OBJECTIVETo observe the efficacy of the treatment of refractory wound by VSD combined with platelet-rich plasma.

METHODSFrom April 2010 to June 2012,15 patients with refractory wound were treated including 11 males and 4 females with an average age of 35.2 years old ranging from 18 to 45 years old. The formation time of wound was from 6 to 24 months, which was unhealed after long-term medication or repeated treatment. The VSD combined with autologous platelet-rich plasma was applied to treat the wound. The wound healing was an indicator and treatment and clinical features were summarized.

RESULTSAll the patients were followed up for 3 to 8 months (means 5 months). The wound of all patients were healed without recurrence.

CONCLUSIONThe curative effect of VSD combined with platelet rich plasma for treatment of refractory wounds is obvious. It could reduce the treatment course and the treatment cost.

Adolescent ; Adult ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Platelet-Rich Plasma ; metabolism ; Wound Healing ; Wounds and Injuries ; metabolism ; physiopathology ; therapy ; Young Adult

Sepsis is a frequently met syndrome with complex clinical symptoms and high mortality in emergency department. Early diagnosis of sepsis and timely treatment can improve survival. In recent years, the application of biomarkers [such as procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] are commonly used in the early diagnosis of sepsis, but their specificity and sensitivity are limited because of the long lag of report time. Soluble leukocyte differentiation antigen 14 sub type (sCD14-ST, namely presepsin) is a kind of novel biomarkers. Presepsin has a high specificity and sensitivity in the diagnosis of sepsis. It has some value to evaluate the severity of sepsis, antibiotic treatment of antibiotics, and prognosis of the patients with sepsis, and its latest detection method is fast and accurate, so it has the feasibility of clinical application.

This paper aims to investigate the value of diffusiion weighted imaging (DWI) and different apparent diffusion coefficient (ADC) methods to predict the curative effects of neoadjuvant chempotherapy (NAC) for breast cancer. From March 2010 to December 2012, seventy-one patients were pathologically confirmed invasive breast cancer by needle puncture biopsy received before surgery, and underwent magnetic resonance before and after NAC, the ADC were measured by mean ADC method and lower ADC method. The pathologic response after NAC was divided to major histological response (MHR) group and non-major histological response (NMHR) group according to Miller & Payne system. Results displayed that ADC values obtained before NAC, at the end of the second cycle of NAC, and after whole course of treatment, had good correlations between mean and lower ADC methods (the Pearson's correlation=0.699, 0.749 and 0.895, respectively). Significant difference in ADC obtained both with mean and lower ADC methods could be found between MHR and NMHR groups after the second cycle of NAC (P< 0.05). After the second cycle of NAC, significant difference in the change rate of ADC could be found between MHR and NMHR groups by using lower ADC method (P<0.05), but not be found by using mean ADC method (P >0.05). In conclusion, DWI could monitor the pathologic changes of breast cancer after NAC, and the lower ADC method might be used to evaluate the curative effect of NAC with the change rate of ADC.
Breast Neoplasms ; drug therapy ; pathology ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Neoadjuvant Therapy

Objective To understand the epidemiology of respiratory syncytial virus(RSV),influenza virus type A and type B(IV-A and IV-B),parainfluenza virus type 1,2,3(PIV-1,2,3)and adenovirus(ADV) among children with acute respiratory tract infection in Shanghai.Methods A retrospective epidemiological investigation was conducted to analyze the prevalence rate,seasonality and susceptible pediatric population of seven common respiratory viruses among hospitalized pediatric patients(<15 years old) with acute respiratory tract infection in Children's Hospital Affiliate to Fudan University Shanghai during 2003 to 2006.Nasopharyngeal aspirates were collected for detecting viral antigens of RSV,IV-A,IV-B,PIV-1,PIV-2,PIV-3 and ADV by direct immunofluorescence assay.Results Total 11214 children were collected during the consecutive four years,among whom 98.7% were presented with acute lower respiratory tract infection.The overall positive detection rate of these seven respiratory viruses was 24.2%.RSV accounted for 17.7%,followed by PIV-3(2.8%),ADV(2.2%),IV-A(0.7%),PIV-I(0.5%),PIV-2(0.3%),IV-B(0.1%)and mixed(0.2%).RSV season often occurred in winter and spring,however,an early season began in autumn every two year.PIV-3,ADV and IV were usually prevalent sporadically and the seasonal patterns were not typical.The median ages of infected pediatric patients were 4 months for RSV,8 months for PIV-3,9.5 months for PIV-1,10.5 months for PIV-2,12 months for ADV,13 months for IV,respectively,which were significantly different by statistical analysis(X2=154.319,P<0.01).The infants and younger children were more susceptible for developing RSV and PIV-3 related diseases.RSV infection significantly decreased along with the age increased.Conclusions RSV is the most commonly identified virus,while infants and neonates are the most susceptible populations for RSV infection.Typically,RSV is prevalent during spring and winter but begins to be active in fall every other year. PIV-3 is found to be the second common viral pathogen and young children are susceptible population.ADV ranks the third pathogen and children with ADV infection tend to be elder. Nevertheless,IV is rare among pediatric population in recent years in Shanghai.In our study,the outbreaks of ADV and IV infections among children are not observed.

