OBJECTIVE:To observe the effect of Sanhuang decoction combined with compound amino acid liposome healing membrane on treatment stage Ⅲ pressure ulcer. METHODS:According to the random number table,ninety cases of stage Ⅲ pres-sure ulcer were divided into control group A,control group B,and experimental group with 30 cases in each group. On the basis of the basic processing for each group,control group A was treated by dressing change with Sanhuang decoction only,control group B by dressing change with compound amino acid liposome healing membrane only,and experimental group by dressing change with Sanhuang decoction combined with compound amino acid liposome healing membrane. The results of treatment were observed and the curative effects were compared among 3 groups after 21 days or pressure ulcer healing. Three groups were com-pared with chi-square test and each two groups were compared with chi-square segmentation method. RESULTS:There was no dif-ference on total curative effect in control group A(62.1%)and control group B(66.7%)(P>0.05),however,there was statistical significance on total curative effect in experimental group(93.3%)and control group A(P<0.05),also in experimental group and control group B(P<0.05). CONCLUSIONS:The effect of Sanhuang decoction combined with compound amino acid liposome healing membrane on treatment of stage Ⅲ pressure ulcer is better than the effect of dressing change with Sanhuang decoction only or compound amino acid liposome healing membrane only,and the healing time of wound is shortened. This research is deserved further study.

Objective To evaluate the effects ofbeta-endorphin (β-EP) and substance P (SP)with sedative and analgesic drugs on mechanical ventilated patients. Methods Twenty-eight mechanical ventilated patients were randomly divided into two groups: midazolam group (M group, 14 cases) and midazolam combined with fentanyl group (M + F group, 14 cases). Eight healthy persons were as control group (C group). The sedative target was VAS≤3 scores and Ramsay 2-4 scores. The levels of serum β -EP and SP were tested before sedation and 12, 24 h after sedation in mechanical ventilated patients and at 8 Am in C group. The sedation levels were evaluated and the hemodynamie and respiratory parameters were recorded before sedation and 1, 12, 24 h after sedation in mechanical ventilated patients. The oxygenation index was measured before sedation and 1,12, 24 h after sedation. Results The levels of serum β -EP and SP in M and M+F group were significantly higher than those in C group(P< 0.05). After sedation, the level of SP in M+F group [(101.42 ± 12.46) ng/L]was significantly lower than that in M group [(132.72 ± 23.82) ng/L] (P < 0.05). Compared with before sedation, there were significant differences in heart rate, VAS and Ramsay scores between M group and M+F group (P< 0.05). Compared with M group, pressure airway and respiratory rate at 12, 24 h and total after sedation were lower in M+F group (P <0.05). The amount of serum SP in mechanical ventilated patients. Fentanyl improves the ventilator synehron and reduces the dose of midazolam.

Objective To investigate pathogens and drug resistance of lower respiratory tract infection(LRTI)in Intensive Care Unit(ICU).Methods Retrospective study of the clinical data,the distribution and the drug-sensitivity of pathogens of 220 cases with LRTI in ICU.Results Totally 280 strains of pathogens were identified by bacterial culturing.The ratio of G-bacteria to total pathogens isolated was 63.5%,of the G+ bacteria was 25.1%,and of the fungi was 11.4%.The main kinds of the G-bacteria were Klebsiella pneumoniae(17.1%),Pseudomonas aeruginosa(13.2%),Acinetobacter baumannii(12.5%),and Stenotrophomonas maltophilia(10.4%).Staphylococcus aureus(SA)(91.4%)was the most prominent in G+ bacteria,and MRSA was 98.4% in SA.The result of drug sensitive test in vitro showed the multiple drug fast rate of Pseudomonas aeruginosa was comparatively high,Stenotrophomonas maltophilia to Levofloxacin was low,Klebsiella pneumoniae and Acinetobacter baumannii were highly sensitive to carbapenems.The susceptibility rate of MRSA to vancomycin was 100%.Conclusion G-bacteria are the majority of the pathogens,isolated from patients with LRTI in ICU.Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,and Stenotrophomonas maltophilia are the chief G-pathogens.Except Stenotrophomonas maltophilia,imipenem and merpenem are relatively active against the G-bacilli.The proportion of MRSA and fungal infection is increasing.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of antimicrobial agents during clinical therapy.

Objective To establish a loop-mediated isothermal amplification method for detection of Campylobacter jejuni.Methods Six sets of primers were designed to recognize Campylobacter jejuni specific gene hipO.One was selected as the optimal primer and its specificity and sensitivity to Campylobacter jejuni were evaluated by LAMP reaction in 60 minutes at 62℃.Results The results recorded by the turbidity meter showed that the sensitivity of LAMP with a detection limit of 6.97×102 copies/μl was ten times that of PCR.Conclusion LAMP is a potential and valuable method of detection of Campylobacter jejuni due to its rapidity,simplicity,low cost and accuracy.It is especially suitable for grass-roots medical units.

Methods: In this study, we prospectively examined 70 LSS patients with intermittent claudication symptoms at a multicenter outpatient clinic. A walking test was administered at baseline and week 4 to assess patients’ walking distance and lower limb pain and numbness. Immediately after the walking test, patients were asked to use the Visual Analog Scale (VAS) to rate their pain and numbness in the front, back, outside, inside, and hip of the lower legs. The reproducibility of the walking test was evaluated using Cohen’s κ analysis and intraclass correlation coefficients (ICCs). Meanwhile, the Swiss Spinal Stenosis (SSS) Questionnaire was used to evaluate the severity of the stenosis. Results: The walking distance ICC at baseline and at week 4 remained unchanged at 0.7, with acceptable interobserver reliabilities for lower limb pain and numbness in both legs. The average VAS score for lower leg pain was 23.2±25.2 mm at baseline and 27.4±28.8 mm at week 4, while the corresponding average VAS score for numbness was 23.4±26.7 mm at baseline and 24.8±25.2 mm at week 4. The ICC score was 0.7 for leg pain and 0.7 for numbness. The mean SSS was 30.2±5.5 at baseline and 29.2±5.2 at week 4, and there was no significant difference in the severity. Conclusions The walking test for LSS has acceptable reproducibility.

