Optimal skin regeneration after full thickness thermal burn injury in the spiny mouse, Acomys cahirinus

The spiny mouse, Acomys cahirinus, shows remarkable regenerative abilities after excisional skin wounding by regrowing hair, sebaceous glands, smooth muscle, skeletal muscle and dermis without scarring. We have asked here whether this same regeneration can be seen after full thickness thermal burn injuries. Using a brass rod thermal injury model we show that in contrast to the lab mouse, Mus musculus, which forms a thick scar covered by a hairless epidermis, the spiny mouse regenerates all the tissues injured — skeletal muscle, dermis, hairs, sebaceous glands such that the skin is externally indistinguishable from its original appearance. Re-epithelialization is faster in Acomys than in Mus but ingression and proliferation of dermal fibroblasts is the same in both species. After 3 weeks the wound epithelium of Acomys has developed a covering of new hair follicles in contrast to Mus. The skeletal muscle of the panniculus carnosus in Mus shows some regeneration but it is incomplete and fibrotic whereas the Acomys muscle is replaced perfectly. There are differences in the macrophage profiles which invade the damaged tissues such as the absence of F4/80 or MOMA-2 +ve cells in Acomys which likely reflect different cytokine profiles resulting from the same injury in these two species.     

Ankle stiffness and tissue compliance in stroke survivors: a validation of Myotonometer measurements

OBJECTIVE: To determine the construct validity of Myotonometer measurements of tissue compliance as being reflective of ankle plantarflexor tone. DESIGN: Cross sectional. SETTING: Motor performance research laboratory. PARTICIPANTS: Twenty-three stroke survivors (67.5+/-10.9y) and 24 control subjects (71.2+/-9.0y) recruited from the community. INTERVENTIONS: Not applicable.Main outcome measures Plantarflexor tone was measured using the Modified Ashworth Scale (MAS), ankle stiffness (total, passive, intrinsic and reflex components) was quantified using a torque motor, and tissue compliance during relaxation and activation of the plantarflexors was measured with the Myotonometer. RESULTS: MAS scores in the stroke group ranged from 1 to 4, whereas all control subjects had normal tone. Mean total ankle stiffness was higher in the stroke group than in the control group (P<.02), mainly due to elevated passive stiffness (P<.03). Compliance did not change as a function of muscle activation in stroke, but it decreased when control subjects contracted their plantarflexors (P<.04). The difference in Myotonometer measurements acquired during active and relaxed states was associated with total ankle stiffness and, specifically, intrinsic stiffness. The relationships were strongest when only stroke data were considered. CONCLUSIONS: Stiffness and compliance measures distinguished between control subjects and persons with hypertonia secondary to stroke. Compliance differences in the relaxed and active gastrocnemius muscle reflected intrinsic stiffness associated with the contractile elements of the plantarflexor group of muscles as a whole.     

中国多灶性运动神经病80例患者临床表现分析

目的全面了解我国多灶性运动神经病患者的临床表现。方法电子检索中国生物医学文献数据库和万方数据库1980～2005年收录的多灶性运动神经病病例报告,并分析其临床表现特点。结果共检索到13个研究、80例患者。其中男性61例,女性19例,均以单肢无力首发,98.75%为慢性进展性,远端重于近端(95.3%),伴有肌肉萎缩(76.3%),肌肉颤动(46.3%),腱反射减低(96.4%),客观感觉障碍少(6.25%),尺神经、正中神经或胫神经存在运动神经传导阻滞(92.1%)。结论多灶性运动神经病是以肢体远端为主的进行性非对称性肌无力、肌萎缩,一般无感觉障碍,在尺神经、正中神经或胫神经存在运动神经传导阻滞为特点。此病易与进行性脊肌萎缩症、慢性格林巴利相混淆。     

