Objective To investigate the clinical efficacy of electroacupuncture plus acupoint application in treating diabetic constipation of yin deficiency and blood stasis type.Methods One hundred and fifty-six patients with diabetic constipation of yin deficiency and blood stasis type were randomly allocated to treatment and control groups, 78 cases each. The treatment group received electroacupuncture plus acupoint application and the control group, oral administration of mosapride citrate tablets. The TCM syndrome scores were recorded in the two groups before and after treatment. The clinical therapeutic effects were evaluated using the Constipation Scoring System (CSS), the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire and the TCM syndrome scores.Results There was a statistically significant post-treatment difference in the total efficacy rate based on CSS, PAC-QOL and the TCM syndrome scores between the two groups (P<0.05,P<0.01). There were statistically significant pre-/post-treatment differences in the TCM syndrome scores in the treatment group (P<0.05). There were statistically significant pre-/post-treatment differences in TCM syndrome dry mouth and tongue, thirst and dry stool scores in the control group (P<0.05). There were statistically significant post-treatment differences in TCM syndrome short breath, weakness, lassitude, stabbing pain, scaly dry skin, fixed pain, sore and weak loins and knees, and chest, palm and sole vexing heat scores between the two groups (P<0.01,P<0.05).Conclusion Electroacupuncture plus acupoint application is an effective way to treat diabetic constipation of yin deficiency and blood stasis type.

Objective: The inhibition on the proliferation of colorectal carcinoma cell strain with different proliferative potential by ATRA was investigated in present study, which would benefit for the therapy of ATRA on colorectal carcinoma. Methods: The proliferation of LS174T and CW-2 colorectal carcinoma cell strain inhibited by ATRA was determined using cell observation, FACS and MTT methods. Results: The growth speed of LS174T cell strain was faster than that of CW-2. ATRA played a significant role on inhibiting the proliferation of LS174T and CW-2 cell strain and inducting the cell differetiation in vitro. Conclusions: ATRA could inhibit the growth of LS174T and CW-2 cell strain. ATRA could inhibit the proliferation of colorectal carcinoma cell and induce cell differentiation to some extent, which was correlated with the concentration of ATRA.

Objective To investigate the therapeutic effect of exosomes extracted from human adipose-derived mesenchymal stem cells(hAMSCs) on traumatic brain injury (TBI) and its possible mechanism.Methods Mesenchymal stem cells(MSCs) were isolated from healthy human adipose tissue and the exosomes were extracted by ultrafiltration.Rats were divided into four groups: sham group, PBS control group, MSCs treatment group and exosomes treatment group.24 h After TBI, the treatment group was locally injected along the lesion area, 30 μL of PBS, 2×105 MSC, 25 μg protein of exosomes respectively, the total volume was 30 μL.We performed the Modified Neurological Severity Score(mNSS) and the forelimb Foot-Fault Test in all rats before injury and at 1, 3, 7, 10, 13, 16, 21 and 30 days after TBI.The rats were sacrificed at 3 and 7 days after TBI respectively,total RNA was extracted from rat brain tissue.The expression of TNF-α and IL-1β were detected by quantitative PCR.The rats were also killed at 30 days after TBI for testing the neuronal apoptosis in lesion area by tunel-neun double imm-unofluorescence.Results Exosomes treatment significantly promotes the recovery of neurological deficits caused by TBI,and the therapeutic effect is similar to MSCs, its possible mechanism may be the inhibition of the acute inflammation and the reducing of the neurons apoptosis after TBI.Conclusions Exosomes extracted from human adipose-derived mesenchymal stem cellshas promoted neurological functionrecovery after traumatic brain injury, which will provide a new and safer TBI treatment for clinical practice.

