[Efficacy of Barbed reposition pharyngoplasty combined with Han-Uvulopalatopharyngoplasty for the treatment of OSAHS patients]

Objective: To study the efficacy of Barbed reposition pharyngoplasty (BRP) combined with Han-Uvulopalatopharyngoplasty (H-UPPP) in surgical treatment of OSAHS patients. Methods: OSAHS patients admitted to our department from June 2021 to February 2022 who met the surgical enrollment criteria were divided into two groups by surgical procedure: H-UPPP operation group [Control group, 47 cases, including 42 males and 5 females, aged 18-64 (37.77±11.65)years, and H-UPPP+BRP group [Study group, 48 cases, including 45 males and 3 females, aged 23-60 (39.10±9.86) years]. The surgical efficacy 6 months after operation was retrospectively analyzed. Meanwhile, the relationship between the surgical efficacy and modified Friedman pharyngeal anatomical stages was analyzed. The postoperative pain VAS score at first 3 days and the incidence of foreign body sensation in pharynx after 6 months of operation were compared between the two groups. Statistical analysis was conducted by SPSS 23.0. Results: There were no significant differences in gender, age, BMI, Friedman pharyngeal anatomical stages, ESS score, AHI and LSpO2 between the two groups, preoperatively (P>0.05). There was significant difference between the two groups in ratio of cumulative time of oxygen saturation below 90% to total sleep time(CT90), preoperatively. Surgical efficacy of H-UPPP operation group was 48.9% (23/47), while H-UPPP+BRP operation group was 70.8% (34/48), which was statistically significant (χ2=4.74, P=0.029). H-UPPP+BRP group seemed to have a higher surgical efficacy than H-UPPP group in patients with Friedman Ⅱb (87% vs. 61.9%) and Ⅲ stage (44.4% vs. 15%), but there was no statistically significant difference (P>0.05). H-UPPP+BRP group had a higher pain VAS score in first three days (t=-3.10, P=0.003), also had higher incidence of pharyngeal foreign body sensation after 6 months of operation (χ2=4.727, P=0.030). Conclusions: In the surgical treatment of OSAHS patients, the overall efficacy of BRP combined H-UPPP surgery is higher than that of H-UPPP surgery alone. It may be more suitable for OSAHS patients with modified Friedman type Ⅱb and type Ⅲ stage.

[Prevalence of Echinococcus infection in small mammals captured from Shiqu County, Sichuan Province from 2015 to 2020]

OBJECTIVE

To investigate the prevalence of Echinococcus infection in small mammals in Shiqu County, Sichuan Province from 2015 to 2020, so as to provide insights into echinococcosis control in Shiqu County.

METHODS

One setting with frequent activity of small mammals was sampled as the survey site from each of 9 townships where human alveolar echinococcosis was hyperendemic, in Shiqu County, Sichuan Province from 2015 to 2020. Two quadrats measuring 50 m × 50 m were assigned in each survey site during the period between July and August from 2015 to 2020 to capture all small mammals in quadrats, and the species of small mammals were identified by morphological characteristics. All captured small mammals were dissected in the field and Echinococcus infection was identified by visual examinations. The affected organs of Echinococcus - infected small mammals were collected, and Echinococcus infection was detected using PCR assay, with Echinococcus species characterized. The prevalence of Echinococcus infection was calculated in small mammals, and the trends in the prevalence of Echinococcus infection were analyzed during the period from 2015 to 2020. In addition, the prevalence of Echinococcus infection was compared in small mammals using visual examinations and PCR assay.

