Objective:To prepare celecoxib nanosuspension ( CXB-NSs) and study the pharmacokinetics of CXB-NSs in rats. Methods:CXB-NSs were prepared by an anti-solvent precipitation and high pressure homogenization method. The particle size, polydispersion index ( PdI) and zeta potential of the nanosuspension were studied. Totally 12 Wistar rats were randomly divided into CXB-NSs group and CXB suspension group, and gastric drug dose was 100 mg·kg-1 . CXB concentration in plasma was determined by HPLC and the pharmacokinetic parameters were calculated by 3P97 software. Results: The particle size, polydispersion index, zeta potential of CXB-NSs was (442. 5 ± 61. 9) nm, 0. 312 ± 0. 057 and ( -31. 6 ± 3. 9) mV, respectively. AUC (0-t) of CXB suspension and CXB-NSs was (5.13 ±0.77) and (13.51 ±3.18) mg·L-1·h, half time (t1/2) was (12.31 ±1.91) and (12.73 ±1.83) h, Tmax was (2. 48 ± 0. 37) and (1. 41 ± 0. 27) h and Cmax was (0. 94 ± 0. 31) and (2. 38 ± 0. 25) mg·L-1 , respectively. Conclusion:CXB-NSs can remarkably increase bioavailability in rats.

Objective To explore the diagnosis and treatment of Kaposiform hemangioendothelioma (KHE),deepen the understanding of KHE and Kasabach-Merritt phenomenon (KMP),and discuss the optimal treatment for KHE.Methods From January 2008 to August 2016,13 cases of KHE were confirmed by surgery or biopsy pathology and admitted to the First Affiliated Hospital of Sun Yat-Sen University,and the clinical diagnosis and treatment were analyzed retrospectively.Results There were 13 patients(7 males and 6 females) with a median age of 1.0 years(0.2-10.0 years),and 84.6%(11/13 cases) were infants and young children,76.9% (10/13 cases) involved with deep tissue,23.1% (3/13 cases) were associated with KMP and they were younger than 1 year old,and 15.4% (2/13 cases) coexisted with hemangioma or lymphangioma.The location,extent and infiltration depth of the lesion were observed by imaging examinations and histopathology showed nodule shaped spindle tumor cells.Radical resection was considered if possible.Dose of Vincristine (0.5 mg/m2 weekly) and Propranolol [1 mg/(kg·d)] were administered.The prognosis was different in thirteen cases undergoing different treatments.After 3 months to 9 years follow-up,41.7% (5/12 cases) survived after tumor treatment.Conclusions KHE happens mostly in infants and young children,with varying clinical manifestations and a high recurrence rate.The diagnosis of KHE is based on histological examination,computed tomography and magnetic resonance imaging while it still need explicit pathological diagnosis is needed.KHE may be accompanied by hemangioma or lymphangioma.Prognosis is affected by many factors and the comprehensive treatment is required.KMP should be remedied preferentially,individual treatment protocol and long term follow-up are necessary.

Environmental Monitoring ; methods ; Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Industry ; Volatile Organic Compounds ; analysis

Objective To explore the method of pre expanded deltopectoral flap for repairing post burn faciocervical scars.Methods Anterior axillary incisions were made and appropriate expanders were implanted above anterior chest wall at the first stage.After a 4 6 months' expanding,the flaps based on perforating branches of the internal mammary artery,branches from the thoracoacromi al area,or perforating branches from deltoid muscle,were designed and raised according to scars and dominant vessels.The donor sites were closed at same time without skin graft.Results 43 patients with 51 flaps were operated for reconstruction of post burn faciocervical scars.All flaps and donor sites survived well.Conclusions Pre expanded deltopectoral flap is an ideal donor site for repairing post-burn faciocervical scars.

