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 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 investigate epidermal growth factor receptor(EGFR)expression and tumor residual to the prognostic value in patients with nasopharyngeal cancer(NPC).Methods 200 patients with NPC were examined for EGFR expression by immunohistochemistry analysis,neck cancer and nasopharyngeal residual.Results In 200 cases with NPC,expression of EGFR of positive and negative were 160 cases(80.0%) and 40 cases (20.0%);the rate of overall survival(OS),disease-free survival (DFS),loeoregional relapse-free survival (LRFS) and distant metastasis-free survival(DMFS)in patients with positive EGFR were 72.3%,63.6%,72.2%,63.8% and negative EGFR were 90.0%,90.0%,90.0%,90.0%,respectively in 3-year(X2=3.95,X2=4.12,X2=3.98,X2=4.15,P＜0.05),the rate of local recurrence,distant metastasis rate in residual were 26.6%,32.5% which is significantly higher than 8.1%,18.1% in without residual(X2=4.75,X2=4.94,P＜0.05);the hish expression of EGFR with DFS,OS were significantly correlated(r=6.457,P＜0.05).Conclusion The overexpress of EGFR had the tendency of poor prognosis.tumor residual after radiotherpy can be a prognostic indicator for patients with NPC.

Purpose To discuss the feasibility of evaluating left ventricular systolic function in patients with acute anterior myocardial infarction (AAMI) with three-dimensional speckle tracking imaging (3D-STI). Materials and Methods Thirty AAMI patients were examined with 3D-STI technique in terms of left ventricular longitudinal strain (LS), radial strain (RS), circumferential strain (CS), area strain (AS), global longitudinal strain (GLS), global riadial strain (GRS), global circumferential strain (GCS) and global area strain (GAS). The results were compared with those of 30 healthy persons and the strain values in normal segments of those AAMI patients. The threshold, sensibility and specificity of those parameters in diagnosing myocardial infarction were analyzed. Results Compared with healthy group, LS reduced in 12 out of 17 segments (12/17), RS reduced in 10/17, CS in 9/17 and AS in 11/17;they mainly focused in the base segment, middle and apex of anterior wall, the base segment and the middle of anterior septal, the apex of aboral septal, and the middle segment, apex of the lateral wall. The GLS, GRS, GCS and GAS were all lower than those in healthy group (differences with statistic signiifcance:P<0.05). In AAMI patient, LS, RS, CS and AS in the infarcted segments were lower compared with those in the normal segments (differences with statistic signiifcance:P<0.05). ROC curve analysis showed that the sensitivity of LS, RS, CS and AS were 89.2%, 79.0%, 77.9%, 85.3%, respectively in the diagnosis of myocardial infarction, and the speciifcity were 65.8%, 71.0%, 66.9%and 92.3%, respectively. The sensitivity of the GLS, GRS, GCS and GAS were 91.2%, 74.0%, 68.9%, 85.3%, respectively in the diagnosis of myocardial infarction, and the speciifcity were 69.8%, 71.0%, 76.9%and 93.3%, respectively. Conclusion 3D-STI can detect the strain values of LV segments efficiently and accurately so as to discriminate normal and infracted segments, which provides a reliable measurement to evaluate the extent of the infarction of the patients with acute anterior wall myocardial infarction.

Objective To understand the relation between smoking and serum uric acid level and to investigate whether the ser-um uric acid has the correlation with the gender,age and smoking history.Methods The data of the gender,age,blood uric acid in1 847 individuals aged 20-80 years with the healthy physical examination and without underlying diseases were performed the statisti-cal analysis.Results With male and female as the research objects,the serum uric acid level of smokers were higher than that of non-smokers and occasional smokers,the difference was statistically significant;the serum uric acid level had no statistically signifi-cant difference between smokers and occasional smokers;the serum uric acid level had no statistically significant difference among non-smoking,occasional smoking and smoking groups for males as the research objects alone;to divide the male subjects into groups according to age,the serum uric acid level of non-smokers,occasional smokers and smokers were not statistically significant among all age groups;serum uric acid level showed the increasing trend with the increase of smoking history,but there was no statistically significant difference.Conclusion The serum uric acid level of smokers is significantly higher than that of non-smokers and occa-sional smokers with male and female as the research objects;the difference in serum uric acid level between smokers and occasional smokers has no statistical significance;excluding the gender factor interference,the serum uric acid level of males is not affected by smoking or age;serum uric acid mean value demonstrates the increasing trend with the increase of smoking history.

