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Bian RH, Huang SX, Zhu JY, Wu J, Fan KW, Hu ZC, Xu YB, Yu QH, Zhang T, Li XY, Chen SZ. [Establishment of a topographic map assessment system for facial and cervical wounds and scars of burn patients based on the Delphi method]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:1115-1121. [PMID: 38129297 DOI: 10.3760/cma.j.cn501225-20230905-00075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To construct a targeted and accurate evaluation system for facial and cervical wounds and scars of burn patients. Methods: The method combining literature analysis and survey research was adopted, and the basic principles of item system construction were followed. From June to August 2020, based on the aesthetic standards of facial and cervical plastic surgery, the topographic map assessment system for facial and cervical wounds and scars of burn patients was preliminarily formed, focusing on the assessment of wounds and scars in the necks and faces of patients after burns. In September 2020, 38 experts in the relevant fields were consulted in advance and the questionnaire was revised according to the experts' opinions. From December 2020 to March 2021, the Delphi method was applied to conduct inquiry by correspondence with 35 experts in relevant fields from Guangzhou, Shenzhen, Shanghai, Beijing, and other cities, who met the inclusion criteria, and the items were screened and established. The effective recovery rate of inquiry questionnaire was calculated to determine the level of enthusiasm of experts, the average authority coefficient of all items was calculated to determine the level of expert authority, the average importance expert score, the average coefficient of variation, and the average full score rate of all the third-level items were calculated to determine the concentration of expert opinions, the average coefficients of variation and Kendall's harmony coefficients of the importance, sensitivity, and operability expert scores of all the third-level items were calculated to determine the degree of coordination of expert opinions. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically analyzed with chi-square test. Results: Among the 35 experts consulted by Delphi method, mainly were male, aged (48±10) years, with 8-38 years of working experience, mainly with associate senior titles and above, all with a bachelor's degree or above education background, and of whom 11 were burn experts, 7 were wound repair experts, 4 were plastic surgery experts, and 13 were rehabilitation medicine experts. Finally, a topographic map assessment system for facial and cervical wounds and scars of burn patients was formed, including 4 first-level items, 21 second-level items, 40 third-level items, and 1 mask. The effective recovery rate of inquiry questionnaire was 100% (35/35). The average authority coefficient of all items was 0.89. The average importance expert score was 4.67, the average coefficient of variation of importance expert score was 0.01, and the average full score rate of all the third-level items was 86.3%. The average coefficients of variation of the importance, sensitivity, and operability expert scores of all the third-level items were 0.01, 0.01, and 0.02, respectively. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically significant (with χ2 values of 1 201.53, 745.67, and 707.07, respectively, P<0.05). Conclusions: The established topographic map assessment system for facial and cervical wounds and scars of burn patients has high scientificity and reliability, which can be used for the evaluation of facial and neck wounds or scars in burn patients.
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Affiliation(s)
- R H Bian
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - S X Huang
- Department of Burns and Wound Repair Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - J Y Zhu
- Department of Burns and Wound Repair Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - J Wu
- Department of Burns and Plastic Surgery, the First Affiliated Hospital, Shenzhen University, Shenzhen 518035, China
| | - K W Fan
- Department of Burns and Plastic Surgery, the First Affiliated Hospital, Shenzhen University, Shenzhen 518035, China
| | - Z C Hu
- Department of Burns and Wound Repair Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Y B Xu
- Department of Burns and Wound Repair Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Q H Yu
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - T Zhang
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - X Y Li
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - S Z Chen
