Objective To explore clinical effect of double-tube continuous negative pressure drainage in the treatment of Morel-Lavallée leision.Methods We retrospectively analyzed the clinical data of 13 patients with Morel-Lavallée leision,which were diagnosed and treated in our hospital from May 2009 to July 2010.They were 11 women and 2 men,aged from 19 to 57 years (average,32.5 years).All patients underwent operations within 3 days after injury,except for 2 patients whose diagnosis was postponed.The operation was performed with small incision and double-tubes were placed for continuous negative pressure drainage.Double-tubes were not removed until effusion was less than 30 ml/24 hours.The heal was defined as no skin necrosis and subcutaneous hydrops at lesion site,no skin floating and sliding at palpation.Results Double-tubes were removed 4 to 12 days postoperatively (average,6.3 day).All of 13 patients were followed up for an average of 13.7 months (range,10 to 18 months).Skin necrosis occurred in 1 patient.Lesions were healed 4 to 10 weeks postoperatively(average,7.2 weeks).No deep infection or delayed hematogenous infection was found.There were no general systematic complications.Superficial infection at wound site occurred in one patient and healed after wound management.Conclusion Application of double-tube continuous negative pressure drainage is a safe,less invasive,low-cost and effective treatment for Morel-Lavallée leision.

Objective To detect the influence of marOR mutations on antibiotic resistance in Shigella spp. Methods The marOR gene with four-base deletion was amplified by overlap PCR, then inserted in a T-vector and transformed into DH5α. The clone of marOR gene with four-base deletion and three point mutations was prepared from the strain having these mutations. Electrophoresis and sequencing were preformed to certify the correction of the cloned genes. Drug susceptibility tests were preformed for the strains harbouring the different clones [DH5α, DH5α (T), DH5α (marOR), DH5α (marOR-CATT), DH5α(marOR-CATT + 3m)]. Results Compared with the control strain (DH5α-T), the antibiotic resistances of marOR with four-base deletion [DH5α (marOR-CATT)] were higher to streptomycin, tobramycin, cefazolin and cefalexin, and the antibiotic resistances of marOR with four-base deletion and three point mutations [DH5α (marOR-CATT + 3m)] were higher to streptomycin and to tetracycline. The antibiotic resistances of DH5α (marOR-CATT) and DH5α (marOR-CATT +3m) to streptomycin, tetracycline, chloramphenicol, cefazolin, levofloxacin, ciprofloxacin and norfloxacin were higher than DH5α (marOR). The diameters of the antibiotics except the trimethoprim between DH5α (marOR-CATT) and DH5α (marORCATT +3m) had not significant disparity. Conclusion The four-base deletion in 1376-1379 sites of the marOR gene increased the resistance of Shigella spp to some antibiotics. The point mutations in 1411, 1417,1435 sites of the marOR gene have little influence on the antibiotic resistance of Shigella spp.

In order to search for new antiplatelet agents with higher potency, a series of tetramethylpyrazine ( TMP) /chalcone hybrids ( 2-26) were synthesized and evaluated based on the principle of bioisostere and hybrid-ization. They exerted inhibitory activity against adenosine diphosphate ( ADP )-induced and arachidonic acid ( AA)-induced platelet aggregation to varied extent. Among them, compound 8 was the most potent with IC50 of 0. 14 mmol/L on ADP-induced platelet aggregation ( 9. 1 folds of TMP and 10. 5 folds of chalcone ) and 0. 09 mmol/L on AA-induced platelet aggregation ( 8. 8 folds of TMP and 10. 0 folds of chalcone) , which was superior to clinically used anti-platelet drug aspirin ( ASP, IC50 =0. 15 mmol/L) .

