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 evaluate the equity of the secondary performance allocation in target hospital.Methods:Through the comparison on the Gini coefficient calculation,the calculation method of Gini coefficient developed by Jianhua Zhang was applied to estimate the secondary allocation result of performance salary in the target hospital from 2014 to 2015.Results:From 2014 to 2015,the Gini coefficient remained at 0.22 or so,the overall allocation was average.Conclusion:Estimating the Gini coefficient was beneficial for the hospital managers control the structure and level of the second performance distribution and modulate the program of the sencond performance distribution in time,so that the distribution of performance salary would be accordant to the designed program and acts as the direction of motivation.

Kaino-sinus syndrome is one new complication of endoscopic sinus surgery. The patient had an operation of endoscopic surgery, because he was suffered from an illness of frontal nasal inverted papilloma again. After operation he was suffering pain in left epicanthal folds and frontal part, and had dry scab in nasal cavity when he breathed cold air. The symptoms could relieve by blocking prenaris. We found he had a big aperture of frontal sinus and dry scab in nasal endoscopic examination. His symptoms disappeared after cleaning and washing accessory nasal cavity by salt water.
Adult ; Endoscopy ; adverse effects ; Humans ; Male ; Nasal Surgical Procedures ; adverse effects ; Paranasal Sinus Neoplasms ; surgery ; Paranasal Sinuses ; pathology ; Postoperative Complications ; Syndrome

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

Immunohisto-chemical S-P method was used to examine the expression of E-cadherin,Vimentin and TGF-β1 in 54 cases oral carcinoma and 10 cases of normal oral mucosa.The positive rates of the expression of E-cadherin,Vimentin and TGF-β1 were 55.6%, 33.33% and 59.3%,respectively in oral carcinoma group(vs normal oral mucosa,P <0.05).The expression of TGF-β1 was correlated with lymph node metastasis,and showed significant positive correlation with Vimentin.Epithelial-mesenchymal transition may promote inva-sion and metastasis of oral carcinoma,and TGF-β1 promotes EMT.

Objective:To investigate the expression of Survivin and programmed cell death 5(PDCD5)protein in mucoepidermoid carcinoma(MEC).Methods:Survivin and PDCD5 were detected by immunohistochemical staining in 20 cases of normal parotid tis-sue(group A),40 cases of pleomorphic adenoma(group B)and 45 cases of MEC tissues(group C).Results:The positive expres-sion ratio of Survivin in group A,B and C was 10.0%,27.5% and 55.6% respectively(χ2 =14.556,P <0.01),while that of PD-CD5 was 85%,65% and 33.3% respectively (χ2 =17.439,P <0.01).The expression of survivin or PDCD5 was related with dif-ferentiation,lymph node metastasis and TNM staging of MEC.Survivin and PDCD5 showed a negative correlation in MEC(χ2 =4.500,P =0.034,γs =-0.316).Conclusion:Survivin over-expression and PDCD5 down-expression may play a role in the de-velopment and progress of mucoepidermoid carcinoma.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

Objective:To investigate the effect and mechanism of hypoxia-inducible factor-1α (HIF-1α)in perihematomal brain tissue on the early formation of edema in patients with hyper-tensive intracerebral hemorrhage.Methods:The perihematomal brain tissue in 32 patients with hypertensive intracerebral hemorrhage were treated with hematoma evacuation.The expressions of HIF-1α and vascular endothelial growth factor(VEGF)were measured by immunohistochem- istry staining technique.The volume of perihematomal edema was determined on the basis of reoperative head CT scan.The results of staining and the volume of edema were analyzed by using double-blind method.Resets:Neuron and vascular endothelial cell swelling were observed 4 hours after cerebral hemorrhage,and the scattered HIF-1α positive neurons were visible.The expressions of HIF-1α reached the peak(at 24 to 48 hours,and went on high expressions at 49 to 72 hours.There was significant difference as compared with the normal brain tissue(P＜0.01). There were positive correlations between the expressions of HIF-1α and VEGF (r=0.72,t=6.37,P＜0.01)and the volume of brain edema(r=0.64,t=4.56,P＜0.01).Conclusions: The expression of HIF-1α in perihematomal brain tissue of hypertensive cerebral hemorrhage iS associated with the early formation of cerebral edema.HIF-1α may accelerate the formation of brain edema by inducing and regulating the expression of VEGF.