Objective: To study the nursing of patients with morbid obesity treated with laparoscopic vertical banded gastroplasty (LVBG). Methods: Before operation, obese degree, obesity-related conditions and mental states were examined routinely. Monitoring of respiratory tract, observing operative complications and instructing of diets were done after operation. Results: Among 6 patients, 5 were at the third degree of obese, one was at second. In obesity-related conditions, 4 patients had hypertension and acantha derma, 1 had arthritis, and all had respiratory sleeping syndrome. The operations were all successful. The food amount food and body weight both decreased significantly 1 month after operation. The common operative complications were mild bleeding (1 case), shoulder-back pain (1 case), nausea and vomiting (5 cases). Diet principle was high protein, low energy, liquid food was the first choice. Conclusion: Observing and preventing respiratory sleeping syndrome are the main points of postoperative cares. Instructing patients to establish correct diet habit is the key to reach the best efficacy of LVBG.

Objective To investigate the risk factors and clinical characteristics,auxiliary examination char-acteristics,treatment and prognosis for acute stroke patients with deep vein thrombosis (DVT),in the hope of provi-ding the detailed clinical data for hospitalized patients with stroke in early prevention,early diagnosis and early treat-ment of DVT.Methods 160 cases of stroke patients were reviewed including 66 cases of patients with hemiplegia after stroke and ultrasound confirmed DVT data analysis,And compared with the same period of 94 cases of DVT in patients with stroke.The purpose of this study was to evaluate the incidence of DVT,possible risk factors,and clinical characteristics.Results Stroke in patients with DVT spent an average of 16d.DVT occurred in elderly patients (65 years or higher) with 44 cases,accounting for 66.67%;Serious paralytic 42 cases (72.72%),long-term bed 52 cases (78.78%);The most commonly comorbid disease was diabetes mellitus,hypertension and hyperlipidemia;The plasma fibrinogen concentration was (5.02 ±1.38) g/L,which was significantly higher than (2.74 ±1.65) g/L of the control group.Compared with control group,the difference was statistically significant (t=4.78,P<0.01). Conclusion Limb paralysis,long-term lie in bed,older age and high condensation state are DVT risk factors,which should be paid to prevent in advance clinically.

Objective To introduce a surgical method for treatment of severe gynecomastia.Methods After designing double rings and ectomizing epidermis between two rings,a supra-medialis derma mammary pedicle of the nipple and areola was formed,most of the gland and fatty tissue was ectomized,the pedicle was fixed with the sarcolemma,and the two rings were sutured together.Resuits There were no severe postoperative complications.Following-up of 9 cases (18 sites) for 6 to 24 months showed symmetrical and satisfactory contour.Conclusions The breast reduction with doublering supra-medialis pedicle can be an effective procedure of severe gynecomastia,in which the supramedialis pedicle can ensure the blood supply of nipple and areola and avoid late mastoptosis.

Objective To understand the late detection of new HIV/AIDS cases in Changshu City from 2015 to 2019， and to provide scientific basis for AIDS prevention and control. Methods The newly reported HIV/AIDS cases in Changshu City from 2015 to 2019 were collected through the “information system for integrated prevention and treatment of AIDS”. According to the criteria for late detection of HIV/AIDS， the influencing factors of late detection of HIV/AIDS were verified and the relevant epidemiological analysis was carried out. Results A total of 423 cases of HIV/AIDS were reported in Changshu City from 2015 to 2019， and the average incidence rate was 4.33/10⁵. The overall incidence rate did not show a downward trend （χ²_trend=3.543， P=0.060）. The incidence rate of males （7.35/10⁵） was higher than that of females （0.93/10⁵）. The trend of incidence rate in males was significantly decreased （χ²_trend=6.264， P=0.012）， but it did not have a significant change in females （χ²_trend=1.717， P=0.190）. The average annual HIV/AIDS late detection rate was 23.88% （101/423）， with the highest in 2015 （33.68%） and the lowest in 2017 （12.94%）.It showed a valley distribution pattern with first decline and then rise. The difference in HIV/AIDS late detection rate in recent five years was statistically significant （χ²=17.087， P=0.002）. At the end of the report， the proportion of male patients （89.11%） was higher than that of females （10.89%）， and nearly half （46.53%） of the patients were in elderly group aged 50 years old （46.53%）. Patients with local registered residence （58.42%） had higher late detection rate than those with foreign household registration （41.58）. Most the patients were junior high school educated （36.63%）， followed by primary school （26.73%） and senior high school （21.78%）. 68.32% of the patients were married and had a spouse. The top three occupations in patients were farmers （24.75%）， workers （24.75%） and business services （22.77%）， and the other occupations accounted for less than 10%. Most of the HIV positive samples were from other diseases （36.63%）， followed by testing consultation （29.70%） and preoperative testing （16.83%）. 77.23% of the late detection patients had no history of sexual diseases. Late detection in homosexuals （57.43%） were higher than that in heterosexuals （42.57%）. Conclusion The late detection rate of HIV/AIDS in Changshu City in recent five years showed a downward trend and then an upward trend. In the future， we should focus on the elderly， MSM， young students and other high-risk groups of HIV infection， strengthen health education and publicity， expand the scope of HIV testing， improve the ability of early detection， and effectively reduce the risk of HIV transmission.

