Objective To explore the effect of the application of the modified eye shield in neonatal phototheraphy . Methods 120 neonates with jaundice were chosen and randomly divided into two groups (60 each).Control group was only applied to normal eye shield, while the improved group used the modified eye shield, wrapping with gauze, and then mositen the eyes with 1~2 Tobramycin eye drops on each side.Both groups were fixed with 3M tapes.After a 24 -hour photothera-py, the incidence rate of reseola, skin rash and eye secretions were compared.Results The improved group has better pro-tective effect and the difference between these two groups is of great statiscally significance(p<0.05).Conclusion The ap-plication of modified eye shield could effectively protect their eyes from neonatal roseola, skin rash and eye secretions, im-prove the feeling of comfort and promote high quality nursing service .

Objective To evaluate the application of a new laparoscopic hepatic forceps for laparoscopic liver resection in pigs.Methods A laparoscopic hepatic forceps was designed by using the CAD software,and was manufactured in coordination with the Hangzhou Kangyou Medical Company for pilot tests.An assessment was made on outcomes of the forceps for blocking hepatic blood flow and controlling cut surface hemorrhage in laparoscopic hepatectomy in 12 pigs.Results The experimental group had a significantly lower intraoperative blood loss than control group(47.8 ?6.9 ml vs 86.3?3.9 ml;t=11.898,P=0.000) and a significantly shorter operation time than control(53.2?7.4 vs 97.5?5.8 min;t=11.541,P=0.000).No significant difference was observed in the weight of resected liver between experimental and control groups(34.7?4.2 g vs 35.3?4.2 g;t=0.245,P=0.812).Conclusions This new laparoscopic hepatic forceps can be used for the occlusion of liver blood flow,offering advantages of less blood loss and shorter operation time and facilitating laparoscopic performance in liver resection.

Object To emphasize the necessity and significance of informed consent in the plastic surgery.Further investigating the ethical implication involved in informed consent principles.To standardize the medical treatment action according to the informed consent principles.Methods Through the literature search method,counseling for experts,sampling surveys and other approaches to elucidate the importancy of informed consent in plastic surgery,to survey and analyze the difficulties and ethical dilemma encountered in the process of standardization.Results Plastic surgeons firmly are aware of the principles of informed consent,as a routine preoperative procedure,however there are still some difficulties in practice.Conclusions To respect the patient's right to know,plastic surgery doctors should be standardized to perform the principle of informed consent; meanwhile hospital should develop a series of systems to regulate the principle of informed consent.

Objective To explore the role of extracellular signal-regulated kinase(ERK)in the apoptosis of hepatic stellate cells(HSC) induced by Arg-Gly-Asp-Ser (RGDS) tetrapeptide. Methods The cultrued HSC cells were divided into six groups including untreated control, fibronertin (FN), FN+RGDS (25 mg/L), FN+RGDS (50 mg/L), FN+RGDS(100 mg/L) and FN+Arg-Gly-Glu-Ser(RGES, 100 mg/L) groups. 3H-thymidine incorporation, transmission electron microscopy and TUNEL were employed to estimate the influence of RGDS on proliferation and apoptosis of HSC. The HSC adhesion rates were observed by toluidine blue colorimetric assay. The expressions of ERK mRNA and ERK protein in HSC were detected by RT-PCR and Western blotting. Results Compared with control and fibronectin groups, RGDS tetrapeptide at concentrations of 25 mg/L, 50 mg/L and 100 mg/L inhibited the proliferation of HSC(P