被动运动和电刺激对尾吊大鼠比目鱼肌肌纤维的影响

目的观察被动运动、电刺激对尾吊大白鼠比目鱼肌各型肌纤维横截面积及肌纤维构成比的影响。方法72只发育期Wistar品系雄性大白鼠(体重68～76g)，随机分为对照组3组，模型组2组，被动运动组2组，电刺激组2组，每组8只。采用SDH染色，结合微机图像分析技术，对比目鱼肌肌纤维横截面积和肌纤维构成比进行定量分析。结果被动运动组、电刺激组比目鱼肌各型肌纤维面积与模型组比较有所增加；悬吊2周后，模型组比目鱼肌红肌纤维比例下降，中间肌纤维比例上升。结论被动运动、电刺激具有减缓尾吊大白鼠比目鱼肌废用性肌萎缩的作用。     

Effect of Normal Saline Infusion on the Diagnostic Utility of Base Deficit in Identifying Major Injury in Trauma Patients

Background
Base deficit (BD) is a reliable marker of metabolic acidosis and is useful in gauging hemorrhage after trauma. Resuscitation with chloride-rich solutions such as normal saline (NS) can cause a dilutional acidosis, possibly confounding the interpretation of BD.
Objectives
To test the diagnostic utility of BD in distinguishing minor from major injury after administration of NS.
Methods
This was a prospective observational study at a Level 1 trauma center. The authors enrolled patients with significant mechanism of injury and measured BD at triage (BD-0) and at four hours after triage (BD-4). Major injury was defined by any of the following: injury severity score of ≥15, drop in hematocrit of ≥10 points, or the patient requiring a blood transfusion. Patients were divided into a low-volume (NS < 2L) and a high-volume (NS ≥ 2L) group. Data were reported as mean (±SD). Student's t- and Wilcoxon tests were used to compare data. Receiver operating characteristic (ROC) curves tested the utility of BD-4 in differentiating minor from major injury in the study groups.
Results
Four hundred eighty-nine trauma patients (mean age, 36 [± 18] yr) were enrolled; 82% were male, and 34% had penetrating injury. Major-(20%) compared with minor-(80%) injury patients were significantly (p = 0.0001) more acidotic (BD-0 mean difference: −3.3 mmol/L; 95% confidence interval [CI] =−2.5 to −4.2). The high-volume group (n = 174) received 3,342 (±1,821) mL, and the low-volume group (n = 315) received 621 (±509) mL of NS. Areas under the ROC curves for the high-volume (0.63; 95% CI = 0.52 to 0.74) and low-volume (0.73; 95% CI = 0.60 to 0.86) groups were not significantly different from each other.
Conclusions
Base deficit was able to distinguish minor from major injury after four hours of resuscitation, irrespective of the volume of NS infused.     

多普勒声学造影与DSA检查对照观察兔肌肉VX2肿瘤血管的实验研究

目的与X线数字减影血管造影对比，探讨彩色多普勒和能量多普勒声学造影检测肿瘤血管特征的应用价值。方法将8只右侧股外侧肌肉种植有VX2肿瘤的新西兰大白兔经耳缘静脉注射自制的新型白蛋白氟碳声学造影剂，采用Acuson公司生产的Sequoia 512超声仪，分别应用彩色多普勒和能量多普勒显像观察肿瘤血管造影增强效果，并与DSA检查对照。结果二维超声检查8只荷瘤兔共发现病灶12个，呈圆形或类卵圆形，边界较清晰。造影后，肿瘤内血流显示率明显增高，血管形态变化明显，条状及分枝状血流数目增多，并有4例清晰显示滋养血管走行，与DSA检查结果相一致。结论彩色多普勒和能量多普勒声学造影(CDE)是检测肿瘤血流特征的重要手段。能量多普勒声学造影优于彩色多普勒造影显像。     

Syndrome of depressed vital functions in the immediate post-operative period of surgical patients: Some aspects of its pathogenesis