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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Huang SB, Hu ZC, Zhang Y, Tang B, Wang P, Xu HL, Wang ZY, Dong YX, Cheng P, Rong YC, Wu J, Zhu JY. [Effects and mechanisms of allogeneic epidermal stem cells on the survival of allogeneic full-thickness skin grafts in nude mice with full-thickness skin defect wounds]. Zhonghua Shao Shang Za Zhi 2021; 37:1061-1069. [PMID: 34794258 DOI: 10.3760/cma.j.cn501120-20200704-00339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects and mechanisms of allogeneic epidermal stem cells (ESCs) on the survival of allogeneic full-thickness skin grafts in nude mice with full-thickness skin defect wounds. Methods: Experimental research methods were applied. Primary ESCs that appeared paving stone-like after being cultured for 7 d were obtained by enzymatic digestion method from one 4-week-old male BALB/c-NU nude mouse (the same strain, age, and sex below). The cells of third passage were identified by flow cytometry to positively express ESC marker CD44 and negatively express CD45, meanwhile, the positive expression of ESC markers of p63 and integrin 6α, and negative expression of CD71 were identified by immunofluorescence method. The ESCs of third passage in the logarithmic growth phase were used for the following experiments. Twenty-six nude mice were equally divided into phosphate buffered saline (PBS) group and ESCs group according to the random number table. A full-thickness skin defect wound was made on the back of each nude mouse, and then the wounds of the two groups were sprayed with equal volumes of PBS and ESCs, respectively. The wounds were transplanted with full-thickness skin grafts cut from the backs of 4 other nude mice. Each ten nude mice from the two groups were selected, the wound healing and skin survival on post surgery day (PSD) 0 (immediately), 3, 7, 14, and 21 were observed, and the survival ratio and shrinkage rate of skin grafts on PSD 3, 7, 14, and 21 were calculated (the number of sample was the number of surviving skin grafts at each time point); the blood perfusion in the skin grafts on PSD 3, 7, and 14 was detected by the laser speckle blood flow imager, and the blood flow ratio of nude mice skin grafts in ESCs group to PBS group at each time point was calculated (the number of sample was the pair number of surviving skin grafts in group pairing at each time point). The skin graft tissue of each 3 nude mice remained in the two groups were collected on PSD 7, and the mRNA expressions and protein expressions of tumor necrosis factor α (TNF-α), interleukin 8 (IL-8), IL-10, type Ⅰ collagen, type Ⅲ collagen, and matrix metalloproteinase 9 (MMP-9) in the tissue were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction and Western blotting, respectively. Data were statistically analyzed with Log-rank test, analysis of variance for repeated measurement, one-way analysis of variance, independent sample t test, and Bonferroni correction. Results: Taking the condition on PSD 0 as a reference, the wounds of nude mice in the two groups healed gradually on PSD 3, 7, 14, and 21, and the shrinkage of skin grafts was gradually obvious. Among them, the shrinkage healing of wound of nude mice in PBS group was more significant than that in ESCs group. On PSD 3, the skin graft of 1 nude mouse failed in ESCs group, while the skin graft of 3 nude mice failed in PBS group. On PSD 7, the skin graft of another nude mouse failed in PBS group. The survival ratio of skin grafts of nude mice in the two groups was similar on PSD 3, 7, 14, and 21 (P>0.05). On PSD 3, 7, 14, and 21, the shrinkage rates of skin grafts of nude mice in ESCs group were (9.2±0.4)%, (19.7±1.2)%, (53.6±3.5)%, and (62.2±5.1)%, respectively, which was significantly lower than (11.0±0.9)%, (47.8±2.8)%, (86.1±7.1)%, and (89.7±9.0)% in PBS group (t=5.719, 26.650, 11.940, 7.617, P<0.01). On PSD 3, 7, and 14, blood perfusion signals were observed in the skin grafts of nude mice in the two groups. The average blood perfusion ratios of the skin grafts of nude mice in ESCs group to PBS group were greater than 1, and there was no statistically significant difference in the overall comparison of 3 time points (P>0.05). On PSD 7, compared with those of PBS group, the mRNA and protein expressions of TNF-α, IL-8, type Ⅰ collagen, and type Ⅲ collagen in the skin graft tissue of nude mice in ESCs group were significantly reduced, while the mRNA and protein expressions of IL-10 and MMP-9 in the skin graft tissue of nude mice in ESCs group were significantly increased (in mRNA comparison, t=2.823, 2.934, 2.845, 2.860, 3.877, 2.916, P<0.05). Conclusions: Allogeneic ESCs can reduce the shrinkage of allogeneic full-thickness skin grafts transplanted on full-thickness skin defect wounds in nude mice, promote the formation of new blood vessels between the skin graft and the wound, reduce inflammation and collagen protein expression, and promote the expression of MMP-9, thus improving the survival quality of skin grafts.
