Objective To investigate the dynamic expression and clinical significance of myoglobin, creatine kinase and inflammatory mediators in the serum of patients with multiple trauma. Methods From May 2013 to March 2015, 56 patients with multiple trauma admitted in EICU were recruited in the study. According to the injury severity, 56 patients were divided into a mild trauma group, a medium trauma group and a severe trauma group. The subjects were further divided into a MODS group and a non-MODS group based on multiple organ dysfunction syndrome (MODS) criteria. Twenty healthy adults undergoing physical examination were recruited as control. Serum myoglobin, creatine kinase, IL-6 and TNF-α levels were measured in the multiple trauma patients (1st day, 3rd day, 7th day and 14th day) and the controls. Results Compared with the controls, the serum levels of myoglobin, creatine kinase, IL-6 and TNF-α in the patients with multiple trauma increased significantly from 1st to 14th day after injury (allP＜0.05). Serum myoglobin, creatine kinase, IL-6 and TNF-α levels on 3rd day after injury reached the peak, then decreased gradually in the mild, medium, and severe trauma groups, among which the changes of serum myoglobin, creatine kinase, IL-6 and TNF-α levels were significant on 3rd day compared with other timepoints (allP＜0.05). On 1st day after injury, serum levels ofmyoglobin, creatine kinase, IL-6 and TNF-α also differed significantly between the MODS group and non-MODS group (allP＜0.05). The AUCs of myoglobin, IL-6 and TNF-α for predicting MODS were 0.527-0.817, 0.641-0.890, and 0.197-0.544, respectively. Conclusions The dynamic changes of serum myoglobin, creatine kinase, IL-6 and TNF-α in patients with multiple trauma are correlated well with the injury severity and prognosis. Serum myoglobin, IL-6 and TNF-α levels may be good markers to predict secondary MODS in multiple trauma patients.
ObjectiveTo study the immunogenicity of human bone marrow mesenchymal stem cells (BMSCs) and the suppression ability to the proliferation of peripheral blood mononuclear cell (PBMC) during osteogenic, chondrogenic, and adipogenic differentiations. MethodsBMSCs were isolated from bone marrow of healthy donors and were induced to osteogenic, chondrogenic, and adipogenic differentiations for 7, 14, and 21 days. The expressions of human leukocyte antigen (HLA) class I and class II were detected by flow cytometry. PBMC were isolated from peripheral blood of healthy donors and were co-cultured with BMSCs at a ratio of 10∶1 for 5 days. The suppression ability of undifferentiated and differentiated BMSCs to proliferation of PBMC were detected by flow cytometry. ResultsThe HLA class I expression was observed but almost no expression of HLA class II was seen in undifferentiated BMSCs. There was no obviously change of the HLA class I and class II expressions during osteogenic and chondrogenic differentiations (P>0.05), and a low expression of HLA class II was kept. The HLA class I expression gradually increased at 14 and 21 days after adipogenic differentiation, showing significant differences when compared with the value at 0 and 7 days (P<0.05);the HLA class II expression also gradually increased at 7, 14, and 21 days after adipogenic differentiation, showing significant differences when compared with the value at 0 day (P<0.05). There was no proliferation of PBMC without the stimulation of CD3 and CD28 microspheres and significant proliferation was observed when CD3 and CD28 microspheres were added, and undifferentiated BMSCs could significantly inhibit the proliferation of PBMC. There was no obvious change of the ability of BMSCs to inhibit the proliferation of PBMC during osteogenic and chondrogenic differentiations (P>0.05);and the ability of BMSCs to inhibit the proliferation of PBMC was gradually weakened at 7, 14, and 21 days after adipogenic differentiation, showing significant differences among different time points (P<0.05). ConclusionBMSCs maintain low immunogenicity and strong immune suppression ability during osteogenic and chondrogenic differentiations, which are suitable for allogenic tissue engineering repair and cell transplantation. However, increased immunogenicity and decreased immune suppression ability after adipogenic differentiation may not be suitable for allogenic tissue engineering repair and cell transplantation.
Objective To investigate the current situations of human resource management in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of human resource management, we designed the questionnaire to investigate the human resource management among 307 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results 56% participants considered that the public pharmacists had professional qualities. Nearly 73% considered that there were good interpersonal relationship; 45% wanted to do present job. Nearly 75% thought that the mechanism of performance appraisal should be consummated. About 63% considered that the learning and training was not fitting and proper. 63%thought they could not develop their ability and talent. Conclusion The human resource management system in public pharmacies should be improved.
