Objective To explore the effect of 1,25-dihydroxyvitamin D3 [1,25-(OH)2VitD3] on insulin resistance and inflammatory response in mice with severe burns under stress. Methods One hundred and thirty mice were randomly divided into healthy group (n=10), experimental groupⅠ(n=40), experimental groupⅡ(n=40) and control group (n=40). The model mice were scalded to 30%of total body surface area (TBSA) burnt (Ⅲ°) in experimental groupⅠ, the experi-mental groupⅡand control group. Mice in experimental groupⅠwere given by gavaging 1,25-(OH)2VitD3 (1μg·kg-1) with 0.6 mL peanut oil at 8 am for every other day. At the same time and by the same way, mice in experimental groupⅡreceived 1,25-(OH)2VitD3 (4μg·kg-1) with 0.6 mL peanut oil, and mice in control group received only 0.6 mL peanut oil. The serum levels of fasting blood glucose (FBG), fasting insulin (FIns), TNF-αconcentration, and the NF-κB positive rate in wound tis-sues were determined respectively on day1, day3, day7 and day14 after burn. Results (1) The values of insulin resistance index (HOMA-IR), serum TNF-αand the NF-κB positive rate in wound tissues were higher at different time points in exper-imental groupⅠ, experimental groupⅡand control group than those in healthy group. (2) The levels of HOMA-IR at the same time points were significantly lower in experimental groupⅠand experimental groupⅡthan those in control group, and the value was significantly lower in experimental groupⅡthan that of experimental groupⅠ(P<0.05). The level of HOMA-IR was the highest at day 3 and then gradually decreased at the different time points in the same group (P<0.05). (3) The se-rum levels of TNF-αand NF-κB positive rate of wound tissues at the same time points were significantly lower in experimen-tal group Ⅰand experimental group Ⅱ than those in control group, and the value was significantly lower in experimental groupⅡthan that of experimental groupⅠ(P<0.05). The serum level of TNF-αand NF-κB positive rate of wound tissues were gradually decreased at the different time points in same group (P<0.05). Conclusion 1,25-(OH)2VitD3 can reduce the insulin resistance and inflammatory response in mice with severe burns under stress.

Objective Study the effect of recombinant human acidic fibroblast growth factor combined suction drainage in the treatment of refractory wound. Methods Fifty-four patients with refractory wound were analyzed from January 2010 to December 2012 and were randomly divided into the treatment group (n=29, treated with rh-aFGF washing dur-ing operation) and control group (n=25, treated with 0.9% NS). Both groups were treated combined suction drainage treatment. Exposed areas of surface and deep tissue were recorded during the treatment, then the rate of deep wound healing and the rate of cavity volume improvement were calculated. Results Wound in the treatment group cured pri-marily, and the area of bone tendons exposure reduced. The rate of deep wound healing and the rate of cavity volume improvement in the treatment group were better than the control group (P<0.05). The treatment group all healed after short time dressing change. However, the control group all healed after long time dressing change or with skin flap transplantation. Conclusion By exogenous long-term supplementing aFGF and it can achieve the purpose of therapy.

OBJECTIVE:To establish the method for rapid quality evaluation of Astragali Radix.METHODS:The moisture of medicinal material was determined by oven drying method;the content of astragaloside Ⅳ was determined by HPLC-ELSD;the content of isoflavone glucoside was determined by HPLC (as reference value).The partial least squares (PLS) method combined with acousto-optic turnable filter-NIDRS was adopted to build quantitative model of above indexes in Astragali Radix (as predict value).According to reference value,60 batches of sample were collected.The spectra pretreatment was conducted by first derivative method combined with Savitzky golay.The optimal bands of moisture,astragaloside Ⅳ and isoflavone glucoside were 1 100-2 300 nm,1 080-2 160 nm,1 170-2 230 nm,respectively.RESULTS:The content determination of moisture,astragaloside Ⅳ and isoflavone glucoside in samples were all in line with methodology requirements.The corrected mean square root deviation of quantitative model for moisture,astragaloside Ⅳ,calycosin glucoside were 0.132 3,0.006 6,0.002 5,respectively;predicted mean square root deviation were 0.237 1,0.016 3,0.004 7;internal cross validation coefficient of correction set were 0.975 9,0.953 3,0.968 0;internal verification deviation of quantitative model were 1.43％,1.90％,1.84％;external verification deviation were 1.73 ％,2.68 ％,2.71％,respectively.CONCLUSIONS:The method is rapid,accurate,simple,pollution-free,and can be used for rapid quality evaluation of Astragali Radix.