Objective To evaluate the significance of surgical exploration for the refractory arterial crisis daring the hypersensitive period (48 h to 96 h) after replantation of severed fingers.Methods One hundred and seventy-one patients experienced refractory arterial crisis during the hypersensitive period after replantation of the proximal thumb from February 1995 to February,2005 in our department.Eighty-seven of them were managed with surgical exploration,including incision injury (n=6),saw injury (n=17),rotation and avulsion injury (n=30), and crush injury (n=34).Eighty-four cases received conservative treatment,including incision injury (n=6),saw injury (n=16).rotation and avulsion injury (n=29),and crush injury (n=33).In the surgery group,the e- mergent explorations were performed as soon as the refractory arterial crisis arose,If arterial spasm or/and thrombosis were found,the involved parts were resected before the artery ends were anastomosed or the finger artery was repaired by cubital vein graft.In the other group,conservative managements were carried out by using intramuscular injection of 30 mg Papaverine and intravenous injection of 20,000-unit Urokinase in 20 mL normal saline.If symptums were not alleviated after half an hour,the procedures were repeated.The conservative managements also included abirritative antipsychotics and analgesia of anodyne.Meanwhile,the survival state of all the digital replants was observed. Results In the surgery group,78 fingers survived,the surviving rate being 89.7%.In the conservative group,41 fingers survived with a surviving rate of 48.8%.The difference was statistically significant (P＜0.01).No obvious complications happened in the two groups.Conclusion Since surgical exploration is crucial to management of refractory arterial crisis during the hypersensitive period after replantation of severed fingers,it should not be readily abandoned.

Objective:To investigate the microsurgical anatomy of thoracodorsal artery perforators, and the clinical effect in repairing the soft tissue defect of hand with the thoracodorsal artery perforator flap (TAP).Methods:From October, 2014 to November, 2014, the axillary arteries in 10 thoracodorsal specimens were perfused with red latex. The number and diameter of the perforators of the thoracodorsal arteries were mearsured. From January, 2015 to February, 2019, 52 cases of soft tissue defects in hand combined with bone and extensor tendon exposure were repaired with TAP. The patients were followed-up in outpatient department to observe the clinical efficacy.Results:The number of perforators of thoracodorsal artery was 2-4 mostly, and 3 perforators was the most. The diameter of perforators was 0.22-0.68 mm, and the distance between the perforating point and the posterior axillary wall was 5.2-11.8 cm. All the operations were completed successfully, and the donor sites were closed directly. In 52 cases, 48 flaps survived, 2 had partially necrosis, and 2 had completely necrosis. The patients were followed-up for 5 to 24 months. The blood supply of the flaps was good with soft texture and good appearance.Conclusion:The TAP is an ideal flap because of its thin in thickness, concealed donor area and no obvious scar after direct suture.

Objective:To analyze failure mode and effect analysis (FMEA) management model on the risk and satisfaction of PICC catheterization in children with leukemia undergoing chemotherapy.Methods:Totally 100 children with PICC catheterized leukemia were admitted to our hospital from June 2015 to December 2018, and their FMEA were managed. Find out the possible failure content and potential risk factors during PICC tube placement operation and maintenance, and calculate the risk value (RPN) according to the formula. Based on RPN values, specific prevention and treatment strategies were formulated and follow-up observation was monitored.Results:After the failure mode and effect analysis, the RPN scores of misevaluation, nonstandard operation, uncooperative children and insufficient preparation for use were (619.5 ± 11.7), (859.3 ± 18.7), (248.6 ± 20.6), (597.4 ± 8.4) points respectively, while those before the intervention were (1 347.5 ± 27.8), (1 127.4 ± 34.7), (427.3 ± 41.9) points, the difference was statistically significant ( t values were 9.563-14.279, P < 0.05). After the failure mode and effect analysis, the RPN scores of drug factor, child factor, ineffective sealing, infusion interruption, inadequate propaganda and maintenance were (598.4 ± 17.4), (537.2 ± 12.1), (407.3 ± 12.1), (178.4 ± 12.1), (8.4 ± 12.1) points, respectively. Before the intervention, the scores were (986.4 ± 30.7), (685.7 ± 17.8), (527.4 ± 23.6), (359.2 ± 29.4) and (148.3 ± 26.5) points, respectively. The differences were statistically significant ( t values were 11.092-19.634, P < 0.05). Conclusion:Failure mode and effect analysis applied to children with leukemia PICC pipeline placement and maintenance can improve the effectiveness of pipeline management and reduce the occurrence of pipeline maintenance risk events.

