[Objective] To summarize the therapeutic and nursing care of vacuum sealing drainage to treat skin avulsion injury. [Methods]We used the method of vacuum sealing drainage combined with split thickness skin graft and pre-and post-operation nursing care to treatment of 21 patients suffering with skin avulsion injury, and compared therapeutic effect with routine therapy group. [Result]Skin graft survival rate in VSD group was higher than in routine therapy group. The dressing change, wound healing time, hospitalization time in VSD group were lower in routine therapy group. [Conclusion] The method of vacuum sealing drainage is good in treatment of intervention skin avulsion injury.

Objective To evaluate the effects of acute peritonitis on rocuronium?induced neuromus?cular blockade in abdominal muscles and function of the sarcoplasmic reticulum of rats. Methods Thirty?six pathogen?free male Sprague?Dawley rats, weighing 220-250 g, were divided into 2 groups using a ran?dom number table: control group (group C, n=12) and acute peritonitis group (group P, n=24). After the rats were anesthetized with pentobarbital sodium, acute peritonitis was induced by artificial gastric per?foration in group P. At 1 and 2 h after operation, the changes in the intra?abdominal pressure (IAP) with different volumes were detected, and blood samples were collected from the orbital veins for determination of serum levels of interleukin?6, tumor necrosis factor?alpha and interleukin?13. Rocuronium 3. 5 mg∕kg was then injected via the caudal vein. The IAP was recorded at 1, 5 and 10 min after administration. The intra?cellular free Ca2+ concentration was assessed using fura?2, and the maximal Ca2+ uptake and release rate in the sarcoplasmic reticulum were calculated. Results Compared with group C, the serum levels of interleu?kin?6 and tumor necrosis factor?alpha at 2 h after operation and IAP at 1 and 2 h after operation were signifi?cantly increased, the IAP was increased at 1, 5 and 10 min after administration of rocuronium, and the maximal Ca2+ uptake rate and amount of calcium uptake in the sarcoplasmic reticulum were decreased in group P ( P<0.01) . Conclusion Acute peritonitis decreases rocuronium?induced neuromuscular blockade in abdominal muscles, which may be related to the impaired Ca2+uptake function of the sarcoplasmic reticu?lum of rats.

Objective:To investigate the relationship between caspase recruitment domain protein 9 (CARD9) level and inflammatory response in cerebral tissue of ischemic brain injury mice.Methods:Totally 24 SPF BALB/c male mice were randomly(random number) divided into 4 groups: sham operated group, ischemia 3 h group, ischemia 6 h group, and ischemia 12 h group, 6 mice in each group. The permanant middle cerebral artery occlusion (pMCAO) model in the ischemia groups was established by using line embolism to block blood flow. Mice in each group were sacrificed at the predetermined time point after operation. CARD9 and p-p65NF-κB levels were detected by Western blot, and the inflammatory factors mRNA and protein including TNF-ɑ, IL-lβ and IL-6 were detected by RT-PCR and ELISA, respectively. The data were analyzed by SPSS 21.0 software, the comparison of measurement data between each two groups was analyzed by independent sample t test, and the correlations between CARD9 and inflammatory factors were analyzed by Pearson analysis. Results:Compared with the sham operated group, the CARD9 levels in the ischemia 3 h, 6 h and 12 h groups were increased significantly [(0.325±0.011) vs. (0.462±0.019), P=0.036; (0.735±0.036), P=0.003; (0.903±0.024), P=0.001], the p-p65NF-κB levels in the ischemia 3 h, 6 h and 12 h groups were increased significantly [(0.227±0.016) vs. (0.316±0.017), P=0.041; (0.445±0.021), P=0.016; (0.671±0.039), P=0.008], the TNF-ɑ levels in the ischemia 3 h, 6 h and 12 h groups were significantly increased [(0.53±0.06) vs. (1.06±0.10), P=0.009; (1.47±0.15), P=0.004; (2.78±0.18), P=0.001], the IL-lβ levels in the ischemia 3 h, 6 h and 12 h groups were significantly increased [(0.55±0.07) vs. (1.01±0.11), P=0.009; (2.13±0.16), P=0.003; (3.09±0.18), P=0.001], and the IL-6 levels in the ischemia 3 h, 6 h and 12 h groups were significantly increased [(1.99±0.18) vs. (4.10±0.41), P=0.006; (8.54±0.84), P=0.002; (11.56±0.96), P=0.001]. Pearson analysis showed that CARD9 was positively correlated with the p-p65NF-κB and TNF-ɑ, IL-lβ, IL-6 ( r=0.894, P=0.001; r=0.747, P=0.008; r=0.810, P=0.001; r=0.773, P=0.007). Conclusions:A positive correlation exists between CARD9 and inflammatory responses in the early stage of ischemic brain injury in mice