RESULTS

A total of 2 692 small mammals were captured in the survey sites of Shiqu County from 2015 to 2020, and morphology characterized 1 360 Microtus fuscus (50.52%) and 1 332 Plateau pika (49.48%). The prevalence rates of Echinococcus infection were 35.63%, 19.16%, 21.41%, 8.40%, 7.68% and 4.44% by visual examinations and 18.96%, 5.36%, 5.61%, 4.58%, 3.30% and 0.37% by PCR assay in small mammals in Shiqu County from 2015 to 2020, both showing a tendency towards a decline year by year (χ² = 215.024 and 117.045, both P values < 0.001). The prevalence of Echinococcus infection was significantly higher in small mammals by visual examinations than by PCR assay during the period from 2015 to 2020 except in 2018 (χ²= 33.597, 21.815, 51.373, 17.268 and 9.537, all P values < 0.01). PCR assay detected a reduction in the prevalence of E. multilocularis infection from 10.21% to 0.37% and a reduction in the prevalence of E. shiquicus infection from 8.75% to 0 in small mammals in Shiqu County from 2015 to 2020, both appearing a tendency towards a decline year by year (χ² = 117.045 and 43.436, both P values < 0.001). In addition, the prevalence of E. multilocularis and E. shiquicus infections reduced from 15.19% to 0.45% and from 8.23% to 0 in M. fuscus, and the prevalence of E. multilocularis and E. shiquicus infections reduced from 7.76% to 0 and from 9.01% to 0 in P. pika in Shiqu County from 2015 to 2020.

CONCLUSIONS

M. fuscus and P. pika were dominant species of small mammals in Shiqu County, Sichuan Province from 2015 to 2020, and E. multilocularis infection was mainly found in M. fuscus and E. shiquicus infection mainly found in P. pika. The prevalence of Echinococcus infection appeared a tendency towards a decline in both M. fuscus and P. pika year by year during the period from 2015 to 2020.

[Mechanism of hepatic fibrosis associated with Echinococcus: a review]

Echinococcosis is a zoonotic parasitic disease caused by Echinococcus infections, and this disorder may cause fibrosis of multiple vital organs, which may further progress into cirrhosis. Early-stage hepatic fibrosis is reversible, and unraveling the mechanisms underlying hepatic fibrosis induced by Echinococcus infections is of great significance for the prevention and treatment of early-stage hepatic fibrosis. Recently, the studies pertaining to hepatic fibrosis associated with Echinococcus infections focus on cytokines and immune cells. This review summarizes the advances in the mechanisms underlying host immune cells- and cytokines-mediated hepatic fibrosis in humans or mice following Echinococcus infections.

Advances in the study of molecular identification technology of Echinococcus species

The larvae of Echinococcus (hydatidcyst) can parasitize humans and animals, causing a serious zoonotic disease-echinococcosis. The life history of Echinococcus is complicated, and as the disease progresses slowly after infection, early diagnosis is difficult to establish. Due to the limitations of imaging and immunological diagnosis in this respect, domestic and foreign scholars have established a variety of molecular detection techniques for the pathogen Echinococcus over recent years, mainly including nested polymerase chain reaction (PCR), multiplex PCR, real-time quantitative PCR, and nucleic acid isothermal amplification technology. In this article, the research progress of molecular detection technology for Echinococcus infection currently was reviewed and the significance of these methods in the detection and diagnosis of hydatid and hydatid diseases was also discussed.

[Clinical effects of transplantation of turbocharged bipedicle deep inferior epigastric perforator flap in breast reconstruction]