Objective:To investigate the clinical effect of a 3D reconstruction assisted preoperative optimal design of anterolateral abdomen cross-region free perforator flaps for repair of soft tissue defects of limbs.Methods:Twenty patients who were treated for soft tissue defects of hand, forearm, foot and ankle in the Department of Hand Surgery, the Sixth Hospital of Ningbo from October 2017 to January 2020 were included in this study. Among the patients,17 had soft tissue defects in hand and forearm and 3 with composite tissue defects including ankle and soft tissue defect of foot. The sizes of soft tissue defects in limbs ranged from 6 cm × 8 cm - 36 cm × 18 cm. Twenty free cross-area perforator flaps were optimal designed with CTA and 3D assisted reconstruction before surgery. Following combinations of flaps were designed: (1) Free perforator flap with inferior abdominal artery and superior abdominal artery; (2) Free perforator flap with superficial iliac circumflex artery and deep iliac circumflex artery; (3) Free perforator flap with superficial iliac circumflex artery and inferior abdominal wall perforator artery; (4) Free perforator flap with perforators of superficial iliac circumflex artery plus superficial abdominal artery; (5) Free perforator flap with perforating artery of lower abdominal wall and superficial artery of abdominal wall. The overall nutritional area of a combined flap were 272.3 cm 2± 12.5 cm 2, 107.4 cm 2± 9.3 cm 2, 193.6 cm 2± 24.2 cm 2, 155.2 cm 2± 20.1 cm 2 and 203.7 cm 2± 16.3 cm 2, respectively. All the donor sites were sutured directly in one stage. The appearance, texture, blood supply, colour, joint movement of affected limbs, recovery and function of donor sites were observed through postoperative follow-up visits at the outpatient clinic. Results:Among the 20 anterolateral transventral perforator flaps, 18 flaps survived successfully; One had partial necrosis after surgery, and healed after dressing change. Subcutaneous haematoma occurred in 1 flap, and survived after drainage. In this study, there was no postoperative infection of flap. A total of 19 flaps healed in one stage, except 1 that had a delayed healing and the flap wound was closed after dressing change for 1 week. According to Disability of Arm, Shouder and Hand (DASH) questionnaire evaluation, which is widely used in the world to evaluate the therapeutic effect after limb injury, combined with the 6-12 months of follow-up, the functional recovery of 17 patients with upper limbs iniury was 7 in excellent, 9 in good and 1 in poor. The overall excellent and good rate achieved 94.1%. All the 3 patients with foot injury recovered well, and the walking and jumping were not significantly affected. The results were all excellent according to the Maryland Foot Function Scoring. Sensation of flaps was evaluated according to the British Sensory Function Evaluation, it showed: 3 in S 2, 15 in S 3 and 2 in S 3+. All 20 flaps had good blood supply, in soft texture, good colour, feeling, thickness and movement. The donor sites all healed well. Conclusion:Combined with an optimal preoperative design, the perforator flap of anterior lateral wall cross-region can obtain a satisfactory clinical efficacy in repair of large area soft tissue defects. It is a feasible treatment method.

Objective To investigate the value of peripheral blood diamine oxidase(DAO)in evaluating the severity of ulcerative colitis(UC).Methods A total of 76 UC patients admitted to Daxing Hospital,Capital Medical University from June 2020 to June 2022 were included in UC group,and were divided into severe ulcerative colitis(SUC)group and non-SUC group according to the severity of the disease.A total of 76 healthy subjects were included as control group.The general data and serum DAO of all subjects were collected for statistical analysis.Results The serum DAO level in UC group was significantly higher than that in control group(P<0.05).The serum DAO level in SUC group was significantly higher than that in non-SUC group(P<0.05).Receiver operating characteristic curve analysis showed that DAO predicted area under the curve(AUC)of UC was 0.751(95%CI:0.672-0.829,P<0.001),and DAO predicted AUC of SUC was 0.866(95%CI:0.807-0.925,P<0.001).Conclusion Serum DAO is an effective test index for evaluating the severity of UC,which is worthy of clinical promotion.