Objective The explore the mechanism responsible for diaphragmatic contractile and relaxation dysfunction in a rat model of sepsis. Methods Thirty-six adult male Sprague-Dawley rats were randomized equally into a sham-operated group and two model groups of sepsis induced by cecal ligation and puncture (CLP) for examination at 6 and 12 h following CLP (CLP-6 h and CLP-12 h groups). The parameters of diaphragm contractile and relaxation were measured, and the calcium uptake and release rates of the diaphragmatic sarcoendoplasmic reticulum (SR) and the protein expressions of SERCA1, SERCA2 and RyR in the diaphragmatic muscles were determined. Results The half-relaxation time of the diaphragm was extended in both the CLP-6 h and CLP-12 h groups with significantly reduced maximum tension declinerate and the peek uptake rate of SERCA (P<0.01). Diaphragmatic maximum twitch force development rate, the maximal twitch, tetanus tensions and the peek release rate of SR decreased only at 12h after CLP (P<0.01). The expression levels of SERCA1 protein decreased significantly in the diaphragmatic muscles at 12h following CLP (P<0.01) while SERCA2 expression level and SERCA activity showed no significant changes. Conclusion In the acute stage of sepsis, both the contractile and relaxation functions of the diaphragm are impaired. Diaphragmatic relaxation dysfunction may result from reduced calcium uptake in the SR and a decreased level of SERCA1 in the diaphragmatic muscles.

Objective The explore the mechanism responsible for diaphragmatic contractile and relaxation dysfunction in a rat model of sepsis. Methods Thirty-six adult male Sprague-Dawley rats were randomized equally into a sham-operated group and two model groups of sepsis induced by cecal ligation and puncture (CLP) for examination at 6 and 12 h following CLP (CLP-6 h and CLP-12 h groups). The parameters of diaphragm contractile and relaxation were measured, and the calcium uptake and release rates of the diaphragmatic sarcoendoplasmic reticulum (SR) and the protein expressions of SERCA1, SERCA2 and RyR in the diaphragmatic muscles were determined. Results The half-relaxation time of the diaphragm was extended in both the CLP-6 h and CLP-12 h groups with significantly reduced maximum tension declinerate and the peek uptake rate of SERCA (P<0.01). Diaphragmatic maximum twitch force development rate, the maximal twitch, tetanus tensions and the peek release rate of SR decreased only at 12h after CLP (P<0.01). The expression levels of SERCA1 protein decreased significantly in the diaphragmatic muscles at 12h following CLP (P<0.01) while SERCA2 expression level and SERCA activity showed no significant changes. Conclusion In the acute stage of sepsis, both the contractile and relaxation functions of the diaphragm are impaired. Diaphragmatic relaxation dysfunction may result from reduced calcium uptake in the SR and a decreased level of SERCA1 in the diaphragmatic muscles.

