Effect of partial splenic embolization on the immune function of cirrhosis patients with hypersplenism

Objective:To discover the effect of partial splenic embolization on the immune function of cirrhotic patients with hypersplenism.Methods:Patients involved in the study were enrolled and divided into three groups,including control group,experimental group,and complication group.Numbers of CD3^+,CD4^+ and CD8^+ T cells and CD4^+CD25^+CDl27^(low/-) Treg cells in the peripheral blood of patients before surgery,1 month,6 months,1 year,and 2 years after surgery were analyzed by fluorescence active cell sorting(FACS).Contents of immunoglobulins(IgA,IgG and IgM) were analyzed by auto immunoassay analyzer.Results:In the peripheral blood of patients from experimental group,numbers of CD3^+,CD4^+ and CD8^+ T cells initially declined,but afterwards increased to normal level;in the peripheral blood of patients from complication group,CD3^+ and CD8^+ T cells showed the same trend,but the number of CD4^+ T cells was below normal level at all detection times.Furthermore,CD3^+,CD4^+ and CD8^+ T cells in the peripheral blood of patients from complication group were initially less than those in experimental group,and afterwards were comparable between two groups.In patients from both experimental group and complication group,the number of CD4^+CD25^+CDl27^(low/-)Treg cells increased 1 month and 6 months after surgery,and gradually restored to normal level.CD4^+CD25^+CDl27^(low/-)Treg cell counts in patients from complication group were initially more than those in patients from experimental group 1 month and 6 months after surgery,but then they were comparable.Furthermore,contents of immunoglobulins(IgA,IgG and IgM) were comparable in three groups at all detection times.Conclusion:Partial splenic embolization influenced the immune function of cirrhotic patients with hypersplenism in the short term but the immune function could afterwards gradually restore to normal.Our results implicated that measures that prevent infection and improve immune function were necessary in early stage after undergoing PSE in order to reduce complications.

Effect of calcium citrate on bone integration in a rabbit femur defect model

Objective:To explore effect of calcium citrate on bone integration in a rabbit femur defect model, and to compare the bone formation with different sizes by radiological and histological study. Methods:Twenty-four male Japanese white rabbits were randomly divided into three groups (Group A.B.C)in this study.Under anesthesia,defects of four sizes(1.2,1.5,2.0 and 2.5 mm) were created in each of the rabbits.Commercially pure calcium citrate powder was placed inside the medullary compartment of the femur(Experimental),while in the contralateral femur(Control) nothing was implanted.The defects were analyzed using radiography and histological analysis by using Imagepro-Plus 6.0 software after animal was sacrificed at 4th(Group A),6th(Group B) and 8th(Group C) weeks postoperatively.Four samples were analyzed for each size of defect and each healing period.Results:The histological and the radiologic evaluation were performed after sacrification of all rabbits on postoperative 4th and 6th weeks,It showed significant difference between the experimental group and the control group when these defects were less than or equal to 2.0 mm.No statistical difference was observed when these defects were larger than 2.0 mm at all healing periods except at the 4th week.Conclusions:Calcium citrate affects the early periods of hone defects healing mechanism in Japanese white rabbits positively,especially when the defect is not too large,We suggest further studies on calcium citrate to determine the effects of various dosages,administration ways and the experimental time on the bone defects.

An overview of the construction of emergency and pre-hospital first aid platform

To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a 'one horizontal and one Longitudinal' treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.

The clinical relevance of MBL2 gene polymorphism and sepsis

Objective:To detect the clinical relevance of mannose-binding lectin 2(MBL2) gene polymorphism and sepsis in Chinese lived in Hainan island.Methods: Blood samples from 57 patients with sepsis and 69 patients without sepsis were collected in the ICU of several large hospitals in Hainan province. Genomic DNA was extracted from whole blood and then PCR purification product was sequenced and typed by 3730 sequencing analyzer. The concentration of MBIL2 in serum was detected by ELISA.Results: We found that genotype and allele distributions in two groups were in accordance with the Hardy-Weinberg Equilibrium. The frequency of GA genotype was significantly higher than that in non-sepsis group(P=0.013). A allele frequency in sepsis group was also much higher than that in non-sepsis group(P=0.028).Logister regression analysis showed that the patients who carried A allele were more prone to get sepsis than G allele carrier(P=0.014, OR=2,550, 95%CI=1.207-5.386). The MBL2 level in serum of sepsis patients with genotype GG and GA was significantly lower than that in non-sepsis group(P<0.05). In sepsis group, the MBL2 serum level of patients with genotype GA was obviously lower than that in patients with genotype GG(P<0.05).Conclusions: The variation of rs 1800450 G→A increased the incidence of sepsis and decreased the level of MBL2 in serum.

Association of MBL2 gene polymorphisms with sepsis in children and adult

Sepsis is a syndrome characterized by systemic inflammatory response caused by infection or toxin, with high morbidity and mortality. Different infection microflora and environment have great influence on the occurrence, development and prognosis of sepsis, but individual genetic factors also play an extremely important role. It was reported that the polymorphisms of mannose-binding lectin 2 gene were closely relevant to the occurrence and development of sepsis, but the conclusions in different studies were inconsistent. Therefore, we performed this reviews on the relevance of mannose-binding lectin 2 gene polymorphisms and sepsis.

