Objective To find ways to reduce vascular crisis of the patients undergoing replantation of severed fingers by pain, adverse analgesics and sleep quality with auricular seeds pressing. Methods 310 digital replantation patients were divided into 2 groups according to admission time. There were 155 cases in the traditional group treated with routine postoperative care ,while 155 cases in the controlled group treated with routine postoperative care plus auricular seeds pressing. Results The scores of pain, adverse analgesics and sleep quality in two groups were statistically significant ( P<0.05). The rate of vascular crisis of the traditional group [18.06%(28/155)] was much more higher than the controlled group [5.16%(8/155)], the difference was significant, χ2=12.571, P < 0.01. Conclusion In digital replantation, auricular seeds pressing was effective to pain relieving, constipation and reduce adverse reactions, and could significantly improve sleeping time and survival rate of the severed fingers.

Objective To investigate the expectation values of dental esthetics during the orthodontic treatment in adolescents with malocclusion.Methods 14～18 year-old adolescents with malocclusion were randomly divided into the treatment group (30 cases) and the control group (21 group) for a prospective study with a period of 1.5 years (0,0.5,1.0,1.5 year respectively),esthetics components of index of orthodontic treatment need (IOTN-AC) and self-made sheet for expectation values of dental esthetics were used to evaluate the values during the follow-up.Results During the follow-up,the IOTN-AC values in the treatment group were decreasing,conversely,the values in the control group were increasing,the expectation values of dental esthetics were increasing in both of the two groups,the differences above were significantly.Conclusions Expectation values of dental esthetics were higher during the follow-up in both of the treatment and untreatment cases,so the dentists and the nurses should encourage the consolidation therapy in treatment cases,and persuade the untreatment cases for orthodontic therapy in order to improve their psychological needs.

Objective To study the effect of nasal tolerance with a dual analogue (Lys262 Ala207) on experimental autoimmune myasthenia gravis (EAMG) and the underlying mechanisms, the clinical and immunological changes were observed in Lewis rats treated with dual analogue Methods Different doses of dual analogues were given to Lewis rats immunized with acetylcholine receptor (AChR) in complete Freud's adjuvant (CFA) and the medium dosage was chosen in the following studies As comparing the effects of treatment of the predetermined dosage of dual analogue at different time points, the body weight and clinical symptoms of Lewis rats immunized with AChR in CFA were evaluated The levels of anti AChR IgG in serum were tested by ELISA Proliferative responses of lymphocytes to no antigen, AChR, dual analogue, control MBP peptide, MBP, or Con A were tested Results Lewis rats receiving dual analogue nasally for 10 consecutive days at the time of immunization (Group A) or the first day after complete remission from the acute phase of the disease (Group B) sparsely developed EAMG with reduced severity than the corresponding control groups The subsiding disease was associated with decreased amount of anti AChR IgG in serum expressed as optic density ( A ) at 405 nm On day 35 post immunization, the A values in group B vs control group were 0 95?0 26 and 1 19?0 12, respectively Proliferative responses expressed as stimulation index (SI) were suppressed in response to antigen specific stimulations in rats receiving dual analogue as compared with rats receiving control peptide For instance, the values of SI in response to AChR in group A and control group were 1 71?0 78 and 3 24?1 31, respectively Those values were suppressed to a less extent in group B vs control group (1 97?0 56 vs 3 19? 1 50) Conclusions Nasal administration of a dual analogue Lys262 Ala207, at two different time points post immunization should ameliorate muscular weakness in EAMG rats involved in decreased levels of anti AChR antibodies and antigen specific T cell proliferation

Objective To observe the effect of mirror therapy and sensory reeducation on sensory function recovery after thumb recon-struction with second toe transplantation. Methods Forty patients after thumb reconstruction with second toe transplantation from January, 2011 to January, 2014 were divided into control group (n=20) and training group (n=20). Both groups accepted routine nursing and rehabili-tation, while the training group accepted mirror therapy and sensory reeducation training in addition. They were followed up for six to eigh-teen months after operation (average 9.3 months) with the two-point discrimination (2-PD) of transplanted toe pulp. Results 2-PD was (7.15±1.15) mm in the training group, very shorter than (10.23±2.23) mm of the control group (t=5.4898, P<0.001). Conclusion The mirror therapy combined with sensory reeducation training can improve the sensory function of the finger pulp that transplanted from the second toe.

Objective To explore the clinical nursing methods for the treatment of the skin degloving injury in foot by the combination of free femoral anterolateral skin flap transplantation and vacuum sealing drainage (VSD) technique. Methods From January 2010 to January 2014, 18 cases of the skin degloving injury in foot were treated by debridement and implant skin, negative pressure drainage and irrigation at first period, then the operation to repair the foot wound by transplant femoral anterolateral skin flap were done at second period. Nurses applied the key technology of VSD into postoperative nursing. Nurses should master the observation method and characteristics for the flow of blood to the flap skin, the method for foot position nursing, afford effective analgesic care, and flap local high flow oxygen therapy,improve the local tissue oxygen partial pressure and introduce the foot early functional exercise during postoperative. Results Eighteen cases flaps all survived. Clients were followed-up for 6 to 12 months,the discovery showed that all of the clients had good flap blood supply,the skin was soft and elastic,and the function of foot were recovered well. Conclusions The combination of of free femoral anterolateral skin flap transplantation and VSD technique apply into foot degloving injury repairation postoperative care,by application of high quality nursing, it really can improve the success rate of surgery and reduce the pain for clients.