Objective: To explore the clinical effects of transplantation of turbocharged bipedicle deep inferior epigastric perforator (DIEP) flap in breast reconstruction. Methods: A retrospective observational study was used. From December 2008 to December 2016, 24 patients who met the inclusion criteria were treated in the Department of Plastic Surgery of Hunan Cancer Hospital, all patients were female, aged 28-51 (36.5±1.6) years. All cases received turbocharged bipedicle DIEP flap for two-staged breast reconstruction. According to the patterns of turbocharged vessels anastomosis, the turbocharged bipedicle DIEP flaps with length of (27.5±0.3) cm and width of (12.8±1.4) cm, were divided into three types: distal end of pedicle anastomosis type, main branch of pedicle anastomosis type, and muscular branch of pedicle anastomosis type. After complete hemostasis in the donor region, the anterior sheath was repaired with intermittent suture, and umbilical reconstruction was completed. Two negative pressure drainage tubes were indwelled, and subcutaneous tissue and skin were sutured layer by layer. The specific ways of vascular anastomosis of the flap pedicle with the internal thoracic vessels of recipient site included anastomosing the proximal end of one artery and one vein, anastomosing the proximal and distal end of one artery and one vein, and anastomosing the proximal end of one artery and two veins. Postoperatively, the survival and blood supply of flaps were observed. The patients were followed up to observe the reconstructed breast shape satisfaction, donor site complications, abdominal wall function, and scar hyperplasia. Results: All turbocharged bipedicle DIEP flaps for two-staged breast reconstruction survived well, with good blood supply. During follow-up for 14 to 56 (20±6) months, the shape of reconstructed breasts was satisfied. Only linear scar was left in the donor sites of abdomen with no complications, and the function of abdominal wall was not affected. Conclusions: For patients with clear indications, transplantation of free turbocharged bipedicle DIEP flap is a safe, reliable, and satisfactory choice for breast reconstruction with autologous tissue.

[A 5-year follow-up study of pneumoconiosis patients with positive autoantibody]

Objective: To explore the progress of small shadow and the change of lung function in pneumoconiosis with positive autoantibody, so as to provide basis for clinical treatment of pneumoconiosis. Methods: A total of 756 patients were admitted to the pneumoconiosis department of the Guangzhou Occupational Disease Prevention Hospital from January 1, 2013 to June 1, 2019. The patients with combined infection were excluded. According to whether the autoantibody was positive, they were divided into positive group and negative group, 25 cases in each group. Follow-up observation of X-ray chest radiographs, chest CT, forced expiratory volume in one second (FEV(1)) and forced expired flow at 50% of FVC (MEF(50)) of pneumoconiosis patients for 5 years, to analyze the influence of positive autoantibody on the morphology of X-ray chest film, the pneumoconiosis promotion in 5 years and lung function. Results: There were 22 males and 3 females in the autoantibody positive group, aged 53.14±10.51 years. In the autoantibody negative group, there were 23 males and 2 females, aged 53.88±8.10 years. During the 5-year observation period, there was no significant difference of small shadow shape, pneumoconiosis stage, and the pneumoconiosis promotion in 5 years between the autoantibody positive group and the autoantibody negative group (P>0.05). However, the increment of small shadow area in the autoantibody positive group was higher than that in the autoantibody negative group (P<0.05). FEV(1) and MEF(50) of the autoantibody positive group were significantly lower than those of the autoantibody negative group in the fourth and third years, respectively (P<0.05). Positive autoantibody was negatively correlated with FEV(1) and MEF(50) (P<0.05). Conclusion: The positive autoantibody can't promote the progress of X-ray, but show more small shadows on chest CT; the positive autoantibody may aggravate the decline of lung function.

[Endemic situation of schistosomiasis in national surveillance sites of Hunan Province from 2015 to 2019]

OBJECTIVE

To analyze the changes in the endemic situation of schistosomiasis in national surveillance sites of Hunan Province, so as to provide scientific basis for the development of the schistosomiasis elimination programme in the province.

METHODS

According to the requirements of the National Guidelines for Schistosomiasis Surveillance in China (2014 version), a total of 41 national schistosomiasis surveillance sites were assigned in all disease-endemic counties (districts) across Hunan Province. During the period between 2015 and 2019, Schistosoma japonicum infections were monitored in local residents, mobile populations and livestock, and snail status was monitored. The morbidity due to schistosomiasis and snail status was compared between years.

