Objective To evaluate the clinical effect of the facial soft tissue defect treated with platelet-rich plasma (PRP) mixed with purified fat.Methods 35 patients with facial soft-tissue defects were treated by PRP mixed with centrifuged fat tissue.Using Fuzzy judgment method the clinical effectiveness of therapeutic outcomes were evaluated on fullness,injection of frequency and satisfaction during 3 to 6 months of follow-up.Results The therapeutic outcomes showed that the reconstructed face became a relative symmetrical and natural appearance with not evidently fat resorption and stable after operation.Both patients and surgeons were satisfied with the results.The score of effectiveness was highest in Fuzzy judgment.Conclusions The efficacy of PRP is significant in enhancing fat graft,reducing fat necrosis and resorption.The fat tissue mixed with PRP is a reliable reconstruction option for the facial soft tissue defect.

Objective To evaluate the effect of limb remote ischaemic preconditioning on pul-monary function in patients undergoing cardiac valve replacement surgery with cardiopulmonary by-pass.Methods Seventy patients,32 males and 38 females,aged 18-70 years,weighing 45-90 kg, ASA physical status Ⅱ or Ⅲ,scheduled for elective cardiac valve replacement surgery with cardiopul-monary bypass,were divided into 2 groups using a random number table,35 in each group.Patients in group R received three cycles of right upper-limb 5 min ischemia (blood-pressure cuff inflation to≥ 200 mm Hg)and 5 min reperfusion (blood-pressure cuff deflation to 0 mm Hg)at 10 min after in-tubation.In group C,the cuff was placed around the arm but not inflated.At 10 min after intubation (T0),at 1 h after aortic declamping (T1)and at 6 h (T2),12 h (T3),24 h (T4)after surgery,arte-rial blood was sampled to conduct gas analysis,PaO2/FiO2ratio and alveolar-arterial oxygen gradient (A-aDO2)were calculated,and the dynamic lung compliance (Cd)and static lung compliance (Cs) were also recorded.The occurrence of pulmonary adverse events was recorded until discharge. Results Compared with T0,PaO2/FiO2was decreased in the two groups at T1-T4,A-aDO2was de-creased at T2-T4,Cs and Cd were increased in group C at T3,and were increased in group R at T2, T3(P<0.05).Compared with group C,the Cs and Cd at T2,T3were increased in group R.There were no significant differences between the two groups in the PaO2/FiO2,A-aDO2at T0-T4.The oc-currence of the pulmonary adverse events was decreased significantly in group R than in group C (P<0.05).The occurrence of pulmonary adverse events was declined significantly in group R than in group C (P<0.05).Conclusion Limb remote ischemic preconditioning can improve the lung compli-ance and reduce the occurrence of the pulmonary adverse events in patients undergoing cardiac valve replacement surgery.

Objective : To investigate the factors affecting concurrent sarcopenia among patients with cardiovascular diseases, so as to provide insights into early identification and prevention of cardiovascular diseases complicated with sarcopenia. Methods: A total of 250 inpatients with cardiovascular diseases in the Sixth Division Hospital of Xinjiang Production and Construction Corps were recruited and divided into the sarcopenia and non-sarcopenia groups according to the diagnostic criteria of sarcopenia. Subjects' basic characteristics, body mass index, blood biochemical indicators and human body composition parameters were collected using questionnaire surveys, and factors affecting concurrent sarcopenia among patients with cardiovascular diseases using a multivariable logistic regression model. Results: Among the 250 patients with cardiovascular diseases, there were 149 males (59.60%) and 101 females (40.40%). The overall prevalence of sarcopenia was 8.40% among the study subjects. The mean age and body mass index were (75.19±9.74) and (20.77±2.19) kg/m2 in the sarcopenia group and (65.24±11.50) years and (25.85±2.87) kg/m2 in the non-sarcopenia group. Multivariable logistic regression analysis identified age (OR=1.115, 95%CI: 1.030-1.207) and body mass index (OR=0.582, 95%CI: 0.445-0.761) were as factors affecting concurrent sarcopenia among patients with cardiovascular diseases. Conclusion Advanced age and low body mass index may increase the risk of concurrent sarcopenia among patients with cardiovascular diseases.

Objective To investigate the clinical characteristics of DCD donor-derived CRKP infection and bleeding in kidney transplantation,and to summarize the experience of diagnosis,treatment and prevention.Methods A retrospective analysis was carried out from July 2016 to December 2017 in hospital,containing clinical data of 4 cases of CRKP-infected DCD donors and 7 cases of kidney transplantation recipients.Results In the CRKP culture of 4 cases of DCD donors,1 case was positive for blood culture,1 case was positive for urine culture,1 case was positive for sputum culture,and 1 case was negative for blood,urine and sputum culture.The corresponding 7 recipients were all positive for blood culture after renal transplantation,4 cases were positive for urine culture,3 cases were positive for sputum culture,and 5 cases were positive for perirenal drainage.Of the 7 patients,4 cases had renal artery hemorrhage,1 of them was died.The average bleeding time was 17.75 days after operation (14-19 days).In 7 patients with renal transplantation,CRP increasd.And in 3 cases of deaths,CRP was stably higher than normal.Meanwhile,CRP in 4 surviving patients gradually decreased to the normal range after effective anti-infection treatment.All 7 patients were treated with carbapenems;2 patients were dead without avibactam therapy;and 5 cases were treated with avibactam and carbapenems and survived,1 case died and 1 case had good renal function recovery.Conclusion Positive CRKP in blood,urine and sputum of DCD donors can lead to CRKP infection in kidney transplant recipients.Even if the body fluids of donors are all negative,the false negative results could not be excluded.Persistent or increased high-level CRP after operation is an early warning on CRKP infection.And CRP can be used as an indicator for evaluating the effectiveness of anti CRKP therapy.The combination of avibactam and carbapenem antibiotics is an effective regimen in the treatment of DCD donor-derived CRKP.