Objective To explore a new method for reconstruction o f full-thickness defect of eyelid. Methods The composed skin flap which was lined the expanded forehead skin flap with oral mucosa were transferr ed to the defect of eyelid and then sutured anatomically to the eyelid skin. Fou r months later, the composed flap was divided to reconstruct upper and lower eye lids and put an artificial eye into it. Results The appearance and function of the eyelid was partly recovered. Conclusion The reconstruction of full-thickness eyelid defect with expanded and prefabricated skin flap with grafted mucosal liner is better and reliable.

Objective: To explore the relationship between post-stroke depression and coping style and social sustian for guiding psychological intervention.Methods: A control study was done in 78 patients with post-stroke depression and 65 patients with non-post-stroke depression by using Medical Coping Modes Questionnaire and Social Sustian Scale.Results: The score of confrontation was lower and that of resignation was significantly higher in depression group than in non-depression group(P

Objective:To understand general hospital medical staff status quo and characteristics of blood -borne occupational exposure , analysis its ethics factor , to make the prevention countermeasures of blood -borne oc-cupational exposure to provide scientific basis .Methods:From January 2013 to December floor all the medical staff of blood -borne occupational exposure cases were retrospectively analyzed .Results:A total of 101 medical staff blood-borne occupational exposure , which is given priority to with the nurse , accounted for 60 .40%;More con-centrated in under 30 employees, accounted for 70.29%;Occupational exposure personnel distribution in the ma-jority with surgical department (42.57%), followed by the physician (36.63%);Wards (60.40%), the operat-ing room (15.84%) and therapy (11.88%) are the sites of occupational exposure often happen;Sharp injury in the composition of the ratio of 87.12%, in the first place, in which a proportion (23.76%), pull out the needle (18.81%) and blood (15.84%), surgical suture (14.85%) and transfusion injection (13.86%) as the sharp injury of frequent occurrence of occupational exposure;Exposure is given priority to with hepatitis b ( 61 .38%) . Conclusion:Medical staff blood-borne occupational exposure risk is high , the hospital infection control personnel must pay attention to occupational exposure of the whole education , strengthen the administration of the occupation-al exposure of ethics , reduce the risk of occupational exposure and injury .

AIM To investigate the immunolore gulation effect of Angelica polysaccharide purified from Angelica sinensis(Oliv.)Diels. METHODS Index of immune organs was weighed and caculated. Phagocytosis of mononuclear macrophage (M?) was determined with carbon particle clearance test. Spectrophotography was used to estimate levels of serum hemolysis IgG, IgM. Mixed lymphocyte reaction was measured by MTT assay. RESULTS In certain concentrations (10～100 mg?kg -1 ), Angelica polysaccharide significantly in creased phagocytic function and spleen index inboth normal and immunosuppression mice,caused by sc cyclophosphamide, but showed no obviouse influnence on thymus index. It also remarkbly decreased levels of serum hemolysis IgG, IgM. CONCLUSION These results suggest that Angelica polysaccharide has potent enhancement on non specific immunity. However, it could suppress humoral immunity.

Objective To investigate the risk factors for nosocomial infections in rehabilitation department of a general hospital. Methods The infection rate, underlying diseases and infection sites were retrospectively reviewed in 1243 patients hospitalized in rehabilitation department of the Second Affiliated Hospital of Wenzhou Medical College from July 1, 2004 to June 30, 2008. Risk factors were determined by multivariate analysis with Logistic regression. Results The infection rate and the frequency of nosocomial infections in rehabilitation department were 18. 34 % (228/1234) and 21. 40 % (266/1243), respectively. Patients with spinal cord injury and those with cerebrovascular diseases accounted for 41.67% (95/228) and 31. 14% (71/228) of the total nosocomial infections, respectively. Urinary tract and lower respiratory tract were the frequent infection sites. The incidence of nosocomial infections was correlated with underlying diseases, age, length of stay, invasive operation, nutrition, sensory or movement disturbance and dysphagia. Conclusions Rehabilitation department has high nosocomial infection rate. Relevant risk factors should be carefully monitored to prevent or reduce the occurrence of the infections.

Objective To explore the impact of TIMP 3 regulated by miR-181b as a target gene on invasion and migration of hepatocellular carcinoma (HCC) in vitro.Methods The expressions of miR-181b were detected using SYBR Green real-time fluorescence quantitative polymerase chain reaction on liver cancer specimens and on HCC cell lines.The protein expression of TIMP 3 in HCC was detected using westen blot,and SKHep-1 as a cell line expressing high miR-181b was chosen through reporter gene experiment.TIMP-3 as a target gene regulated by miR-181b and its effect on invasion and migration treated by anti-miR-181 b were studied using transwell and cell scarification test,respectively.Results The expression of miR-181b in HCC was higher than cancer-adjacent tissues and normal liver tissues.The differences among them were significant.There was a correlation between the high expression of miR-181b and invasiveness and metastasis in HCC.The protein expression of TIMP-3 in HCC was significantly lower than normal liver tissues and cancer-adjacent tissues.Expression of miR-181b mRNA was detected in various HCC cell lines such as Hep3B,HepG2,Huh 7,SKHep-1,SNU182,SNU449 and hepatocyte,with the expression of miR-181b in SKHep-1 being the highest (P＜0.01).TIMP3-3UTR was low when the expression of miR-181b was high (P＜0.05).The invasion and migration abilities of SKHep-1 were significantly inhibited by anti-miR-181b (P＜0.05).Conclusion The data suggested that miR-181b promoted invasion and migration of SKHep-1 by down-regulating TIMP-3 in HCC.

