In situ metabolic flux analysis to quantify the liver metabolic response to experimental burn injury

Trauma such as burns induces a hypermetabolic response associated with altered central carbon and nitrogen metabolism. The liver plays a key role in these metabolic changes; however, studies to date have evaluated the metabolic state of liver using ex vivo perfusions or isotope labeling techniques targeted to specific pathways. Herein, we developed a unique mass balance approach to characterize the metabolic state of the liver in situ, and used it to quantify the metabolic changes to experimental burn injury in rats. Rats received a sham (control uninjured), 20% or 40% total body surface area (TBSA) scald burn, and were allowed to develop a hypermetabolic response. One day prior to evaluation, all animals were fasted to deplete glycogen stores. Four days post-burn, blood flow rates in major vessels of the liver were measured, and blood samples harvested. We combined measurements of metabolite concentrations and flow rates in the major vessels entering and leaving the liver with a steady-state mass balance model to generate a quantitative picture of the metabolic state of liver. The main findings were: (1) Sham-burned animals exhibited a gluconeogenic pattern, consistent with the fasted state; (2) the 20% TBSA burn inhibited gluconeogenesis and exhibited glycolytic-like features with very few other significant changes; (3) the 40% TBSA burn, by contrast, further enhanced gluconeogenesis and also increased amino acid extraction, urea cycle reactions, and several reactions involved in oxidative phosphorylation. These results suggest that increasing the severity of injury does not lead to a simple dose-dependent metabolic response, but rather leads to qualitatively different responses.     

Acheron regulates vascular endothelial proliferation and angiogenesis together with Id1 during wound healing

RNA binding protein acheron has proved to be either the mediator of integrin‐extracellular matrix interactions or the regulatory factor that participates in vertebrate development, cell differentiation and cell death. We report the role of acheron in vascular endothelial proliferation, angiogenesis and wound healing post‐trauma. Co‐immunoprecipitation showed that Acheron forms a ternary complex with β1 integrin and Id1 in human umbilical vein endothelial cells following stimulation with serious trauma serum. Acheron, vascular endothelial growth factor (VEGF), and β1 integrin mRNA expression was apparently inhibited, and capillary density and wound healing rate also were reduced in Id1‐deficient mice trauma model. Acheron together with Id1 significantly induces VEGF, not CD105 level inhibition by serious trauma serum for 24 h. In conclusion, we have demonstrated that acheron may be an effective mediator of promoting endothelial proliferation, angiogenesis and wound healing probably by regulating VEGF together with Id1. Copyright © 2011 John Wiley & Sons, Ltd.     

Na-K-Cl cotransporter-1 in the mechanism of cell swelling in cultured astrocytes after fluid percussion injury

Brain edema and associated increased intracranial pressure are major consequences of traumatic brain injury (TBI). An important early component of the edema associated with TBI is astrocyte swelling (cytotoxic edema). Mechanisms for such swelling, however, are poorly understood. Ion channels/transporters/exchangers play a major role in cell volume regulation, and a disturbance in one or more of these systems may result in cell swelling. To examine potential mechanisms in TBI-mediated brain edema, we employed a fluid percussion model of in vitro barotrauma and examined the role of the ion transporter Na(+)-K(+)-2Cl(-)-cotransporter 1 (NKCC1) in trauma-induced astrocyte swelling as this transporter has been strongly implicated in the mechanism of cell swelling in various neurological conditions. Cultures exposed to trauma (3, 4, 5 atm pressure) caused a significant increase in NKCC1 activity (21%, 42%, 110%, respectively) at 3 h. At 5 atm pressure, trauma significantly increased NKCC1 activity at 1 h and it remained increased for up to 3 h. Trauma also increased the phosphorylation (activation) of NKCC1 at 1 and 3 h. Inhibition of MAPKs and oxidative/nitrosative stress diminished the trauma-induced NKCC1 phosphorylation as well as its activity. Bumetanide, an inhibitor of NKCC1, significantly reduced the trauma-induced astrocyte swelling (61%). Silencing NKCC1 with siRNA led to a reduction in trauma-induced NKCC1 activity as well as in cell swelling. These findings demonstrate the critical involvement of NKCC1 in the astrocyte swelling following in vitro trauma, and suggest that blocking NKCC1 activity may represent a useful therapeutic strategy for the cytotoxic brain edema associated with the early phase of TBI.     