Objective To explore the influence of resistive respiratory training for patients with chronic obstructive pulmonary disease(COPD) on rehabilitation effect.Methods According to the digital table,68 COPD patients were randomly divided into the observation group and control group,34 cases each group.The observation group were taken respiratory muscle training under the supervision of rehabilitation nurses for 8 weeks,and the respir-atory muscle training including shrinkage lip diaphragm breathing training and abdominal muscle resistance training. Before and after the abdominal muscle resistance training and training were given 1 h double nasal oxygen tube contin-uous low flow oxygen inhalation.The control group were taken pursed lips abdominal breathing training.In the two groups before treatment and 8 weeks after, the blood gas analysis ( PaO2 , PaCO2 ) , pulmonary function test ( FEV1 , FEV1/FVC%) and respiratory muscle function( MIP,MEP) were detected.Results After treatment,blood gas anal-ysis in the two groups comparison(tPaO2 =2.95,tPaCO2 =2.07),pulmonary function(tFEV1 =2.38,tFEV1/FVC%=2.04) and respiratory muscle physiology index(tMIP =6.40,tMEP =4.04),the differences were statistically (all P<0.05).In the observed group before and after treatment,blood gas analysis(tPaO2 =19.23,tPaCO2 =3.05),pulmonary function(tFEV1 =2.67,tFEV1/FVC%=4.19)and respiratory muscle physiology index(tMIP=9.09,tMEP=9.67) were compared,the differences were statistically(all P<0.01).Conclusion Respiratory mus-cle resistance training can improve COPD patients with respiratory muscle strength and endurance,and it has the cura-tive effect to improve pulmonary function.

Objective To investigate and compare the clinical effects of intraarticular injection of sodium hyaluronate and diprospan on knee osteoarthritis. Methods 94 patients with knee osteoarthritis were divided into two groups, the HA group and Cortieosteroid group. Each patient in the HA group was treated with intra-articular injection of sodium hyaluronate at 2.5 ml every week for 5 weeks, and each patient in the Corticosteroid group was treated with intra-articular injection of diprospan at 1ml on the first and fourth week. The clinical assessments included pain,joint effusion,and Lequesne Index. Assessments were done at baseline, at week 4, and week 12. Results 88 cases were followed up for 3 months. A significant decrease in VAS scores for pain and in Lequesne Index was found in both groups at week 4 when compared to baseline and there were no significant differences between the two groups. However,at 12 week improvement in pain score and Lequesne Index was found in favour of hyaluronic acid. In addition,diprospan seemed to have preferable short-term effect on patient with joint effusion. Conclusion Both intra-articular injection of sodium hyaluronate and diprospan provided clinically significant improvement in short-term and demonstrated that hyaluronic acid had a more long-term beneficial effect in patients with knee osteoarthritis.

Objective To evaluate the predictive performance of diaphragm thickening fraction ( DTF) assessed by ultrasound in the feasibility of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease ( COPD ) . Methods Forty-three patients with COPD were enrolled for prospective study.All patients were ventilated mechanically for more than 48 hours and were expected to be weaned when they met clinical criteria in the intensive care unit from February 2015 to August 2015.Patients received a spontaneous breathing trial under pressure support for 1 h.At the end of spontaneous breathing trial, the right hemi-diaphragm was visualized in the zone of apposition using a 6-13 MHz linear ultrasound probe. Diaphragm thickness was recorded at end-inspiration (DTei) and end-expiration (DTee), and the DTF was calculated as percentage from the following formula:(DTei -DTee) /DTee.Also the rapid shallow breathing index ( RSBI ) was calculated.Patients meeting weaning criteria were extubated.Weaning successfully was defined as spontaneous breathing for >48 h without any form of ventilation support.Results Twenty-five patients were weaned successfully and failure of weaning was found in 18 patients.A significant differences in DTF ( 39.66 ±13.22 )%vs.( 23.84 ±8.85 )%, P <0.05 and RSBI ( 62.74 ±26.05 ) vs.( 98.89 ± 35.44) , P <0.05 were observed between patients with successful weaning and patients with failure.The sensitivity and specificity of DTF≥30 % for successful weaning were 84% and 83.88 %, respectively.The area under the receiver operating characteristic curve was 0.872 ( 95 % CI: 0.759-0.985 ) for DTF.By comparison, when RSBI was ≤105, there was a sensitivity of 92 %, and a specificity of 38.89 % for determining successful weaning.The area under the receiver operating characteristic curve was 0.804 ( 95 %CI: 0.669-0.940) for RSBI. Conclusions This study shows that in a cohort of COPD patients, the assessment of DTF using diaphragm ultrasound may be useful to predict success weaning or failure during spontaneous breathing trial.