Objective To observe ultrasonographic features and significance of scoring of the lung in preterm infants.Methods Totally 37 preterm infants (preterm group) and 33 term infants (term group) without cardiopulmonary disease nor hypoproteinemia were enrolled,and infants in each group were divided into＜1 week,1-4 weeks and ＞4 weeks subgroup,respectively.All the infants underwent lung ultrasonography and scoring.The ultrasonography scores were compared between preterm infants and term infants among different ages.Results The main ultrasonic manifestations of the lung in preterm infants were diffuse distribution of dense B-lines,with or without " falls sign" suggesting alveolar effusion.The ultrasonographic score of the lung in preterm infants and term infants was (15.24± 2.76) and (12.21 ±3.62),respectively (t=3.962,P＜0.001).There was no statistical difference of ultrasonographyic scores in ＜1 week subgroups between preterm infants and term infants (t =-0.669,P =0.513).There were statistical differences of ultrasonographic scores in 1-4 weeks subgroups and ＞4 weeks subgroups between preterm group and term group (both P＜0.05).In preterm group,the ultrasonographic scores demonstrated no statistical difference among 3 subgroups (F=0.960,P=0.393),whereas statistical difference was found among 3 subgroups in term group (F =4.277,P =0.023).The ultrasonographic score of preterm infants showed negative correlation with gestational age (r=-0.352,P=0.033),and the linear regressive equation was Y=33.805-0.548X.Conclusion The main ultrasonic manifestations of the lung in preterm infants were diffuse distribution of dense B-lines,some with "falls sign" suggesting alveolar effusion,which are more significant in smaller gestational age infants.

Objective:To investigate the efficacy of free thin sensate superficial circumflex iliac artery perforator flap based on lateral cutaneous branch of the subcostal nerve for repair of soft tissue defect in the foot and ankle.Methods:A retrospective case series study was made on clinical data of 9 patients with soft tissue defect in the foot and ankle admitted to 80th Group Military Hospital from December 2017 to December 2019. There were 8 males and 1 females, with the age of 28-63 years [(47.3±12.3)years] and the body mass index (BMI) of 16.7-27.8 kg/m 2 [(23.9±3.9)kg/m 2]. The size of soft tissue defect ranged from 10 cm×6 cm to 20 cm×12 cm. All patients were treated with the free thin sensate superficial circumflex iliac artery perforator flap based on lateral cutaneous branch of the subcostal nerve. After debridement or tumor resection, a thin sensate flap was harvested by intra-adipose tissue dissection between the superficial and deep fat layers. The size of flap ranged from 13 cm×8 cm and 13 cm×10 cm. The thickness of the defatted flap ranged from 3-6 mm. The distance from the anterosuperior iliac spine to the point where the lateral cutaneous branch of the subcostal nerve crossed the iliac crest ranged from 7.5-10.0 cm. The flap survival, complications, and reoperation were observed after operation. The sensory recovery of the flap was evaluated using Tinel sign and nine-grid method including monofilament touch perception, vibration perception, pinprick perception, temperature perception, and static two-point discrimination test. The joint range of motion, and shoewear and walking problems were recorded. At the last follow-up, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to assess the affected foot and ankle. The injury at the donor site was detected as well. Results:All patients were followed up for 6-35 months [(21.1±10.1)months]. All flaps survived without infection or tumor reoccurrence. One patient developed ulceration, then surplus skin on the reconstructed heel was resected. One patient underwent flap debulking and removal of internal fixation. One or more sensory modalities within the nine areas in each flap could be detected at postoperative 3-6 months. The monofilament touch, vibration, pinprick, and temperature perception were presented in almost all regions of each flap at postoperative 12 months. However, only one patient in one region was noted with the static two-point discrimination, in which the distance of the two points was set as 25 mm. The range of ankle motion was slightly limited in 2 patients who underwent osseoligamentous complex reconstruction. All patients were able to wear normal shoes and walk without pain. At the last follow-up, the AOFAS ankle-hindfoot score ranged from 78 to 97 points [(86.4±7.4)points], significantly improved from preoperative 10-70 points [(44.2±18.4)points] ( P<0.01). No patients complained of pain at the donor site, but the widening linear scar was noted. Conclusion:For medium-sized soft tissue defect of the foot and ankle, the free thin sensate superficial circumflex iliac artery perforator flap based on lateral cutaneous branch of the subcostal nerve can be defatted with the requirement and has advantages in defect site appearance, sensory restoration, wearing ordinary shoes, painless walking, good functional recovery, and minimal donor site morbidity.