RESULTS

The sero-prevalence of S. japonicum infections was 2.57% and 1.56% in local residents and mobile populations in national surveillance sites of Hunan Province from 2015 to 2019, respectively, and the sero-prevalence appeared a tendency towards a decline over years. A higher sero-prevalence rate of S. japonicum infections was seen in men than in women (P < 0.01). During the 5-year study period, the sero-prevalence rate of human S. japonicum infections appeared a tendency towards a decline in the marshland, embankment, inner embankment and hilly types of endemic areas over years. There were 44 and 19 egg -positives detected in local residents and 5 and 1 egg-positives in mobile populations in 2015 and 2016 respectively. A total of 9 346 domestic animals were monitored from 2015 to 2019, and 6 egg-positives were detected in 2015 and 2016 (all were bovine). A total of 0.155 billion m² settings were surveyed from 2015 to 2019, and the mean density of living snails appeared a tendency towards a decline over years, with a 45.79% reduction in 2019 as compared to 2015. However, no S. japonicum infections were identified in snails during the 5-year period. A total of 1 469 mixed snail samples were detected using loop-mediated isothermal amplification (LAMP), and 6 positive snail samples were identified in 2015 (one sample) and 2017 (5 samples).

CONCLUSIONS

The overall endemic situation of schistosomiasis appears a tendency towards a decline in Hunan Province, and the prevalence of S. japonicum infections is at a low level in humans and livestock; however, there is still a risk of schistosomiasis transmission. Improvements of health education, intensification of schistosomiasis examinations in mobile populations and reinforcement of the surveillance-response system is required to consolidate the achievements of schistosomiasis control in Hunan Province.

[Survey of the capacity building of the county-level schistosomiasis diagnosis network laboratory in Hunan Province]

OBJECTIVE

To examine the construction and operation of the schistosomiasis diagnostic network platform in Hunan Province, so as to provide insights into the improvements of the schistosomiasis diagnostic network laboratory system in the province.

METHODS

According to the criteria and requirements for the construction of the county-level schistosomiasis diagnostic network laboratory in China, the establishment and operation of the laboratory were assessed using self-assessment and field review in national schistosomiasis surveillance sites of Hunan Province.

RESULTS

A total of 41 county-level schistosomiasis diagnostic network laboratories were built in national schistosomiasis surveillance sites of Hunan Province, and 36 met the requirements for the construction of the national schistosomiasis diagnostic network laboratory in China, which were approved for inclusion in the province-level schistosomiasis diagnostic network laboratory. During the six inter-laboratory comparisons performed by the national schistosomiasis diagnostic reference center of China, full consistency was achieved by 3 county-level schistosomiasis diagnostic network laboratories in Hunan Province, and the coincidence rates for re-review of serological and pathogenic detection samples were 98.40% and 100%, respectively.

CONCLUSIONS

The county-level schistosomiasis diagnostic network laboratory system has been preliminarily built and under effective operation in Hunan Province; however, the building capability remains to be improved.

[Advances in the research of antibacterial composite dressings based on bacterial cellulose]

Bacterial cellulose (BC) is a promising material for wound dressing due to its predominant water binding capacity, mechanical property, biodegradability, and histocompatibility. Whereas BC itself exhibits no antimicrobial activity. To gain antimicrobial activity, several kinds of antibacterial agents have been introduced into BC. However, all of the antibacterial composite dressings are still in the stage of experimental research. In this paper, the types, antibacterial mechanism, and shortcomings of antibacterial composite dressings based on BC are summarized, in order to make prospects of the research trends of antibacterial composite dressings based on BC in future.

Increased solubility of glutathione S-transferase-P16 (GST-p16) fusion protein by co-expression of chaperones groes and groel in Escherichia coli

Human cdk (cyclin dependent kinase) inhibitor p16 was fused with glutathione S-transferase (GST) and the GST-p16 fusion protein is under the control of T7 promoter. When expressed in E. coli BL21(DE3), most products existed in the form of insoluble inclusion bodies. When co-expressed with molecular chaperones E. coli GroESL, most GST-p16 products accumulated in the soluble form with a 5-6 fold increase in solubility. When coproduced with human protein disulfide isomerase (PDI), there was no improvement in the solubility of GST-p16 fusion protein.