Fifty adult male and female surgical patients (age 25–40 years) undergoing elective and emergency surgical procedures were subjected to isocapnoeic, hypocapnoeic and hypercapnoeic ventilation during anaesthesia; the PaCO₂ ranged between 22–90 mm Hg. Three developed the syndrome of depressed vital functions in the post-surgical period by scoring less than 7 out of 10, the others recovered normally with complete restoration of reflex activity, consciousness and skeletomuscular tone, scoring on an average 8 out of 10 points. The role of muscle relaxant drugs in this syndrome and also the depression of the central nervous system is discussed.Supported by the State Medical Research Council of Government of Andhra Pradesh, Hyderabad 500 029, India.     

Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study

OBJECTIVE: To compare the effects of traditional Chinese acupuncture with sham acupuncture on upper-extremity (UE) function and quality of life (QOL) in patients with chronic hemiparesis from stroke. DESIGN: A prospective, sham-controlled, randomized controlled trial (RCT). SETTING: Patients recruited through a hospital stroke rehabilitation program. PARTICIPANTS: Thirty-three subjects who incurred a stroke 0.8 to 24 years previously and had moderate to severe UE functional impairment. INTERVENTIONS: Active acupuncture tailored to traditional Chinese medicine diagnoses, including electroacupuncture, or sham acupuncture. Up to 20 treatment sessions (mean, 16.9) over a mean of 10.5 weeks. MAIN OUTCOME MEASURES: UE motor function, spasticity, grip strength, range of motion (ROM), activities of daily living, QOL, and mood. All outcomes were measured at baseline and after treatment. RESULTS: Intention-to-treat (ITT) analyses found no statistically significant differences in outcomes between active and sham acupuncture groups. Analyses of protocol-compliant subjects revealed significant improvement in wrist spasticity (P<.01) and both wrist (P<.01) and shoulder (P<.01) ROM in the active acupuncture group, and improvement trends in UE motor function (P=.09) and digit ROM (P=.06). CONCLUSIONS: Based on ITT analyses, we conclude that acupuncture does not improve UE function or QOL in patients with chronic stroke symptoms. However, gains in UE function observed in protocol-compliant subjects suggest traditional Chinese acupuncture may help patients with chronic stroke symptoms. These results must be interpreted cautiously because of small sample sizes and multiple, unadjusted, post hoc comparisons. A larger, more definitive RCT using a similar design is feasible and warranted.     

Risperidone in Children and Adolescents with Conduct Disorder: A Single-Center, Open-Label Study

Background: Risperidone is one of the most commonly used atypical antipsychotic drugs in the treatment of children and adolescents. However, the data about its use in children and adolescents with conduct disorder (CD) are limited.Objective: The aim of this study was to investigate the effectiveness and tolerability of risperidone in controlling major symptoms of CD in children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and severe CD.Methods: Children and adolescents were eligible for this single-center, open-label study if they met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for ADHD and ODD and also were diagnosed with severe CD. The patients were treated with risperidone in an open-label fashion for 8 weeks, starting at a daily dosage of 0.25 mg or 0.5 mg (depending on their body weight) in 2 divided doses.Results: The study population comprised 21 children and adolescents (17 boys, 4 girls) with a mean (SD) age of 10.8 (3.6) years. The mean (SD) dosage of risperidone at the end of 8 weeks of treatment was 1.27 (0.42) mg/d (range, 0.75-2.0 mg/d). On the basis of the global improvement subscale of the Clinical Global Impression scale, 16 of 20 patients (80%) were classified as responders. Significant improvements were observed after risperidone treatment in the inattention, hyperactivity/impulsivity, ODD, and CD subscales of the Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (parent and teacher forms). No severe adverse events were reported.Conclusions: The results of this study are consistent with previous findings and suggest that risperidone may be an effective and well-tolerated atypical antipsychotic drug for the treatment of children and adolescents with CD. However, further studies, particularly placebo-controlled and double-blinded, are needed to better define the clinical use of risperidone in children and adolescents with CD.