Objective To analyze the factors influencing the occurrence of post-embolization syndrome(PES)after transhepatic arterial chemoembolization(TACE).Methods A total of 107 patients with hepatocellular carcinoma(HCC),who received TACE treatment at authors'hospital between February 2021 and March 2023,were included in the study.Among them,56 patients developed PES(PES group)and 51 patients did not develop PES(non-PES group).The demographic data,medical history,pathological findings,laboratory indicators and operation-related materials were compared between the two groups,and the risk factors for PES were analyzed.Results There were statistically significant differences in tumor diameter,albumin(ALB)level,preoperative physical condition(ECOG)score,type of embolization agent,drug-loaded microspheres,number of microspheres,and dosage of loaded drug between the two groups(all P＜0.05).Multivariate Logistic analysis revealed that drug-loaded microspheres,number of microspheres,and dosage of loaded drug were the independent risk factors for PES occurring after TACE(all P＜0.05).Conclusion HCC patients treated with TACE using drug-loaded microspheres,large amount of microspheres and high dosage of loaded drug have a higher risk of PES occurring after TACE.For patients having the above risk factors,the formulation of corresponding perioperative intervention strategies is necessary so as to avoid the occurrence of PES and to improve the safety of TACE.

Objective To analyze the application value of evidence-based nursing(EBN) in LASEK surgery.Methods Totals of 120 cases of LASIK surgery patients from December 2013 to December 2015 were selected, and divided into observation group and control group by sortition. Patients in observation group received EBN, while patients in control group received routine nursing. Systolic blood pressure(SBP), diastolic blood pressure( DBP ) , heart rate, and SAS score before surgery, postoperative complications after 1 week, visual acuity, diopter and intraocular pressure after 4 weeks, and Haze grading are observed in two groups. Results The preoperative SBP, DBP and heart rate in observation group were lower than in the control group, SAS score in observation group was lower than the control group, differences were statistically significant ( P<0.05);complication rate 1. 67% in observation group was lower than 8. 67% in control group 1 week after surgery. The difference was statistically significant (χ2=5. 886, P<0. 05 ); 4 weeks after surgery, visual acuity in observation group was higher than that in control group, diopter was lower than in control group, and intraocular pressure was lower than in control group, The difference was statistically significant ( P<0.05);4 weeks after surgery, 1.67% patients in observation group were Haze 1 and was lower than that 11.67% in control group (P<0.05).Conclusions The application of EBN in LASEK surgery can effectively relieve patients′negative emotions, reduce the complication rate, and improve the surgical curative effect.

Objective To analyze the relationships between pulmonary ground-glass nodules(GGN)and bronchi and blood vessels and their diagnostic values for infiltrative lesions based on high-resolution computed tomography(HRCT)target scanning technology.Methods Patients with GGN detected by HRCT target scanning and complete pathological results were retrospectively selected as the research subjects.The relationships between GGN and bronchi and blood vessels in patients with different pathological types were analyzed,and the relationships for detecting infiltrative lesions were further analyzed,using pathological results as the gold standard.Results Three hundred patients were divided into 237 cases of pre-invasive lesions and 63 cases of infiltrative lesions according to pathological results.There were statistically significant differences in lesion properties and lesion morphology in patients with different types of GGN(P＜0.05).There were statistically significant differences in the relationships between GGN and bronchi and blood vessels in the pre-invasive lesions and the infiltrative lesions(P＜0.05).Based on the pathological results as the gold standard,the sensitivity of HRCT bronchial classification,vascular classification,and their combined detection of infiltrative lesions were 84.13％(53/63),95.24％(60/63),and 95.24％(60/63);specificity were 83.12％(197/237),87.34％(207/237),and 87.34％(207/237);accuracy were 83.33％(250/300),89.00％(267/300),and 89.00％(267/300).Conclusion Evaluating the classification of pulmonary GGN and bronchi and blood vessels by HRCT target scanning technology has good value in identifying infiltrative lesions.The combined diagnosis of the two signs can further improve the accuracy of detection.

OBJECTIVETo observe and evaluate the clinical effects of improved scapula flap in repairing refractory wound.

METHODSTen patients, with refractory wounds (ranging from 11 cm×7 cm to 16 cm×15 cm) on face and extremities combined with bone and tendon exposure as a result of traffic injury, burns, or diabetic feet, were hospitalized from February 2008 to February 2013. The wounds were repaired with improved scapula flap ranging from 12 cm×8 cm to 17 cm×16 cm. Six of them were grafted directly; 4 of them were grafted with bridging. The vessel of flap was freed to the subscapular vessel and its thoraco-dorsal branch, forming the T-shape vessel pedicle with circumflex scapular vessel, and the vessels on two sides of vessel pedicle were anastomosed with vessels in recipient area. The donor sites were sutured directly or covered with autologous medium-thickness skin graft.