Objective To explore the effect of lysophosphatidic acid(LPA)on blood-brain barrier(BBB) permeability and its possible mechanism.Methods LPA or LPA+suramin(L+S)were stereotaxically injected into the right eaudate nucleus in SD rats in vivo.Evans blue(EB)was used to quantitatively measure the permeability of BBB at different time points.The expression of matrix metalloproteinase-9 was detected by immunohistochemistry technique.The pathological ultrastruetural changes of BBB were assessed by transmission electron microscopy.Results The BBB permeability began to increase after LPA administered into ipsilateral eaudate nucleus,and reached the peak at 24h.Then the permeability of BBB gradually lowered after 48h.In comparison with the same time points of control group,there were quite significant differences(P＜0.01).After L+S was injected,the change of BBB permeability had differences in comparison with those of LPA group in the same time points,(P＜0.05).MMP-9 positive cells were mainly vascular endothelial cells.The numbers of MMP-9 positive blood vessels grew at 6h in LPA group,and the expression of it reached maximum at 24h,then the number of it decreased at 48h,showing significant statistical differences in comparison with the L+S group(P＜0.01),It was observed microscopically that ultrastrueture of BBB of the LPA group was changed sharply,such as basement membrane roughed and fragmented,astroeyte end-feet swolled markedly and perivaseular space enlarged obviously.But there were no remarkable changes in BBB in L+S group.Conclusion LPA can induce increase of BBB permeability and its possible mechanism is the strong expression of MMP-9 protein produeted by endothelial cells through the mediation of LPA receptor,leading to degradation of basement membrane.

Objective To study the clinical and the epidemiological features of hospitalized children with influenza virus infection. Methods Two hundred and fifty-three inpatients with laboratory-confirmed influenza virus infection from 1999 to 2008 were reviewed for analyzing the clinical and epidemiological characteristics. Type A and B influenza viruses in the nasopharyngeal aspirates were detected by immunofluorescence assay. Mann-Whitney U test were performed for comparing the median age and the length of hospitalization. Chi-square test was performed for comparing the proportion of patients with fever and cough. Results Among 253 hospitalized children aged between 5 days and 127 months, 182 (71.9%) were boys and 71 (28. 1%) were girls. The median age was 18 months. Fifty-three cases were infants younger than 6 months. 95 cases were children aged between 6 months and 2 years, 85 cases were aged between 2 years and 5 years and 20 cases were older than 5 years. The diagnosis of influenza-related admission included pneumonia (190 cases), bronchitis (49 cases) and upper respiratory tract infection (14 cases). Eleven cases developed febrile convulsion, 6 cases had acute exacerbation of asthma and 3 cases had concomitant viralencephalitis. Twenty-nine cases had basic diseases. Cough and fever were the most common symptoms. Two hundred and thirty-eight cases presenting cough and 209 case presenting fever. Sixty-seven percent (140/209) had high fever with body temperature higher than 39 ℃. The average duration of fever was (5. 0 ±2. 9) days. Fever and cough were both more common in children older than6 months (X2 = 22. 895,P<0. 01; X2 = 16. 992,P<0. 01, respectively). Febrile convulsion occurred in children older than 2 years. Fifteen point five (39/251) developed leukocytopenia. Conclusions Children younger than 5 years old are at high risk of influenza-related hospitalization. We should emphasize influenza vaccination in previously healthy children aged between 6 months and 5 years and children with underlying diseases.

