) were decreased (both P

BACKGROUND:Continuing stress stimulation has been confirmed to promote repair of rotator cuff injury.This experiment attempts to fu rther quantify the intensity of stress stimulation in order to reach a better therapeutic effect in the entire process of rotator cuff injury repair.OBJECTIVE:To explore the biomechanical performance of stress stimulation with different intensities on repair of acute rotator cuffinjuryMETHODS:Sixteen male New Zealand rabbits were randomly divided into high intensity,low intensity and control groups,with 12 animals in each group.Rabbits were received a rotator cuff acute injury and reconstructing insertion of supraspinatus tendon on greater tuberosity of humerus.At 1 week after operation,rabbits were treated by continuous passive motion(CPM)apparatus,which was-60°to 60° flexion-extension for the high intensity group,and-15° to 15° for the low intensity group.At 2 weeks after operation,the CPM was performed every other day,with 10 minutes per time;which was changed to daily training from week 3 with the same frequently,and 15 minutes per time at week 4.Rabbits in the control group were housed freely.Each 4 animals were sacrificed at weeks 2,3 and 4 after operation,and the largest tensile strength and severity at osteotendinous junction were compared.RESULTS AND CONCLUSION:The maximum tensile intensity and stiffness of the supraspinatus tendon in the low intensity group were greater than that of the control and high intensity group(P＜0.05),which was smallest in the high intensity group.All the breakage point existed at the intra-articular portion.The result demonstrated that low intensity stimulation exhibits superior repair effect in acute rotator cuff injury,while high intensity stimulation is harmful to the early repair of acute rotator cuff injury.

BACKGROUND: Hip-preserving treatment is advocated in the treatment of early avascular necrosis of the femoral head.OBJECTIVE: To compare the clinical efficacy of simple core decompression and three-dimensional porous core decompression combined with autologous bone marrow transplantation on early avascular necrosis of the femoral head.METHODS: Thirty patients (39 hips) with early avascular necrosis of the femoral head at phase I-II according to the staging criteria of the Association Research Circulation Osseuse (ARCO) who had been admitted to the First Affiliated Hospital of Luzhou Medical University between March 2011 and May 2016 were surgically treated and followed up.Seventeen patients (22 hips, trial group) were treated with three-dimensional porous core decompression combined with autologous bone marrow transplantation, including 10 cases of ARCO stage I and 12 cases of ARCO stage II; the other 13 patients (17 hips, control group) were treated with simple core decompression, including 7 cases of ARCO stage I and 10 cases of ARCO stage II. Harris scores, X-ray and magnetic resonance imaging were used to evaluate the surgical efficacy at 1, 3, 6, 9, 12, 18, 24, 30, 36 months after the operation.RESULTS AND CONCLUSION: The incision healed primarily in all patients, and no infection occurred. The follow-up lasted for 1-3 years (average 2.5 years). At the last follow-up, the Harris scores in both trial group and control group were significantly improved compared with the baseline (P < 0.05); moreover, the Harris scores of ARCO stage I and II patients were significantly higher in the trial group than the control group (P < 0.05). Collapse of the femoral head was observed in one hip (stage I) and one hip (stage II) of the trial group, and in three hips (stage I) and five hips (stage II) of the control group, and then hip arthroplasty was performed. The number of the patients developing collapse of the femoral head in the trial group was significantly less than that in the control group (P < 0.05). Compared with simple core decompression, three-dimensional porous core decompression combined with autologous bone marrow transplantation is more adept to improve patient's function and delay disease progression in the treatment of ARCO stage I and II early avascular necrosis of the femoral head.

OBJECTIVETo investigate the treatment of postoperative chyle leak after surgery for digestive malignancies.

METHODSFrom December 2008 to February 2012, in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, clinical data of 19 patients with chyle leak after digestive system cancer surgery were retrospective analyzed.

