Objective To explore the method of treatment of sunken cheek deformity.Methods The longitudinal platysma-faseial flap was overturned 180 degree upward,the flap's pedicle located in the margin of mandible,and then combined with abdominal dermis fat graft to form as a sandwich,which filled in the sunken area of face.Results Five patients were treated with this method from 2003 to 2007,and satisfactory results were gained but only mild absorption was found in the transplanted tissue area during followed up for 3 months to 3 years.Conclusion Platysma-fascial flaps survive easily with rich blood supply and strong anti-infection,and are also easy to incise and operate as well,which,together with free abdominal dermis fat flap,could increase the amount of the needed tissue.It is a better approach to repair the sunken cheek deformity and in particular suitable for the more serious deformity in patients with sunken cheek.

The article describes the current situation of training mode of community nurses in community health service institutions in Hubei province from several aspects,including training object,training target,training base,teaching staff,training organization and government,training method and time,training curriculum,training effect evaluation and certification.The article suggests a multitude of factors influencing the training quality,such as formal training,dominant job training,and monotonous community training content and less training time.Overall,the government should be done something to increase government support and funding and accelerate the community nursing services and community nursing education.It is also essential to establish community nursing personnel training mechanism,improve and perfect the community health personnel training system,increase the construction of community nursing practice base and facilities and strengthen clinical practice skills.

AIM:Todetecttheeffectofspironolactoneonhyperthyroxine-inducedatrialremodeling.METH-ODS:New Zealand rabbits were divided into control group ( C ) , hyperthyroxine group ( H ) and spironolactone group ( S) .Thyroxin was given to the rabbits in group H and group S by intraperitoneal injection for 4 weeks , and then spirono-lactone was given in group S by gavage for 2 weeks.Atrial fibrillation (AF) was induced by burststimulation after ad-ministration.The inducing rate of AF and atrial effective refractory period ( AERP) were tested by intra-cardiac electro-physiologic instrument.The expression of AF-related Ca2+channel (Cav1.2), K+channels (Kv1.5 and Kv4.3) and con-nexins (Cx40 and Cx43) at mRNA and protein levels was detected by real-time PCR, immunohistochemistry and Western blot.RESULTS:Spironolactone reduced the inducing rate of AF .No significant difference of AERP between group H and group S was observed (P>0.05).Compared with group H, the protein expression of Cav1.2 was significant increased in group S (P<0.05).The expression of Kv1.5 at mRNA and protein levels in group S was significantly lower than that in group H (P<0.05), while the protein expression of Kv4.3 in group S was significantly decreased compared with group H (P<0.05).The mRNA expression of Cx43 in group S was significantly decreased compared with group H (P<0.01), whereas the protein expression of Cx 40 in group H was significantly higher than that in group S ( P<0.05 ) .CONCLU-SION:Spironolactone attenuates the hyperthyroxine-induced atrial remodeling in rabbits , and reduces the susceptibility of the myocardium to AF .

Objective To investigate the polymorphism of glutathione S-transferease P1 gene(GSTP1) and the association between the mutation and susceptibility in childhood asthma.Methods The distribute frequency of Ile105/Ile105,Ile105/Val105 and Val105/Val105 ge-notype in GSTP1 of 51 children with asthmatic and 40 normal children were studied with polymerase chain reaction-restriction tragment length polymorphism(PCR-RFLP).Results The frequencies of Ile/Ile Ile/Val,Val/Val genotype were 66.7%,27.4% and 5.9%,the frequencies of Ile,Val allele were 80.4% and 19.6% in the asthmatic group.But the frequencies of Ile/Ile,Ile/Val,Val/Val genotype were 90.0%,7.5% and 2.5%,the frequencies of Ile,Val allele were 93.8%,6.2% in control group.The frequencies Ile/Val,Val/Val genotype and Val allele in asthmatic group were more than that in control group.A significant difference was found in the frequency distribution of GSTP1 genotypes between two groups(?2=6.947 P

Objective To investigate the practical anatomy and clinical applications of the lateral sural nerve-lesser saphenous vein vascular plexus island flap with median sural nerve preserved.Methods Ten lower limbs injected with color red latex and 20 fresh limbs were observed.Based on anatomical studies,the island flap pedicled with the vascular axis of lateral sural nerve and lesser saphenous vein was designed for clinical application in 63 cases.In procedure,the median sural nerve were preserved in donor site and the distal end of the lesser saphenous vein were not ligated.Results The accompanying arteries formed a favourable vascular plexus around the nerve and the vein,lied along the lateral sural nerve and the lesser saphenous vein and nourished the skin through cutaneous branches.The distance of the lateral ankle to the confluent of lateral and median sural nerve was (8.5± 0.8) cm.63 patients with soft tissue defects in the distal leg and foot were repaired.Their appearance and function were satisfaction without feeling lose in the heel and lateral side of the foot.Conclusions The lateral sural nerve-lesser saphenous vein vascular island flap is a reliable source of soft tissue to cover defects in the lower leg and foot.This flap has sufficient blood supply and high survival rate without the sacrifice of the median sural nerve.