This paper introduces the history of Ilizarov technology,led to the design and application of Bone Lengthening Growth Diary,and describes the specific application effect.On this basis,to think about Bone Lengthe-ning Growth Diary’ clincial application:constantly improve the nurses’ professional level; follow the basic princi-ples of medical ethics;strengthen the doctor-patient communication and humanstic care.

Objective To investigate the clinical effect of low molecular weight heparin (LMWH) and pressure pump on perioperative deep vein thrombosis (DVT) in patients with hip fracture and analyze the effect of LMWH on coagulation function. Methods Retrospective analysis of 95 cases hip fractures patients with clinical data, according to the preventive medication of DVT were divided into LMWH group of 42 cases and LMWH joint pressure pump group of 53 cases. The incidence rate of DVT and the degree of limb swelling after operation in two groups were observed. The differences of blood coagulation function indexes, blood rheology and hip function recovery were compared between the two groups. Results The the incidence rate of DVT in combination group was 1.89% (1 cases ), lower than LMWH group of 14.29% (6 cases )(χ2=5.278,P=0.022). After two weeks' treatment, the difference of anterior thigh circumference and calf circumference in combination group was less than LMWH group (P<0.05). The prothrombin time (PT) and activated partial thromboplastin time (APTT) in two groups post-treatment were lower than those pre-treatment, the D-dimer (D-D) was higher than that pre-treatment(P<0.05), but there was no significant difference between two groups. After 3 months' treatment, the Harris functional independence measure (FIM) in combination group was higher than that in LMWH group (P<0.05). Conclusion LMWH combined with pressure pump could significantly reduce the incidence of perioperative DVT in patients with hip fracture, improve the blood coagulation function and hip function.

Objective To study CGRP,Ang Ⅱ and ET in healthy offsprings from different families history of essential hypertension. Methods Sixty healthy offsprings with or without a family history of essential hypertension were recruited and divided into two groups: (1) 30 from family with either one parent of essential hypertension; (2) 30 from family with both parents of essential hypertension; (3) control group,30 subjects from family with parents negative history.The levels of plasma CGRP,Ang Ⅱ and ET were determined by radioimmunoassay. Results The plasma levels of CGRP,Ang Ⅱ in one parent group were(28.3?10.4 pg/mL),(52.5?11.1 pg/mL) and (37.7?14.7 pg/mL),(58.4?9.1 pg/mL) in both parents group,which were increased significantly as compared with those in the control group (CGRP 19.9?10.5 pg/mL,Ang Ⅱ 45.3?9.9 pg/mL,P

0.05).The major toxicity and side effects were bone marrow inhibition,gastrointestinal reaction and mucosal reaction.The difference of hematologic toxicity and gastrointestinal between the two groups was statistically significant(P0.05).The GEM group could be well tolerated for the concurrent chemoradiotherap of patients with stage Ⅲ～Ⅳa nasopharyngeal carcinoma(NPC).

Objective: To investigate the effect of combined hypoxia and high fat diet (HFD) on endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) of myocardium in experimental rats with its possible mechanisms.
Methods: A total of 60 male SD rats were randomly divided into 3 groups, n=20 in each group. Control group, the rats were fed by normal diet with normal oxygen condition. Hypoxia group, the rats were fed by normal diet with simulated 5000m altitude oxygen condition. Combined hypoxia and HFD (H+HFD) group, the rats were fed by HFD and simulated 5000m altitude oxygen condition. All animals were treated for 4 weeks and peripheral blood and myocardium specimen were collected. Hemoglobin was examined by automatic blood cell analyzer, plasma malondialdehyde (MDA) was measured by TBA method, superoxide dismutase (SOD) activity was detected by WST-1 method, mRNA and protein expressions of eNOS were examined by real time PCR and Western blot analysis respectively, the myocardium nitrates and nitrites (NOx) was measured by nitrate reductase method.
Results: Compared with Control group, Hypoxia group and H+HFD group had increased mRNA and protein expressions of eNOS, H+HFD group had lower NOx levels than the other 2 groups P<0.05. Compared with Hypoxia group, H+HFD group showed obviously increased total cholesterol, LDL-cholesterol and decreased SOD activity, diseased MDA level P<0.05.
Conclusion: Upon hypoxia alone, H+HFD may further reduce NOx level of myocardium, it implies aggravated chronic hypoxia impairment, which might be related to dyslipidemia and lack of anti-oxidative ability in experimental rats.