Objective This study is to identify long-term functional recovery and maturity of regenerated nerve fibers after repairing mouse nerve defects with chitosan/polylactide-co-polyglycolide artificial nerve grafts ( CPANGs ) . Methods Mouse sciatic nerve defects, 2mm in length, were bridged by CPANGs (n=6), with nerve autograft (n=6) and nerve defect (n=6) as controls.Plantar test, electrophysiological examination and laser Doppler perfusion imaging following nerve crush were carried out at 1 year after repair to assess nerve function recovery , while muscle wet weight ratio, histological assessment and transmission electron microscopy were performed to evaluate nerve re -innervation and maturity of regenerated nerve fibers .Results When compared to the autograft group , the CPANG group did not show statistically significant difference in functional recovery in terms of paw withdrawal latency , neurogenic vasodilatation , amplitude and latency of compound muscle action potentials ( CMAPs ) , wet weight ratio of gastrocnemius and tibialis cranialis muscles , number of myelinated nerve fibers and density of unmyelinated axons .However , both these two repair groups exhibited significantly longer CMAPs latency , thinner myelin sheath and a lag-behind shift of diameter distribution of myelinated axons as compared to the normal control .Conclusion At 1 year after the mouse sciatic nerve defect was repaired by CPANGs , sensory and autonomic nerve function , number of regenerated axons and muscle re-innervation degree were recovered to the same extent as nerve autografting , but the regenerated nerve fibers were in a state of immaturity .

Objective To discuss decision of the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction.Methods The length of esophageal resection margin of intraoperative,postoperative and pathological large slice under the microscope of 50 cases adenocarcionma of esophagogastric junction underwent radical gastrectomy were measured,and the proximal invasive length of esophagus in large pathological slice were also measured,and the relationship between it and pathological factors was analyzed.Determined the minimum safety cut edge distance.Results In 46 of 50 patients,proximal intramural spread of the tumor was observed.The invasive length of tumor from 0.1 cm to 3.5 cm.The invasive length of tumor was <1.0 cm with 11 patients,1.0-1.5 cm with 19 patients,1.5-3.0 cm with 15 patients,in only 1 patient was the distance of spread 3.5 cm.Invasive length of adenocarcionma of esophagogastric junction had a significant difference between the groups in different pathological factors(P<0.001).Conclusion The length of 3.5 cm is the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction(SiewertⅡ,Ⅲ type) by abdominal incision.

Objective:To describe the current situation of IHR ( 2005 ) public health emergency core capacity at the provincial, city, district or county level for health departments in China, discover gaps in the implementation of IHR(2005) public health emergency core capacity, and thereby provide reference for the construction of IHR(2005) public health emergency core capacity. Methods: A survey was conducted from 211 questionnaires of IHR (2005) public health emergency core capacity, which included 7 provinces, 64 cities, and 140 counties ( districts) in the health departments. Results:The indicator of IHR (2005) public health emergency core capacity is suitable for the conditions in China;there is a lack of institution building in China concerning IHR (2005) public health emergency core capacity;there is a decreasing trend at the provincial, city and county ( district) level. Conclusion:Recommen-dations were proposed to strengthen China’s institution building of IHR (2005) public health emergency core capaci-ty, focus on strengthening construction of county (district) level IHR (2005) public health emergency core capacity, strengthen the weak links of the IHR (2005) public health emergency core capacity index, strengthen China’s appli-cability research concerning IHR (2005) public health emergency core capacity.

Objective To investigate the protective effects of ulinastatn on the lungs in patients with lung cancer undergoing lobectomy. Methods Forty ASA Ⅱ or Ⅲ patients with stage Ⅲ lung cancer, aged 50-64 yr weighing 53-70 kg undergoing lobectomy were randomly divided into 2 groups ( n = 20 each): control group (group C) and ulinastatin group (group U). In group U ulinastatin 10 000 U/kg in 20 ml normal saline was infused iv over 30 min immediately after induction of anesthesia. The patients were premedicated with diazepam 10 mg and scopolamine 0.3 mg im. Anesthesia was induced with midazolam 0.05 mg/kg, fentanyl 4 μg/kg, TCI of propofol (Cp 4 μg/ml) and vecuronium 0.12 mg/kg and maintained with TCI of propofol (Cp 2-3 μg/ml) and intermittent iv boluses of fentanyl and vecuronium. The patients were intubated with double-lumen tube. Correct position of the tube was checked with fiberoptic bronchoscope. One-lung ventilation (OLV) was performed (VT 6-8 ml/kg, RR 10-16 bpm, I:R 1:2, FiO2 100% ). PETCO2 was maintained at 35-45 mm Hg. Arterial blood samples were taken before anesthesia (T0, baseline), at 0.5 h and 1 h of OLV (T1, T2 ) and 4 h and 24 h after operation (T3, T4 )for blood gas analysis and determination of plasma TNF-α, IL-6 and IL-10 concentrations. Respiratory index (RI)was calculated. (RI= PA-a O2 /PaO2 ).Results Compared with the baseline values at To, plasma TNF-α and IL-6 concentrations and RI at T1-4 and plasma IL-10 concentrations at T1-3 were all significantly increased in group C,while in group U plasma TNF-α and IL-6 concentrations at T2,3 and plasma IL-10 concentrations and RI at T1-4 were all significantly increased ( P ＜ 0.05 ). Plasma TNF-α and IL-6 concentrations and RI were significantly lower while plasma IL-10 concentration was significantly higher in group U than in group C (P ＜ 0.05).Conclusion Ulinastatin 10 000 U/kg can effectively protect the lungs in patients with lung cancer undergoing lobectomy by attenuating systemic inflammatory response.

