Objective To observe the correlation between CD64 index levels in peripheral blood and the severity and prognosis factors of postoperative traumatic sepsis,and investigate the clinical effect of these changes in the development of postoperative traumatic sepsis.Methods A total of 560 patients with trauma were enrolled in the study,and these patients were divided into the postoperative traumatic sepsis group (210 cases) and the postoperative general trauma group (350 cases) according to clinical manifestations.According to the severity of the postoperative traumatic sepsis,these patients were divided into low-risk group (64 cases),moderate-risk group (75 cases) and high-risk group (71 cases).According to clinical prognosis,these patients with post-traumatic sepsis were divided into survival group (178 cases) and death group (32 cases).The CD64 index in peripheral blood and APACHE Ⅱ score were analyzed and measured by flow cytometry.The differences and correlation between CD64 index levels and APACHE Ⅱ score were compared and analyzed,and the relationship between CD64 index levels and the severity and prognosis of postoperative traumatic sepsis were also assessed.Results The CD64 index levels of postoperative traumatic sepsis group were higher than the postoperative general trauma group (P<0.05).The differences in terms of CD64 index,APACHE Ⅱ score and mortality rate among low-risk group,moderate-risk group and high-risk group were statistically significant,in which high-risk group was the highest,followed by moderate-risk group,and low-risk group was the lowest(P<0.05).Compared with the survival group,the death group had higher CD64 index levels and APACHE Ⅱ score (P<0.05).The CD64 index levels were positive correlated with APACHE Ⅱ score (r=0.72,P=0.00) and mortality (r=0.56,P=0.00).ROC curves analysis results showed that the area under curve of CD64 index was 0.874 (95%CI:0.765~0.896), and the optimal operating point was 7.08,which had 82.6% sensiticity and 86.4% specificity.Conclusion The increased CD64 index levels in postoperative traumatic sepsis are closely related to the severity and prognosis of disease,and the CD64 index levels can be effective predictor with some clinical application value.

Objective To investigate the efficacy of frontoparietal drill versus parietal drill in the burring hole and drainage for chronic subdural hematoma(CSDH),and provide an evidence for clinical application.Methods A total of 82 patients with CSDH from January 2013 to January 2016 in our hospital were randomly divided into observation group and control group.The observation group chose frontoparietal drill which located at the front 1/4 point at the axial view with the thickest hematoma.Control group chose parietal drill which nearby the parietal tuberodties at the axial view with the thickest hematoma.The postoperative residual hematoma volume,intracranial gas volume,recurrence rate,neurologic function and mental state between two groups were compared.Results The postoperative residual hematoma volume,intracranial gas volume,the recurrence rate and CSS were lower compared with the control group,the differences were significant(P<0.05).The MMSE score of observation group were higher that of the control group,the difference was significant(P<0.05).Conclusion The frontoparietal drill has a better effect to remove the hematoma and promotes neural functional recovery.

Objective To explore the clinical efficacy of dynamic hip screw( DHS) and proximal femoral nail anti-rotation( PFNA) in treatment of patients with Parkinson’ s disease and intertrochanteric fracture. Methods A total of 62 elderly patients of Parkinson’ s disease with femoral intertrochanteric fracture in our hospital from February 2010 to February 2014 were divided into two groups according to different internal fixations,with 31 cases in DHS group and PFNA group respectively. The operation time,X-ray fluoroscopy times,intraoperatve blood soss,the healing time of fracture,postoperative complications and Harris score between two groups were recorded and compared statistically. Results The operation time,intraoperatve blood soss and the clinical healing time of PFNA group were significantly lower than those of DHS group,the differences were statistically significant (P<0. 05). But the times of intraoperative fluoroscopy of PFNA group was more than that of DHS group,the difference was statistically significant (P<0. 05). The Harris score of hip function results showed that the excellent rate of PFNA group was significantly higher than that of DHS group, the difference was statistically significant (P=0. 034). All patients were fol-lowed up for 6 to 48 months. There were 4 cases with complications after operation in DHS group,1 cases of complications in PFNA group,the difference in complications was not significant (P>0. 05). Conclusion The PFNA has the advantages of shorter operation time,less bleed-ing,faster healing time in treatment for elderly patients with Parkinson’ s disease and intertrochanteric fracture,worth clinical promotion.

