BACKGROUND:Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation. OBJECTIVE:To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle. METHODS:Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION:The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finaly cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them stil needed skin graft operation once more. The total survival rate between the two groups has no statistical significance(P > 0.05). The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statisticaly different (P < 0.05). So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.

OBJECTIVE:To systematically review the effectiveness and safety of olanzapine in the prevention and treatment of chemotherapy-induced nausea and vomiting(CINV),and provide evidence-based reference for clinical treatment. METHODS:Re-trieved from Medline,PubMed,EMBase,Cochrane Library,Clinical Trials.gov,CBM,CJFD,VIP and Wanfang Database,ran-domized controlled trials (RCT) about olanzapine (test group) versus other drugs or conventional antiemetic regimen (control group)in the prevention and treatment of CINV were collected,Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad. RESULTS:Totally 19 RCTs were included,involving 1 794 patients. Re-sults of Meta-analysis showed,olanzapine can significantly improve the complete control rate of patients with acute CINV [RR=1.12,95%CI(1.06,1.18),P<0.001],delayed CINV[RR=1.26,95%CI(1.14,1.39),P<0.001],overall CINV [RR=1.62,95%CI (1.32,1.99),P<0.001] and breakthrough CINV[RR=2.05,95%CI(1.47,2.86),P<0.001],there were significant differences be-tween 2 groups;there were no significant differences in the incidence of tiredness,dizziness,lethargy and constipation(P>0.05). CONCLUSIONS:Olanzapine is safe and effective in the prevention and treatment of CINV and can be recommended in treating breakthrough and refractory CINV. Besides,olanzapine in the prevention and treatment of CINV belongs to“off-label use”,so the clinicians should have a comprehensive consideration of chemotherapy and patients’consent.

Objective To observe the clinical efficacy of acupuncture plus contralateral needling in treating post-stoke myodystonia. Method Totally 120 patients with post-stroke myodystonia were randomized into group A, B, C and D, 30 in each group. Group A was intervened by yin-reducing and yang-tonifying needling method plus contralateral needling; group B was by ordinary acupuncture plus contralateral needling, group C was by yin-reducing and yang-tonifying needling alone, while group D by ordinary acupuncture. Clinical Spasticity Index (CSI) was observed before and after intervention. Result After treatment, the CSI scores (tendon reflex, muscle tension, episodic spasm scores and total score) were significantly changed in the four groups (P<0.01, P<0.05). The tendon reflex score, muscle tension score and total score in group A were significantly different from that in the other three groups after intervention (P<0.01,P<0.05). There was a significant difference in comparing the episodic spasm score between group A and D after intervention (P<0.01). There were significant differences in comparing the tendon reflex score, muscle tension score and total score between group B and D after intervention (P<0.05). The total score in group C was markedly different from that in group D after intervention (P<0.05). Conclusion Yin-reducing and yang-tonifying needling method plus contralateral needling is an effective method in treating post-stroke myodystonia.

Objective:To analyze the clinical applicability of the sixth edition of nursing measures classification in children's general surgery, to provide a basis for standardizing clinical nursing terms and to promote the clinical use of standardized terminology of nursing measures.Methods:The research method of this study was mapping method. The electronic nursing records of the general surgery of Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from October 1st to December 31st, 2018, including the records of care records for free entry and the records of nursing measures related to medical orders were selected. The degree of matching between electronic care records and classification of nursing measures (sixth edition of nursing measures classification) was compared with conceptual consistency. Difficulties and time-consuming analysis of the characteristics of the standardized care measures obtained by matching.Results:A total of 4 560 independent electronic care records mapped 86 treatments in seven areas. Among them, 98.84% (4 507/4 560) of the nursing records were completely matched with the nursing measures, 0.83% (38/4 560) of the nursing records were partially matched with the nursing measures, and 0.33% (15/4 560) of the nursing records did not match the nursing measures. Difficulty and time-consuming were expressed as standard deviation, which were 2.20±0.45 and 2.03±1.25 respectively.Conclusions:The classification of nursing measures can be used to describe the daily behavioral activities of the children's general surgery nurses, and can also solve the standardization problem of the nursing records in the presentation, and is suitable as a standardized nursing language for the nursing records of children's general surgery.