Objective:To explore the regional brain activities in healthy adolescent subjects after sleep deprivation (SD) using amplitude of low-frequency fluctuation (ALFF) method.Methods:Total of 16 healthy adolescent subjects (8 males,8 females;aged 13-20 years) were recruited in the community and the campus through the internet and posters.Each of the 16 healthy adolescent subject underwent the attention network test and magnetic resonance imaging (MRI) session twice:once was after rested wakefulness (RW condition),and the other was after SD condition.Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features.The mean ALFF signal values of the different brain areas were performed to investigate their relationships with the accuracy rate,reaction time and lapse rate in the attention network test,and were analyzed with a receiver operating characteristic (ROC) curve to investigate their sensitivities and specificities to distinguish the SD condition from the RW condition.Results:Subjects showed a lower response accuracy rate [(83 ± 12) ％ vs.(97 ± 4) ％,P ＜ 0.05],a longer response time [(832 ± 134) ms vs.(715 ± 97) ms,P ＜ 0.05] and a higher lapse rate [(15 ± 11)％ vs.(2.4 ±7.3)％,P ＜0.05] under SD condition than under RW condition.They showed higher ALFF area in the right cuneus (BA 17,BA 18),and lower ALFF areas in the right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex (BA 46) and left inferior parietal cortex (BA 39) under SD condition than under RW condition.Under SD condition,the mean ALFF signal value of the right claustrum showed a significant positive correlation with the accuracy rate (r =0.69,P ＜0.05),and a negative correlation with the lapse rate (r =-0.71,P ＜0.05).The mean ALFF signal value of the dorsolateral prefrontal cortex showed a significant positive correlation with the reaction time (r =0.68,P ＜ 0.05).The values of area under the curve of the right cuneus,right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex and left inferior parietal cortice were 0.9,0.8,0.9,0.8 and 0.9,respectively.These different ALFF areas also showed high degree of sensitivities and specificities.Conclusion:Sleep deprivation leads to the dysfunction in the default mode network,anticorrelatedtask-positive network,and advanced cognitive function brain areas,and the functional compensation in the visual network.

Objective This study compares a dual-freeze protocol with a triple freeze protocol for hepatic cryoablation in the Tibetan pig model.Method Cryoablation with a dual-(10-5-10-5 min)and triple-freeze (5-5-5-5-10-5 min) protocol for the normal livers of 9 Tibet pigs was performed under exposed operation.Temperature changes of cryoprobes and diameter changes of iceballs were measured during the ablation,and seven days later the pathological changes of cryozones were reviewed and the surface and depth cryolesions were measured.Results Compared with cryoablation with two freeze-thaw cycles,there was a greater iceball diameter for cryoablation by three freeze-thaw cycles.Also,seven days after cryosurgery,there were similar surface and deep cryolesions in dual-and triple-freeze protocols.Pathologically,the triple freezing protocol was associated with a longer zone of complete necrosis.Conclusions With the same freezing time (20 min),the triple-freeze protocol may become a more powerful liver-ablation method in cryosurgical application.

Objective To explore the effect of radiofrequency heating on type Ⅱ collagen expression in a rabbit model of osteoarthritis.Methods Knee osteoarthritis was induced in the right hind legs of 54 male rabbits using modified Hulth modeling.The rabbits were randomly divided into a model group which was not given any special treatment,a Lugua polypeptide group and a radiofrequency hyperthermia group.The Lugua polypeptide group was injected with Lugua polypeptide;the radiofrequency hyperthermia group was treated with radiofrequency irradiation.Six,12 and 18 days after the treatment,the morphological condition of the rats' right femoral medial condyle cartilages were evaluated using modified Mankins scoring and the type Ⅱ collagen content of the cartilage was detected using a quantitative PCR technique.Results At the same time points after treatment,the average Mankins scores were decreased in all the 3 groups,with that of the model group was significantly higher than those of both of the other groups,and the radiofrequency hyperthermia group's average score was significantly better than that of the Lugua polypeptide group.The average type Ⅱ collagen content was significantly increased in all the 3 groups to various extent (the radiofrequency hyperthermia group ＞ Lugua polypeptide group ＞ model group).For the radiofrequency hyperthermia group,the average Mankins score decreased significantly and the average type Ⅱ collagen content increased significantly as the treatment continued.Conclusion Radiofrequency hyperthermia is superior to Lugua polypeptide for treating knee osteoarthritis,at least in rabbits.Its therapeutic effectiveness may be related to a significant increase of type Ⅱ collagen in the cartilage.

As a promising modality for cancer therapy, photodynamic therapy (PDT) still acquired limited success in clinical nowadays due to the extremely serious hypoxia and immunosuppression tumor microenvironment. To ameliorate such a situation, we rationally designed and prepared cascade two-stage re-oxygenation and immune re-sensitization BSA-MHI148@SRF nanoparticles via hydrophilic and hydrophobic self-assembly strategy by using near-infrared photodynamic dye MHI148 chemically modified bovine serum albumin (BSA-MHI148) and multi-kinase inhibitor Sorafenib (SRF) as a novel tumor oxygen and immune microenvironment regulation drug. Benefiting from the accumulation of SRF in tumors, BSA-MHI148@SRF nanoparticles dramatically enhanced the PDT efficacy by promoting cascade two-stage tumor re-oxygenation mechanisms: (i) SRF decreased tumor oxygen consumption via inhibiting mitochondria respiratory. (ii) SRF increased the oxygen supply via inducing tumor vessel normalization. Meanwhile, the immunosuppression micro-environment was also obviously reversed by two-stage immune re-sensitization as follows: (i) Enhanced immunogenic cell death (ICD) production amplified by BSA-MHI148@SRF induced reactive oxygen species (ROS) generation enhanced T cell infiltration and improve its tumor cell killing ability. (ii) BSA-MHI148@SRF amplified tumor vessel normalization by VEGF inhibition also obviously reversed the tumor immune-suppression microenvironment. Finally, the growth of solid tumors was significantly depressed by such well-designed BSA-MHI148@SRF nanoparticles, which could be potential for clinical cancer therapy.

[This corrects the article DOI: 10.1016/j.apsb.2022.07.023.].