BACKGROUND:Chitosan is wel known as good biocompatibility and biodegradability;however, its extensive use in biomedical applications is restricted due to its poor transfection efficiency. OBJECTIVE:To prepare the polyethyleneimine-chitosan/DNA nanoparticles loading enhanced green fluorescent protein gene, and to detect their physicochemical properties and gene transfection efficiency towards chondrocytes in vitro.
METHODS:Low molecular weight polyethyleneimine was covalently linked to chitosan backbone to construct chitosan-graft-polyethyleneimine;then the chitosan-graft-polyethyleneimine was mixed with DNA nanoparticles, which loaded enhanced green fluorescent protein gene, by a complex coacervation method. The nanoparticle morphology was observed under a scanning electron microscopy. The sizes and zeta-potentials of the
nanoparticles were measured by a Marven-nano laser diffractometer. The binding capacity of plasmid DNA was evaluated by agarose gel electrophoresis analysis. The gene transfection experiments in vitro were performed towards rabbit’s chondrocytes. The gene transfection efficiency was measured with flow cytometry and under fluorescence microscope. How marked DNA entered into the nucleus of chondrocytes mediated by the nanoparticles was detected by laser scanning confocal microscopy.
RESULTS AND CONCLUSION:The prepared nanoparticles were mainly spherical, with an average size of (154.6±18.6) nm, and zeta-potential of (24.68±6.82) mV. The agarose gel electrophoresis analysis confirmed that the nanoparticles could effectively protect plasmid DNA from DNase Ⅰ-induced degradation. Gene transfection in vitro proved that the nanoparticles were efficient in transfecting rabbit’s chondrocytes and the expression of green fluorescent proteins was observed under fluorescent microscope, with a transfection efficiency of (23.80±1.74)%that was significantly higher than that of the naked plasmid DNA and chitosan/DNA nanoparticles (P<0.05). But no significant differences were observed between polyethyleneimine-chitosan/DNA nanoparticles and LipofectamineTM 2000. These findings indicate that the polyethyleneimine-chitosan/DNA nanoparticles can effectively protect plasmid DNA from nuclease degradation, and exhibit the favorable transfection ability towards articular chondrocytes.

Objective:To investigate the mechanism and effects of autophagy on cisplatin(DDP)-induced apoptosis in human gas-tric cancer cell line SGC7901. Methods:Cell proliferation was determined by an MTT assay after the SGC7901 cells were treated with DDP and/or chloroquine. Cell apoptosis was determined by flow cytometry. Autophagy and related protein expressions were detected by Western blot. Autophagy was quantitatively analyzed by fluorescence microscopy after monodansylcadaverine staining was per-formed. Results:The cells were treated with 5 mg/L of DDP for 24 h, the rate of cell apoptosis was (21.07 ± 2.12)%. Autophagy, char-acterized by an increase in the number of autophagic vesicles and LC3-II protein level, was observed in DDP-treated cells. After autoph-agy was inhibited by chloroquine, the rate of cell apoptosis was increased to (30.16 ± 3.54)%. In addition, caspase-3 and P53 protein levels were increased, but Bcl-2 protein was decreased. Conclusion:Autophagy protected human gastric cancer cell line SGC7901 from DDP-induced apoptosis. In addition, the inhibition of autophagy could promote apoptosis. The combined therapy of DDP and chlo-roquine may be a promising therapeutic strategy for gastric cancer.

BACKGROUND:Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation. OBJECTIVE:To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle. METHODS:Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION:The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finaly cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them stil needed skin graft operation once more. The total survival rate between the two groups has no statistical significance(P > 0.05). The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statisticaly different (P < 0.05). So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.