High density lipoproteins increase cytoplasmic free calcium in bovine aortic endothelial cells

This study examined the influence of human high density lipoproteins (HDL) on the intracellular free calcium of cultured bovine aortic endothelial cells (BAECs). Intracellular Ca2+ concentration ([Ca2+]i) was determined by a fluorescent calcium indicator, Fura-2. It was found that, in the presence of 1 mmol/L extracellular calcium, HDL resulted in a biphasic elevation of [Ca2+]i in BAECs, consisting of an initial, transient component followed by a lower, but more sustained component. Doses of HDL from 25 to 200 micrograms protein/ml induced marked concentration-dependent elevations of [Ca2+]i in BAECs. The sustained component was abolished by deprivation of extracellular calcium or by pretreatment of endothelial cells with a calcium influx blocker, NiCl2, HDL-induced elevation of [Ca2+]i was attenuated in a concentration-dependent way by an inhibitor of calcium release, tetracaine. Repeated applications of HDL (100 micrograms protein/ml) markedly blunted the initial peak component of the calcium transient of BAECs. These results demonstrate that both intracellular and extracellular calcium pools are responsible for the biphasic elevation of [Ca2+]i induced by HDL in cultured BAECs.

[Effect of beneficial mixture for body immune function on serum acute phase reaction protein levels in acute traumatic patients]

The levels of acute phase reaction protein (ARP)--haptoglobin (HP), plasma albumin (Palb), transferrin (TF) and alpha-acid glycoprotein (alpha-AG), and the effect of Beneficial Mixture for Body Immune Function (BMBIF), were studied in 20 cases with acute injury. The results were shown that the metabolism of the protein of traumatic body was in disorder: the levels of HP and alpha-AG significantly increased, while the levels of Palb and TF obviously decreased. After the treatment of BMBIF, the ARP recovered to a certain extent. This proved that BMBIF could adjust the disorder of ARP metabolism.

Clinical significance of the changes in serum fibronectin in severely burned patients

The Agar gel single diffusion technique was used to investigate the changes in serum fibronectin (FN) in severely burned patients, and coupled with the study of simultaneous changes in the internal organ function, the development of MOF and severe systemic infection. The results suggested that the deficiency or decrease in serum FN made the host more prone to severe systemic infection, even to MOF.

Clinical significance of the alterations of plasma prostaglandin E2 (PGE2) in severely burned patients

Agar gel single diffusion and radio immunological analyses were employed to determine the levels of serum C3c, C4, IgA, IgM, IgG and plasma PGE2 in 24 severely burned patients. The results were compared with the development of postburn immunosuppression, severe infection and MOF. There were marked decreases in serum C3c, C4 and Ig, which were especially marked in patients with MOF. Furthermore, plasma PGE2 decreased markedly in patients with MOF and/or severe systemic infection. The results suggest that the decrease of deficiency in plasma PGE2 was closely related to the immunosuppression and the development of severe systemic infection and/or MOF, which supported the hypothesis that PGE2 might play a role in immunoprotection, but not immunosuppression, in burned patients.

A preliminary exploration of the relationship between tumour necrosis factor (TNF) and monocytic in vitro production of interleukin-1 (IL-1) and internal organ dysfunction in severely burned patients

Biological assays were adopted in this study to examine the changes in serum tumour necrosis factor (TNF) activity and blood monocytic in vitro production of interleukin 1 (IL-1) in 24 severely burned patients. The myocardial and hepatic enzymes (which included aspartate aminotransferase (AST), creatine kinase (CPK), lactate dehydrogenase (LDH), alpha hydroxybutyric dehydrogenase (alpha-HBDH) and alanine amino-transferase (ALT) and some indices of biochemical metabolism (including lactic acid (LA), total protein (TP), albumin (Alb) and colloid osmotic pressure (COP)) were simultaneously measured. The results showed an evident increase in serum TNF activity and a decrease in in vitro production of IL-1 postburn; all the changes in TNF and IL-1 were correlated significantly with those of myocardial and hepatic enzymes in MOF patients. Furthermore, there were marked fever, hypoproteinaemia, tissue ischaemic and hypoxic symptoms such as hyperlacticaemia, and signs reflecting tissue hypercatabolic states. These all suggested that TNF and IL-1 might play important roles in the development of MOF.