RESULTSNine flaps survived after surgery; the wounds were healed. Few blisters and exudation were observed at the distal end of one flap, which was cured after dressing change for 2 weeks. The pedicles of the bridge-like flap were divided 4-6 weeks after surgery. All the patients were followed up for 6 to 12 months. Slight swelling was observed in 2 flaps. The appearance and texture of the other 8 flaps were good, and the function of the recipient area recovered. No obvious hypertrophic scar was observed in donor site on the back, with normal function of shoulder joint and pulsation of named vessels.

CONCLUSIONSRepairing refractory wounds with improved scapula flaps can result in good appearance, texture, and satisfactory function, which should be popularized in clinic.

Objective : To investigate the association between c. 1311C > T and c. 1004C > A of glucose⁃6 ⁃phosphate dehydrogenase (G6PD) gene single nucleotide polymorphism ( SNP) with the risk of G6PD deficiency in Guangxi population. Methods : 417 patients with G6PD deficiency were randomly selected as case group , and 295 healthy patients were selected as control group. The c. 1311C > T and c. 1004C > A were genotyped using the SNPscanTM multiple SNP method , and the haplotype frequency of two sites were analyzed by SHEsis. Results : In the case and control group , there were statistically significant differences in the distribution frequency of genotype TT , CC + CT and allele T at c. 1311C > T locus [TT vs CC :(P = 0. 001 , OR = 0. 373 , 95% CI = 0. 204 - 0. 683) ; TT vs CC + CT :(P = 0. 001 , OR = 0. 371 , 95% CI = 0. 203 - 0. 678) ; T vs C :(P = 0. 002 , OR = 0. 601 , 95% CI = 0. 435 - 0. 829)] ;however, there was no significant difference in genotype and allele distribution frequency at c. 1004C > A locus (P > 0. 05) . The results of the rate method showed that compared with genotype CC , the genotype CT at c. 1311C > T increased the expression level of G6PD enzyme , while the genotype TT decreased the expression level of G6PD enzyme(P < 0. 05) , the haplotype analysis showed that C ⁃C and T ⁃C were associated with G6PD risk (P < 0. 05) . Conclusion In Guangxi population , c. 1311C > T locus genotypes TT , CC + CT and allele T were related to the decreased risk of G6PD deficiency.

Objective : To investigate the association between c. 1311C > T and c. 1004C > A of glucose⁃6 ⁃phosphate dehydrogenase (G6PD) gene single nucleotide polymorphism ( SNP) with the risk of G6PD deficiency in Guangxi population. Methods : 417 patients with G6PD deficiency were randomly selected as case group , and 295 healthy patients were selected as control group. The c. 1311C > T and c. 1004C > A were genotyped using the SNPscanTM multiple SNP method , and the haplotype frequency of two sites were analyzed by SHEsis. Results : In the case and control group , there were statistically significant differences in the distribution frequency of genotype TT , CC + CT and allele T at c. 1311C > T locus [TT vs CC :(P = 0. 001 , OR = 0. 373 , 95% CI = 0. 204 - 0. 683) ; TT vs CC + CT :(P = 0. 001 , OR = 0. 371 , 95% CI = 0. 203 - 0. 678) ; T vs C :(P = 0. 002 , OR = 0. 601 , 95% CI = 0. 435 - 0. 829)] ;however, there was no significant difference in genotype and allele distribution frequency at c. 1004C > A locus (P > 0. 05) . The results of the rate method showed that compared with genotype CC , the genotype CT at c. 1311C > T increased the expression level of G6PD enzyme , while the genotype TT decreased the expression level of G6PD enzyme(P < 0. 05) , the haplotype analysis showed that C ⁃C and T ⁃C were associated with G6PD risk (P < 0. 05) . Conclusion In Guangxi population , c. 1311C > T locus genotypes TT , CC + CT and allele T were related to the decreased risk of G6PD deficiency.