两种植骨方式在胸腰椎结核手术中的应用

目的:比较不同植骨方式治疗胸腰椎结核的手术效果,探讨颗粒自体骨与块状自体骨两种植骨方式在治疗胸腰椎结核的临床疗效。方法:2008年1月至2010年12月期间在我院手术治疗的胸腰椎结核患者132例,其中采用块状自体骨进行骨移植的患者60例,采用颗粒状自体骨进行骨移植的患者72例,随机从两种植骨方式中各抽取20例患者进行回顾性分析,对两组患者术中出血量、住院时间、术后神经功能改善情况、植骨融合情况、后凸畸形矫正状况进行对比。结果:所有患者均一期愈合,无全身并发症,两组患者随访12~36个月,平均18个月,影像学提示内固定位置良好,无松动及断裂,结核病灶无复发。块状骨组术后6个月随访植骨融合率15%(3/20)术后9个月融合率45%(9/20),术后12个月融合率95%(19/20)。颗粒骨组术后6个月随访植骨融合率45%(9/20)术后9个月融合率80%(16/20),术后12个月融合率100%。块状骨组术前Cobb角为29.8°±5.0°,术后Cobb角为14.7°±2.5°,末次随访Cobb角为16.0°±2.9°。颗粒骨组术前Cobb角为30.9±7.6°,术后Cobb角为15.6°±3.8°,末次随访Cobb角为16.7°±3.8°,两组病人术后cobb角较术前有明显矫正,末次随访无明显丢失,两组比较无显著性差异(P0.05)。颗粒骨组术中出血量明显少于块状骨组,两组比较有统计学意义(P0.05)。住院时间两组比较无显著性差异(P0.05)。结论:颗粒状自体骨与块状自体骨相比在胸腰椎结核手术中植入方便,出血量少,植骨融合时间短,融合率高,是胸腰椎结核植骨的理想选择。     

Tracing and 3-dimensional representation of the primary afferents from the moth ear

Heliothine moths perceive acoustic information via two auditory sensory neurons only. Previous cobalt staining experiments have described the projection pattern of the two auditory neurons, called the A1 and the A2 cell, plus one additional neuron, the so-called B cell, up to the prothorax. We have obtained new and improved data about the projection pattern of the three sensory afferents by means of fluorescent staining experiments combined with scanning confocal microscopy. The present data show the fine structure of each sensory axon that arises from the moth ear and its ascending pathway relative to that of the others. In accordance with the previous data, the A2 auditory cell was found to extend projections in the pterothorax only. A novel finding is that terminal branches of the A2 cell cross the midline. The staining pattern of the two remaining neurons, the A1 and B cell, which project tightly together in the thoracic ganglia, differ somewhat from that previously described. As demonstrated here, one of these two neurons, the A1 cell, terminates in the prothoracic ganglion whereas the other, the B cell, projects further on via the cervical connectives to the subesophageal ganglion. The current data, therefore, indicate that none of the auditory afferents in the heliothine moth projects to the brain.     

Altered spinal kinematics and muscle recruitment pattern of the cervical and thoracic spine in people with chronic neck pain during functional task

Knowledge on the spinal kinematics and muscle activation of the cervical and thoracic spine during functional task would add to our understanding of the performance and interplay of these spinal regions during dynamic condition. The purpose of this study was to examine the influence of chronic neck pain on the three-dimensional kinematics and muscle recruitment pattern of the cervical and thoracic spine during an overhead reaching task involving a light weight transfer by the upper limb. Synchronized measurements of the three-dimensional spinal kinematics and electromyographic activities of cervical and thoracic spine were acquired in thirty individuals with chronic neck pain and thirty age- and gender-matched asymptomatic controls. Neck pain group showed a significantly decreased cervical velocity and acceleration while performing the task. They also displayed with a predominantly prolonged coactivation of cervical and thoracic muscles throughout the task cycle. The current findings highlighted the importance to examine differential kinematic variables of the spine which are associated with changes in the muscle recruitment in people with chronic neck pain. The results also provide an insight to the appropriate clinical intervention to promote the recovery of the functional disability commonly reported in patients with neck pain disorders.     