Comparison of risk factors associated with sepsis between road traffic injuries and non-road traffic injuries in ICU patients with severe trauma

Objective:To estimate the incidence and related risk factors of sepsis between road traffic injuries (RTIs) and non-RTIs.Methods:Clinical data of 339 patients with severe trauma who were admitted into ICU in both Third Affiliated Hospital of Army Military Medical University and ChongGang General Hospital from January 2012 to December 2015 were retrospectively analyzed.Twenty items of potential risk factors affecting sepsis were evaluated by univariate and multivariate Logistic Analysis with the purpose of drawing a comparison between RTI patients and non-RTI patients.Results:There were 154 cases of RTI and 185 cases of nonRTI entering the study period.The significant independent risk factor of sepsis in RTIs was SOFA 11 (0R=4.821;95% CI=1.901-12.226;P=0.001).The significant independent risk factors of sepsis in non-RTIs were SOFA 11 (OR=12.410;95% CI=2.559-60.185;P=0.002),trachcal intubation (OR=8.913;95% CI=2.322-34.206;P=-0.001),APACHE Ⅱ 15 (0R=3.684;95% CI=1.750-7.753;P=0.001).Conclusions:The clinical medical personnel should not give equal treatment to RTI patients and non-RTI patients admitted in ICU in that factors predicting sepsis within above two groups are different.The sample volume should be increased and validated in further prospective research.

Consensus statement on layout and delivery of automatic external defibrillator in China

1.Introduction Sudden cardiac death(SCD)refers to sudden death due to a variety of cardiac causes.It is manifested as a sudden loss of consciousness,cardiac arrest,and respiratory arrest and generally shows early symptoms that are atypical and not easily detected[1].According to a recent study,nearly 544000 patients suffer from SCD every year in China[2].

A case report of Vibrio vulnificus infection in the lower limbs by sea fish stabbing and literature review

Objective: To summarize and analyze the clinical treatment experience of Vibrio vulnificus sepsis and improve the success rate of treatment. Methods: The clinical data of a patient with vibrio vulnificus sepsis admitted to the Department of Critical Care Medicine, the First Affiliated Hospital of Hainan Medical College in October 2019 were analyzed. Summarize the experience of treatment and compare with other literatures to analyze the most reasonable clinical treatment of vibrio vulnificus sepsis. Results: The patient was acutely ill, the disease progressed rapidly, fever, soft tissue swelling and pain, necrosis, ulceration and pus, systemic multiple organ failure, family members finally gave up treatment, microbiology culture prompted: Vibrio parahaemolyticus. Conclusions: Early intervention, blood purification, debridement, removal of infection sources and inflammatory mediators can improve the survival rate of patients with Vibrio vulnificus infection. Due to the high mortality rate, clinicians should pay attention to it.

Bioinformatics analysis of interaction between MBL2 and MASPs family proteins

Objective:To predict and analyze the interaction between mannose-binding lectin 2(MBL2)protein and mannan-binding lectin-related serine proteases(MASPs)family proteins by bioinformatics.Methods:Homology modeling(Swiss-model)and fold recognition(Phyre 2)were used to construct the structure of MBL2 protein and MASPs family proteins,respectively.STRING database and ZDOCK 3.02 were used to predict and analyze the interaction between MBL2 and MASP1 and MASP2 proteins.Results:MBL2 had direct interaction with MASP1 and MASP2,and formed an interaction network with COLEEC11,COLEC10,FCN2,and C4B.The binding sites of MBL2 and MASP1 and MASP2 overlapped highly.MBL2 participated in the binding of MASP1 residues,and most of them(77%)were also involved in the binding of MASP2,suggesting that MBL2 interacted with the proteins of MASPs family through the same region.Conclusion:MBL2 and MASPs family proteins play an important role in the activation of the complement system and immune defense of the body.

Non-Hodgkin's lymphoma involving chronic difficult-to-heal wounds:A case report

BACKGROUND Non-Hodgkin's lymphoma(NHL)is a malignant tumor that originates from the lymphoid tissues and can potentially affect numerous organs within the body.Among these,the skin stands out as one of the primary sites affected by NHL,often presenting with multiple extra-nodal manifestations.In this report,we present an unusual case of NHL involving chronic wounds in the lower extremities that were difficult to heal.The scars were successfully treated using radiotherapy in combination with extended excision debridement and peroneal artery perforator flap grafting,resulting in satisfactory outcomes.CASE SUMMARY A 19-year-old male patient presented with ulceration of the skin on the left calf near the ankle accompanied by purulent discharge.Subsequent pathologic biopsy confirmed a diagnosis of NHL(extranodal NK/T-cell lymphoma,nasal type).Initial treatment comprised local radiotherapy and wound care;however,the wound exhibited prolonged non-healing.Consequently,the patient underwent a series of interventions including radiotherapy,wound enlargement excision debridement,and peroneal artery perforator flap grafting.Ultimately,successful healing was achieved with favorable postoperative outcomes characterized by good texture of the flap without any signs of rupture or infection.CONCLUSION The combination of radiotherapy,wound enlargement excision debridement,and peroneal artery perforator flap grafting may present a favorable treatment modality for chronic non-healing lower leg wounds resulting from NHL.

Anthropomorphic hand based on twisted-string-driven da Vinci’s mechanism for approaching human dexterity and power of grasp

Designing anthropomorphic prosthetic hands that approach human-level performance remains a great challenge.Commercial prosthetics are still inferior to human hands in several important properties, such as weight, size, fingertip force,grasp velocity, and active and passive dexterities. We present a novel design based on the under-actuated da Vinci’s mechanism driven by a flexible twisted string actuator(TSA). The distributed drive scheme allows structural optimization using a motion capture database to reproduce the natural movement of human hands while keeping adaptability to free-form objects. The application of TSA realizes a high conversion from motor torque to tendon contraction force while keeping the structure light,flexible, and compact. Our anthropomorphic prosthetic hand, consisting of six active and 15 passive degrees of freedom, has a weight of 280 g, approximately 70% of that of a human hand. It passed 30 of the 33 Feix grasp tests on objects in daily living and retained a loading capacity of 5 kg. This simple but intelligent mechanism leads to excellent stability and adaptability and renders feasible wide applications in prosthetics and in service robots.