Objective To investigate the correlation between different operation timing of thoraco-scopic partial pneumonectomy and intraoperative intrapulmonary shunt rate in patients with novel coronavirus(SARS-CoV-2)infection.Methods A total of 120 patients,65 males and 55 females,aged 30-75 years,BMI 18.5-25.0 kg/m2,ASA physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic partial pneumo-nectomy from December 2022 to May 2023 were selected.The patients with SARS-CoV-2 infection were di-vided into three groups according to different operation timing after infection:5-8 weeks after infection(group B),9-12 weeks after infection(group C),and 13-16 weeks after infection(group D),30 pa-tients in each group.In addition,30 non-infected patients were selected as the control group(group A).Blood gas analysis was performed at 10 minutes of two-lung ventilation(TLV)and 15 and 30 minutes of one-lung ventilation(OLV)to measure radial artery and mixed venous blood gases.Intrapulmonary shunt rate(Qs/Qt)was calculated accordingly.Multiple linear regression analysis was used to investigate the cor-relation between different operation timing and intrapulmonary shunt rate in patients with SARS-CoV-2 infec-tion.The occurrence of postoperative pulmonary complications(PPCs)within 7 days after surgery was re-corded.Results Compared with group A,groups B and C exhibited significant decreases in PaO2 levels and increases in Qs/Qt ratios at 10 minutes of TLV as well as at 15 and 30 minutes of OLV(P＜0.05),group D exhibited significant decreases in PaO2 levels and increases in Qs/Qt ratios at 15 and 30 minutes of OLV(P＜0.05),group B exhibited significant increases in postoperative pulmonary infection rates and the incidence of respiratory failure within 7 days after surgery(P＜0.05).Compared with group B,the inci-dence of pulmonary infection and respiratory failure within 7 days after surgery were significantly reduced in group D(P＜0.05).Multiple linear regression analysis revealed that shorter infection time(β=-0.478,95％CI-3.857 to-1.231,P＜0.001),worsening clinical types of infection(β=0.274,95％CI 0.368 to 3.453,P=0.016),and preoperative persistent symptoms(β=-0.240,95％CI-5.986 to-0.537,P=0.019)were associated with increased intrapulmonary shunt rate at 10 minutes of TLV.Shor-ter infection time(β=0.267,95％CI 0.130 to 3.018,P=0.033),worsening clinical types of infection(β=-0.391,95％CI-4.715 to-1.323,P=0.001),preoperative persistent symptoms(β=-0.497,95％CI-10.484 to-4.491,P＜0.001),and preoperative dyspnea(β=-0.246,95％CI-8.596 to-0.691,P=0.022)were associated with increased intrapulmonary shunt rate at 15 minutes of OLV.Conclusion SARS-CoV-2 infection increases intrapulmonary shunt rate 5-8 and 9-12 weeks after infection,but the intrapulmonary shunt rate gradually recovers at 10 minutes of TLV 13-16 weeks after in-fection,and patients who undergo surgery during this interval have a lower incidence of PPCs.The shorter infection time,the aggravation of clinical classification of infection,and the presence of persistent symptoms before surgery are associated with the increase of intrapulmonary shunt rate.

Objective To evaluate the efficacy of transverse thoracic muscle plane-thoracic nerve block combined with general anesthesia when used for modified radical mastectomy. Methods Sixty female patients, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, aged 45-63 yr, weighing 48-72 kg, scheduled for elective modified radical mastectomy, were divided into 3 groups ( n=20 each) using a random number table method: thoracic nerve block-general anesthesia group ( group P+G ) , transverse thoracic muscle plane-thoracic nerve block-general anesthesia group ( group T+P+G) and general anesthesia group ( group G ) . Anesthesia was induced with midazolam, propofol, fentanyl and cisatracurium and maintained with sevoflurane, fentanyl and cisatracurium. Thoracic nerve block typeⅠ and Ⅱ was per-formed after implanting laryngeal mask airway in group P+G. Transverse thoracic muscle plane block was performed after performing thoracic nerve block typeⅠandⅡin group T+P+G. Flurbiprofen 50 mg was in-travenously injected after operation as a rescue analgesic to maintain the Visual Analogue Scale score≤3. The consumption of opioids, emergence time and time for removal of the laryngeal mask airway were recor-ded. Ramsay sedation score was recorded at 10 min after removal of the laryngeal mask airway. The require-ment for rescue analgesia, time of passing flatus and development of nausea and vomiting within 24 h after operation were recorded. Results Compared with group G, the emergence time, time for removal of the laryngeal mask airway and time of passing flatus were significantly shortened, and the Ramsay sedation score, consumption of fentanyl and requirement for rescue analgesia were decreased in P+G and T+P+G groups ( P<0. 05) , and the incidence of nausea and vomiting was significantly decreased in group T+P+G ( P<0. 05) . Compared with group P+G, the time for removal of the laryngeal mask airway and time of pass-ing flatus were significantly shortened, the consumption of fentanyl was decreased ( P<0. 05) , and no sig-nificant change was found in the requirement for rescue analgesia or incidence of nausea and vomiting in group T+P+G ( P>0. 05) . Conclusion Transverse thoracic muscle plane-thoracic nerve block combined with general anesthesia can provide satisfactory perioperative analgesia and is helpful in improving prognosis for the patients undergoing modified radical mastectomy.