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Affiliation(s)
- S B Huang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Z C Hu
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y Zhang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - B Tang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - P Wang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - H L Xu
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Z Y Wang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y X Dong
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - P Cheng
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y C Rong
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - J Wu
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen 518037, China
| | - J Y Zhu
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
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Zhou QQ, Hu ZC, Tang W, Xia ZY, Wang J, Zhang R, Li X, Chen CY, Zhang B, Lu L, Zhang H. Precise anatomical localization and classification of rib fractures on CT using a convolutional neural network. Clin Imaging 2021; 81:24-32. [PMID: 34598000 DOI: 10.1016/j.clinimag.2021.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop a convolutional neural network (CNN) model for the detection, precise anatomical localization (right 1-12th and left 1-12th) and classification (fresh, healing and old fractures) of rib fractures automatically, and to compare the performance with the experienced radiologists. MATERIALS AND METHODS A total of 640 rib fracture patients with 340,501 annotations were retrospectively collected from three hospitals. They consisted of a classification training dataset (n = 482), a localization training dataset (n = 30), an internal testing dataset (n = 90) and an external testing dataset (n = 38). RetinaNet with rib localization postprocessing and the result merging technique were employed to structure the CNN model. ROC curve, free-response ROC curve, AUC, precision, recall, and F1-score were calculated to choose the better option between model I (training classification and localization data together) and model II (adding an additional classification model to model I). RESULTS The detection and classification performance of rib fractures was better in model II than in model I. The sensitivity of localization reached 97.11% and 94.87% on the right and left ribs, respectively. In the external dataset with different CT scanner and slice thickness, model II showed better diagnostic performance. Moreover, the CNN model was superior in diagnosing fresh and healing fractures to 5 radiologists and consumed shorter diagnosis time. CONCLUSIONS Our CNN model was capable of detection, precise anatomical localization, and classification of rib fractures automatically.
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Affiliation(s)
- Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.168, gushan Road, Nanjing, Jiangsu Province 211100, China
| | - Zhang-Chun Hu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.168, gushan Road, Nanjing, Jiangsu Province 211100, China
| | - Wen Tang
- Institute of Advanced Research, Infervision Medical Technology Co., Ltd., Beijing 100025, China
| | - Zi-Yi Xia
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.168, gushan Road, Nanjing, Jiangsu Province 211100, China
| | - Jiashuo Wang
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, No.639, Long Mian Avenue, Nanjing, Jiangsu Province, 211198, China
| | - Rongguo Zhang
- Institute of Advanced Research, Infervision Medical Technology Co., Ltd., Beijing 100025, China
| | - Xinyang Li
- Institute of Advanced Research, Infervision Medical Technology Co., Ltd., Beijing 100025, China
| | - Chen-Yu Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Bing Zhang
- Department of Radiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing 210008, China
| | - Lingquan Lu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.168, gushan Road, Nanjing, Jiangsu Province 211100, China.
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Li XS, Zhang QJ, Zhu J, Zhou QQ, Yu YS, Hu ZC, Xia ZY, Wei L, Yin XD, Zhang H. Assessment of kidney function in chronic kidney disease by combining diffusion tensor imaging and total kidney volume. Int Urol Nephrol 2021; 54:385-393. [PMID: 34024009 DOI: 10.1007/s11255-021-02886-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 05/08/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to investigate the value and feasibility of combining fractional anisotropy (FA) values from diffusion tensor imaging (DTI) and total kidney volume (TKV) for the assessment of kidney function in chronic kidney disease (CKD). MATERIALS AND METHODS Fifty-one patients were included in this study. All MRI examinations were performed with a 3.0 T scanner. DTI was used to measure FA values, and TKV was obtained from DTI and T2-weighted imaging (T2WI). Patients were divided into three groups (mild, moderate, severe) according to eGFR, which was calculated with serum creatinine. Differences in the FA values of the cortex and medulla were analysed among the three groups, and the relationships of FA values, TKV, and the product of the FA values and TKV with eGFR were analysed. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic efficiency of the FA values, TKV, and the product of the FA values and TKV for kidney function in different CKD stages. RESULTS Medullary FA values (m-FA), TKV, and the product of the m-FA values and TKV (m-FA-TKV) were significantly correlated with eGFR (r = 0.653, 0.685, and 0.797, respectively; all P < 0.001). ROC curve analysis showed that m-FA-TKV exhibited better diagnostic performance than m-FA values (P = 0.022). CONCLUSION m-FA-TKV obtained by DTI significantly improves the accuracy of kidney function assessment in CKD patients.
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Affiliation(s)
- Xue-Song Li
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Qing-Juan Zhang
- Department of Nephrology, The Affiliated Jiangning Hospital with Nanjing Medicine University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Jiang Zhu
- Department of Nephrology, The Affiliated Jiangning Hospital with Nanjing Medicine University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Zhang-Chun Hu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Zi-Yi Xia
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Liang Wei
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Xin-Dao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China.