Objective To explore the prognostic factors influencing the short-term outcome in patients with acute cerebral in-farction through the prospective study for guiding clinical treatment .Methods 92 patients with acute cerebral infarction were in-cluded in the study ,whose neurological functions were assessed via National Institute of Health Stroke Scale (NIHSS) and compu-ted tomography or magnetic resonance imaging performed within 24 h of symptom onset .All of the patients were administered with same medication regimen for acute cerebral infarction .The NIHSS and the modified Rankin Scale were used to assess the extent of disability at 15 d after admission .Multivariable logistic regression was used to analyze the associations between different factors and the two 2 prognostic factors respectively .Results When the difference of two NIHSS scores was treated as the dependent variable , the infarction volume was associated with the difference in multivariable regression ,the OR of the two groups with larger Infarction volume OR=2 .352 and OR=5 .161 ;When the Rankin Scale scores were treated as the dependent variable ,the outcome in rehabili-tation group was better than those in no rehabilitation group (OR=0 .207) .Patients with the greater baseline NIHSS scores had the worse prognosis ,the OR of the two groups with larger score OR=1 .257 and OR=1 .032 .The age ,gender ,admission time as well as infarction area were not significantly associated with clinical prognosis .Conclusion The baseline NIHSS scores and infarct vol-ume were independent prognostic factors for the short-term outcome in patients with acute cerebral infarction ,who should obtain re-habilitation treatment to improve prognosis .

Objective To analyze risk factors of multiple drug-resistant infections in neonatal intensive care unit (NICU). Methods The clinical data from 284 hospitalized pediatric patients were retrospectively analyzed from June 2011 to July 2015 . The differences between 59 cases with multiple drug-resistant infections and 225 cases with non-multiple drug-resistant infections were compared and analyzed by logistic regression. Results All of 284 cases were single birth. Fifty-nine cases ( 13 . 13 ± 9 . 03 days old) had multiple drug-resistant infections, in which 42 were males and 17 were females. Two hundred and twenty-ifve cases ( 14 . 21 ± 8 . 34 days old) had non-multiple drug-resistant infections, in which 175 cases of males and 50 cases of females. Single factor analysis showed that 8 factors, including gestational age, birth weight, days in hospital, Apgar score at birth, mechanical ventilation, parenteral nutrition, and the categories and duration of use of antimicrobial agents, were the risk factors of multiple drug-resistant infections (P?

Objective To study effect of piracetam combine with hyperbaric oxygen in treatment of acute carbon monoxide poisoning patients with electrocardiogram and its effects on Lactate clearance.Methods 60 patients of acute carbon monoxide poisoning who received therapy from February 2011 to February 2016 in our hospital were selected as research objects.All accord with the diagnostic criteria of acute carbon monoxide poisoning.According to draw method,those patients were divided into the experimental group(n=30)and the control group(n=30).The two groups were given a large number of sustained oxygen,intracranial pressure,protect brain cells,promote blood circulation and improve microcirculation and other basic symptomatic treatment.The control group on the basis,was treated with hyperbaric oxygen,one times a day,a total of ten times.while the experimental group was treated with piracetam combine with hyperbaric oxygen,hyperbaric oxygen method with the control group,intravenous drip of Piracetam and Sodium Chloride Injection,each 100ml,two times a day,a total of treatment for ten days.Then abnormal ECG,creatine kinase isoenzymes(CK-MB),troponin(cTnl),lactate clearance,incidence of delayed encephalopathy,mortality,therapeutic effect of two groups were compared.Results ECG abnormal rate there was no difference between the two groups before treatment,after treatment,the abnormal rate of the experimental group was significantly lower than the control group [6.66(2/30)vs.33.33％(10/30)](P<0.05); CK-MB、cTnl、6h and 24h after treatment,Lactate clearance rate was significantly higher than control group[(15.80±2.03)％vs.(10.26±2.01)％,(20.75±3.12)％vs.(13.07±2.56)％](P<0.05);DEACMP rate and mortality was significantly lower than the control group[6.66％(2/30)vs.33.33％(10/30),3.33％(1/30)vs.30.00％(9/30)](P<0.05); The total effective rate was significantly higher than the control group[95.56％(28/30)vs.75.56％(22/30)](P<0.05).Conclusion Piracetam combine with hyperbaric oxygen is well for acute carbon monoxide poisoning,which can improve the clearance rate of lactic acid,improve hypoxia and myocardial injury,and reduce the abnormal ecg.

Objective To understand the incidence of metabolic syndrome (MS) among populations in the west Jiangxi area and its distribution characteristics.Methods A total of 6 714 people in west Jiangxi area were performed the cross-sectional survey for analyzing the prevalence situation of MS among different age groups and its components related factors.Results The MS incidence rate in west Jiangxi area was 14.6% (male 10.4%,female 19.8%),which in young,middle-aged and elderly groups were 9.4%,14.5% and 9.4% respectively,in which the prevalence rate of various age groups in the youth group were 2.3% fro the group A,7.5% for the group B and 13.8% for the group C respectively.The statistic analysis showed that MS was related with the related risk factors such as age,sex,blood pressure,body mass index,blood sugar and blood lipids.Conclusion The incidence rate of MS in the west Jiangxi area is positively correlated with the age,the risk factors are dominated by obesity,and the MS onset shows the rejuvenation trend.

In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase chain reactions with sequence-specific primers (PCR-SSP) in 42 patients with CU (19 men and 23 women, mean age 30.67+/-12.45 y old as well as 193 racially matched healthy persons in ethnic Han from Hubei provinece. Gene frequencies of HLA-DRB1 * 12, * 0901 (RR=3.11, chi2=7. 579, P=0.006; RR= 2.47, chi2 =5.684, P=0.017) were significantly increased in CU patients as compared with that in healthy people. Gene frequencies of HLA-DQB1 * 05 (RR=0.26, chi2=6.683, P=0.01) were significantly decreased in CU patients. It was suggested that CU was found strongly associated with HLA-DRB1 * 12, * 0901 and HLA-DQB1 * 05, the former might be the genetic markers for susceptibility to CU, but the latter might play a resistive role.
Alleles ; Chronic Disease ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; HLA-DQ Antigens/*genetics ; HLA-DR Antigens/*genetics ; Polymerase Chain Reaction ; Urticaria/*genetics