[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 compare anesthetic effect and safety of general anesthesia and combined spinal and epidural anesthesia used in autonomic nervous hyperresponsive surgery for patients with paraplegia.Methods 26 paraplegic patients were randomly divided into two groups-control group and treatment group from February 2011 to November,2015,each with 13 cases.The control group used general anesthesia,while the treatment group used combined spinal and epidural anesthesia,to observe onset time,duration,intraoperative hemodynamic changes and complications,Complications,length of stay and cost,Days and costs of hospitalization,satisfaction of patients and their families,of anesthesia in two groups.Results The dosage of narcotics and the onset time of the treatment group were better than that of the control group.The difference between the two groups was significant,and had statistical significance (P＜0.05) Two groups of patients after surgery,diastolic blood pressure,systolic blood pressure and heart rate were lower in the treatment group than in the control group,and had statistically significant difference (P＜0.05);The postoperative complications of the treatment group were significantly better than those of the control group,and had statistically significant difference (P＜0.05);There were statistically significant differences in postoperative pain degree between the two groups (P＜0.05);Two groups of patients in hospital days,hospital costs,satisfaction rate had statistically significant difference,Have statistical significance (P＜0.05).Conclusion In autonomic nervous hyperresponsive surgery for patients with paraplegia,anesthetic effect and safety of combined spinal and epidural anesthesia is significantly better than that of general anesthesia,featured by the rapid onset of action,long duration,fewer complications,strong safety and patients' great satisfaction.It is worth generalizing and applying clinically.

bnormality in these parameters was improved.

Objective To determine the relationship between serum levels of MCAF/MCP-1 (monocyte chemotactic and activating factor/monocyte chemoattractant protein-1), RANTES(regulated on activation, normal T-cell expressed and secreted) and the disease activity of systemic lupus erythematosus(SLE). Methods Serum levels of MCAF and RANTES were measured by ELISA. Results ①Serum level of MCAF but not RANTES, was significantly increased in patients with SLE as compared with controls. ②Serum level of MCAF but not RANTES, was markedly higher in patients with active disease than those with inactive disease. ③No significant differences were found in the serum levels of MCAF and RANTES between patients with renal damage and those without. Conclusions These results suggest that MCAF may be involved in the pathogenesis of SLE, and serum MCAF levels could be an indicator for the disease activity of SLE.

Objective To determine the relationship between serum interferon-inducible T cell alpha chemoattractant(I-TAC)levels and disease activity in patients with systemic lupus erythematosus(SLE).Methods Serum level of I-TAC was measured by sandwich ELISA.Results①Serum level of I-TAC was significantly increased in patients with SLE as compared with controls,and significantly higher in patients with active SLE than those of the inactive.Serum level of I-TAC showed significant positive correlation with disease activity,erythrocyte sedimetation rate(ESR),logarithm of serum ANA titer,and negative correlation with serum C3levels.②Serum level of I-TAC was significantly higher in patients with renal involvement than those without renal diseases.Conclusions These results suggest that I-TAC might be involved in the pathogenesis of SLE,and its serum level might be used as a good indicator for the disease activity of SLE and renal involvement.

Aim To study the pharmacodynamics of antianxietic compound prescription capsule ( ACPC ) on acute stress in rats and the influence upon the ex-pression of ERK/CREB signal pathway and brain-de-rived neurotrophic factor ( BDNF) in the cerebral cor-tex and hippocampus of rats. Methods The elevated plus maze ( EPM ) test was applied to observe the effects of ACPC on acute stress rats administered 7 d low-, medium- and high-dose ( 0. 75 , 1. 5 , 3 g · kg-1 ) . The expression of ERK/CREB signal pathway and BDNF in the cerebral cortex and hippocampus of rats were studied by using Western blot method. Re-sults In EPM, high-dose of ACPC increased signifi-cantly the rat open arm time ( OT%) ( P<0 . 05 ) and the percentage of open arm entries ( OE%) ( P <0. 05). In Western blot, the medium-dose of ACPC reduced significantly p-ERK1/2 expression in hippo-campus ( P <0. 05 ) , and high-dose group decreased significantly the expression of p-ERK1/2 and p-CREB in the cortex and hippocampus of rats ( P <0. 05 ) . High-dose group increased significantly the expression of BDNF in the cortex and hippocampus of rats ( P<0. 05 , P<0. 01 ) . Conclusion ACPC has anti-anxie-ty effect in the model of EPM, and its mechanism may be related to the ERK/CREB signal pathway and in-creased BDNF expression.