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Niu K, Wu XP, Fu Q, Lang KP, Zou SP, Hu ZC, Liu ZQ, Zheng YG. Effects of lipids and surfactants on the fermentation production of echinocandin B by Aspergillus nidulans. J Appl Microbiol 2021; 131:2849-2860. [PMID: 33987908 DOI: 10.1111/jam.15136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/03/2021] [Accepted: 04/28/2021] [Indexed: 11/30/2022]
Abstract
AIMS Echinocandin B (ECB) is a kind of lipopeptide antifungal antibiotic, as well as the key precursor of antifungal drug Anidulafungin. Its efficient bioproduction plays an important role in promoting the industrial production of Anidulafungin. METHODS AND RESULTS In this study, methyl oleate and Tween 80 were firstly used to enhance the ECB fermentation by Aspergillus nidulans, the results showed that the ECB titre was significantly enhanced with the addition of methyl oleate and Tween 80. Among the lipids, methyl oleate was found to play a pivotal role in increasing the ECB titre to 2123 mg l-1 , which was more than five times higher than that of the control. The addition of Tween 80 in the medium resulted in ECB titre increased to 2584 mg l-1 . The scanning electron microscope (SEM) and N-phenyl-1-naphthylamine (NPN) assay indicated that Tween 80 could influence the cell membrane permeability of A. nidulans, and enhance the intracellular and extracellular substance exchange, therefore lead to the increasing of ECB titre. CONCLUSIONS Methyl oleate and Tween 80 are optimal carbon sources and surfactants for efficient ECB biosynthesis respectively. SIGNIFICANCE AND IMPACT OF THE STUDY Surfactant was used in ECB fermentation for the first time, which provided feasible ideas for optimizing the fermentation process of other fungi.
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Affiliation(s)
- K Niu
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
| | - X P Wu
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
| | - Q Fu
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
| | - K P Lang
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
| | - S P Zou
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
| | - Z C Hu
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
| | - Z Q Liu
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
| | - Y G Zheng
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, P. R. China
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Hu ZC, Jiang C, Liu SY, Zhang ZM, Zhang S, Fan SY, Zheng LH, Ma CS, Yao Y. [Current status and quality analysis of interventional therapy for patients with atrial fibrillation in China]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:224-228. [PMID: 33706455 DOI: 10.3760/cma.j.cn112148-20201123-00929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To define the current status and analyze the medical quality of interventional therapy for patients with atrial fibrillation (AF) in China. Methods: This survey was performed in all seven large regions of China, one to three regional major medical centers were selected from each region. Medical records of patients underwent interventional therapy for AF in the year 2017 were randomly inspected. CHA2DS2-VASc score, prescribed anticoagulant after ablation, indication of left atrial appendage occlusion (LAAO), and complications in the medical records were analyzed. Results: A total of 10 800 AF catheter ablations and 447 LAAOs were performed in 17 regional medical centers in 2017. There were 10/17 centers performing AF catheter ablation<500 cases and 7/17 centers performing LAAO<20 cases. A total of 1 347 cases of catheter ablation and 160 cases of LAAO were selected for further analysis. Among all selected cases, 15.8% (238/1 505) non-valvar AF cases recorded CHA2DS2-VASc scores. The anticoagulation rate after AF catheter ablation was 98.6% (1 328/1 347), anticoagulation rate was higher than 90% in 16 out of 17 centers. The complication and severe complication rates of AF catheter ablation were 0.9% (12/1 347) and 0.4% (5/1 347), respectively. The differences of complication and severe complication rates in AF catheter ablation were similar between centers performing<500 cases and centers performing ≥500 cases (0.5% (2/413) vs. 1.1% (10/934), P>0.05; 0.5% (2/413) vs. 0.3% (3/934), P>0.05). The coincidence rate of LAAO indication was 81.3% (130/160), and the rate was higher in center performing ≥20 cases than in centers performing<20 cases (84.8% (106/125) vs. 68.6% (24/35), P<0.05). The complication and severe complication rates of LAAO were 3.1% (5/160) and 1.9% (3/160). The rate of complications in LAAO was higher in center performing<20 cases than in centers performing ≥20 cases (8.6% (3/35) vs. 1.6% (2/125), P<0.05), and there was no significant difference in severe complication rate (5.7% (2/35) vs. 0.8% (1/125), P>0.05). Conclusions: Interventional therapy for AF in China is generally standardized and safe. The overall incidence of complications post AF interventional ablation is low, the anticoagulation rate after AF catheter ablation is high, and the adherence rate of LAAO indication is fair. The indicators mentioned above vary widely among centers.