Objective To evaluate the curative effect of neoadjuvant chemotherapy via arterial infusion on advanced colorectal carcinoma. Methods One hundred and twenty-eight advanced colorectal carcinoma patients in stage Ⅱ B or Ⅲ were randomly divided into 2 groups. Sixty-eight cases received preoperative arterial infusion chemotherapy( the treatment group),and chemotherapy regimen consist of Oxaliplatin(L-OHP) 130 mg/m2, Hydroxycamptothecin (HCPT) 20 mg/m2 and Dexifluridine (FUDR)600 mg/m2. Femoral arterial infusion chemotherapy administrated 8 ～ 14 days preoperative. Sixty cases received surgery directly(the control group). The adverse reaction and histology effect after arterial infusion chemotherapy were observed, and resection rate,complications,pathology stage,together with long term survival were compared. Results Adverse reaction were mostly grade Ⅰ -Ⅱ gastrointestinal discomfort and bone marrow depression with arterial infusion chemotherapy. Resection rate was 97. 1% (66/68) ,and 64 cases(96. 9%) underwent raclical (R0) resection in the treatment group, which were higher than those in the the control group(73. 3%(44/60) and 79. 5%,respectively) (x2 = 14. 848,8. 906, Ps ＜ 0. 05). Histology effect of the treatment group was 72. 7%, and the pathology stage downstaged compared to preopeartion. Percent of patients in stage Ⅱ in the treatment group was higher than that in the control group( P ＜ 0. 05). The median survival time of test group was 53. 0 months, 1- ,3-,and 5-year survival rates were 95.3%,85.9% and 44.6%, respectively. In the control group, the median survival time was 42.0 months, 1-, 3-, and 5-year survival rates were 92.6%, 75.9% and 22.0%,respectively. There was significant difference in 5-year survival rate(x2 = 6. 385, P ＜ 0. 05). No difference in postoperative complications between two groups(P ＞ 0. 05). Conclusion The neoadjuvant chemotherapy via arterial infusion is of great significance on downstnging the pathology of advanced colorectal carcinoma, raising the excision rate, especially radical resection, and long term survival rate.

Objective: To observe the effect of electroacupuncture (EA) on the electrogastrogram and gastric antrum ghrelin in rats with diabetic gastroparesis (DGP). Methods: Fifty Sprague-Dawley (SD) rats were randomly divided into group A, group B, group C, group D and group E, 10 rats in each group. Group A was the blank control group without intervention. Group B, Group C, Group D and Group E were treated with single dose intraperitoneal injection of 2% streptozotocin (STZ), combined with 8-week high glucose and high fat diet to establish DGP rat models. Group B was the model group without treatment. Group C was the EA at acupoint group, was treated with EA at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6). Group D was the EA at non-acupoint group, was treated by EA at the control points of Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6). Rats in the metoclopramide control group received 1.7% metoclopramide solution [10 mL/(kg·bw)] by gavage. Rat's blood glucose level was measured by blood glucose meter; gastric emptying rate was detected using phenol red as a marker; the electrogastrogram was detected by BL-420F biological function system; the protein level of ghrelin was detected by enzyme-linked immunosorbent assay (ELISA); the expression of ghrelin mRNA was detected by real-time polymerase chain reaction (RT-PCR). Results: Compared with group A, the blood glucose of group B, C, D and E were significantly increased before and after the treatment (all P<0.01); after treatment, the gastric emptying rate of group B was significantly decreased (P<0.01), the migration rates of small intestine in group B, C, D and E were significantly lower (all P<0.01), and the protein content of ghrelin in group C was significantly decreased (P<0.01); the expressions of ghrelin mRNA were significantly increased in group B, C, D and E (all P<0.01), the mean amplitudes of electrogastrogram in group B and D were significantly decreased (both P<0.01). After treatment, compared with group B, the blood glucose of group C was significantly decreased (P<0.05), the gastric emptying rate and small intestine migration rate were significantly increased in group C and E (P<0.05, P<0.01), the small intestinal migration rate was significantly increased in group D (P<0.05), the expression of ghrelin in protein and mRNA in group C was significantly lower (P<0.01), the expression of ghrelin mRNA in group E was significantly lower (P<0.05), and the mean amplitude of electrogastrogram in group C was significantly increased (P<0.05). After treatment, compared with group D, the protein and mRNA expressions of ghrelin in group C were significantly decreased (P<0.01). After treatment, compared with group E, the protein expression of ghrelin in group C was significantly decreased (P<0.01). Conclusion: EA at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6) could regulate the blood glucose level of DGP model rats, enhance electrogastrogram activity, promote gastric emptying, and regulate ghrelin expression in protein and mRNA.