Gingseng is commonly used in traditional Chinese medicine community for the treatment of depression-like disorders. Ginsenosides is considered to be the major active components of ginseng. Previous studies have demonstrated that ginsenosides produced antidepressant-like action in various mouse models of behavioral despair. The present study aimed to examine whether ginsenosides could affect the chronic unpredictable mild stress (CUMS)-induced depression in rats. The mechanism(s) underlying the antidepressant-like action was investigated by measuring serum corticosterone level, glucocorticoid receptor (GR), mineralocorticoid receptor (MR) and brain-derived neurotrophic factor (BDNF) mRNA levels in brain tissues. CUMS, being lasted for 6 weeks, caused depression-like behavior in rats, as indicated by the significant decrease in sucrose consumption and increase in immobility time in the forced swim test. Whereas serum corticosterone level was significantly increased in rats exposed to CUMS, expressions of GR mRNA in hippocampus, and BDNF mRNA in hippocampus and frontal cortex, were decreased in CUMS-treated rats. Daily intragastric administration of ginsenosides (12.5, 25, 50 mg x kg(-1)) during the six weeks of CUMS significantly suppressed behavioral and biochemical changes induced by CUMS. However, there was no significant difference in MR mRNA level among groups. The results suggest that the antidepressant-like action of ginsenosides is likely mediated by modulating the function of hypothalamic- pituitary -adrenal axis and increasing the expression of BDNF in brain tissues.
Adrenal Glands ; drug effects ; metabolism ; Animals ; Brain-Derived Neurotrophic Factor ; genetics ; metabolism ; Depression ; drug therapy ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Ginsenosides ; administration & dosage ; Humans ; Hypothalamus ; drug effects ; metabolism ; Male ; Panax ; chemistry ; Pituitary Gland ; drug effects ; metabolism ; Random Allocation ; Rats ; Rats, Wistar

Objective To evaluate the effectiveness of computer-assisted navigation system on open reduction as treatment for complicated orbital fractures.Methods The computed tomography (CT) data for 6 patients with complicated orbital fractures were obtained before surgery and imported into the surgical planning software.After 3-dimensional (3D) construction and segmentation,data from the unaffected side were used to guide the reduction data,and surgical simulation was performed.All patients underwent open reduction under the guidance of the navigation system.The segments were then reduced to the predetermined places.CT measurements were used to evaluate navigation accuracy and bone symmetry.Results A fairly accurate match between the intraoperative anatomy and the computed tomography images was achieved through registration,with a systematic error of 1 mm difference.With guidance of the navigation system,open reduction of fractures was performed in all cases.The reduction was checked by postoperative computed tomography scans,with a good match with preoperative planning noted.The maximal deviation between the reduction and preoperative planning was less than 2 mm.The postoperative facial appearance of the patients was clearly improved.Conclusions Navigation-guided open reduction of complicated orbital fractures can be regarded as a valuable treatment option for this potentially complicated procedure.

Objective:To evaluate the efficacy of perioperative analgesia with esketamine in the patients undergoing thoracoscopic surgery.Methods:A total of 90 patients of either sex, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective thoracoscopic lobectomy under general anesthesia, were divided into 3 groups ( n=30 each) by a random number table method: control group (C group) and different doses of esketamine groups (S 1 group, S 2 group). Before induction of anesthesia, esketamine 0.1 and 0.2 mg/kg were intravenously injected in S 1 group and S 2 group, respectively, while esketamine was not given in group C. Anesthesia was routinely induced in all the three groups. During anesthesia maintenance, esketamine 0.1 and 0.2 mg·kg -1·h -1 were intravenously infused in group S 1 and group S 2, respectively, and the remaining drugs used for anesthesia maintenance were the same in the three groups. Patient-controlled intravenous analgesia (PCIA) was used after operation, and PCIA solution contained sufentanil 2 μg/kg in group C, and esketamine 1 mg/kg was mixed on the basis as previously described in S 1 and S 2 groups. Aminotriol ketorolac was given as rescue analgesia to maintain numeric rating scale score at rest ≤3. The total amount of propofol and remifentanil during operation, effective pressing times of PCIA in postoperative 0-24 h and >24-48 h periods, and requirement for rescue analgesia were recorded. The occurrence of adverse reactions such as respiratory depression, nausea and vomiting, dizziness and salivation, and emergence time were recorded after surgery. The serum interleukin-6 (IL-6) concentration was measured by enzyme-linked immunosorbent assay at 30 min before and after surgery, and the malondialdehyde (MDA) concentration in serum was measured by thiobarbituric acid colorimetric analysis. The postoperative recovery was assessed using the 50-item quality of recovery scale at 1 and 2 days after surgery. The development of chronic pain was followed up by telephone within 1-3 months after surgery. Results:Compared with group C, the intraoperative consumption of remifentanil, effective pressing times of PCIA in postoperative 0-24 h and >24-48 h periods, rate of rescue analgesia, and postoperative serum IL-6 concentration were significantly decreased, and the 50-item quality of recovery scale score was increased in S 1 and S 2 groups, and the postoperative serum MDA concentration was significantly decreased in group S 2 ( P<0.05). Compared with group S 1, the consumption of intraoperative remifentanil was significantly decreased ( P<0.05), and no significant change was found in postoperative serum IL-6 and MDA concentrations in group S 2 ( P>0.05). Compared with group S 2, the postoperative emergence time was significantly shortened in S 1 and C groups ( P<0.05). There was no statistically significant difference in the intraoperative consumption of propofol, incidence of adverse effects and incidence of chronic pain among the three groups ( P>0.05). Conclusions:Esketamine for perioperative analgesia (dose before anesthesia induction 0.1 mg/kg, dose for maintenance of anesthesia 0.1 mg·kg -1·h -1, dose for postoperative PCIA 1 mg/kg) can raise the quality of analgesia and improve the quality of early postoperative recovery in the patients undergoing thoracoscopic lobectomy.