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Affiliation(s)
- Z C Hu
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - C Jiang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S Y Liu
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Z M Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S Y Fan
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - L H Zheng
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - C S Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yan Yao
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Zhou QQ, Tang W, Wang J, Hu ZC, Xia ZY, Zhang R, Fan X, Yong W, Yin X, Zhang B, Zhang H. Automatic detection and classification of rib fractures based on patients' CT images and clinical information via convolutional neural network. Eur Radiol 2020; 31:3815-3825. [PMID: 33201278 DOI: 10.1007/s00330-020-07418-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop a convolutional neural network (CNN) model for the automatic detection and classification of rib fractures in actual clinical practice based on cross-modal data (clinical information and CT images). MATERIALS In this retrospective study, CT images and clinical information (age, sex and medical history) from 1020 participants were collected and divided into a single-centre training set (n = 760; age: 55.8 ± 13.4 years; men: 500), a single-centre testing set (n = 134; age: 53.1 ± 14.3 years; men: 90), and two independent multicentre testing sets from two different hospitals (n = 62, age: 57.97 ± 11.88, men: 41; n = 64, age: 57.40 ± 13.36, men: 35). A Faster Region-based CNN (Faster R-CNN) model was applied to integrate CT images and clinical information. Then, a result merging technique was used to convert 2D inferences into 3D lesion results. The diagnostic performance was assessed on the basis of the receiver operating characteristic (ROC) curve, free-response ROC (fROC) curve, precision, recall (sensitivity), F1-score, and diagnosis time. The classification performance was evaluated in terms of the area under the ROC curve (AUC), sensitivity, and specificity. RESULTS The CNN model showed improved performance on fresh, healing, and old fractures and yielded good classification performance for all three categories when both clinical information and CT images were used compared to the use of CT images alone. Compared with experienced radiologists, the CNN model achieved higher sensitivity (mean sensitivity: 0.95 > 0.77, 0.89 > 0.61 and 0.80 > 0.55), comparable precision (mean precision: 0.91 > 0.87, 0.84 > 0.77, and 0.95 > 0.70), and a shorter diagnosis time (average reduction of 126.15 s). CONCLUSIONS A CNN model combining CT images and clinical information can automatically detect and classify rib fractures with good performance and feasibility in actual clinical practice. KEY POINTS • The developed convolutional neural network (CNN) performed better in fresh, healing, and old fractures and yielded a good classification performance in three categories, if both (clinical information and CT images) were used compared to CT images alone. • The CNN model had a higher sensitivity and matched precision in three categories than experienced radiologists with a shorter diagnosis time in actual clinical practice.
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Affiliation(s)
- Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No. 168, gushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Wen Tang
- Institute of Advanced Research, Beijing Infervision Technology Co Ltd, Yuanyang International Center, Beijing, 100025, China
| | - Jiashuo Wang
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, No.639, Long Mian Avenue, Nanjing, 211198, Jiangsu Province, China
| | - Zhang-Chun Hu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No. 168, gushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Zi-Yi Xia
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No. 168, gushan Road, Nanjing, 211100, Jiangsu Province, China
| | - Rongguo Zhang
- Institute of Advanced Research, Beijing Infervision Technology Co Ltd, Yuanyang International Center, Beijing, 100025, China
| | - Xinyi Fan
- Institute of Advanced Research, Beijing Infervision Technology Co Ltd, Yuanyang International Center, Beijing, 100025, China
| | - Wei Yong
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68, Changle Road, Nanjing, 210006, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68, Changle Road, Nanjing, 210006, China
| | - Bing Zhang
- Department of Radiology, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No. 168, gushan Road, Nanjing, 211100, Jiangsu Province, China.
