Objective To investigate the value of combined therapy for hand post-burn scars.Methods We retrospectively analyzed 78 hands post-burn scars in 46 cases from 2007 to 2011.A mong them,scar contracture releasing,scar excision,free skin grafting and fixation with Kirschner's pins were performed in 38 hands,scar excision and regional flat transfer were performed in 18 hands,scar excision and skin grafting were performed in 18 hands,abdominal expanded flap transplantation and scar excision were performed in 4 hands.All patients received elastic sleeve pressure therapy,sili cone gel for external application and function training.Within six months after the operation,52 hands received drug delivery by wax therapy,16 hands incision with scar proliferation received drug injection into scar.We followed up all patients from half a year to three years after the treatment to observe the recovery of the appearance and function of the hands.Results We mainly chose surgery,elastic sleeve pressure therapy,silicone gel for external application,drug injection into scar,wax therapy,function training and so on treating the hand post-burn scars and found that the joins deformities caused by scar contracture were largely or totally corrected.The function and appearance were satisfying.Conclusions It is a good method to treat hand scars by surgery and post-surgery combined physical rehabilitation therapy,which deserves to popularization.

Objective To observe the acute pain service for analgesia effect and complications of postopera-tive analgesia and satisfaction after cesarean section.Methods 360 patients undergoing cesarean section and postop-erative continue analgesia were randomly divided into two groups.The control group (group C,n =178)was given with routine postoperative self -control analgesia give guidance.In the observation group (group A,n =182),a group for acute pain was founded,and the patients were explained about PCA self -control analgesia related knowledge before operation,together with the APS analgesia group people,the patients were given with postoperative pain management,observed self -control analgesia efficacy and side effects,and gives the corresponding treatment and guidance.The difference of analgesia incomplete and complication were observed such as nausea and vomiting,calm, itchy skin.Questionnaires that postoperative analgesia satisfaction survey were filled inafter discharged.The satisfac-tion of nurse with the APS were observed.Results Postoperative analgesia complication in group A were significantly lower than that in group C(P <0.01,P <0.05),APS analgesic incomplete in group C was significantly higher than groupA (χ2 =11,P <0.01).The satisfaction of PCA in group A were significantly higher than group C (P <0.01, P <0.05),ward nurses job satisfaction also increased significantly (t =2.63,P <0.05).Conclusion Acute pain service effectively improve analgesic quality and reduce related complications after cesarean section increase patients postoperative analgesia satisfaction,increase the ward nurses job satisfaction.

ObjectiveTo study the expression levels of YB-1 protein in hepatocellular carcinoma (HCC) tissues,tissues adjacent to tumour and normal liver tissues,and to explore the clinical significance.MethodsTo study the expression levels of YB-1 protein,immunochemistry was carried out on 58 HCC tissues and their corresponding adjacent tissues to tumour and on 20 normal liver tissues.The YB-1 protein with nuclear translocation was detected by Western blot in HCC tissues,tissues adjacent to tumour,normal liver tissues,HCC cell lines including QGY-7701 and SMMC-7721,and a normal hepatic cell line LO2.ResultsPositive signals of YB-1 protein were detected at a high level in HCC tissues (72.4％,42/58) when compared to tissues adjacent to tumour (41.4％,24/58) and to normal liver tissues (35 ％,7/20) (P＞0.05).The nuclear expression of YB-1 (31％,18/58) was significantly correlated with the pathologicalgrade,tumour size and portal venous invasion (P＜0.05).Using Western blot,the YB-1 protein with nuclear translocation was expressed at a higher level in HCC tissues (0.474±0.107) than in tissues adjacent to tumour and in normal liver tissues (P＜0.05).Similar results were obtained in HCC cell lines and the normal hepatic cell line (P＜0.05).ConclusionThe high expression of YB-1 in HCC and its nuclear translocation may be involved in human HCC progression.YB-1 may be a potential target for HCC treatment in the future.