Objective To explore the prognosis related genes of pancreatic ductal adenocarcinoma (PDAC)and investigate the molecular regulation mechanism.Methods Gene expression data of 102 PDAC patients with complete clinical survival data were selected from gene expression database of National Center for Biotechnology Information.The 106 transcription regulation gene collection was collected from Transfac database.The 715 microRNA (miRNA)target regulation gene collection was selected according to PicTar and TargetScanS method.Biological pathway data obtained from the Kyoto Encyclopedia of Genes and Genomes (KEGG).The known cancer genes were collected from the cancer gene census (CGC) database.Univariate Cox proportional hazards model was used to analyze the correlation between gene expression data and survival time,then obtained survival related candidate genes from the whole genome. Then the enriched genes were analyzed by hypergeometric distribution algorithm from three databases. Multiple correction testing was performed by BH-FDR method (FDR < 0.05 ).Kaplan-Meier was performed for survival curve analysis of PDAC.Results The results of data of 102 PDAC patients analyzed by univariate Cox proportional hazards model indicated that 273 genes were significantly related to the survival time of patients (P <0.000 1 ).After 273 survival genes were enrichment analyzed in 106 transcription factor regulation gene collection,12 survival genes enriched transcription factor target gene sets were found.After 273 survival genes were enrichment analyzed in 715 miRNA target regulation gene collection,11 survival genes enriched miRNAs target sets were discovered.After 273 survival genes were enrichment analyzed in pathway data of KEGG,15 survival genes enriched pathways were obtained. Period circadian clock 2 (PER2 )was regulated by CCAAT/enhancer binding protein (CEBPA)at transcription level and regulated by miRNA-32 after transcription.The prognosis of PDAC was affected by circadian rhythm pathway.The 102 patients with PDAC were ranked according to the expression of PER2 from high to low,the first 51 cases were included in PER2 higher expression group and the left were included in PER2 lower expression group.Kaplan-Meier survival analysis indicated that PER2 was significantly correlated with prognosis of PDAC (P <0.01 ).Conclusion CEBPA/miRNA-32/PER2 and its related circadian clock pathway may be the target pathway in interfering the development of PDAC,and is correlated with the prognosis of PDAC.

ObjectiveTo explore the effects of companion support on insulin pump therapy in adolescents with type 1 diabetes.Methods A total of 60 patients were randomly divided into experimental group and control group,30 cases respectively. Patients in control group were given routine education,while patients in experimental group received additional intervention of companion support. Changes of blood glucose,the occurrence of negative events during the use of insulin pump and standardized usage of insulin pump were compared between two groups. Blood glucose before sleep in one random day was recorded and the fluctuation of blood glucose was compared between two groups.Results After six months,fasting and postprandial blood glucose,glycated hemoglobin and the occurrence of negative events during the use of insulin pump in experimental group were significantly lower than those in control group (P<0.05). The waveform stability at one random day before sleep of experimental group was better than that of control group.Conclusions Companion support plays curial roles in controlling blood glucose, improves the standardization of insulin pump operation and effectively reduces the negative events in adolescents with type 1 diabetes undergoing temporary insulin pump therapy.

Objective:To compare the predictive ability of Sequential Organ Failure Assessment(SOFA)scores for the prognosis of sepsis between elderly and non-elderly patients.Methods:Medical information of patients with sepsis based on the diagnostic criteria for sepsis were screened from the database of critical care units of the Beth Israel Deaconess Medical Center in the United States during 2001 to 2012.Hospital mortality was chosen as the primary outcome for the prognosis of sepsis, and receiver operating characteristics(ROC)curve analysis was performed to compare the differences in predictive ability of SOFA scores for the prognosis of sepsis between the elderly(≥60 years)and the non-elderly on admission.Parameters related to age, heart rate and body temperature were added into the SOFA scoring systems, and the differences in predictive ability of SOFA scores versus the modified SOFA scores for sepsis were compared by using ROC curve analysis.Multivariable regression models were used to assess the associations of the modified SOFA scores with clinical outcomes in the elderly sepsis patients.Results:A total of 10 206 patients with sepsis were included in this study, including 6 928(67.88%)elderly patients and 3 278(32.12%)non-elderly patients.ROC curve analysis showed that the power of admission SOFA score for predicting hospital mortality in elderly sepsis patients(AUC=0.67, 95% CI: 0.65-0.68)was lower than in non-elderly sepsis patients(AUC=0.75, 95% CI: 0.72-0.78). AS compared with the SOFA scores, the modified SOFA scores after increasing the parameters related to age, heart rate and body temperature significantly improved the predictive power for hospital mortality of sepsis patients, only in elderly(AUC: 0.67 vs.0.69, P<0.01), but not in non-elderly patients(AUC: 0.75 vs.0.75, P=0.77). After adjusting for potential confounders and in elderly sepsis patients, multivariate regression analysis showed that the modified SOFA scores were significantly associated with multiple clinical outcomes, including hospital mortality( OR=1.17, 95% CI: 1.15-1.19, P<0.01), 28-day mortality( HR=1.12, 95% CI: 1.10-1.13, P<0.01), 90-day mortality( HR=1.10, 95% CI: 1.08-1.11, P<0.01). Conclusions:The predictive ability of SOFA scores for the prognosis of sepsis is lower in elderly patients than in non-elderly patients.The predictive value of SOFA scores for the prognosis of elderly sepsis patients can be improved by increasing parameters related to age, heart rate and body temperature.