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Hu ZC, Xu G, Zhang XW, Ma K, Jin JJ, Li PS. [Meta-analysis of the effects of dexmedetomidine combined with ketamine during dressing changes in burn patients]. Zhonghua Shao Shang Za Zhi 2020; 36:458-464. [PMID: 32594705 DOI: 10.3760/cma.j.cn501120-20190327-00145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To systematically evaluate the safety and efficacy of dexmedetomidine combined with ketamine during dressing changes in burn patients using meta-analysis. Methods: Foreign language databases including PubMed, Cochrane Central, Embase, and Web of Science were searched with the terms of " burns, dexmedetomidine, ketamine, and dressing" , and Chinese databases including Chinese Journal Full-Text Database, Wanfang Data, and China Academic Journal Network Publishing Database were searched with the terms in Chinese version of ",,,,," to retrieve the publicly published randomized controlled trials on the application of dexmedetomidine combined with ketamine for sedation and analgesia during dressing changes in burn patients from the establishment of each database to March 2019. The outcome indexes included systolic blood pressure at 5 minutes after administration, arousal restlessness score, ketamine dosage, dressing change time, body movement/recovery time, pain score, Ramsay sedation scores at 10 minutes after the start of dressing change and 1 hour after dressing change, physician satisfaction score, neuropsychological symptoms, nausea and vomiting times, nausea and vomiting score. RevMan 5.3 and Stata 14.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 396 burn patients were included in 7 articles, including 198 patients in dexmedetomidine+ ketamine group who received dexmedetomidine and ketamine for sedation and analgesia, and 198 patients in ketamine alone group who received ketamine alone for sedation and analgesia. The bias risks of the seven studies included were uncertain. Compared with those of ketamine alone group, the systolic blood pressure at 5 minutes after administration, arousal restlessness score, nausea and vomiting score of patients in dexmedetomidine+ ketamine group were significantly decreased, with standardized mean differences of -13.89, -0.84, and -0.99 (95% confidence interval=-20.89--6.89, -1.17--0.52, -1.31--0.68, P<0.01), the Ramsay sedation score at 10 minutes after the start of dressing change and that at 1 hour after dressing change were significantly increased, with standardized mean differences of 1.53 and 0.72 (95% confidence interval=1.05-2.02, 0.13-1.31, P<0.05 or P<0.01), and the number of neuropsychological symptom and number of nausea and vomiting were significantly reduced, with relative risks of 0.20 and 0.16 (95% confidence interval=0.07-0.58, 0.05-0.58, P<0.01). The patients in the two groups were similar in ketamine dosage, dressing change time, body movement/recovery time, pain score, and physician satisfaction score. There was no publication bias in dressing change time or ketamine dosage (P>0.05), while the other indexes might have publication bias (P<0.05). Conclusions: Compared with ketamine alone, combination of dexmedetomidine and ketamine during dressing changes in burn patients can reduce the occurrence of restlessness, nausea and vomiting, neuropsychological symptoms, and other complications, better stabilize blood pressure, and enhance sedation effect.
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Affiliation(s)
- Z C Hu
- Clinical Medical College, Yangzhou University, Yangzhou 225001, China
| | - G Xu
- Department of Burns and Plastic Surgery, Jiangsu Subei People's Hospital, Yangzhou 225001, China
| | - X W Zhang
- Clinical Medical College, Dalian Medical University, Dalian 116000, China
| | - K Ma
- Clinical Medical College, Yangzhou University, Yangzhou 225001, China
| | - J J Jin
- Department of Burns and Plastic Surgery, Jiangsu Subei People's Hospital, Yangzhou 225001, China
| | - P S Li
- Department of Burns and Plastic Surgery, Jiangsu Subei People's Hospital, Yangzhou 225001, China
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Hu ZC, Wu LM, Liu SY, Shen LS, Zhao MH, Liu LM, Ding LG, Zheng LH, Yao Y. [Clinical characteristics of cardiomyopathies complicated with ventricular thrombosis]. Zhonghua Yi Xue Za Zhi 2019; 99:3587-3591. [PMID: 31826576 DOI: 10.3760/cma.j.issn.0376-2491.2019.45.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To summarize the clinical characteristics of cardiomyopathy complicated with ventricular thrombosis. Methods: The clinical data of inpatients suffered from cardiomyopathy complicated with ventricular thrombosis in Fuwai Hospital between January 2015 and May 2019 were analyzed retrospectively. Results: A total of 125 cases were reviewed, and 24.8% were female. Dilated cardiomyopathy was the most common disease (62.4%), followed by arrhythmogenic right ventricular cardiomyopathy (ARVC) (13.6%) and hypertrophic cardiomyopathy (11.2%). There were 74.4% thrombosis in left ventricle, 12.8% in right ventricle and 12.8% in biventricle. The proportions of right ventricle thrombosis were higher in ARVC than in other cardiomyopathies (52.9% vs 6.5%, P<0.01). The majority suffered from cardiac function New York Heart Association (NYHA) Class Ⅲ (45.6%) and class Ⅳ (39.2%). The ratio of NYHA Class Ⅳ was higher in female patients than in male ones (25.8% vs 10.6%, P<0.05). In lab detection, positive results of D-Dimer and N terminal-pro B type natriuretic peptide (NT-proBNP) accounted for 72.8% and 97.6%, respectively. There were 2.5% patients died in the hospital or discharged because of the worsening of illness, the chances were higher in female than male patients (9.7% vs 0, P<0.01). Among these patients, one succumbed to massive ischemic stroke caused by ventricular thrombus detachment under standard anticoagulation therapy. Conclusions: Dilated cardiomyopathy is the most common cardiomyopathy complicated with ventricular thrombosis. The most common location of thrombosis is left ventricle. Right ventricle thrombosis is more common in ARVC. The majority suffer from moderate or severe cardiac dysfunction. Higer proportion of female patients suffer from anemia, severe condition and poor prognosis.