Objective To observe the efficacy and adverse reaction of intrapleural hyperthermic perfusion and intrapleural chemotherapy for patients with malignant pleural effusion (MPE) caused by lung cancer.Methods A total of 103 patients with MPE caused by lung cancer were assigned into one of two groups:intrapleural hyperthermic perfusion group (n =65) and intrapleural chemotherapy group (n =38).The disease control rate,MPE progress free survival,the relationship between vascular endothelial growth factor (VEGF) concentration in pleural effusion and curative effect and adverse reactions were observed.Results The overall disease control rate in intrapleural hyperthermic perfusion group and intrapleural chemotherapy group was 81.5％ and 52.6％ respectively,with a significant difference (x2 =9.834,P =0.002).The median MPE progress free survival of the two groups was 3.10 and 2.15 months respectively,with a significant difference (x2 =10.512,P =0.001).A significant difference of the median MPE progress free survival was observed in low VEGF concentration subgroup between intrapleural hyperthermic perfusion and intrapleural chemotherapy (3.34 months vs.2.20 months;x2 =9.409,P =0.002),but no difference was observed in high VEGF expression subgroup (2.85 months vs.2.10 months;x2 =2.429,P =0.119).The main adverse reactions included gastrointestinal adverse reaction,fatigue and hematotoxicity.Fatigue occurred in intrapleural hyperthermic perfusion group more commonly compared with intrapleural chemotherapy group (67.7％ vs.13.2％;x2 =28.595,P ＜ 0.001).Conclusion Compared with intrapleural chemotherapy,intrapleural hyperthermic perfusion can better improve disease control rate and MPE progress free survival in MPE patients caused by lung cancer,and it's adverse reactions are tolerated easily.The MPE progress free survival prolonging is observed especially in VEGF low expression subgroup.VEGF level in pleural effusions maybe could predict efficacy of intrapleural hyperthermic perfusion.

Exosomes are extracellular vesicles with a diameter of 30-100 nm formed during the processes of "endocytosis-fusion-exocytosis".Exosomes can be released by various types of cells and may carry important biological molecules,such as lipids,proteins,and nucleic acids.They are also involved in signal transduction and exchange of substances between cells and can regulate the physiological and pathological processes in various systems.They also play an important role in liver diseases,including liver cancer,viral hepatitis,liver fibrosis,and alcoholic and non-alcoholic fatty liver disease.This article reviews the research advances in exosomes in liver diseases.

Objective To obsOrvO thO safOty and OffOct of intraopOrativO cOll salvagO and autologous blood transfusion during cOsarOan sOction with cOntral placOnta prOvia.Methods From April 2015 to March 2016, 25 prOg-nants with cOntral placOnta prOvia diagnosOd by MRI and ultrasound and undOrwOnt sOlOctOd caOsarOan sOction in thO POoplO′s Hospital of WOnzhou wOrO includOd. WhOn thO amount of blood in thO rOcovOry tank was 450 mL or thO obstOtrician rOquirOd, thO wash and rOtransfusion dOvicO was startOd-up. Hb and Hct wOrO mOasurOd bOforO and aftOr thO parturiOnt, and thO blood was rOcovOrOd. ThO blood loss, rOcovOry of blood, blood transfusion, allogOnOic RBC infusion and thO sidO OffOcts aftOr transfusion and 42 d of postpartum wOrO rOcordOd.Results No sOrious complica-tions wOrO rOcordOd in all prOgnants. FivO casOs(20% ) wOrO only rOcovOrOd and thO autologous blood transfusion and transfusion of thO allogOnOic RBC wOrO not carriOd out. In 14 casOs(56% ),only thO autologous blood was rOturnOd to thO puOrpOra. ThO volumO of blood transfusion was 705 mL(430,1 535). Six casOs(24% ) had massivO blOOding during thO opOration,3690 mL(1 900,8 750),and thO autologous blood transfusion volumO was 2939 mL(1 167, 4 206),and thO allogOnOic RBC transfusion was 3.5U(1.5,11.5).Conclusion Autologous blood transfusion can bO usOd safOly in thO caOsarOan sOction of thO cOntral placOnta prOvia, and can rOducO thO allogOnOic RBC transfusion.