Objective To summarize surgical strategies and skills against aneurysms of posterior circulation .Methods Twenty-one cases of posterior circulation aneurysms who had undergone microsurgery between March 2008 and March 2013 were analyzed retrospectively .Two of these cases had their basilar artery aneurysms clipped via the pterion approach and five through the subtemporal approach .Five posterior cerebral artery aneurysms were clipped via the subtemporal approach , two anterior inferior cerebellar artery aneurysms were clipped via the retrosigmoid approach , three posterior inferior cerebel-lar artery aneurysms were clipped through the far lateral approach , and two vertebral artery aneurysms were clipped similar-ly approach.Results All the aneurysms were clipped successfully .According to Glasgow Outcome Scale (GOS), the cura-tive effect was poor in 3 cases(GOS 2-3 points), good in 16 cases(GOS 4-5 points) and 2 patients died(GOS 1 point). Conclusion Aneurysms of posterior circulation can be treated through microsurgery .Proper surgical strategies , operative ap-proach and delicate surgical skills are critical to the success of surgeries and curative effects .

Objective To investigate cognitive status and influencing factors for hand hygiene(HH)among health care workers(HCWs),and provide basis for scientific management of HH.Methods In April 2013,HCWs in a general hospital were selected by randomly sampling method,questionnaires were used to survey the implementation of HH in recent one month and HCWs’cognition on knowledge about HH.Results A total of 750 HCWs were in-vestigated,652 available questionnaires were collected.The frequency of hand washing and hand disinfection per day among most HCWs were 10 - 19 times,accounting for 46.62% and 47.85% respectively;30.52% of HCWs washed their hands for ≥30 seconds each time,60.58% of HCWs dried hands with paper towel after washing hands,57.21 % of HCWs abided by six-step hand washing method.The overall correct rate of cognition on ten op-portunities that requiring HH in clinical practice was 68.68%.The main factors influencing the implementation of HH were as follows:skin irritation of hand sanitizer and hand disinfectant subjectively considered by HCWs (63.34%),inadequate hand washing facilities(41 .10%);high cost of hand sanitizer ,hand disinfectant,and dry paper towel (38.96%),et al.Conclusion In addition to intensifying education on HH,installing rational HH facili-ties and improving HH standard are key points in strengthening HH in general hospital.

Objective To investigate the clinical significance of soluble intercellular adhesion molecule‐1 and inflammatory factors (CRP ,IL‐17) in elderly patients with colorectal carcinoma .Methods The expression of sICAM‐1 ,CRP and IL‐17 in 76 ca‐ses of elderly patients and 32 cases of youg patients with colorectal cancer were detected by enzyme linked immunosorbent assay be‐fore and after surgery ,and to analyze its clinical significance correlated with pathological parameters .Meanwhile ,60 cases of healthy were controls .Results The serum levels of IL‐17 and sICAM‐1 were higher in patients with different ages of colorectal cancer than those of the normal control group (P<0 .05) ,and the concentrations of the two group after operation were significantly lower than those of the normal control group (P<0 .05) .The CRP levels of the young group and old group were similar to that of the normal control group (P>0 .05) .The level of CRP before operation in the young group was higher than that in the normal control group (P<0 .05) .The levels of serum IL‐17 and sICAM‐1 were significantly different between the young and the old group(P<0 .05) , while the CRP level was similar in the two groups (P>0 .05) .The serum levels of sICAM‐1 and IL‐17 in colorectal cancer patients were associated with the degree of differentiation ,depth of invasion ,lymph node metastasis and TNM staging (P<0 .05) .The level of CRP was significantly correlated with the depth of invasion ,lymph node metastasis and TNM staging (P<0 .05) .Conclusion The serum levels of sICAM‐1 ,CRP and IL‐17 reflect the invasion and metastasis of colorectal cancer in a certain extent ,which play important roles in predicting the development and prognosis of colorectal cancer .

The implications of Survivin, CyclinD1, p21WAF1, Caspase-3 in the development, progression and prognosis in cervical cancer were investigated. By using immunohistochemical SP method, the expression of Survivin, CyclinD1, p21WAF1 , Caspase-3 was detected in 41 cases of cervical cancer, 17 cases of cervical intraepithelial neoplasia (CIN) and 10 cases of normal tissues, and their relation with pathological grade, clinical stage, metastasis and survival time was analyzed.The results showed that the positive expression rate of Survivin, CyclinD1 in cervical cancer was significantly higher than in CIN group and normal control group (P＜0.05). The median survival time in the patients with cervical cancer positive for Survivin and CyclinD1 was significantly shorter than in those with negative expression (P＜0.05). The expression of both Survivin and CyclinD1 was not related with tumor grade, clinical stage and metastasis (P＞0. 05). The positive expression rate of p21WAF1 , Caspase-3 in cervical ca rcer was significantly lower than in CIN group and normal control group (P＜0.05), and had a close relation with tumor grade (P＜0.05). The expression of Survivin in cervical cancer in cervical cancer was negatively associated with that of Caspase-3 (P＜0.01), but positively with that of CyclinD1 (P＜0.01). Cox Multivariate analysis revealed that Survivin was the independent prognostic indicator influencing the survival time of the patients with cervical cancer (P＜0.05). It was suggested that the high expression of Survivin or CyclinD1, and low expression of p21WAF1 or Caspase-3 was closely correlated with the development of cervical cancer. Survivin and CyclinD1 could be used as a useful indicator to predict the prognosis of cervical cancer.