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Affiliation(s)
- Z C Hu
- Center of Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
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10
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Hu ZC, Xu G, Lian HB, Xia SZ, Jin JJ, Zhang XW, Chai HG, Li PS. [Advances in the research of heterotopic ossification caused by burns]. Zhonghua Shao Shang Za Zhi 2019; 35:634-637. [PMID: 31474052 DOI: 10.3760/cma.j.issn.1009-2587.2019.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Heterotopic ossification is a rare complication of burns, and its incidence and risk factors are still unclear. Through summarizing the literature on heterotopic ossification caused by burns at home and abroad, the author searched for the risk factors of heterotopic ossification after burn and the new progress of its prevention and treatment. It was realized that the size, depth and healing time of burn wounds were related to heterotopic ossification; the nonsteroidal anti-inflammatory drugs, radiation therapy, and their combination therapy can be used for the prevention of heterotopic ossification; surgery is an effective means of treating heterotopic ossification.
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Affiliation(s)
- Z C Hu
- Clinical Medical College, Yangzhou University, Yangzhou 225001, China
| | - G Xu
- Department of Burns and Plastic Surgery, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
| | - H B Lian
- Department of Burns and Plastic Surgery, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
| | - S Z Xia
- Department of Burns and Plastic Surgery, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
| | - J J Jin
- Department of Burns and Plastic Surgery, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
| | - X W Zhang
- Clinical Medical College, Dalian Medical University, Dalian 116000, China
| | - H G Chai
- Clinical Medical College, Dalian Medical University, Dalian 116000, China
| | - P S Li
- Department of Burns and Plastic Surgery, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
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Guo WL, Geng J, Zhan Y, Tan YL, Hu ZC, Pan P, Sheng M, Wang J, Huang SG. Forecasting and predicting intussusception in children younger than 48 months in Suzhou using a seasonal autoregressive integrated moving average model. BMJ Open 2019; 9:e024712. [PMID: 30782741 PMCID: PMC6340449 DOI: 10.1136/bmjopen-2018-024712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The aims of this study were to highlight some epidemiological aspects of intussusception cases younger than 48 months and to develop a forecasting model for the occurrence of intussusception in children younger than 48 months in Suzhou. DESIGN A retrospective study of intussusception cases that occurred between January 2007 and December 2017. SETTING Retrospective chart reviews of intussusception paediatric patients in a large Children's hospital in South-East China were performed. PARTICIPANTS The hospital records of 13 887 intussusception cases in patients younger than 48 months were included in this study. INTERVENTIONS The modelling process was conducted using the appropriate module in SPSS V.23.0. METHODS The Box-Jenkins approach was used to fit a seasonal autoregressive integrated moving average (ARIMA) model to the monthly recorded intussusception cases in patients younger than 48 months in Suzhou from 2007 to 2016. RESULTS Epidemiological analysis revealed that intussusception younger than 48 months was reported continuously throughout the year, with peaks in the late spring and early summer months. The most affected age group was younger than 36 months. The time-series analysis showed that an ARIMA (1,0,1 1,1,1)12 model offered the best fit for surveillance data of intussusception younger than 48 months. This model was used to predict intussusception younger than 48 months for the year 2017, and the fitted data showed considerable agreement with the actual data. CONCLUSION ARIMA models are useful for monitoring intussusception in patients younger than 48 months and provide an estimate of the variability to be expected in future cases in Suzhou. The models are helpful for predicting intussusception cases in Suzhou and could be useful for developing early warning systems. They may also play a key role in early detection, timely treatment and prevention of serious complications in cases of intussusception.
