Objective To better understand the treament effect of postexposure after biting by dogs and other animals in,Cixi city,and to provide evidence for rabies control.Methods The people,who were bitten by dogs and other animals,were investigated.All related information was collected such as the date and site of bite,animal species,postexposure treatment including vaccination and anti-rabies serum or human anti-rabies immune globulin.Results Total 21,504 cases had received the postexposure treatment from January to September in 2007.Among 21,504 people,95% were attributed to dog bites.62% of people had received the treatment within 12 hours after exposure.All people had received five doses of vaccine.Total 783 people had been administered anti-rabies serum.Furthermore,no sever side effect and rabies cases occurred among these people.Conclusions The injury caused by dogs was still a major potential factor to cause rabies in the rabies endemic area.The timely and correct postexposure treatment with good quality of vaccine could prevent from rabies.

Objective: To evaluate the relationship between preoperative nystagmus and visual outcome of congenital cataract surgery. Methods: Retrospective review of 81 patients (84 eyes) who underwent surgery for cataract was conducted,in which 7 cases of unilateral cataract and 3 of bilateral cataract were associated with preoperative nystagmus. All patients lacked other structural ocular defects or neurologic abnormalities and were old enough to cooperate with recognition visual acuity testing. Outcome parameters studied were best-corrected postoperative visual acuity of the eyes. Results: Best corrected postoperative visual acuity of the nystagmus eyes was 0.05 or worse in 3(23%,3/13), between 0.05 and 0.3 in 9(69%,9/13),and 0.3 or better in 1(8%,1/13).Best corrected visual acuity of the eyes without nystagmus was 0.05 or worse in 6(8%),between 0.05 and 0.3 in 24(34%),and 0.3 or better in 41 ((58%).) There was a statistical significance of preoperative visual acuity compared to postoperative visual acuity in cataract with(P=0.04) or without nystagmus. The great statistical significance was shown in the improvement of visual acuity between the patients with nystagmus and without nystagmus. Conclusion: Preoperative nystagmus in children with cataract does not preclude visual improvement, but may predict a poorer visual acuity outcome after cataract surgery. In these patients a decision must be made as to whether or not surgical intervention for the cataract would be worthwhile at this stage.

Objective To compare clinical outcomes of clavicular hook plate and coracoclavicu-lar screw fixation in treatment of acrmioclavicular dislocation (Tossy Ⅲ). Methods From August 2003 to January 2008,38 patients with acromioclavicular dislocation (Tossy Ⅲ) were randomly divided into two groups that were treated with coracoclavicular screw and clavicular hook plate fixation respective-ly. The range of shoulder movement was restricted after operation until the fixation was removed three months later. The shoulder function was evaluated by using Japanese Orthopedic Association (JOA) sco-ring system. The functional scores were compared before and after removal of the internal fixation in two groups. Results All patients were followed up, which showed no statistical difference upon final shoulder function of two groups. There was no loosening or migration of internal fixators. No redislocation occurred after removal of internal fixations. Seven patients complained shoulder pain and three had severe shoulder pain affecting sleep quality in coracoclavicular screw group. The pain was alleviated after remov-al of fixation. Conclusions Coraeeclavicular screw and clavicular hook plate fixation have similar clinical effect in treatment of acromioclavicular dislocation (Tossy Ⅲ), with satisfactory recovery of shoul-der function. Many complications of acromioclavicular fixations can be avoided by restriction of shoulder movement after operation and early functional exercise after removal of fixation.

Objective:To research the curative effect of moxifloxacin solution atomization inhalation in the treatment of chronic obstructive pulmonary disease (COPD) combined with respiratory failure.Methods:94 cases of COPD patients combined with respiratory failure from May 2014 to May 2016 were selected and divided into the control group(n=47) and the research group (n=47) acording to the lottery method,the control group received routine treatment,while the research group was treated based on the control group with moxifloxacin solution inhalation treatment.The curative effect,serum tumor necrosis factor-α(TNF-α),c-reactive protein (CRP) and interleukin 10 (IL-10),creatine phosphokinase (CK),aspertate aminotransferase (AST) levels,the blood oxygen partial pressure (PaO2),CO2 partial pressure (PaCO2),APACHE Ⅱ score and occurrence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate of research group was higher than that of the control group (P＜0.05).The serum levels of TNF alpha,CRP,PaCO2,CK,AST,APACHE Ⅱ score of research group were evidently lower than those of the control group (P＜0.05).The serum levels ofIL-10,PaO2 of research group were evident higher than those of the control group (P＜0.05).The occurrence of adverse reactions showed no differences between the two groups (P＞0.05).Conclusion:Moxifloxacin solution atomization inhalation was effective in the treatment of COPD combined with respiratory failure,which might be related to the inhibition of inflammatory response,and improvment of breath.