OBJECTIVETo develop a high-performance liquid chromatography (HPLC) method for the simultaneous determination of rutin, hyperoside, isoquercetin, astragulin, quercetin, and kaempferol in Apocynum venetum and its extracts.

METHODThe separation was carried out on a Shim pack ODS (4.6 mm x 250 mm, 5 microm) colum eluted with in mobile phases of water containing 0.2% phosphoric acid and acetonitrile containing 0.2% phosphoric acid in acetonitrile gradient mode. The column temperature was 40 degrees C, and the flow rate was 1.0 mL x min(-1). The detection wavelength was set at 360 nm.

RESULTThe good seperation of six flavonoids was achieved within 40 min, with the relative standard deviations (RSD) of intra- and inter-day precision < or = 2.0%. Calibration curves of rutin, hyperoside, isoquercetin, astragulin, quercetin, and kaempferol showed good linear relationship (R2 > 0.999 7, n = 6). The average recoveries of the six flavonoids were within 97.30% - 105.8% (RSD 2.6%). Three batches of A. venetum and 2 batches of its extracts were determined.

CONCLUSIONThe developed method is simple, accurate, and repeatable, and can be readily used as a powerful tool for the quality control of A. venetum and its extracts.

Apocynum ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Flavonoids ; analysis ; Quality Control ; Reproducibility of Results

Human infection with avian influenza A (H7N9) is an acute contagious respiratory disease. Acute respiratory distress syndrome (ARDS) is a common complication in patients with severe avian influenza A (H7N9), for whom mechanical ventilation (MV) is an important supportive method. A patient, suffered from severe avian influenza A (H7N9) and complicated with ARDS, was admitted to the Second Affiliated Hospital of Guizhou Medical University in January 2017. With very intensive care for oxygenation, respiration and consciousness, and monitoring, she was successfully cured by comprehensive managements, among which noninvasive mechanical ventilation (NIV) was the major respiratory support method. The result demonstrate that, in patients with conscious state, satisfied expectoration ability and relatively good cooperation, and with close observation of oxygenation and respiratory rate, NIV may be accepted as an effective method for patient with ARDS caused by severe avian influenza A (H7N9).

BACKGROUNDPost-traumatic stress disorder (PTSD) is a mental disorder with delayed or chronic onset caused by unusual, threatening, or disastrous psychological trauma, and it is an important manifestation of post-disaster mental and behavioral disorders. Studies have shown that IL-6 is a cytokine associated with PTSD occurrence. This study aimed to explore the role of cytokine and ethnicity in the pathogenesis of PTSD by examining levels of serum cytokines IL-2, IL-6, IL-8, TNF-α, and cortisol in PTSD patients of Li and Han ethnic groups.

METHODSLevels of serum cytokines IL-2, IL-6, IL-8, TNF-α, and cortisol were examined by enzyme-linked immunoabsorbent assay (ELISA) method and assessed by PCL-C scale among 30 PTSD patients of Han ethnicity and 30 of Li ethnicity, and compared with 30 normal controls of Han and Li ethnicity, respectively.

RESULTSPTSD patients of Li ethnicity scored higher than PTSD patients of Han ethnicity, and normal controls of Li and Han ethnic groups in each of the re-experiencing, avoidance/numbing, and hyperarousal symptoms. The differences reached statistical significance (P < 0.05). In PTSD patients of Li ethnicity compared to patients of Han ethnicity and normal controls of either Li or Han ethnicity, the levels of IL-2, IL-6, IL-8, and TNF-α were higher, and the level of cortisol was lower.

CONCLUSIONSThere are ethnic differences in re-experiencing, avoidance/numbing, and hyperarousal symptoms among PTSD patients. The levels of serum cortisol and cytokines are strongly associated with the race.

Adult ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hydrocortisone ; blood ; Interleukin-2 ; blood ; Interleukin-8 ; blood ; Male ; Stress Disorders, Post-Traumatic ; blood ; Tumor Necrosis Factor-alpha ; blood