BACKGROUND: There are lots of researches about using adipose-derived stem cells to promote damage repair, but the studies from the perspective of exosome from adipose-derived stem cells based on proteomics and bioinformatics technologies are rarely reported. OBJECTIVE: To analyze the differentially expressed proteins of exosome from adipose-derived stem cells between diabetic patients with leg ulcers and healthy adults through proteomics and bioinformatics technologies, so as to screen out the diagnostic and prognostic landmarks. METHODS: Adipose-derived stem cells were obtained from 25 diabetic patients (trial group) with leg ulcers who accepted debridement skin grafting at the Department of Plastic and Burn, Second Affiliated Hospital of Air Force Military Medical University from October 2018 to May 2019 and 10 healthy adults who concurrently accepted liposuction (control group). Exosomes from adipose-derived stem cells were extracted for identification. Three cases were randomly selected from each group for proteomics analysis. LFQ technology was used to conduct quantitative analysis. GO and Pathway analysis for the differentially expressed proteins were performed using clueGO (version 2.5.4) was used to do. The transactional analysis between proteins was conducted (String database, version 11.0, R software clusterProfi ler package, FDR < 0.25). RESULTS AND CONCLUSION: (1) Totally 231 quantitative differentially expressed proteins were screened out, 31 kinds of which had significant difference. There were 29 down-regulated proteins and 2 up-regulated proteins in the trial group. (2) Differential proteins had a high correlation with nutrition and metabolic diseases. Differentially expressed proteins were mostly expressed in extracellular vesicles and platelet alpha granules and were mainly involved in two biological processes-coagulation process and lipid transport. The main molecular functions of differential proteins were related to enzyme inhibitor activity and heparin binding capacity. (3) The pathway analysis of PPI and KEGG showed that the significantly down-regulated ITGA2B and ITGB3 proteins were closely related to the course of the disease in the trial group, both of which are expected to be the new targets in stem cell treatment for diabetes with leg ulcers.

Smart dressings, which show obvious advantage and potential in wound treatment and real-time monitoring, attract widespread attention in recent years. Real-time and dynamic acquiring wound information is vital to the treatment and prognosis of wound. Further research on smart dressings is helpful for wound management, personalized treatment, and realization of medical application translation of health monitoring technology. In the article, we categorize smart dressings and conclude their functions according to the type of micro-environment information of wound gathered by smart dressings.

Objective:To explore the application and effect of information management in nursing of incontinence associated dermatitis (IAD) among elderly patients.Methods:From April 2019, the Cadre Department of Zhejiang Provincial People's Hospital carried out information management of IAD in elderly patients. Relying on the Ding Talk platform to provide nurses with information training and assessment of IAD knowledge, and to carry out information management of skin management in the elderly incontinent patients. Using before-after study, we randomly selected data of 80 elderly patients from October 2018 to March 2019 as control group, and selected data of 80 elderly incontinent patients from April to September 2019 as experimental group. We observed the incidence and time of IAD between two groups.Results:After information management, the incidence of IAD of experimental group patients was 13.75% (11/80) lower than that 33.75% (27/80) of control group with a statistical difference ( P<0.05) . The time of IAD of experimental group was (10.46±2.01) d, which was significantly later than that [ (5.47±2.29) d] of control group ( P<0.05) . Conclusions:Information management can effectively reduce the incidence of IAD in elderly patients, delay the occurrence time and improve the nursing effect.

Objective To explore the effects of visual management health education model on incontinence-associated dermatitis (IAD) in inpatients.Methods A total of 55 incontinence patients hospitalized in the People's Hospital of Zhejiang Province from February 2017 to February 2018 were selected as the observation group,and visual management health education was carried out.Another 58 incontinence patients hospitalized from January 2016 to December 2016 were selected as the control group,and routine health education was carried out.The incidence and duration of IAD,self-efficacy and nursing satisfaction were compared between the two groups after 1 months of nursing intervention.Results There were 1 cases of first degree dermatitis and 1 case of second degree dermatitis,with a total incidence of 3.64％.There were 6 cases of first degree dermatitis,2 cases of second degree dermatitis,and 1 cases of third degree dermatitis,with a total incidence of 15.52％.The difference was statistically significant (P ＜ 0.01).The duration of IAD of the observation group and the control group was (13.5 ± 3.1) d and (7.6 ± 2.4) d respectively,and the difference between the two groups was statistically significant (P＜ 0.01).The results,coping,self management,general self-efficacy and total score of the patients in the observation group before and after visual management nursing intervention were significantly higher than those in the control group,and all the differences were statistically significant (P ＜ 0.05).The satisfaction on technical operation and clinical nursing quality of the patients in the observation group was higher than that of the control group (P ＜ 0.05).There was no significant difference in the ward environment and service attitude between the two groups (P ＞ 0.05).Conclusions Visual management can reduce IAD and improve self-efficacy and nursing satisfaction of inpatients with incontinence.