RESULTSNineteen cases of chyle leak were all identified between the second and the fourth postoperative day and were all initially managed with conservative treatment including early fasting, parenteral nutrition(PN), 24-hour continuous infusion of somatostatin, and low pressure suction drainage. Eight patients were treated successfully for 6 to 10 days with a significant reduction of the daily drainage volume. Ten patients had enteral nutrition(EN) and their drain tubes were repeatedly washed with 30 ml of compound meglumine diatrizoate injection every day until the drainage volume decreased to 200 ml/day. The time to resolution of chyle leak in these ten patients ranged from 12 to 24 days. One patient had no significant decrease in fluid drainage and developed abdominal distension after one week of conservative treatment. Surgical closure of chyle leak was performed on the 11th postoperative day, abdominal cavity drainage tube was removed on the 4th postoperative day. The patient was discharged home in good condition.

CONCLUSIONMost postoperative chyle leak after surgery for digestive malignancies can be successfully managed with conservative treatment. Somatostatin and the drainage are the main therapeutic approaches. When chyle leak is not resolved with conservative treatment, surgical treatment should be considered to prevent serious complications.

Adult ; Aged ; Anastomotic Leak ; therapy ; Chyle ; Digestive System Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Retrospective Studies

As a novel transdermal drug delivery technology of minimally invasive, safe and efficient, microneedles have received increasing attention. The microchannels formation by microneedles onto the skin is a prerequisite and key for microneedles to deliver drugs. However, there is still a lack of systematic evaluation in skin microchannels. This review summarized influencing factors and evaluation methods in microchannels formation and healing by microneedles, including geometric parameters, materials for preparation, drugs, penetration parameters, differences among the skin of subjects, and presence or absence of occlusion. This review provides reference for other scholars to further study the effectiveness and security of microneedle applications.

Objective To identify the association of HLA-DQA1 and-DQ B1 alleles with vitiligo in Chinese Hans in Anhui province.Methods Polymerase chain reaction sequence-specific primer (PCR-SSP) method was used to analyze the distribution of HLA-DQA1 and-DQB1 alleles among 187 patients with vitiligo and 273 healthy controls.Results The frequencies of HLA-DQA1*0302,-DQB1*0303,-DQB1*0503 alleles were significantly increased in the patients with vitiligo compared with those in the controls,and HLA-DQA1*0501 allele frequency was mark edly decreased.HLA-DQA1*0302,-DQA1*0601,-DQB1*0303,-DQB1*0503 alleles were p ositively associated,whereas HLA-DQA1*0501 allele was negatively associated wit h childhood vitiligo,and HLA-DQB1*0303 allele was positively associated with ad ult vitiligo,in comparison with those in the controls.The frequency of HLA-DQB 1*0303 allele was significantly increased in localized vitiligo patients compare d with that in the controls,whereas frequencies of HLA-DQA1*0302,-DQB1*0303,-DQB1*0503 alleles were significantly increased and the frequency of HLA-DQA1*050 1 allele was markedly decreased in generalized vitiligo patients.Conclusions HLA-DQA1*0302,-DQA1*0601,-DQB1*0303 and-DQB1*0503 alleles could be the suscep tible alleles of vitiligo,while HLA-DQA1*0501 allele could be the protective al lele in Chinese Hans in Anhui province.There may be different genetic backgroun ds between childhood and adult patients,and between localized and generalized vitiligo.