ObjectiveTo investigate the efficacy of lamivudine combined with low-dose hepatitis B immune globulin to prevent HBV reinfection after liver transplantation. MethodsThe clinical data of 76 cases of HBV-related liver disease after liver transplantation using lamivudine combined with low-dose hepatitis B immune globulin to prevent HBV re-infection were retrospectively analyzed, and the HBV re-infection risk factors were analyzed. ResultsSeventy-six patients' HBsAg became negative after liver transplantation, HBV re-infect in 9 cases.The re-infection rate was 9.2% (7/76) and 11.8% (9/76), respectively, in 1-year and 2-year after liver transplantation. ConclusionsLamivudine combined with low-dose hepatitis B immune globulin after liver transplantation can be effective preventing re-infection with HBV.HBeAg positive and HBV-DNA positive before liver transplantation is risk factors of HBV re-infection.
ObjectiveTo review the role of vertebral subchondral bone in maintaining normal physiological function of the intervertebral disc and in the intervertebral disc degeneration in light of bone anatomy, microstructure, histopathological features, and MRI imaging features. MethodsThe related home and abroad literature concerning vertebral subchondral bone and intervertebral disc degeneration was extensively reviewed and comprehensively analyzed. ResultsVertebral subchondral bone is part of the vertebral endplate and is defined as the vascularized cortical and trabecular bone layer located between the cartilage endplate and vertebral body. It not only plays a cushion shocks role in terms of conducting stress and effectively resists the hydrostatic nucleus, but also ensures the normal supply of disc nutrition. Subchondral bone sclerosis caused by bone remodeling abnormality severely decreases the ability of subchondral bone stress absorption and protective function of disc, which finally leads to increased inflammatory factors locally and hindered nutrition pathway of disc and enhanced disc degeneration. ConclusionTo further strengthen the knowledge and understanding of the vertebral subchondral bone will play a positive role in the study on the pathogenesis of intervertebral disc degeneration.
The dose data produced by treatment plan system (TPS) in intensity-modulated radiation therapy (IMRT) has many gradient edge points. Considering this feature we proposed a new interpolation algorithm called treatment plan dose interpolation algorithm based on gradient feature in intensity-modulated radiation therapy (TDAGI), which improves the Canny algorithm to detect the gradient edge points and non-edge points by using the gradient information in the dose data plane. For each gradient edge point, the corresponding gradient profile was traced and the profile's sharpness was calculated, and for each non-edge point, the dispersion was calculated. With the sharpness or dispersion, the kernel coefficients of bi-cubic interpolation can be obtained and can be used as the central point to complete the bi-cubic interpolation calculation. Compared with bi-cubic interpolation and bilinear interpolation, the TDAGI algorithm is more accurate. Furthermore, the TDAGI algorithm has the advantage of gradient keeping. Therefore, TDAGI can be used as an alternative method in the dose interpolation of TPS in IMRT.
ObjectiveTo study the value of CT angiography (CTA) in the surgical treatment of bone tumors with the temporary balloon blocking technique. MethodsA retrospective analysis was made on the clinical data of 36 bone tumor patients between April 2008 and October 2013. There were 22 males and 14 females, aged from 25 to 83 years (mean, 46 years). The tumor located at the sacrococcygeal region in 17 cases, at the ilium in 12 cases, at the pubis in 5 cases, and at the proximal femur in 2 cases. Before surgery, CTA was performed to measure the external diameter of aortaventralis and arteria iliac communis, and the distance between the low renal artery and the abdominal aortic bifurcation as well as mark the anatomical relationship between the low renal artery, the abdominal aortic bifurcation and bony landmarks of vertebral body. According to these data, suitable balloon was chosen and the balloon positioning was guided in the surgery to completely excise tumor assisted by balloon blocking technique. ResultsThe CTA results showed that the external diameter of aortaventralis and arteria iliaca communis was (1.545±0.248) cm and (1.060±0.205) cm respectively, and the distance between the low renal artery and the abdominal aortic bifurcation was (10.818±1.165) cm. The three-dimensional reconstruction showed that the opening of the low renal artery was mainly located at L1 (16/36, 44.4%) and the abdominal aortic bifurcation mainly located at L4 (22/36, 61.1%). Effective block of abdomial aorta was performed; the blood pressure obviously increased in 3 cases after balloon inflation, and pulse of the left dorsal artery of the foot decreased in 1 case after removal of balloon, which were relieved after expectant treatment. The operation time was 118-311 minutes; the intraoperative blood loss was 200-1 800 mL, 21 patients were given blood transfusion, and the amount of blood transfusion was 400-1200 mL; and the aortic clamping time was 40-136 minutes. All patients were followed up 5-44 months (mean, 21 months). According to Enneking standard, the results were excellent in 9 cases, good in 20 cases, fair in 5 cases, and poor in 2 cases at 3 months after operation. There were 10 cases of dysfunction of urination and defecation, 2 cases of tumor recurrence, and 3 cases of death after surgery. ConclusionCTA and three-dimensional reconstructions technique can accurately measure the external diameter of aortaventralis and arteria iliaca communis and the distance between low renal artery and abdominal aortic bifurcation and offer great help to choose appropriate balloon and locate the balloon during surgery. The balloon blocking technique under the assistance of CTA can obviously reduce intraoperative blood loss and tumor recurrence, supply a clear view in surgery and shorten the operation time.