Objective To investigate the effects of recombinate mouse granulocyte-macrophage-colony-stimulating factor(GM-CSF) alone with mesenchymal stem cells(MSCs) on injured lung of rots after exposure to hyperoxia. Method Mouse MSCs were separated, cultured, amplificated, identified and labeled with 4', 6-diamidino-2-phenylindole(DAPI). Thirty-two 3-day-old Sprague Dawley(SD) rats from four litters were randomly divided(random number) into four groups, namely hypemxia exposured + GM-CSF + MSCs group(group A), hyperoxia exposured + GM-CSF group( group B), hyperoxia exposured + MSCs group( group C) and hypemxia exposured group(group D). All rats were placed in a closed Plexiglas chamber with a minimal flow in and out, providing six to seven exchanges of the chamber volume per hour and maintaining O_2 levels above 95%. Seven days lair,all of them were taken out of the chamber. Rats in group A were treated with 5 x 10~4 MSCs intraperitoneally alone with 9 μg/kg GM-CSF subcutaneously, rats in group B received 9 μg/kg GM-CSF subcutaneously, rats of group C were treated with 5 x 10~4 MSCs intraperitonealiy and rats of group D were administrated with phosphatebuffered solution(PBS). Three days latter, all animals were sacrificed by an injection of 120 mg/kg sodium pentobarbital, perfused with cold 0.9% NaCl, and the left lungs were removed. The upper lobe of them were grinded to make tissue homogenates used for ELASA, and the lower lobes of them were made into frozen sections for fluorescence microscope. The right lungs were fixed in situ for 2 hours by intratracheal instillation of 10% neutral formalin and then were still fixed for additional 24 hours. Sagittal sections of paraffin-embedded middle lobe and upper lobe of left hmg tissue were used for Immunohistochemistry and histological study respectively, Immunohistochemistry was used to detect the expression of telomerase reverse transcrip tase(TERT) grade. Results Among 4groups, there were significantly differences in radical alveolar counts(RAC), TNF-α and IL-β1 in tissue homogenates( P < 0. 01 ). Compared with group D, increase in RAC and the decrease in both TNF-α and IL-β1 were found in other groups, and furthermore there were obvious differences in those changes between group A and group B as well as between group A and group C. There were significant differences in TERT(P<0.01) among four groups. The TERT grade in group A and group B were increased more markedly. DAPI-positive cells were found in group A and group C with significantly differences(6.23 ± 1.88, 5.10 ± 0.91, t = 1.53, P<0.05).Conclusions The protective effects of GM-CSF/MSCs on injuried lungs of new born rats after exposure to hyperoxia may be associated with the increase in the proliferation of stem cells improving the local micro-environment of lung tissue. This protective effects against lung injury induced by hyperoxia exposure may be attributed to the synergism between GM-CSF and MSCs.

Objective To study the prophylactic effects of nasal tolerance with a dual analogue (Lys262-Ala207) on experimental autoimmune myasthenia gravis (EAMG) and observe the underlying mechanisms, the clinical and immunological changes in Lewis rats treated with dual analogue nasally. Methods The effects of the predetermined dosage of a dual analogue Lys262-Ala207 were compared at different time points, and the dual analogues or control peptides were given nasally before (Group A or CA) or on the day (Group B or CB) of immunization with acetylcholine receptor (AChR) in complete Freund's adjuvant for 10 consecutive days. The clinical scores were evaluated for 50 days after immunization. The levels of anti-AChR IgG in serum were tested by RIA. Proliferative responses of lymphocytes to no antigen, Lys262-Ala207, AChR, AChR-?100-116, MBP peptide, or Con A were tested. The numbers of mononuclear cells expressing CD4 and/or CD25 from lymph nodes were enumerated using flow cytometry. Results As compared with the corresponding control groups, Lewis rats in group A or B developed EAMG with reduced severity and loss of AChR within the neuromuscular junction. The levels of anti-AChR IgG (21.96?3.37 and 29.41?4.59) were also decreased. Proliferative responses were suppressed in response to antigen-specific stimulations in rats receiving dual analogue, whereas the numbers of CD4+CD25+ T cells were higher in group A (11.34%?1.62%) and B (8.68%?1.83%) than in their corresponding control groups. Conclusions Nasal administration with a dual analogue Lys262-Ala207, at two different time points before and on the day of immunization ameliorated muscular weakness in EAMG rats associated with decreased levels of anti-AChR IgG in serum, suppressed antigen-specific T cell proliferation and increased numbers of CD4+CD25+ T cells from lymph nodes as compared to rats receiving control peptides. The results of our study suggest that the mucosal tolerance with dual analogue should be served as an alternative maneuver in human MG.