Objective: To investigate the effects of miR-26a targeting high mobility group protein 1 (HMGA1) gene on the growth, invasion and migration of colon cancer cells, and to clarify whether the HMGA1 gene was the target gene of miR-26a. Methods: The miR-NC (miR-NC group), miR-26a mimics (miR-26a mimics group) and miR-26a inhibitor (miR-26a inhibitor group) were transfected into the human colon cancer SW480 cells. RT-PCR and Western blotting methods were used to detect the mRNA and protein expression levels of HMGA1. Luciferase reporter gene detection kit was used to detect the double luciferase activity in SW480 cells and to determine whether HMGA1 was the target gene of miR-26a. The cell proliferation activities of cells in various groups were detected by CCK8 assay; the number of invasion and migration cells was detected by Transwell chamber method. Results: HMGA1 gene was the target gene of miR-26a. Compared with miR-NC group, the proliferation activities of colon cancer SW480 cells in miR-26a mimics group at after 24, 48 and 72 h after transfection were significantly decreased (P<0. 01), while the proliferation activities of colon cancer SW480 cells in miR-26a inhibitor group were significantly increased (P<0. 01). Compared with miR-NC group, the proliferation activities of colon cancer SW480 cells, the number of invasion and migration cells in miR-26a mimics group and miR-26a mimics + pcDNA3. 1-HMGA1 group at different time points were significantly decreased (P<0. 01); the proliferation activities of colon cancer SW480 cells, the number of invasion and migration cells in miR-NC + pcDNA3. 1-HMGA1 group were increased (P<0. 01). Compared with miR-26a mimics group, the proliferation activities of colon cancer SW480 cells, the number of invasion and migration cells in miR-26a mimics+ pcDNA3. 1-HMGA1 group at different time points were increased (P<0. 01); compared with miR-NC+pcDNA3. 1-HMGA1 group, the proliferation activities of colon cancer SW480 cells, the number of invasion and migration cells in miR-26 mimics + pcDNA3. 1-HMGA1 group at different time points were decreased (P<0. 01). Conclusion: HMGA1 gene is the target gene of miR-26a. Up-regulation of the expression of miR-26a can inhibit the proliferation of colon cancer SW480 cells and downregulation of the expression of miR-26a can promote the proliferation of colon cancer SW480 cells.

Mushroom poisoning is the most important cause of death in food-borne poisoning in China, mainly caused by amanitin, which is caused by rapid progression, complex mechanism and latency. Early identification, diagnosis and treatment are important to improve the prognosis of fatal mushroom poisoning. This article analyzes the clinical characteristics, identification process and treatment of 14 patients with amanitin-containing Galerina sulciceps mushroom poisoning in a family, so as to improve the identification ability of the first physician in recognizing and managing early-stage mushroom poisoning, and to increase the cure rate through early bundle therapy of mushroom poisoning.

Mushroom poisoning is the most important cause of death in food-borne poisoning in China, mainly caused by amanitin, which is caused by rapid progression, complex mechanism and latency. Early identification, diagnosis and treatment are important to improve the prognosis of fatal mushroom poisoning. This article analyzes the clinical characteristics, identification process and treatment of 14 patients with amanitin-containing Galerina sulciceps mushroom poisoning in a family, so as to improve the identification ability of the first physician in recognizing and managing early-stage mushroom poisoning, and to increase the cure rate through early bundle therapy of mushroom poisoning.