Objective? To establish a WeChat online system supporting continued nursing care for patients receiving enteral bladder augmentation and to evaluate its effects on continued nursing care for patients with neurogenic bladder in spinal cord injury who received enteral bladder augmentation. Methods? Totally 60 patients with low-compliant neurogenic bladder in spinal cord injury who received enteral bladder augmentation and were discharged from Zhejiang Provincial People's Hospital between March 2016 and March 2018 were selected by convenient sampling, and divided into the observation group (n=30) and the control group (n=30) according to the random number table. Patients in the control group received conventional nursing care after discharge, while patients in the observation group received nursing care after discharge via the WeChat online support system. The follow-up duration was 3 months. Bladder self-management compliance, urinary catheter-associated complications, bladder function, quality of life and negative emotions at discharge and 3 months after discharge were compared between the two groups. Results? The score of bladder self-management compliance, anxiety score, depression score, and scores of physical function, role function, emotional function and social function in quality of life in the observation group were better than those in the control group 3 months after discharge (P＜0.05); the rates of urinary tract infection and urethral injury of the observation group were 3.3% and 6.7%, while those of the control group were 26.7% and 33.3%, respectively; the incidence rate of urinary catheter-associated complications of the observation group was lower than that of the control group (P＜0.05); and the parameters of bladder function such as bladder volume, bladder compliance, residual urine volume and maximum detrusor pressure of the observation group were better than those of the control group (P＜ 0.05). Conclusions? The WeChat online support system can improve patients' bladder self-management compliance, reduce the urinary catheter-associated complications, enable the recovery of bladder function, ameliorate their negative emotions, and improve their quality of life.

Objective:To study the trinucleotide repeats of GCN (GCA, GCT, GCC, GCG) encoding Alanine in exon 3 of the PHOX2B gene among healthy individuals from southwest China and two patients with Congenital central hypoventilation syndrome (CCHS). Methods:The number and sequence of the GCN repeats of the PHOX2B gene were analyzed by capillary electrophoresis, Sanger sequencing and cloning sequencing of 518 healthy individuals and two newborns with CCHS, respectively. Results:Among the 1036 alleles of the 518 healthy individuals, five alleles were identified, including (GCN) 7, (GCN) 13, (GCN) 14, (GCN) 15 and (GCN) 20. The frequency of the (GCN) 20 allele was the highest (94.79%). And five genotypes were identified, which included (GCN) 7/(GCN) 20, (GCN) 13/(GCN) 20, (GCN) 14/(GCN) 20, (GCN) 15/(GCN) 20, (GCN) 20/(GCN) 20. The homozygous genotypes were all (GCN) 20/(GCN) 20, and the carrier rate was 89.58%. Four GCN sequences of the (GCN) 20 homozygous genotypes were identified among the 464 healthy individuals. The GCN repeat numbers in the exon 3 of the PHOX2B gene showed no significant difference between the expected and observed values, and had fulfilled the, Hardy-Weinberg equilibrium. The genotypes of the two CCHS patients were (GCN) 20/(GCN) 25 and (GCN) 20/(GCN) 30, respectively. Conclusion:It is important to determine the GCN repeats and genotypic data of the exon 3 of the PHOX2B gene among the healthy individuals. The number of GCN repeats in 518 healthy individuals was all below 20. The selection of appropriate methods can accurately detect the polyalanine repeat mutations (PARMs) of the PHOX2B gene, which is conducive to the early diagnosis, intervention and treatment of CCHS.