AMOS-PCR and MLVA were carried out to identify the Brucella strains isolated in Fujian province, which were classified as B. melitensis biovar 2 or 3 by conventional microbiological tests. All these 3 isolates were identified to be B. melitensis by AMOS-PCR. The genetic patterns obtained by MLVA were queried in the Brucella 2007 database and clustered with B. melitensis strains. It is evident that these two molecular assays may be used as the assistant tools in the identification of Brucella strains.

Objective:To summarize and analyze the application effect of combined polyfoliate and free flaps of superficial temporal artery and its branches in the wounds on the head and face.Methods:From February 2019 to January 2020, patients diagnosed with head and face skin tumors in the Department of Plastic Surgery of Xiangya Changde Hospital were selected. The lesions were excised, and the superficial temporal artery and its different branches (the parietal branch, the frontal branch, and the perforating branch of the frontal branch) were used to design polyfoliate and free flaps for wound repair. Patients were treated with polyfoliate flaps designed using the parietal or frontal branch with the proximal end of the trunk as the vascular pedicle, polyfoliate flap designed using the perforating branch of the frontal branch with the proximal end of the frontal branch as the vascular pedicle, polyfoliate flap designed using the trunk and parietal branch with the frontal branch as the vascular pedicle, and a free flap designed using the trunk with the proximal end of the parietal branch as the vascular pedicle. All donor sites of the flaps were closed primarily. The survival of the flaps were observed after surgery, and the appearance of the flaps and the recurrence of facial tumors were followed up.Results:In this study, all the patients were aged 18 to 69 years with an average age of 57 years and were diagnosed with head and face skin tumors. Among the six patients, there were five men and one woman. All the flaps survived, and no tumor recurrence was noted during the postoperative follow-up period of 1 month to 10 months. The texture of these flaps was similar to the surrounding skin, with no color difference. In addition, no noticeable scar was noted on both the flaps and the donor sites. The outcome of the repair was satisfactory.Conclusions:The design of polyfoliate and free flaps using different combinations of the superficial temporal artery and its branches can facilitate flexible repair of the wounds on the head and face. This method exhibits certain advantages, such as skin characteristics of the flaps similar to that of the surrounding skin, direct closure of the donor sites, and a satisfactory repair.

Objective:To summarize and analyze the application effect of combined polyfoliate and free flaps of superficial temporal artery and its branches in the wounds on the head and face.Methods:From February 2019 to January 2020, patients diagnosed with head and face skin tumors in the Department of Plastic Surgery of Xiangya Changde Hospital were selected. The lesions were excised, and the superficial temporal artery and its different branches (the parietal branch, the frontal branch, and the perforating branch of the frontal branch) were used to design polyfoliate and free flaps for wound repair. Patients were treated with polyfoliate flaps designed using the parietal or frontal branch with the proximal end of the trunk as the vascular pedicle, polyfoliate flap designed using the perforating branch of the frontal branch with the proximal end of the frontal branch as the vascular pedicle, polyfoliate flap designed using the trunk and parietal branch with the frontal branch as the vascular pedicle, and a free flap designed using the trunk with the proximal end of the parietal branch as the vascular pedicle. All donor sites of the flaps were closed primarily. The survival of the flaps were observed after surgery, and the appearance of the flaps and the recurrence of facial tumors were followed up.Results:In this study, all the patients were aged 18 to 69 years with an average age of 57 years and were diagnosed with head and face skin tumors. Among the six patients, there were five men and one woman. All the flaps survived, and no tumor recurrence was noted during the postoperative follow-up period of 1 month to 10 months. The texture of these flaps was similar to the surrounding skin, with no color difference. In addition, no noticeable scar was noted on both the flaps and the donor sites. The outcome of the repair was satisfactory.Conclusions:The design of polyfoliate and free flaps using different combinations of the superficial temporal artery and its branches can facilitate flexible repair of the wounds on the head and face. This method exhibits certain advantages, such as skin characteristics of the flaps similar to that of the surrounding skin, direct closure of the donor sites, and a satisfactory repair.

Objective:To investigate the efficacy of plasma exchange (PE) in treatment of patients with acute respiratory distress syndrome (ARDS).Methods:Forty-two patients who met the inclusion criteria in the intensive care unit of Chenzhou First People′s Hospital were randomly divided into control group and plasma exchange (PE) group with 21 cases in each group. The control group received conventional treatment; while the PE group received conventional treatment plus PE. The mechanical ventilation time (MVT), length of ICU stay (ICU LOS), 28-day mortality and 90-day mortality of patients were analyzed. The oxygenation index, SOFA score, norepinephrine (NE) dose, C-reactive protein (CRP), procalcitonin (PCT) and IL-6 levels were evaluated before and after treatment.Results:In the control group the oxygenation index, IL-6, PCT and CRP were significantly improved after treatment ( t=-4.50, 2.46, Z=-3.53, t=5.55, all P<0.05), but the SOFA score and NE dose were not significantly changed ( t=1.98, Z=-0.47,all P>0.05). In the PE group, the oxygenation index, SOFA score, IL-6, PCT, CRP were significantly improved and the NE dose was reduced after treatment ( t=2.18, 9.23, 5.26, Z=-3.77, t=7.27 and Z=-2.54,all P<0.05). The oxygenation index, SOFA score, IL-6, CRP were significantly better after treatment and NE dose was lower in PE group than those in the control group ( t=2.18, -2.21, -2.12, -2.61 and Z=-2.11, all P<0.05). Compared with the control group, the MVT(14.0±5.2d vs. 18.4±6.3d), ICU LOS(19.3±4.9d vs. 23.2±7.3d) and 28-day mortality (14.3%(3/21) vs. 42.8%(10/21)) in the PE group were significantly decreased ( t=-2.48, -2.04 and χ2=4.20,all P<0.05). There was no significant difference in the 90-d mortality between the two groups (28.6%(6/21) vs. 52.4%(11/21), χ2=2.47, P=0.208). Conclusion:Therapeutic plasma exchange can significantly reduce the inflammatory response, improve the organ function and reduce the short-term mortality of ARDS patients.

Percutaneous dilatational tracheostomy (PDT) is a surgical method for quickly establishing an artificial airway, which has been favored by clinicians because of its simple operation, small trauma and bedside operation. However, for patients with tracheal intubation in intensive care unit (ICU), the tip and balloon of the existing endotracheal tube will not only hinder percutaneous puncture, but also hinder insertion of guidewire and tracheotomy tube, and consequently affect the process of PDT. On the contrary, blind withdrawal of the existing endotracheal tube may cause the tracheal tube tipleave the glottis, leading to an emergency airway situation that endangers the patient's life. Therefore, the medical staff from intensive care medicine department of the First People's Hospital of Chenzhou designed a laryngeal mask and its monitoring device, which is convenient for withdrawal of endotracheal tube, and obtained the national utility model patent of China (patent number: ZL 2020 2 2795887.1). The device is composed of a laryngeal mask and a monitoring device. The laryngeal mask mainly includes a laryngeal mask body, a vent tube, a guidance tube and other components. The laryngeal mask body is mainly used to seal the throat and provide the air supply channel for the patient together with the ventilation tube. The main function of the guidance tube is to accommodate the tracheal tube and facilitate the withdrawal of the inserted tracheal tube. During percutaneous dilatation tracheotomy, this device can monitor the withdrawal of tracheal catheter in real time, and immediately ensure the airway patency of patients without re-intubation when the cuff of tracheal catheter exits the glottis. The utility model has the advantages of real-time monitoring, simple operation, safety and convenience, and is worthy of transformation and promotion.