Objective:To study the effects on lymphocyte & T subset of SARS patients treated by integrative traditional Chinese and western medicine(ICWM). Methods:48 patients were randomly divided into two groups, the control group treated by western medicine (WM) alone and the test group treated by ICWM. The test group patients took the traditional Chinese medicine by 3 weeks based on their conditions. Lymphocyte and T subset were measured. Results:① At pretreatment, absolute value of lymphocyte of 38 patients in all patients were low. There were 19 patients with lowered CD3 +, and 28 patients with lowered CD4 +/CD8 + ratio in 38 patients with T subset measured. ② The value of lymphocyte in plasma in patients after ICWM treatment increased from 1 00?10 9?0 46?10 9 L -1 to 1 92?10 9?0 74?10 9 L -1 ( P

Objective To explore the related factors affecting the formation of different types of thrombosis in patients with STEMI. Methods Retrospective data were collected from September 2014 to October 2018 in Henan Province People's Hospital for emergency interventional treatment of patients with STEMI. According to the type of thrombus detected by OCT, they were divided into two groups, which were red thrombus group and white thrombus group. Clinical baseline data, coronary angiographic findings, and OCT results were collected in patients with STEMI. Logistic regression analysis was used to analyze the type of thrombosis in patients with STEMI. Results The rate of thrombus detection was 100％ in 92 patients with STEMI. According to OCT diagnostic criteria, 73 (79.3％) patients were classified into red thrombus and 19 (20.7％) were white thrombus. There was no significant difference in infarct-related artery and location between the two groups (P>0.05) , but there was more multiple vascular lesions in the white thrombus group than that in the red thrombus group. There was significant difference in the incidence of plaque rupture and thin fibrous cap in the two groups (P<0.05). The incidence of plaque rupture and thin fibrous cap lipid plaque was higher in the red thrombus group. Plaque rupture (OR = 2.894, 95％CI:2.704-2.956) , thin fibrous cap plaque (OR = 8.033, 95％CI: 7.985-8.283) , single vessel disease (OR = 1.746, 95％ CI: 1.659-1.785) are risk factors for red thrombosis formation. Conclusion Single vessel lesion, plaque rupture andthin fibrous cap lipid plaque are associated with red thrombus formation.While, multiple vessel lesions and stable plaque are associated with white thrombus formation.

Objective To investigate the predictive value of metabolic syndrome in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).Methods A total of 660 patients with ACS admited to cardiovascular department,first affiliated hospital of zhengzhou university were enrolled in this study from January 2009 to June 2010.The enrollment criteria were:the stenosis degree were above 75％ in at least one coronary artery by coronary angiography and successful PCI procedure.Exculsion criteria were:liver and renal insufficiency,malignancies and valvular heart diseases.The relevant clinical data and labtory examination were recorded after admission. The patients were followed up by outpatients interview or telephone from March to June 2011 and adverse cardiovascular events were recorded.The patients were divided into MS and non-MS groups,and basic clinical data were compared between two groups.The proportion difference between two groups were tested by chi square. Multivariate logistic regression was established to analyze the factors related to progonosis.The survival ratio was estimated using the Kaplan-Meier method.Statistical significance was established at a P value of less than 0.05.Results ①A total of 606 (91.7％) patients successfully accepted follow-up.Mean follow-up time were ( 14.3 ±1.7 ) months.95 patients experienced adverse cardiovascular events ( 15.7％ ).②There were 393 patients (64.96％ ) satisfied the definition of metabolic syndrome.The patients in MS group were with higher BMI,SBP,DBP,blood glucose and disordered lipid (all P ＜ 0.05 ),with less fale patients (P =0.016),less current somking (P =0.008 ) and with higher platelet (P =0.037 ). The incidence of adverse cardiovascular events in two groups were 17.81％ and 11.79％ ( P ＞ 0.05 ). ③ Multivarite logistic regression revealed that the predictors of adverse cardiovascular events were age [ OR =2.628,95％ confidence interval (CI) 1.395 ～ 4.954,P =0.003 ],New York Heart Association (NYHA) ≥ 3 grade ( OR =2.310,95％ CI 1.095 ～4.870,P =0.028) and left ventricular ejection fraction (LVEF) ( OR =4.328,95％ CI 1.955 ～9.580,P ＜ 0.001 ).However,MS was not related with prognosis ( OR =1.170,95％ CI 0.583 ～ 2.345,P =0.659 ).④The cumulative survival rates of no adverse cardiovascular events in the two groups were no significant difference ( P ＞ 0.05 ).Conclusions MS is a risk factor with coronary heart disease.Howerer,it has no relationship with adverse cardiovascular events in patients with ACS after PCI.