Lung injury risk assessment during blast exposure

Blast pulmonary trauma are common consequences of modern war and terrorism action. To better protect soldiers from that threat, the injury risk level when protected and unprotected must be assessed. Knowing from the literature that a possible amplification of the blast threat would be provided by some thoracic protective systems, the objective is to propose an original approach to correlate a measurable parameter on a manikin with a pulmonary risk level. Using a manikin whose response is correlated with the proposed tolerance limits should help in the evaluation of thoracic protective system regarding injury outcomes.A database including lung injury data from large mammals have been created, allowing the definition of iso-impulse tolerance limits from no lung injury to severe ones (∼60% of ecchymosis). As the use of this metric is not sufficient to evaluate the performance of protective systems on a manikin, the iso-impulse tolerance limits were associated with the thoracic response of post-mortem swine under blast loading. It was found that the lung injury threshold in terms of incident impulse is 58.3 kPa·ms, corresponding to a chest wall peak of acceleration/velocity/displacement of 7350 m/s², 3.7 m/s and 6.4 mm respectively. Lung injuries are considered as severe (30–60% of ecchymosis) when the incident impulse exceed 232.8 kPa·ms, leading to a chest wall peak of acceleration/velocity/displacement of 79.7 km/s², 14.7 m/s and 30.1 mm respectively.The defined lung tolerance limits are valid for a 50 kg swine (unprotected) exposed side-on to the blast threat and against a wall.     

Endophthalmitis caused by Fusarium: An emerging problem in patients with corneal trauma. A case series

Background

Although fortunately very rare in countries with a temperate climate, certain factors, such as clinical or pharmacological immunosuppression, may cause Fusarium-related fungal infections to become an emerging problem. Moreover, Fusarium is one of the most important etiological agents in exogenous endophthalmitis, which is often favored by the disruption of the epithelial barriers.

微创踝关节融合术治疗老年创伤性踝关节炎中的临床效果及对患者氧化损伤与骨代谢的影响

目的:研究微创踝关节融合术治疗老年创伤性踝关节炎中的临床效果及对患者氧化损伤与骨代谢的影响。方法:收集2014年3月至2015年3月我院收治的94例老年创伤性踝关节炎患者,按随机数表法分为实验组和对照组,每组各45例。两组患者在手术前均进行常规检查,对照组采用常规开放式踝关节融合术,实验组采用微创踝关节融合术。对比两组治疗后血清氧化损伤指标肌红蛋白(MYO)、缺血修饰白蛋白(IMA)、总抗氧化能力(TAC)、丙二醛(MDA)水平,骨代谢指标碱性磷酸酶(ALP)、酸性磷酸酶(ACP)、甲状旁腺素(PTH)、骨钙素(BGP)、降钙素(CT)水平,视觉疼痛模拟评分(VAS)、美国矫形外科足踝协会(AOFAS)评分及不良反应的发生情况。结果:治疗后,实验组血清MYO、IMA、MDA水平显著低于对照组[(20.48±2.59)ng/mL vs.(27.07±2.97)ng/m L,(65.68±8.20)U/L vs.(74.27±9.01)U/L,(5.01±1.03)nmol/L vs.(9.64±2.17)nmol/L](P0.05),血清TAC水平显著高于对照组[(11.40±2.50)kU/L vs.(7.36±1.03)kU/L](P0.05);血清ALP、BGP、CT水平均显著高于对照组[(103.28±12.47)U/L vs.(90.53±10.02)U/L,(11.08±1.42)ng/L vs.(8.01±1.23)ng/L,(61.39±5.87)ng/L vs.(50.28±4.92)ng/L](P0.05),ACP、PTH水平均显著低于对照组[(5.21±0.60)U/L vs.(8.03±0.92)U/L,(42.95±5.38)ng/L vs.(60.49±6.92)ng/L](P0.05);VAS评分显著低于对照组[(1.06±0.23)分vs.(3.79±0.67)分](P0.05),AOFAS评分显著高于对照组[(73.02±6.28)分vs.(65.58±5.13)分](P0.05);不良反应总发生率显著低于对照组[6.66%(3/45) vs. 20.41%(10/49)](P0.05)。结论:微创踝关节融合术可调节老年创伤性踝关节炎患者的骨代谢,增强骨密度,减少术后不良反应,有利于改善患者预后。