Anti-glutamic acid decarboxylase antibody-associated encephalitis is a kind of autoimmune encephalitis mediated by anti-glutamic acid decarboxylase antibody, which belongs to anti-neuronal intracellular synaptic protein antibody-associated encephalitis. Clinical manifestations include stiff-person syndrome, cerebellar ataxia, limbic encephalitis, seizures, etc., often associated with a variety of autoimmune diseases, rarely associated with tumors. Detection of anti-glutamic acid decarboxylase antibody is crucial for clinical diagnosis. Immunotherapy helps to relieve symptoms and improve prognosis. The incidence of this disease is low, and there are few reports at home and abroad. This paper intends to review the research on this encephalitis, hoping to improve the clinicians′ understanding and the level of diagnosis and treatment of the disease.

Objective To investigate the phenotypes and percentages of B 10 cells in different tis-sues from wild-type mice and to identify their biological functions .Methods The percentages of B10 cells derived from different tissues of mice and their responses to lipopolysaccharide ( LPS) stimulation were ana-lyzed by flow cytometry .Magnetic-activated cell sorting ( MACS ) and fluorescence-activated cell sorting (FACS) were used to purify B10 cells, CD4+CD25-T cells and Treg cells.CD4+CD25-T cells and Treg cells labeled by CFSE were co-cultured with or without B10 cells, and then their proliferation were evaluated after 72 h.Results (1) A subset of CD19+CD5+CD1dhigh regulatory B cells was identified in spleen , pe-ripheral blood and lymph nodes from wild-type mice , of which the highest frequency was detected in spleen (3.95%±0.79%, P<0.05).The isolated B cells from different tissues were stimulated by LPS , PMA, ionomycin and monensin (L+PIM) in vitro to express IL-10.Among them, splenic CD19+IL-10+B cells showed the highest expression of IL-10 (P<0.05).(2) Prolonged LPS stimulation (48 h) to CD5+CD1dhigh B cells enhanced the expressions of IL-10 (P<0.01).(3) CD19+CD5+CD1dhigh B cells inhibited the prolif-eration of CD4+CD25-T cells in vitro in a dose-dependent manner (P<0.01), but increased the secretion of IL-10 by CD4+T cells (P<0.01) and the proliferation of Treg cells in vitro (P<0.01).Conclusion Com-pared with other tissues , the percentage of B10 cell subset in spleen is the highest in wild-type mouse , and B10 cells subset can be activated through Toll-like receptor ( TLR ) signaling pathway .The responses of CD4+CD25-T cells and Treg cells in co-culture with B10 cells are regulated by B 10 cell subset through an increased IL-10 production .B10 cells might be a useful cell population for the treatment of inflammatory au-toimmune diseases.

Objective To evaluate the ultrasonic feature and clinical significance of persistent left superior vena cava(PLSVC)in fetal life.Methods Fetal echocardiography was performed in 3368 fetuses.Thirty-one fetuses of PLSVC were confirmed.Results The dilated coronary sinus was observed in 30 of 31 fetuses.Congenital heart defects were presented in 14 of these cases,and extracardiac anomalies were presented in 6 fetuses.Both congenital heart defects and extracardiac anomalies were observed in 4 fetuses.Conclusions PLSVC is always associated with congenital heart defects.The prognosis Of affected fetuses largely depends on whether or not the PLSVC is associated with a congenital heart defect.Prenatal diagnosis of PLSVC can help US plan perinatal counseling and ameliorate the postnatal course.