ObjectiveTo investigate the anti-apoptotic ability of synovium-derived mesenchymal stem cells (SMSCs) by comparing the apoptosis induced by tumor necrosis factor α (TNF-α) between SMSCs and bone marrow mesenchymal stem cells (BMSCs). MethodSMSCs and BMSCs were isolated with tissue adhering and density gradient centrifugation respectively, and cells at passages 3-5 were used in further experiments. After immunophenotype identification and differentiation induction, cells were divided into 4 groups. In the experimental groups, apoptosis of SMSCs and BMSCs were induced by 20 ng/mL TNF-α and 10 μg/mL cycloheximide, and cells were cultured in normal culture medium in the control groups. Cellular morphology were observed by inverted phase contrast microscope. After apoptosis induction for 24 hours, cell viability was determined by cell counting kit 8 assay and apoptotic index was detected by flow cytometer. Moreover, the level of Cleaved Caspase-8, 3 were determined by Western blot. ResultsBoth SMSCs and BMSCs accorded with the definition criteria of MSCs according to results of immunophenotype identification and differentiation induction. After apoptosis induction, cells became shrinking and partially floated and cellular morphologies became worse than those in the control groups. After apoptosis induction for 24 hours, cell viabilities of SMSCs and BMSCs in the control groups were both 100%, and no apoptotic cells were observed. However, cell viabilities of SMSCs and BMSCs in the experimental groups were 60.13%±8.63% and 46.55%±10.54% respectively, which were both significantly lower than those in the control groups (P<0.05) , and cell viability in the SMSCs experimental group was significantly higher than that in the BMSCs experimental group (t=3.152, P=0.006) . The apoptotic index was 36.54%±8.63% in the SMSCs experimental group and was 53.77%±11.52% in the BMSCs experimental group, both were significantly higher than the control groups (1.12%±0.24% and 1.35%±0.31%) (P<0.05) . What's more, it was significantly lower in SMSCs experimental group than that in BMSCs experimental group (t=3.785, P=0.001) . Moreover, no expression of Cleaved Caspase-8, 3 was detected in the control groups. But the levels of Cleaved Caspase-8, 3 were significantly enhanced in the experimental groups and they were lower in SMSCs than in BMSCs (t=13.870, P=0.000; t=7.309, P=0.000) . ConclusionsTNF-α induced apoptosis is lower in SMSCs than in BMSCs, which means that SMSCs may have stronger anti-apoptosis ability than BMSCs.
ObjectiveTo investigate The role of tumor necrosis factor-α (TNF-α) in pancreatitis-associated adrenal cells' apoptosis of severe acute pancreatitis (SAP). MethodsForty Wistar rats were randomly divided into sham operation group (SO group) and SAP group by random number method, the SAP group was divided into 3, 6, 12, and 24 h 4 subgroups, 8 rats in each group. SAP model was induced by retrograde injection of 5% sodium taurocholate into the bilipancreatic duct. At 3, 6, 12, and 24 h after operation, serum amylase and lipase was measured, adrenal injury was evaluated by histological examination, apoptosis of the adrenal cells was observed by TUNEL method, and expressions of TNF-α and Caspase-3 protein were detected by Western blot. ResultsThe levels of serum AMY and LIP, histopathological scores of pancreatic tissues and adrenal tissues at each time point after operation in SAP group increased significantly than SO group (P < 0.05). With the duration extension of SAP, the apoptosis index of adrenal cells in SAP group progressively heightened, and were higher than those in the SO group (P < 0.05). And the expressions of TNF-α and Caspase-3 protein in adrenal tissues of SAP group gradually increased, at 24 h this data slightly decreased, but still higher than SO group (P < 0.05). ConclusionTNF-α may be involved in the pathogenesis of adrenal injury in SAP rats by activate the protein expression of Caspase-3.