OBJECTIVE: To investigate the clinical characteristics and treatment of pneumocystis carinii pneumonia (PCP) in children with acute lymphoblastic leukemia (ALL), in order to improve the early diagnosis and effective treatment. METHODS: Clinical data of five children with ALL developing PCP in the post-chemotherapy granulocyte deficiency phase were analyzed retrospectively. The clinical manifestations, laboratory tests, imaging findings, treatment methods and effect were summarized. RESULTS: The male-to-female ratio of the five children was 1∶4, and the median age was 5.5 (2.9-8) years old. All patients developed PCP during granulocyte deficiency phase after induction remission chemotherapy. The clinical manifestations were generally non-specific, including high fever, tachypnea, dyspnea, non-severe cough, and rare rales in two lungs (wet rales in two patients). Laboratory tests showed elevated C-reactive protein (CRP), serum procalcitonin (PCT), (1,3)-β-D-glucan (BDG), lactate dehydrogenase (LDH) and inflammatory factors including IL-2R, IL-6 and IL-8. Chest CT showed diffuse bilateral infiltrates with patchy hyperdense shadows. Pneumocystis carinii(PC) was detected in bronchoalveolar lavage fluid (BALF) or induced sputum by high-throughput sequencing in all patients. When PCP was suspected, chemotherapy was discontinued immediately, treatment of trimethoprim-sulfame thoxazole (TMP-SMX) combined with caspofungin against PC was started, and adjunctive methylprednisolone was used. Meanwhile, granulocyte-stimulating factor and gammaglobulin were given as the supportive treatment. All patients were transferred to PICU receiving mechanical ventilation due to respiratory distress during treatment. Four children were cured and one died. CONCLUSION PCP should be highly suspected in ALL children with high fever, dyspnea, increased LDH and BDG, and diffuse patchy hyperdense shadow or solid changes in lung CT. The pathogen detection of respiratory specimens should be improved as soon as possible. TMP/SMZ is the first-line drug against PCP, and the combination of Caspofungin and TMP/SMZ treatment for NH-PCP may have a better efficacy. Patients with moderate and severe NH-PCP may benefit from glucocorticoid.
Caspofungin/therapeutic use* ; Child ; Child, Preschool ; Dyspnea ; Female ; Humans ; Male ; Pneumonia, Pneumocystis/therapy* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Respiratory Sounds ; Retrospective Studies

OBJECTIVETo analyze the chemical constituents of the non-alkaloid fraction of Uncaria macrophylla.

METHODSThe constituents were separated and purified by silica gel chromatography and recrystalization, and their structures were identified by infrared, mass and nuclear magnetic resonance spectrometry.

RESULTSSix compounds were isolated from the non-alkaloid fraction of Uncaria macrophylla, whose structures were identified as beta-sitosterol, beta-daucosterol, ursolic acid, alpha-amyrin acetate, 3beta, 6beta, 23-trihydroxyurs-12-en-28-oic acid, 3beta-hydroxyurs-12-en-27, and 3beta-hydroxyurs-12-en-27, 28-dioic acid, respectively.

CONCLUSIONSUrsolic acid is the main component in the non-alkaloid fraction of Uncaria macrophylla. Alpha-amyrin acetate and 3beta-hydroxyurs-12-en-27, 28-dioic acid are isolated and characterized for the first time from this plant.

Oleanolic Acid ; analogs & derivatives ; isolation & purification ; Triterpenes ; isolation & purification ; Uncaria ; chemistry

Objective To map the locus of the gene CYLD1 for multiple familial trichoepithelioma (MFT), and identify the mutation of this gene in a large Chinese Han family with MFT. Methods The local genome scan was performed using 18 microsatellite markers spanning 9p21 and 16q12-q13 in this MFT family. Linkage software was used for two-point linkage analysis. All 17 coding exons of the CYLD1 gene and the adjacent splice sites were amplified using PCR. Mutation scanning was carried out by DNA sequencing. Results ① Two-point linkage analysis revealed a LOD score of 3.31 under the assumption of an autosomal dominant inheritance with disease-allele frequency of 0.00001 and penetrance of 99.9%. ② A four-basepair deletion of exon 18 in the CYLD1 gene was detected, designated c.2355-2358delCAGA. Conclusions Multiple familial trichoepithelioma is a genetically heterogeneous disorder. The gene CYLD1 for this MFT family localizes to 16q12-q13, not 9p21.