Objective To understand the occurrence of catheter-associated urinary tract infection(CAUTI)in pa-tients with catheterization,and provide evidence for reducing the incidence of CAUTI.Methods Based on monito-ring requirement for CAUTI in competency building project of healthcare-associated infection(HAI)prevention and control established by Hospital Infection Management Committee of Chinese Hospital Association,CAUTI among patients who hospitalized and received urinary catheterization ≥2 days in a hospital from January to December 2014 were analyzed prospectively,incidences of CAUTI in different patients were compared.Results A total of 6 046 patients with urinary catheterization were monitored,166 of whom developed CAUTI,incidence of CAUTI was 2.75%,the total urinary catheter days were 31 833 days,incidence of CAUTI was 5.21 per 1 000 urinary catheter days.There was no significant difference in the incidence of CAUTI among patients of different genders (χ2 =1 .23, P =0.54);incidence of CAUTI in patients > 60 years old was higher than those ≤60 years (4.72% vs 2.07%,χ2=30.38,P <0.01);incidence of CAUTI in patients with different duration of catheterization was significantly dif-ferent(χ2 = 251 .14,P <0.01 );with the prolongation of duration of catheterization,incidence of CAUTI also in-creased(trendχ2 =211 .82,P <0.001 ).Patients in department of neurology had the longest average catheterization time(14.84 days)and highest incidence of CAUTI(15.00%,10.11 ‰);patients in the other departments of surgery had the shortest average catheterization time(3.56 days)and lowest incidence of CAUTI(0.97%,2.74‰);inci-dences of CAUTI in patients with urinary catheterization in different departments were significantly different(χ2 =302.24,P <0.001).166 CAUTI patients were isolated 66 isolates of pathogenic strains,86.36% were gram-nega-tive bacilli,33.33% of which were Escherichia coli .Conclusion CAUTI is related to the age of patients and dura-tion of indwelling urinary catheter.Daily assessment on the necessity of indwelling catheter and timely removal of catheter is helpful for reducing the occurrence of CAUTI.

Objective To establish a bedside available risk scoring system of no-reflow in the acute stage of STEMI.Methods Data from STEMI patients treated with PCI divided into model group and validation group were analyzed.Multivariable binary logistic regression analysis was used to identify independent no-reflow predictors of the model group.Finally,a score according to the odds ratio on logistic regression analysis was designed,and then risk stratification was established,and no-reflow high-risk patients with myocardial infarction were selected.The authenticity and reliability of the logistic regression courses were validated using receiver operator characteristic curve (ROC)and Hosmer-Lemeshow goodness-of-fit.Results Multivariate logistic regression analysis demonstrated that female (OR =0.587,P =0.019),Killip class of myocardial infarction≥2 (OR =3.656,P <0.01),TIMI flow ≤2 before primary PCI (OR =0.774,P =0.013),thrombus burden score ≥4 on baseline angiography (OR =2.629,P <0.01),pain to balloon time ≥ 6 h (OR =1.485,P =0.083)were independent correlate predictors of no-reflow phenomenon in the STEMI after PCI.The risk score system demonstrated a good risk prediction in the model group with AUC of 0.716 (95%CI:0.671 -0.761)based on ROC analysis.There was no significant discrepancy between multivariate logistic regression analysis and Hosmer-Lemeshow goodness-of-fit (χ2 =1.027,P =0.994).In risk stratification,total value <2 was assigned into low risk level,and 2-5 was put into the medium risk level,and >5 was arranged into high risk level.The risk score system demonstrated a good risk prediction in the validation group with AUC of 0.891 (95%CI:0.822 -0.959)based on ROC analysis.ROC analysis in the validation group was applied to Killip class,thrombus burden,score and risk stratification in the validation group ,and the no-reflow score was more accurate,with a larger area under the curve (AUC = 0.851,95% CI:0.776 -0.927 ).Conclusions Establishment of no-reflow scoring system with STEMI patients undergoing PCI was benefit to select high risk patients with no-reflow.

Objective To study the effects of 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) on experimental allergic encephalomyelitis (EAE) and its immune-modulating mechanisms. Methods 1,25-(OH)2D3 were given to Lewis rats immunized with myelin basic protein (MBP) in complete Freud’s adjuvant (CFA) respectively on the same day of immunization (the prevented group) and the presenting day of symptoms (the treated group). Then clinical symptoms were scored until the 13th day after immunization, when rats were sacrificed. Mononuclear cells (MNC) in draining lymph nodes were collected for the following studies: (1)Total number of MNC in the lymph nodes were counted. (2) Numbers of CD~+4CD~+ 25 cells and CD~+ 86 cells were determinated by flow cytometry. (3) The concentrations of interferon(IFN)-? and interleukin(IL)-4 in cell culture supernatant were measured by enzyme-linked immuno sorbent assay (ELISA). Results 1,25-(OH)2D3 could delay the peak EAE severity in the prevented group while it could relieve the progression of EAE and lower the peak score in the treated group (3.3?0.6 vs 4.0?0.3, P