Objective:To investigate the preventive effect and safety of prophylactic anticoagulant therapy with different doses on portal vein thrombosis after laparoscopic splenectomy and pericardial devascularization.Methods:109 hospitalized patients with portal hypertension undergoing laparoscopic procedures were divided into non preventive anticoagulant group(36 case), low dose prophylactic anticoagulant group(39 case), high dose preventive anticoagulant group(34 case). the incidence of portal vein thrombosis, the Yerdel greading, platelet count, APTT and bleeding complications were observed.Results:The incidence of portal vein thrombosis was 75%(27 cases), 49%(19 cases) and 29%(10 cases)respectively, (χ 2=14.719, P=0.001). There was no statistically significant difference among groups of postoperative platelet count[(569±46)×10 9/L, (565±42) ×10 9/L, (536±45)×10 9/L, F=0.074, P=0.909]; The level of D-dimer in the non-prophylactic anticoagulation group was significantly higher than that in the prophylactic anticoagulation groups[(6.35±1.24) mg/L, (2.97±0.48) mg/L, (2.13±0.38) mg/L, F=7.85, P=0.002]; The postoperative PT prolongation time in the prophylactic anticoagulation groups was longer than that in the non-prophylactic anticoagulation group[(18.5±0.7)s, (17.4±0.6)s, (12.7±0.2)s, F=30.88, P<0.001]. Conclusion:High dose prophylactic anticoagulation therapy can effectively reduce the incidence of portal vein thrombosis after laparoscopic splenectomy combined with pericardia devascularization without increasing the risk of postoperative bleeding.

Objective: To discuss the therapeutic effect of using tibial island flap of second toe for the treatment of fibular hallux flap donor site defect. Methods: From March 2012 to April 2015, 18 tibial island flaps of second toe were transferred to repair donor site defect on fibular hallux that can not sutured directly, and the subsequent donor site wound on the second toe were sutured. Results: On an average of 13 months follow-up, all 18 flaps survived with primary healing. Texture and appearance of the tibial island flaps were satisfactory; The flaps had good sensory recovery, S3⁺ in 14 patients and S4 in 4 patients. Severe contracture of the first toe web were not observed. The donor site of second toe got good recovery with normal activity of interphalangeal joint. Conclusions The tibial island flap of second toe is a good option for treatment of the defect on fibular hallux flap donor site. Meanwhile, it also meets the requirement of " donor site care" .

Ferroptosis is a new type of programmed cell death that is closely associated with the pathophysiological process of ischemic stroke. Ferroptosis inhibitors can improve neurological function and provide neuroprotection after cerebral ischemia. Therefore, the role of ferroptosis in ischemic stroke and the regulation of ferroptosis to intervene in the occurrence and development of ischemic stroke have become a research hotspot. This article reviews the molecular mechanism and potential therapeutic targets of ferroptosis during ischemic stroke, hoping to provide new perspectives for the treatment of ischemic stroke.

Objective: To introduce the design of modified Reading man flap, and observe the clinical effect of modified flap for repairing digit and toe wounds. Methods: From July 2014 to September 2017, dorsal skin defects on 37 digits and 18 toes were repaired with our modified Reading man flaps. The revised design was characterized with enlargement the major flap and extending the minor flap proximally, and all donor site defect were sutured primarily through the major flap recover the defect and the minor flap repair the subsequent donor defect. Results: All the detects in 55 patients were repaired by the modified Reading man flaps with direct donor sites closure. With average of 11.5 months (9.5-25.7 months) follow-up, all flaps survived with satisfactory texture and appearance, the bulky deformity and scar contracture did not occur. Partial necrosis of tip in the minor flaps occurred in 2 toes and healed by wound dressing. The function of the toe joints was good and the walking gait was normal. Partially impaired PIP joint function with limited flexion occurred in 2 cases. Based on the TAM evaluation criteria, the results were excellent in 28 digits, good in 7 digits, and the overall satisfactory rate was 94.6%. Conclusions The modified Reading man flap can get good clinical effects for treatment of the digit and toe dorsal skin defect with the advantages of simple procedure, easy transfer and direct closure of donor sites. Flaps appearance and joints function can get good result postoperatively.