Clinical significance of the change of blood monocytic interleukin-1 production in vitro in severely burned patients

Biological methods were employed to measure the dynamic changes in the in vitro IL-1 production by blood monocytes in 24 severely burned patients. The serum myocardial and hepatic enzymes (C-reactive protein) (CRP), plasma lactic acid (LA), etc. were simultaneously measured. The results showed an obvious decrease in blood monocyte IL-1 production in vitro and increases in CRP, LA and serum enzymes. These changes were more evident in patients complicated with organ injury, multiorgan failure and systemic infection. It is suggested that blood monocytes are superstimulated postburn in vivo and produced large amounts of IL-1 leading to exhaustion of monocyte function. These changes might promote the development of severe systemic infection and internal organ injury even multiple organ failure.

The significance of changes in serum tumour necrosis factor (TNF) activity in severely burned patients

In order to explore the pathogenesis of postburn internal organ injury (OI) and multiple organ failure (MOF), serum TNF activity was measured by biological assay in 24 severely burned patients. Parameters related to internal organ functions were simultaneously measured. The results showed an obvious increase in serum TNF activity accompanied by increased serum myocardial and hepatic enzymes, plasma lactate and aggregations of WBC in internal organ tissues. Serum protein levels decreased substantially. These changes were more marked in patients suffering from both OI and MOF. It is suggested that large amounts of TNF are produced postburn and might have an important role in the development of OI and MOF.

[The use of Chinese traditional medicines to improve impaired immune functions in scald mice]

For the purpose of searching for immunomodulators, this experiment studied the effects of 6 kinds of Chinese traditional herbs on the restoration of the suppressed immune functions in scald mice, including cell-mediated, humoral and non-specific immunity. All control non-treated scald mice showed definite depression of immune functions in various degrees. Polygonum cuspidatum, Taraxacum officinale and Oidenlandia diffusa (wild) roxb showed immunomodulating effects as measured with 3 immunological parameters. But the effects varied according to the dosage of drugs. Rehmannia glutinosa gave definite improving effects on cell-mediated and non-specific immunity, but no significant effect on humoral immunity, while Gui Ling Gao only showed some effect on humoral immunity.

Further explorations of abnormalities in serum proteins following burns

This report extends our earlier studies of the abnormal protein bands found in burn sera by use of Western blotting and ion exchange chromatography. The current studies indicated that some of the protein bands contained materials with immunosuppressive activity. One of these materials cross reacted with anti human haptoglobin antibody. Many of the other proteins in the bands were found to be acute phase reactant proteins without immunosuppressive activity. Some proteins in these bands have not yet been characterized or tested for immunosuppressive activity.

[The combined modulating effects of cerium nitrate with certain Chinese traditional drugs on altered cell-mediated immunities in scald mice]

Altered cell-mediated immunities (CMI) is one of the important causes of increased susceptibility to infection and, high mortality of burned patients. This paper presents the experimental work on mice with scald injury to restore their altered CMI by local application of cerium nitrate (CE) or systemic administration of Astragalus membranaceus (AM) or Lonicera japonica Thunb (LJT), as well as combination use of these drugs. The proliferative response to Con A and the ability of IL-2 production of murine spleen cells and the delayed hypersensitivity test using DNFB as sensitizer were chosen as the parameters of CMI. Results showed that CMI of untreated scald mice was suppressed to 50-60% of normal control 11 days following scald injury. While either CE used locally or AM or LJT given by oral with different dosages might bring up the depressed CMI to various degrees, near the normal level and some even above normal. When CE was used accompanied with AM or LJT, their effects on restoration of CMI were significantly better than that when any single drug was administered alone.