Objective:To compare the effects of Feishu(BL13)combined with Tianshu(ST25)and Feishu(BL13)alone on pulmonary function and tissue inflammation in asthma model rats. Methods:Forty-eight Sprague-Dawley rats were randomly divided into a normal group,a model group,a lung treatment group,and a lung-intestine treatment group according to the random number table method,with 12 rats in each group.Except for the normal group,rats in the other three groups were sensitized by ovalbumin followed by atomization stimulation to establish the asthma model.After the model was made successfully,rats in the lung treatment group were treated with acupuncture at bilateral Feishu(BL13)for 30 min;rats in the lung-intestine treatment group were treated with acupuncture at bilateral Feishu(BL13)and Tianshu(ST25)for 15 min,respectively,for 30 min in total.Acupuncture was performed once a day for 14 d.Rats in the other two groups did not receive any intervention.After intervention,the pulmonary function of each group of rats was measured by a pulmonary function tester.The histopathological changes stained by hematoxylin-eosin staining and the collagen deposition degree stained by Masson in lung tissue,as well as the inflammatory cells in the bronchoalveolar lavage fluid(BALF)stained by Wright's-Giemsa staining were observed under a light microscope;the levels of interleukin(IL)-4,IL-5,IL-13,IL-17,IL-25,IL-33,leukotrienes(LT),thymic stromal lymphopoietin(TSLP),and prostaglandin D2(PGD2)were detected by enzyme-linked immunosorbent assay. Results:Compared with the normal group,the peak expiratory flow(PEF),the dynamic lung compliance(Cdyn),the forced expiratory flow 25%(FEF25%),the forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),and the maximum mid-expiratory flow(MMEF)in the model group were significantly decreased(P<0.01 or P<0.05);the lung resistance(RL),the collagen deposition,the IL-4,IL-5,IL-13,IL-17,IL-33,LT,TSLP,and PGD2 levels,and the neutrophil proportion in the BALF were increased significantly(P<0.01 or P<0.05).Compared with the model group,the FEF25%and FEV1/FVC in the pulmonary function were significantly increased(P<0.01,P<0.05),while the collagen fiber deposition and the levels of IL-4,IL-5,IL-13,IL-17,LT,TSLP,and PGD2 were significantly decreased(P<0.01 or P<0.05)in the lung treatment group;the PEF,FEF25%,and FEV1/FVC in pulmonary function were significantly increased(P<0.01 or P<0.05),while the RL and the collagen fiber deposition,as well as the neutrophil proportion and the levels of IL-4,IL-5,IL-13,IL-17,IL-33,LT,TSLP,and PGD2 in the BALF were significantly decreased(P<0.01 or P<0.05)in the lung-intestine treatment group.Compared with the lung treatment group,the IL-5 level in the rat lung tissue of the lung-intestine treatment group was decreased(P<0.05). Conclusion:Acupuncture in the lung treatment and the lung-intestine treatment groups improved pulmonary function,lung inflammation,and inflammatory cells in the BALF in asthma model rats;the lung-intestine treatment was better than lung treatment in improving the IL-5 level.The combination of Feishu(BL13)and Tianshu(ST25)was superior to Feishu(BL13)alone in the treatment of asthma in trend.