With the discovery of exosomes,new pathways of intercellular information and material exchange mediated by exosomes are attracting more and more attention from researchers. The process of exo-some production overlaps with many viral assembly and outflow pathways,suggesting that exosomes may be related to viral infections. In vitro experiments also show that exosomes play a very important role in viral in-fections. On one hand,exosomes can transfer viral nucleic acids and proteins,and may change microenviron-ment to promote the spread of infection. On the other hand,exosomes can induce immune responses by activa-ting antiviral pathways or transferring antiviral molecules. Do they promote or suppress the spread of infec-tion? What are the factors that affect their functions? In this paper,we review the role of exosomes in viral in-fection in order to provide a reference for better understanding the process of viral infection and immune re-sponses,and to provide a new train of thoughts for the prevention,diagnosis and treatment of viral diseases.

Objective:To investigate the characteristics of coronary angiography and types of intracoronary thrombus in patients with acute myocardial infarction (AMI) who were classified according to changes of ST segment in electrocardiogram (ECG).Methods:A total of 232 consecutive AMI patients within 24 h of symptom onset undergoing primary percutaneous coronary intervention (PCI) in Henan Provincial People’s Hospital from September 2016 to August 2018 were included. According to the changes of ST segment, patients were divided into three groups: ST-elevated group (161 cases), ST-unoffset group (28 cases) and ST-depression group (43 cases). Optical coherence tomography (OCT) during primary PCI were performed and intracoronary thrombus types were differentiated according to OCT. One-way analysis of variance, Chi-square test and Fisher exact probability test were used to analyze the clinical baselines, angiographic characteristics and intracoronary thrombus types among the three groups. A P<0.05 was considered statistically significant. Results:Left anterior descending coronary artery and right coronary artery were the most common infarct related arteries in the ST-elevated group and ST-depression group, while left circumflex artery was more common in the ST-unoffset group ( P<0.001). The infarct sites in the ST-elevated group and ST-depression group were mostly located in the proximal and middLe segments, while those in the ST-unoffset group were mostly located in the middLe and distal segments ( P=0.008). The proportion of occlusive lesion in the ST-elevated group and ST-unoffset group was higher than that in the ST-depression group (68.3% vs. 30.2%, P<0.05; 67.9% vs. 30.2%, P<0.05). The proportion of single vessel in the ST-elevated group and ST-unoffset group was higher than that in the ST-depression group (36.0% vs. 4.7%, P<0.05; 39.3% vs. 4.7%, P<0.05). The proportion of collateral circulation of infarct related artery in the ST-unoffset group and ST-depression group was higher than that in the ST-elevated group (35.7% vs. 16.1%, P<0.05; 58.1% vs. 16.1%, P<0.05). The incidence of red thrombus in the ST-elevated group and ST-unoffset group was significantly higher than that in ST-depression group (76.4% vs. 34.9%, P<0.05; 64.3% vs. 34.9%, P<0.05). Conclusions:Compared with the ST-depression group, the proportions of single-vessel, occlusive lesion and red thrombus are higher in the ST-unoffset group and ST-elevated group. Therefore, in acute non ST-segment elevated myocardial infarction, those without ST-segment deviation are different from those with ST-segment depression. It is recommended to further divide acute myocardial infarction into ST segment elevation type, ST segment unoffset type and ST segment depression type according to ECG.