AIM:To investigate the effect of quercetin on the biological functions of rat bone marrow-derived endothelial progenitor cells (EPCs) and its potential mechanisms.METHODS:The bone marrow-derived mononuclear cells of Sprague-Dawley rats were isolated by density gradient centrifugation.The differentiated EPCs were cultured specially and stained with DiI-Ac-LDL and FITC-UEA-1.CD133+ and FLK-1+ were detected on the cell surfaces.After 14 d, the EPCs were incubated with a PI3K inhibitor BYL719 (3 μmol/L) and an ERK inhibitor FR180204 (15 μmol/L).After incubation of the inhibitors for 2 h, the cells were treated with quercetin at different concentrations (0, 10, 20, 40, 80 and 100 μmol/L).MTT assay and Transwell assay were used to detect cell viability and the number of migratory cells.The protein levels of AKT, eNOS, ERK and their phosphorylated status were determined by Western blot.RESULTS:Quercetin enhanced the viability and migration of the EPCs at a dose-dependent manner.However, the PI3K inhibitor BYL719 suppressed the QUE-induced cell viability and migration.Moreover, ERK inhibitor FR180204 exerted the similar inhibitory effect on the cell viability but had no effect on cell migration.Quercetin activated the phosphorylation of AKT, eNOS and ERK.On the other hand, BYL719 was observed to inhibit the phosphorylation of AKT and ERK.FR180204, however, was showed to inhibit the phosphorylation of ERK only.On the contrast, the stimulatory effects that quercetin exerted on the expression of eNOS and its phosphorylation were suppressed by BYL719 and FR180204.CONCLUSION:Quercetin stimulates the viability and migration of EPCs via PI3K/AKT/eNOS and ERK/eNOS signaling pathway, which would be beneficial for cardiovascular health.

[Objective] To investigate the relation among the polymorphism of interleukin-8 (IL-8) gene A-251T and apolipoprotein E (ApoE) gene with late-onset Alzheimer's disease (LOAD). [Methods] Polymerase chain reaction and restrietive fragment length polymorphism (PCR-RFLP) were used to detect the polymorphism distribution of IL-8 gene A-251T and ApoE gene of 185 people in Han ethnicity of Guangdong province (study group: 88 LOAD patients, eontrolled group: 97 people). The correlation of these genes was analyzed. [Results] (1) The differences of genotypes and alleles of IL-8 gene A-251T between study group and controlled group had no statistical significance. (2) The frequency of ApoE 64 allele in study group was significantly higher than that in controlled group, as risk factor of LOAD (OR=2.272, P=0.003). (3) Study group and controlled group were both divided into two groups by carrying ApoE ε4 allele or not. The differenees of IL-8 genotypes were no significant whether in carrying ApoE ε4 allele group or not (carrying ε4 group: P=0.965; no carrying ε4 group: P=0.523). [Conclusion] It is suggested that lL-8 gene A-251T polymorphism perhaps has no relation with LOAD and has no interaction with ApoE ε4 allele.

Objective To assess the clinic value of transthoracic echocardiography in diagnosis of infective endocarditis.Methods Transthoracic echocardiography features and clinic data of 114 patients with infective endocarditis were analyzed retrospectively.The form,activity and coaptation of cardiac valve were observed.The vegetation was found,and the surrounding structure of valve and fundamental heart disease were studied.Results Among 114 patients,the primary symptom presented as fever in 104 patiens.Fundamental heart disease was found in 69 patients;and systemic disease was found in 5 patients.Blood culture was positive in 35 patients.Mitral valve was involved in 46 patients.Aortic valve was involved in 48 patients.Tricuspid valve was involved in 17 patients.Pulmonary valve was involved in 1 patient.Prosthetic valve was infected in 9 patients.Multi-valves were infected in 7 patients.There were serious complications in 19 patients.Ultrasound showed vegetation in 56 of 59 patients underwent surgery.And the diagnostic accuracy rate was 94.92％ (56/59).Conclusion Transthoracic echocardiography can be used to accurately diagnose infective endocarditis.