Objective To evaluate the impact of the percentage of residual blasts in bone marrow at the end of induction chemotherapy ( T1 ) or during myelosuppression phase (T2) on prognosis of de novo acute myeloid leukemia(AML) (non M3) in 105 cases.To refine AML risk-stratification by combining the percentage of residual blast cells (T1 or/and T2) with cytogenetic data based the South West Oncology Group (SWOG) criteria.Methods The data of 105 de novo AML ( non M3 ) patients hospitalized between January 1st 1999 and February 1st 2008 were retrospectively reviewed.Results were analyzed with SPSS15.0 software.Results ( 1 ) Patients were divided into two subgroups by a cutoff of 5% residual bone marrow blasts at T1 or 12 time point.Patients with percentage of residual bone marrow blast cells <5% had better complete remission (CR) rate,relapse-free survival (RFS) and overall survival (OS) than the patients with percentage ≥5% at T1 or T2.The percentage of residual bone marrow blast cells at T1 was correlated with that at T2.(2) The prognosis of patients with intermediate karyotypes with percentage < 5 % at T1 or T2 was similar to that of the patients with favorable karyotypes.The patients with intermediate karyotypes and percentage of residual bone marrow blasts ≥5% at TI or T2 are defined as a subgroup with prognosis similar to that of patients with unfavorable karyotypes.(3) COX regression analysis showed that the percentage of residual bone marrow blasts at T1 or T2 is an independent prognostic factor of AML.The percentage of residual bone marrow blasts at T1 may be more helpful in prognostification than that at T2.Conclusion AML patients with percentage of residual bone marrow blasts < 5% after induction chemotherapy ( T1 or T2) have better CR rate,RFS,OS than the patients with percentage ≥5% at the same time point.Combination of cytogenetics and percentage of residual bone marrow blasts at T1 or T2 is helpful to divide patients with intermediate karyotypes into two subgroups with different prognosis.Thus,a better decision of treatment strategy can be designed.

Objective To compare the effects and medical cost of 2 kinds of transparent dressings on the central venous catheter maintenance. Methods Selecting 75 patients with single lumen central venous catheter in the Geriatrics and ICU of the Tertiary Hospital during April to June 2017,according to the number of puncture, 38 cases (odd numbers)with bordered transparent dressings were selected as the experimental group, and 37 cases (even numbers) with transparent dressings were selected as control group. The dressings were changed weekly,and will be changed if there's rolling edge, dermatitis, seepage and wet. Unplanned tube drawing after 28 days, adverse reaction in the site of puncture, unwell fixed condition of dressings and the related medical costs was evaluated.Results The incidence rate of loosing dressings and dermatitisin the experimental group is significantly lower than those in the control group(P<0.05).The direct cost,indirect cost and total cost in experimental group were significantly lower than those in control group(P<0.05). Conclusion Bordered transparent dressings can promote the effect of tube fixing and decrease nursing manpower cost and medical cost in central venous catheter maintenance,which can be popularized in clinics.

Objective:To study the clinical characteristics and differences of severe hyperbilirubinemia caused by hemolytic disease of the newborn (HDN) and glucose-6-phosphate dehydrogenase (G6PD) deficiency.Methods:From January 2014 to December 2021, newborns (gestational age ≥ 35 weeks and postnatal age ≤ 28 d) admitted to the Department of Neonatology of Hunan Children's Hospital with severe hyperbilirubinemia caused by HDN or G6PD deficiency were retrospectively analyzed. According to the etiology of hyperbilirubinemia, they were assigned into HDN group and G6PD deficiency group. The general conditions, clinical manifestations, laboratory results, treatment and prognosis of the two groups were compared using SPSS 26.0 software.Results:A total of 532 cases were in the HDN group and 413 cases in the G6PD deficiency group. The HDN group reached peak hyperbilirubinemia earlier than the G6PD deficiency group [3(2,5) d vs. 6(4,8)d, P<0.05]. The HDN group had lower peak value of total serum bilirubin [379.5(345.6,426.7) μmol/L vs. 486.4 (413.5,577.4) μmol/L] and lower incidence of anemia [37.4% (199/532) vs. 55.0% (227/413)]than the G6PD deficiency group.The incidence of anemia with elevated reticulocyte percent(Ret%) in the HDN group was higher than the G6PD deficiency group[66.3%(132/199) vs. 5.7%(13/227), P<0.05]. Compared with the G6PD deficiency group, the incidences of exchange transfusion and repeated (≥2 times) exchange transfusion, acute bilirubin encephalopathy(ABE) and the mortality rate after withdrawal of treatment in the HDN group were significantly lower ( P<0.05). Conclusions:Neonatal severe hyperbilirubinemia caused by HDN has early onset. G6PD deficiency caused hyperbilirubinemia has higher incidences of anemia, more severe jaundice and ABE, without increased Ret%.