Objective: To investigate and analyze the actual intake of protein and energy in adult patients with severe burns during post burn days (PBDs) 3 to 14. Methods: Records of 52 adult patients with severe burns [37 males and 15 females, (37±9) years old], admitted to the Department of Plastic Surgery and Burns of Tianjin First Central Hospital from January 1st 2011 to December 31st 2017 and meeting the study inclusion criteria, were retrospectively analyzed. Nutrition intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations of patients during PBDs 3 to 14 were obtained from critical care records. During PBDs 3 to 7 and PBDs 8 to 14, the personal daily total energy intake and the ratio of it to energy target of patients were calculated and compared; the personal daily intake of carbohydrate, fat, and protein and calorigenic percentages of carbohydrate, fat, and protein accounted for total energy intake, and the ratios of non-protein calories to total nitrogen of patients were calculated and compared; the personal daily energy and protein intake of patients from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations were analyzed; the percentages of energy intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total energy intake, and the percentages of protein intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total protein intake of patients were calculated. Vomiting and diarrhea of patients during PBDs 3 to 7 and PBDs 8 to 14 were recorded. Levels of serum albumin, prealbumin, blood glucose, and triglycerides, 24-hour excretion of urinary nitrogen, nitrogen balance values of patients on PBDs 7 and 14 were recorded or calculated. Data were processed with paired t test and chi-square test. Results: (1) The personal daily total energy intake of patients during PBDs 3 to 7 and PBDs 8 to 14 were (8 696±573) and (11 980±1 259) kJ respectively, and ratios of them to energy target [(13 290±1 561) kJ] were 65.4% and 90.1% respectively. The personal daily total energy intake of patients during PBDs 3 to 7 was obviously lower than that during PBDs 8 to 14 (t=18.172, P<0.01). (2) The personal daily intake of carbohydrate, fat, and protein of patients during PBDs 8 to 14 were obviously higher than those during PBDs 3 to 7 (t=15.628, 22.231, 10.403, P<0.01). The personal daily calorigenic percentages of carbohydrate, fat, and protein accounted for total energy intake of patients were 56.8%, 25.1%, and 18.3% respectively during PBDs 3 to 7 and 54.2%, 27.0%, and 18.7% respectively during PBDs 8 to 14. The calorigenic constituent ratio of personal daily intake of carbohydrate, fat, and protein accounted for total energy intake of patients during PBDs 3 to 7 was close to that during PBDs 8 to 14 (χ²=0.185, P>0.05). The ratios of non-protein calories to total nitrogen (kJ∶g) of patients during PBDs 3 to 7 and PBDs 8 to 14 were 469∶ 1 and 456∶ 1 respectively. (3) The personal daily energy intake of patients from routes of oral diet and parenteral nutrition preparations during PBDs 8 to 14 [(4 394±978), (5 723±898) kJ] were obviously higher than those during PBDs 3 to 7 [(2 137±453), (4 855±825) kJ, t=26.516, 6.583, P<0.01], while the personal daily energy intake of patients from routes of enteral nutrition preparations during PBDs 8 to 14 was close to that during PBDs 3 to 7 (t=1.922, P>0.05). The constituent ratio of personal daily energy during PBDs 3 to 7 was close to that during PBDs 8 to 14 (χ²=4.100, P>0.05). The personal daily protein intake of patients from route of oral diet during PBDs 8 to 14 was (58±22) g, obviously higher than (25±6) g during PBDs 3 to 7 (t=14.514, P<0.01). The personal daily protein intake of patients from routes of enteral nutrition preparations and parenteral nutrition preparations during PBDs 8 to 14 was close to those during PBDs 3 to 7 (t=1.924, 1.110, P>0.05). The constituent ratio of personal daily protein intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total protein intake during PBDs 8 to 14 was close to that during PBDs 3 to 7 (χ²=5.634, P>0.05). (4) There were 3 patients with vomiting and 4 patients with diarrhea during PBDs 3 to 7, and 1 patient experienced both of them during PBDs 8 to 14. The levels of serum albumin, prealbumin, blood glucose, and triglycerides, 24-hour excretion of urinary nitrogen, and nitrogen balance values of patients on PBDs 7 and 14 were (29±4) and (30±4) g/L, (132±42) and (171±48) mg/L, (7.4±2.8) and (6.7±2.8) mmol/L, (1.5±0.7) and (1.4±0.7) mmol/L, (30.5±4.3) and (34.5±2.2) g, -(25.1±2.6) and -(23.7±3.9) g, respectively. Conclusions The personal daily total energy intake of patients during PBDs 3 to 7 was lower than that during PBDs 8 to 14. The calorigenic constituent ratio of personal daily intake of carbohydrate, fat, and protein accounted for total energy of patients during PBDs 3 to 7 was close to that during PBDs 8 to 14. Energy and protein intake were mostly derived from parenteral nutrition preparations during PBDs 3 to 7, while those during PBDs 8 to 14 were mainly derived from parenteral nutrition preparations and oral diet.