Objective To analyze the impact of health education on osteoporosis after fracture patients with osteoporosis awareness, self-efficacy and fracture efficacy. Methods All 142 osteoporotic fracture patients were randomly divided into observation group and control group 71 cases, the implementation of comprehensive health education observation group were compared osteoporosis knowledge questionnaire (OKT), osteoporosis self-efficacy scale (OSES), lumbar spine bone mineral density and fractures situation. Results After 3 and 6 months in the observation group were signifi-cantly higher OKT score(P<0.05), exercise performance after 3 and 6 months in the observation group OSES of calci-um and performance scores were significantly higher(P<0.05),after 3 and 6 months in the observation group were sig-nificantly higher lumbar spine BMD(P<0.05), after three months in the observation group fractures was significantly better than the control group(P<0.05). Conclusion Osteoporosis is adversely affected by the patient fractures and osteo-porosis-related health education helps to enhance patient awareness of osteoporosis and self-efficacy, improved bone density and fractures.

Objective To investigate the 3D reconstruction of multislice spiral CT technology applications in the diag-nosis and postoperative ankle fracture assessment. Methods DR using X-ray and 3D reconstruction of multislice spiral CT technique in patients with ankle fractures preoperative examination and classification, for review after observing the quality of reduction and fixation into quality. Results Preoperative DR typing results compare with intraoperative find-ings, PAB, PER, SAB SER type Kappa values were 0.76, 0.80, 0.77, 0.75, had a good consistency . Preoperative CT reconstruction with intraoperative findings result of the comparison , PAB, PER, SAB SER type Kappa values were 1, 0.92, 0.90, 0.90, excellent consistency, CT reconstruction typing and intraoperative findings consistent results. The sensitivity and specificity were far superior to DR. DR and CT reconstruction after treatment in PAB, PER, SER type reset mass were significantly different (P<0.05), CT three reconstruction PER, fixed into the SER type mass was signif-icantly different (P<0.05). Conclusion Spiral CT reconstruction of ankle fracture before surgery and postoperative re-duction treatment, quality assessment and internal fixation into a higher accuracy than the X-ray examination, and more reliable.

Objective To investigate the influence of family rehabilitation education on the daily living abilities and pa-tient function of elderly patients after hip fracture surgery. Methods Seventy-three elderly patients who received hip fracture surgery were selected and randomly divided into the intervention group with 37 patients and the control group with 36 patients. The control group received conventional hospital discharge guidance and follow-up visits and the in-tervention group received family rehabilitation education;The intervention group was given family rehabilitation educa-tion and followed up for at least 12 months after hospital discharge. The patients ’ joint function, daily living activities and life quality improvement situation were observed. Results Within 12 months after surgery, the Harris hip joint scores of both groups improved significantly (P<0.05) and the hip joint function recovered remarkably; The Harris hip joint scores of intervention group were significantly higher than the control group in 3 months, 6 months and 12 months after the surgery (P<0.05). The FIM scores of intervention group were significantly higher than the control group in 3 months, 6 months and 12 months after the surgery (P<0.05); The GH, PF, RP, BP, MH, VT and RE scores of in-tervention group were significantly higher than the control group in 3 months, 6 months and 12 months after the surgery (P<0.05) and the SF scores was significantly higher than the control group in 6 months and 12 months after the surgery (P<0.05). Conclusion Family rehabilitation is an important step of postoperative function rehabilitation for the el-derly patients after hip facture surgery and the implementation of family rehabilitation education after hospital dis-charge, can help the patients maintain right rehabilitation training, improve hip joint function rehabilitation, daily living abilities recovery and promote the patients ’ life quality.