Though all the marketed drugs of dipeptidyl peptidase IV inhibitors are structurally different, their inherent correlation is worthy of further investigation. Herein we rapidly discovered a novel DPP-IV inhibitor 8g (IC50 = 4.9 nmol.L-1) which exhibits as good activity and selectivity as the market drugs through scaffold hopping and drug splicing strategies based on alogliptin and linagliptin. This study demonstrated that the employment of classic medicinal chemistry strategy to the marketed drugs with specific target is an efficient approach to discover novel bioactive molecules.
Dipeptidyl-Peptidase IV Inhibitors ; chemical synthesis ; chemistry ; Drug Design ; Drug Discovery ; methods ; Humans ; Hypoglycemic Agents ; chemical synthesis ; chemistry ; Linagliptin ; chemical synthesis ; chemistry ; Molecular Structure ; Piperidines ; chemical synthesis ; chemistry ; Structure-Activity Relationship ; Uracil ; analogs & derivatives ; chemical synthesis ; chemistry

Objective To compare the advantages and values of several special staining methods of chondrocytes . Methods Twelve 7-day old healthy C57BL/6J mice were killed to obtain the cartilage tissue of the knee joint in order to isolate the chondrycytes .Type II collagen was used to assess the chondrocytes .Then the chondrocyte climbing slices were prepared.The materials were fixed, and HE staining, Safranin O-fast green staining, SA-β-gal staining and immunohistochemical staining of Type II collagen were performed and compared .Results HE staining showed clear morphology of the chondrocytes .The cell nuclei were stained blue and the cytoplasm was pink .Safranin O-fast green staining showed that the nuclei were pink and the cytoplasm green .SA-β-gal staining showed that the aging cells were green while the young cells were colorless .Immunohistochemical staining of type II collagen showed the distribution of type II collagen and they were stained brown while the cell nuclei were blue .Conclusions HE staining and safranin O-fast green staining can provide more information than the other staining techniques .SA-β-gal staining is useful in the analysis of aging chondrocytes .Immunohistochemical of type II collagen can be used to study type II collagen .

Objective To investigate the clinical features and risk factors of recurrent communityacquired pneumonia (CAP) in elderly patients.Methods Clinical data of elderly CAP patients admitted to the first affiliated hospital of Sun Yat-Sen university from January 2012 to December 2014 were analyzed retrospectively,including 48 cases of recurrent CAP and 299 cases of non-recurrent CAP.The clinical features were compared between two groups,and the risk factors of recurrent CAP were assessed with logistic regression analysis.Results No significant differences were observed between the two groups in age,sex,smoking,drinking,average hospital stays and total hospitalization expenses (all P ＞ 0.05).In the recurrent pneumonia group,the chronic obstructive pulmonary diseases [54.2％ (26/48) vs.35.5％ (106/299),χ2 =6.146,P=0.013],diabetes [41.7％ (20/48) vs.19.7％ (59/299),χ2 =11.317,P=0.001],the clinical symptoms include cough [79.2％ (38/48) vs.58.5％ (175/299),χ2 =7.432,P =0.006],sputum [70.8％ (34/48) vs.54.5％ (163/299),χ2 =4.488,P =0.034],fever [64.4％ (31/48) vs.40.8％(122/299),χ2 =9.488,P =0.002],poor appetite [52.1％ (25/48) vs.33.1％ (99/299),χ2 =6.483,P =0.011],choking cough [8.3％ (4/48) vs.2.7％ (8/299),χ2 =3.966,P =0.046],poor spirit [45.8％ (22/48) vs.28.4％ (85/299),χ2 =5.875,P =0.015],bilateral lung lesions [41.7％ (20/48)vs.28.8％ (68/299),χ2 =7.825,P =0.005],the complication of respiratory failure [31.3 ％ (15/48) vs.14.7％ (44/299),χ2 =8.012,P =0.005] were higher than those in non-recurrent group.Logistic regression revealed that chronic obstructive pulmonary disease (OR =2.607,95％ CI:1.268-5.358,P =0.009),diabetes (OR =2.948,95％ CI:1.457-5.966,P =0.003) and the history of respiratory failure (0R=2.778,95％CI:1.264-6.108,P=0.011) were risk factors of recurrent CAP.Conclusions Elderly patients with recurrent CAP has a higher rate of cough,sputum and fever,and the scope of lung lesions is broader.Chronic obstructive pulmonary disease,diabetes and the history of respiratory failure are the independent risk factors for recurrent CAP in the elderly.

Objective We sought to establish the standard operation procedures in department of cardiology.Methods According to the method of constructing standard operation procedures,the standard operation procedures for the department of cardiology was constructed through induction and consulting literature materials.Results 16 standard operation procedures for the department of cardiology were developed,including 8 SOP of common diseases to rescue,2 SOP of common operation in perioperative period,4 SOP for common instruments,2 SOP for common drugs usage.Conclusions Construction of standard operation procedures in department of cardiology can provide the basis for clinical nursing work,it can also supply methodological reference to build the standard operation procedures in other departments.