Objective: To analyze the clinical value of sirolimus plus prednisone for the treatment of the refractory kaposiform hemangioendothelioma(RKHE) and Kasabach-Merritt syndrome(KMS). Method: Clinical retrospective analysis was carried out for 10 patients recruited in Children′s Hospital Affiliated to Capital Institute of Paediatrics from January 2014 to January 2017 who were non responders to or relapsers after the treatment of propranolol, prednisone, pingyangmycin and lauromacrogol(5 cases RKHE, 5 cases RKHE plus KMS, age ranged from 6 days to 9 years); patients were treated with sirolimus at the dosage of 0.035 ml/(kg·d), once a day, for 6-410 days; the diagnosis of 10 patients were confirmed by pathological biopsy and immunohistochemical examination(IHC); the difference of the coagulation parameters and the platelet counts, the size of tumor and ecchymosis at different stages of treatment were recorded and measured by scale and ultrasonography; the side effects of sirolimus were recorded as well. Result: Clinical characteristics of 10 cases (6 male and 4 female) RKHE with KMS were refractory dark red hard hemangioma or ecchymosis, the platelet counts were lower than 30.0×10⁹/L, (15±7)×10⁹/L, coagulation tests were obviously abnormal, fibrinogens were significantly decreased(0.8±0.5)g/L, the fibrin lysates and D-dimer were significantly increased(100±23)mg/L, (10 000±2 200)ng/L, the prothrombin time and activated partial thromboplastin time were prolonged(25.0±2.1)s, (58.0±3.4)s. The pathologic characteristics of the tumors were similar: spindle tumor cells, mass distribution and deeply stained nuclei tumor cells. IHC revealed positive staining for D2-40, CD31 and CD34. Stainings for factor Ⅷ and GLUT-1 were negative. In five cases RKHE plus KMS were treated with sirolimus and prednisone, after (6.5±0.7) days treatment, the platelet counts were obviously increased(72.0±0.6)×10⁹/L, coagulation parameters were obviously improved, fibrinogen significantly increased(1.5±0.2)g/L, the fibrinlysates and D-dimer significantly decreased(7±3)mg/L, (2 300±200)ng/L, the prothrombin time and activated partial thromboplastin time were prolonged(15±2.3)s, (42±3.4) s, and the sizes of tumor and ecchymosis were slightly shrunken 18%±3%, 38%±5%; after (30±5.7) days treatment, the platelet counts and coagulation parameters returned to normal(146±36)×10⁹/L, and the size of tumor and ecchymosis were obviously shrunken 73%±3%, 97%±3%; after (3±0.4) months treatment, the tumor was obviously shrunken by 93%±2% and no longer palpable. In five cases with RKHE without KMS manifested stubborn dark red hard hemangiomatous plaques, coagulation tests and platelet were obviously normal, these patients were treated with sirolimus, after (2.0±0.6) months treatment, the tumor became shrunken 8%±3%, with continuous treatment the tumor shrunk gradually, after (4.0±3.2)months(2-18 mouths) the tumor was not eliminated 51%±7%. Conclusion RKHE and KMS have typical clinical, laboratory and pathological characteristics, sirolimus plus prednisone have remarkable efficacy and minor side effects, it should be recommended for the treatment of KHE with KMS.