Objective:To investigate the risk factors of moderate to severe cancer-related fatigue (CRF) in patients undergoing chemotherapy of prostate cancer, and to construct a nomogram model to predict the occurrence of CRF.Methods:Using the case data questionnaire, Brief Fatigue Inventory, Social Support Rating Scale and International Prostate Symptom Scores, 724 patients of prostate cancer treated by chemotherapy in Shanghai Tenth People′s Hospital from August 2016 to June 2021 were selected and were treated with 1∶1 ratio, and the indexes of the moderate and severe CRF group (216 cases) and the non-moderate and severe CRF group (216 cases) were compared. According to the ratio of 7∶3, the envelope method was used to divide into training set and validation set. The independent risk factors of moderate and severe CRF were explored by univariate analysis and multivariate Logistic regression analysis, and the risk prediction model was established and the nomogram model was constructed. The C-index and area under ROC curve were used to verify the prediction effect of the model.Results:Multivariate Logistic regression analysis showed that BMI ranged from 24.0 to 27.9 kg/m 2 ( OR=1.733), BMI≥28.0 kg/m 2 ( OR=3.126), neutropenia occurred during chemotherapy ( OR=1.747), chemotherapy course >6 months ( OR=1.893), moderate social support level ( OR=1.244), low social support level ( OR=2.434), mild urinary tract symptoms ( OR=1.264), moderate urinary tract symptoms ( OR=3.371) and severe urinary tract symptoms ( OR=5.297) were independent risk factors for moderate and severe CRF. The nomogram model constructed according to the above risk factors was internally verified by the training set and the validation set, and its C-index was 0.854 and 0.741 respectively. The area under ROC curve training set was 0.823, and the validation set was 0.733. Conclusions:The nomogram model can effectively predict the occurrence of moderate to severe CRF in patients with prostate cancer undergoing chemotherapy.

Objective To evaluate the impact of community-aged care program (CACP) on cognitive function and fall risk among elderly adults.Methods A total of 91 elderly were included in Senior Apartment of Jiangxi province by cluster sampling and they were divided into the control group and the CACP group. Health assessment and functional screening were conducted before intervention and nine months after intervention. Results Before intervention, there were no difference between two groups in aspects of general social demo-graphic data, clinical characteristics, cognitive function, depression, fall risk, daily life activities ability and quality of life(P>0.05). After intervention, indictors of health assessment of CACP group were superior to those of the control group (P>0.05).Conclusions CACP intervention could improve cognitive function effectively and reduce fall risk for the elderly.

ObjectiveTo develop the comprehensive geriatric assessment (CGA) nursing information management system and to explore its application value. MethodsCGA and mobile nursing information system were combined to design and develop the CGA nursing information management system. Totally 196 geriatric inpatients admitted in Geriatric Hospital of Nanjing Medical University from April 1st to June 30th, 2018 were selected using convenient sampling. These geriatric patients were managed by the well-trained nursing staff using the system, including CGA at admission and before discharge and continuous CGA. The changes of CGA at admission and discharge were used to assess the clinical application value of the CGA nursing information management system. ResultsThe consistency rate of the implementation of CGA nursing intervention with CGA nursing norms was 67%-91%. The geriatric patients' pain scores at discharge decreased compared with those at admission(P＜0.01), but there was no statistically significant difference in malnutrition risk, pressure ulcer, fall and ADL scores (P＞ 0.05). ConclusionsThe CGA nursing information management system is conductive to the implementation of CGA clinically, the monitoring of the effects of CGA nursing intervention, and the nursing quality control by nursing managers, which is worth promoting clinically and in communities.

Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.

Objective:To investigate the efficacy and safety of dermal anchoring method combined with low energy electron beam irradiation in the removal of chest wall keloids.Methods:Clinical data of patients with medium and large-sized chest wall keloids treated in Plastic Surgery Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2015 to May 2021 were analyzed retrospectively. The keloid was completely removed from the superficial fascia layer, and a small patch of scar dermis tissue was retained in the center of the keloid. When the cutting edge was sutured, the above-mentioned dermis tissue was anchored to achieve tension reduction. Then low energy electron beam irradiation treatment was carried out within 24 h after surgery, with an irradiation range of 5-10 mm from the incision edge and a subcutaneous depth of 2 cm. The lesions were irradiated for 3 times, with a 24 h interval between each exposure. The total irradiation dose was 20 Gy. The width, severity of hyperplasia (expressed in height), and recurrence of keloids at 3, 6, and 12 months after surgery were recorded. Patient satisfaction was evaluated one year after surgery (with a total score of 10 points, 0-3 points of dissatisfaction, 4-7 points of general satisfaction, 8-10 points of great satisfaction), and the incidence of radiation complications was observed. SPSS 25.0 software was used for statistical analysis of the data, with measurement data represented by Mean±SD. Repeated measurement analysis of variance was conducted for the same variable at different periods, and counting data was represented by %. χ2 test was used for group comparison. P<0.05 indicated the difference with statistical significance. Results:A total of 39 patients with 39 scars were included. There were 15 males and 24 females, aged (30.9±9.5) years. The preoperative scar width was (43±5) mm (rang 38-48 mm), and the scar volume was 20.0 mm×38.0 mm×7.5 mm-80.0 mm×48.0 mm×1.6 mm. After the surgery, the wound showed a mild protrusion with minimal exudation, and the wound was dry and clean after irradiation. The scar width at 3, 6, and 12 months after surgery was (1.3±0.5), (1.8±0.5), and (2.9±0.5) mm, respectively, with statistically significant difference ( P<0.01); the severity of scar hyperplasia was (0.9±0.3), (1.3±0.3), and (1.8±0.3) mm, with statistically significant difference ( P<0.01); the recurrence rates of keloids were 12.8% (5 cases), 23.1% (9 cases), and 25.6% (10 cases), respectively, with no statistically significant difference ( P>0.05). The patient satisfaction score at 1 year after surgery was 2-10, average of 7. There were 4 cases (10%) of dissatisfaction, 10 cases (26%) of general satisfaction, 25 cases (64%) of great satisfaction. No radiotherapy complications occurred. Conclusion:Dermal anchoring method combined with low energy electron beam irradiation can achieve good therapeutic effects in the removal of chest wall keloids. The recurrence rate of keloids is low, and patient satisfaction is high.

Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.