Objective To investigate the delay of door to signature time in primary percutaneous coronary intervention (PCI) and its influence in patients with ST segment elevation myocardial infarction (STEMI),therefore to provide a scientific basis for further effective shortening the time of primary PCI in patients with STEMI.Methods A total of 226 patients who diagnosed with STEMI and underwent primary PCI at Henan Provincial People's Hospital from June 2016 to December 2017 were enrolled in the study.Observation indicators include:(1) baseline data of patients;(2) time segments in primary PCI:total ischemic time (TIT),door to balloon time (DTBT),door-to-signature time (DTST),signature to balloon time (STBT);(3) the demographic characteristics of the family members who signed informed consent;and (4) the psychological factors and coping strategies of family members before signing informed consent.All data was analyzed using SPSS software (version 22.0).Multiple linear regression analysis was used to analyze the influencing factors of delay of DTST.A P＜0.05 was considered statistically significant.Results In this study,226 patients with STEMI who were first diagnosed in our hospital had a mean age of 55.23±10.80 years,and 181 (80.1％) were male.The median of TIT,DTBT,DTST,STBT were 312 min,166 min,82 min,and 80 min.The ratio of DTST in DTBT and TIT was 50％ and 28.5％,respectively.The multiple linear regression analysis showed that the number of direct family members (P＜0.001),the degree of educational in middle school and below (P=0.010),high school/technical secondary school (P=0.029),families worrying about the high cost of medical care (P=0.020),families consulted each other repeatedly (P=0.022),and consulted the other medical staff(P=0.022) are risk factors of DTST delay,and city residence (P=0.048) is the protection factor of DTST delay.Conclusions The long time of DTS is a reality of the practice of primary PCI in China.The factors that lead to longer DTST include demographic characteristics,psychological factors and coping strategies of family members.The STBT of primary PCI in China should be taken into the value while emphasizing the DTBT.

Objective:To investigate the risk factors of ST-segment elevation myocardial infarction (STEMI) with early left ventricular thrombus (LVT) under emergency percutaneous coronary intervention(PCI)mode.Methods:The clinical data were collected from 784 patients with STEMI treated with emergency percutaneous coronary intervention (pPCI) in our hospital from January 2014 to April 2019 . The observation indexes included baseline data, coronary angiography, disease course, laboratory examination and auxiliary examination. Patients with severe organic heart disease and having previous history of LVA and LVT were excluded. Totally 38 patients with LVT were selected as the experimental group and 114 patients with non-LVT selected as the control group according to the principle of age (the smallest absolute age difference between the experimental group and the control group) and sex. Data was analyzed by software Graphpad Prism5, SPSS 22.0 and Medcalc software were used for statistical analysis, and the Logistic regression model was established. A P<0.05 was considered statistically significant, and the risk factors of early LVT formation were retrospectively analyzed. Results:There was a linear relationship between the prolongation of TIT and the occurrence of LVT ( χ2= 304, P<0.01), and the Spearman relation was highly positive ( ρ=0.626, P<0.01). Multivariate conditional logistic regression analysis showed that prolonged TIT (total ischemic time), increased total amplitude of ST elevation, TIMI blood flow ≤ grade 2 after pPCI, decreased LVEF and LVA were independent risk factors for LVT, and their odds ratios ( OR) were 1.996, 13.689, 16.996, 0.868 and 9.195, respectively. Model 1 was constructed as LVA and the total amplitude of elevation of ST segments, and the receiver operating characteristic (ROC) was drawn, and the area under the ROC curve (AUC) was calculated as 0.889. Model 2 was obtained by adding TIT, LVEF and postoperative TIMI blood flow≤2, and the AUC was 0.990. Delong method was used to compare the AUC values between the two groups, and there was a statistical difference ( Z=3.294, P=0.001). Conclusions:The risk factors of STEMI complicated with early LVT under "emergency PCI mode" may have changed. Clinicians should conduct early screening of high-risk people factors of LVT in order to reduce its incidence and improve the prognosis. It may be helpful to actively carry out emergency bedside echocardiography before operation.