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Affiliation(s)
- Wan-Liang Guo
- Department of Radiology, Children's Hospital of Soochow University, Suzhou, China
| | - Jia Geng
- Clinical Laboratory, The 3rd hospital of Yulin, Yulin, China
| | - Yang Zhan
- Department of Radiology, Children's Hospital of Soochow University, Suzhou, China
| | - Ya-Lan Tan
- Department of Radiology, Children's Hospital of Soochow University, Suzhou, China
| | - Zhang-Chun Hu
- Department of Radiology, Children's Hospital of Soochow University, Suzhou, China
| | - Peng Pan
- Department of Radiology, Children's Hospital of Soochow University, Suzhou, China
| | - Mao Sheng
- Department of Radiology, Children's Hospital of Soochow University, Suzhou, China
| | - Jian Wang
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, China
| | - Shun-Gen Huang
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, China
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Hu ZC, Tan YL, Huang SG, Pan P, Liu XB, Wang J, Guo WL. Molecular imaging of Toll-like receptor 4 detects ischemia-reperfusion injury during intussusception. Oncotarget 2018; 9:7882-7890. [PMID: 29487699 PMCID: PMC5814266 DOI: 10.18632/oncotarget.23609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/13/2017] [Indexed: 11/25/2022] Open
Abstract
We investigated the expression of Toll-like receptor 4 (TLR4) in the acute phase of intestinal I/R injury during intussusception and evaluated whether anti-TLR4 antibody-conjugated lead sulfide quantum dots (TLR4-PbS QDs) could be used to detect and monitor the injury. We first established a mouse model of I/R injury during intussusception. TLR-PbS QDs were then intravenously administered to intestinal I/R injured mice and visualized using whole-body fluorescence imaging in the second near-infrared window (NIR-II). Immunohistochemical analysis of intestinal tissue from the mice revealed that TLR4 expression was higher in the I/R injury group than the control and TAK-242 groups (5.189 ± 2.482, 1.186 ± 1.171, and 2.400 ± 0.857, respectively, P < 0.05). NIR-II fluorescence intensity was also higher in the I/R injury group than in the control and TAK-242 groups (86.415 ± 10.955, 38.975 ± 8.619, and 71.977 ± 3.838, respectively; P < 0.05). Thus, anti-TLR4-PbS QDs bound to TLR4 on the cell membranes of intestinal epithelial cells with high specificity in vitro and in vivo. These results indicate that TLR4 promotes intestinal I/R injury during intussusception and that the injury can be noninvasively imaged using TLR4-PbS QDs.
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Affiliation(s)
- Zhang-Chun Hu
- Radiology Department, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Ya-Lan Tan
- Radiology Department, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Shun-Gen Huang
- General Surgery Department, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Peng Pan
- Radiology Department, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Xiao-Bo Liu
- General Surgery Department, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Jian Wang
- General Surgery Department, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Wan-Liang Guo
- Radiology Department, Children's Hospital of Soochow University, Suzhou, 215003, China
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Hu ZC, Korus RA, Levinson WE, Crawford RL. Adsorption and biodegradation of pentachlorophenol by polyurethane-immobilized flavobacterium. Environ Sci Technol 1994; 28:491-496. [PMID: 22165886 DOI: 10.1021/es00052a023] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Abstract
beta-D-Galactosidase (E 3.2.1.23) from Aspergillus oryzae was immobilized with polyurethane foam (PUF). Among several immobilization methods attempted in this work, the immobilized enzyme preparation by in-situ co-polymerization between enzyme and prepolymer HYPOL 3000 showed the highest activity. The intrinsic kinetics of PUF-immobilized enzyme was determined in a dynamic bed reactor, used to increase transport rates. The immobilization mechanism in PUF was studied by measurements of immobilized enzyme kinetics and by using scanning electron microscopy combined with immuno-gold labeling techniques. The results showed that immobilization was predominantly by covalent bonding between primary amino groups of beta-D-galactosidase and isocyanate groups of the prepolymers. Entrapment in the PUF micropores assisted the immobilization of enzymes, and adsorption on the surface of macropores was not important for immobilization. The bicinchoninic acid method was applied for the determination of PUF loading capacity and specific enzyme activity and used to determine enzyme deactivation during immobilization.
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Affiliation(s)
- Z C Hu
- Department of Chemical Engineering, University of Idaho, Moscow 83843
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Hu ZC, Yu ZY. [The advances in the research on hepatocyte growth factor]. Zhonghua Nei Ke Za Zhi 1993; 32:198-200. [PMID: 8222985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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