Objective:Analysis of influencing factors of enteral nutrition interruption in critically ill patients in general surgery department and its impact on prognosis.Methods:A total of 91 cases of critically ill patients in general surgery department were selected who were admitted to the general surgery of General Hospital of Eastern Theater Command of the Chinese People′s Liberation Army in Nanjing from June 2021 to March 2022 by convenient sampling method, demographic and enteral nutrition interruption data were collected,and patients were divided into enteral nutrition interruption group and enteral nutrition uninterrupted group to investigate the analysis of the factors of affecting enteral nutrition interruption and its impact on prognosis by Logistic regression analysis.Results:There were 59 cases in the enteral nutrition interruption group and 32 cases in the enteral nutrition uninterrupted group. There were statistically significant differences in gender, analgesic and sedatives, Gastro-kinetic agent and feeding intolerance between both groups ( χ2 values were 4.51-9.97, all P<0.05). Logistic regression analysis results showed that gender ( OR=4.566, 95%CI 1.332-15.657, P<0.05), analgesic and sedatives ( OR=3.437, 95%CI 1.112-10.621, P<0.05), and feeding intolerance ( OR=4.116, 95%CI 1.257-13.479, P<0.05) were the factors of enteral nutrition interruption. There were statistically significant differences between the two groups in the number of days of enteral nutrition up to goal in 3 days, 3-7 days and 7 days, albumin,length of stay in intensive care unit, total length of stay and hospitalization expenses between both groups ( Z values were -2.80 - -0.73, all P<0.05). Conclusions:Female, analgesic and sedatives and feeding intolerance are the risk factors of enteral nutrition interruption in critically ill patients in general surgery department, and enteral nutrition interruption has an adverse impact on the prognosis.Medical staff should avoid excessive use of analgesic and sedatives, and do well in feeding tolerance management to reduce the occurrence of enteral nutrition interruption.

Objective To explore the effects of health education based on health belief model in elderly patients with 0 grade diabetic foot. Methods Elderly patients with 0 grade diabetic foot of endocrinology ward were selected by convenience sampling in Yantai Yuhuangding Hospital of Shandong Province as subjects form 1st January to 31st March 2014. Patients were divided into observation group (n=49) and control group (n=51) with the random number table. On the end of the study, there were 47 patients in observation group and 42 in control group. Patients of both groups all received the same treatment and knowledge education during hospitalization. After discharge, monthly telephone follow-up was carried out for patients in control group along with answering questions, while health education based on health belief model was applied for patients in observation group. The glucose and TG control condition, self-care behavior and foot situation were compared between two groups. Results Six months and three years after intervention, the fasting plasma glucose (FPG), plasma glucose two hours after glucose load (2hPG), glycosylated hemoglobin (HbA1c), triglyceride (TG) of patients in observation group were lower than those in control group with significant differences (P< 0.05). Three years after intervention, the diabetes self-care behavior of patients in observation group was significantly better than that in control group (P<0.05); the situation of ulcer/infection, deformity, blister/callosum, xerosis cutis/chapped skin, pain/twitch of lower limbs and anaesthesia in the foot of patients in observation group was better than those in control group with significant differences (P<0.05). Conclusions The health education based on health belief model for elderly patients with 0 grade diabetic foot can make the effects of glucose control and blood lipid control lasting and stable. Besides, the self-care ability of diabetic foot of patients improves by knowledge learning again and again and correcting unhealthy life styles so as to reduce the risk of infection, ulcer, thanatosis and amputation.

Objective: To explore the choice of the donor site of flap and the repair method of secondary wound of flap donor site in tissue repair and reconstruction operation. Methods: From January 2014 to September 2018, 62 cases of scar contracture deformity, 15 cases of skin tumor, 20 cases of skin and soft tissue injury, and 25 cases of chronic wound were admitted to the Burn Center of People′s Liberation Army of First Affiliated Hospital of Air Force Medical University, with 84 males and 38 females, aged from 3 to 89 years. Four repair strategies adopted for tissue repair and reconstruction and good repair of the donor site of flap were as follows: designing the flap rationally according to the condition around the wound or the size and shape of wound, choosing pre-expanded technique of the donor site of flap for repair of scar deformity optimally, making full use of the surrounding condition of flap donor site, and repaired with the distal flap, i. e. replacing the important site with secondary site. The donor site of flap was repaired by direct suture or peripheral flap and distal flap. The wound size of patients ranged from 3.0 cm×2.0 cm to 20.0 cm×18.0 cm, and the flap area ranged from 3.5 cm×2.0 cm to 25.0 cm×22.0 cm. The survival condition of flap, healing condition of donor site and recipient site, and follow-up condition of donor site and recipient site were recorded. Results: Wounds of 122 patients were repaired with a total of 148 flaps designed by the above four repair strategies. All the flaps survived well, and the wound and flap donor site healed well. Follow-up for 3 to 36 months showed that the shape and function of recipient site and flap donor site were satisfactory. Conclusions According to the specific condition of the wound and anatomical structure of the surrounding tissue of flap donor site, overall surgical design with flexibility and personalization can achieve effects of good repair of the wound and reduce the secondary damage of flap donor site.