Objective:To evaluate the clinical efficacy of the bridge pedicled transplantation of medial leg fascial flap combined with medial hemisoleus muscle flap for contralateral leg soft tissue defect.Methods:Between January of 2012 and January of 2018, 12 patients with soft tissue defect of the leg were treated with bridge pedicled transplantation of contralateral medial leg fascial flap combined with medial hemisoleus muscle flap by posterior tibial artery. There were 9 males and 3 female, aged from 19 to 53 years (mean, 35 years). The size of the soft-tissue defects ranged from 12 cm×8 cm to 18 cm×9 cm. The immediate coverage of the fascial and muscle flaps and vessel pedicle were repaired by a meshed split-thickness skin graft. The donor site was closed directly. After the transplantation of the one pedicle and two flaps survived, vascular pedicle was cut off.Results:All the fascial and muscle flaps survived completely. No clinical vascular deficiency was found on the fascial and muscle flaps postoperatively. One case developed distal muscle flap small skin graft necrosis, and spontaneous healed after 2 weeks of dressing change. Follow-up period ranged from 2.5 to 4.5 years (mean 3.8 years). A good contour was confirmed both at the recipient and donor sites. Satisfactory clinical results were obtained in this series.Conclusion:This method is suitable for the treatment of soft tissue defects of the leg with only one major blood vessel, which reduces the damage to the donor site.

Objective:To evaluate the efficacy of the repairing anterior tibial adjacent double wounds by transposition with single-pedicle two flaps of the medial head of gastrocnemius.Methods:Between January of 2012 and January of 2018, 10 patients with the anterior tibial adjacent double wounds (7 males and 3 female, aged from 21 to 45 years) were treated by transposition with single-pedicle two flaps of the medial head of gastrocnemius. The size of the soft-tissue defects ranged from 2.0 cm×2.5 cm to 4.5 cm×4.0 cm. The medial head of the gastrocnemius was divided into two flaps with a single pedicle to repair two adjacent wounds of the anterior tibial. The muscle flaps were immediately covered by a meshed split-thickness skin graft, and the wound in donor site was closed directly.Results:All the muscle flaps survived completely. No clinical vascular deficiency was found on the muscle flaps postoperatively. Small wound dehiscence was developed in one patient and spontaneously healed 2 weeks after dressing change. Patients were followed up for 2.0 to 4.5 years. A good contour was confirmed at the recipient and donor sites. Satisfactory clinical results were obtained in this series.Conclusion:This method is suitable for the repair of two adjacent small wounds of the anterior tibial which can reduce the damage to the donor site.

The important function of the endplate is to transmit stress and supply nutrition. Endplate degeneration might induce or promote degeneration of the intervertebral disc, causing a series of spine diseases that seriously impair people’s health and life quality. Endplate chondrocytes can respond to mechanical stimulation, which is an important factor affecting endplate degeneration. Inappropriate mechanical stimulation will accelerate endplate degeneration. This review summarized the effects of mechanical stimulation on vertebral endplate chondrocyte apoptosis, synthesis inhibition, calcification, and extracellular matrix degradation. The endplate degeneration induced by mechanical stimulation is regulated by a complex network of signal pathways composed of various signal transduction factors. The signal pathways involved in this review included NF-κB, Wnt, Hedgehog, MAPK, RhoA/Rock-1, AKT/mTOR, TGF-β signaling pathway and miRNA related signals. The interconnection of these pathways was highlighted and summarized. Multiple signaling pathways work together to regulate endplate chondrocyte metabolism, which ultimately leads to the endplate degeneration. This review might shed light on early diagnosis and precise treatment of cartilage endplate degeneration.

Ossification of the spinal ligaments (OSL) is characterized by the appearance of pathologic bone tissue within the spinal ligamentous tissue. OSL tends to occur in the cervical and thoracic segments with important cause of spinal stenosis. Compression of the spinal cord or nerve roots by ossified masses can lead to severe neurological dysfunction, which has a tremendous impact on the quality of life of patients. However, the exact etiology and pathogenesis of OSL are still unclear. Epigenetic regulation is widespread in organisms and refers to the appearance of heritable changes in gene expression without alteration in genomic DNA sequence. As an important form of biodiversity regulation, epigenetic regulation plays an important role in development of several diseases. Epigenetic regulation has multiple manifestations in OSL, including DNA methylation, histone modifications, and non-coding RNA regulation. Sequencing tools, such as gene microarrays, have revealed significant differences in DNA methylation profiles and non-coding RNA expression between ossified and normal spinal ligaments. These differences can cause abnormal expression of osteogenesis-related target genes through direct or indirect pathways, thus affecting the ossification process of spinal ligaments. In addition, interactions between these epigenetic regulatory mechanisms constitute a large and complex regulatory network. Consequently, an in-depth understanding of the role of different epigenetic regulatory mechanisms and the linkages between them in the initiation and progression stages of OSL is expected to provide a valuable reference for the clinical diagnosis and treatment of OSL-related diseases.