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.

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 .

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.

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.

Animals ; Berberine ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Humans

Objective To investigate clinicopathological features of scalp angiosarcoma, and to analyze the relationship of tumor stage and treatment with prognosis. Methods Clinical and follow-up data were collected from 16 patients with non-metastatic primary scalp angiosarcoma treated in the Department of Plastic and Reconstructive Surgery of Zhongda Hospital, Southeast University from September 2002 to June 2013. According to the seventh edition American Joint Committee on Cancer (AJCC)TNM staging system for soft tissue sarcomas (2010), staging of scalp angiosarcoma was performed for the 16 patients. Statistical analysis was carried out by the Kaplan-Meier method for survival rates and by the Log-rank test for survival curve. The Cox regression model was used for multivariate regression analysis. Results Of the 16 patients, 4 had stageⅠangiosarcoma, 4 stage Ⅱangiosarcoma, and 8 stage Ⅲ angiosarcoma. The tumor usually began as ecchymosis-like lesions on the head or face in early stage, and progressed into dark red infiltrative plaques, nodules and ulcers which easily ruptured and bled in later stage. Histopathological examination showed generalized vascular proliferation and infiltration with high histological morphological diversity. Cytologic atypia was commonly seen. The median time to recurrence was 15 months, and local recurrence occurred in 7 patients. The median time to metastasis was 20.5 months, and distant metastasis was observed in 8 cases, including 4 cases of pulmonary metastasis, 2 lymph node metastasis, 1 liver metastasis and 1 bone metastasis. The survival time was 33.0 ± 4.4 months (median, 32 months)in 4 patients with stage Ⅰangiosarcoma, 24.0 ± 7.9 months(median, 15 months)in 4 patients with stage Ⅱangiosarcoma, and 23.9 ± 3.9 months (median, 24 months)in 8 patients with stage Ⅲ angiosarcoma. Additionally, the survival time was 23.4 ± 5.2 months(median, 21 months), 24.4 ± 5.7 months(median, 24 months)and 35.8 ± 9.7 months(median, 26 months) in 5 patients receiving surgical treatment alone, 7 patients receiving surgical treatment and radiotherapy, and 4 patients receiving surgical treatment, radiotherapy and immunotherapy, respectively. Conclusions Surgical treatment combined with radiotherapy and immunotherapy may serve as the first-choice treatment for scalp angiosarcoma. Tumor size and treatment regimens are main factors influencing prognosis of scalp angiosarcoma.

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 analyze the risk factors of multiple drug resistant bacterial infections in patients with chronic obstructive pulmonary disease (COPD), and provide guidance for disease control and prevention. Methods Clinical data of 814 COPD patients were retrospectively analyzed from June 2011 to May 2015, including patient's age, gender, smoking history, age of onset, severity, aggravated frequency, duration of exacerbations, diabetes mellitus, complications, use frequency and use duration of glucocorticoid, use frequency of antimicrobial agents and use duration of each time, types of antimicrobial drugs used, combined with antibacterial drugs, plasma albumin concentration, blood glucose, bacteria culture detection of multi drug resistant bacteria infection. The risk factors of multi drug resistant bacteria infection were analyzed. Results A total of 857 pathogenic bacteria were isolated from 814 COPD patients with pulmonary infection. Multiple drug resistant bacteria infection were detected in 170 cases, and 175 strains (20.42%) were detected. The detection rate of multi drug resistant/PAN resistant pseudomonas aeruginosa (MDR/PDR-PA) was 55.38% (36/65). There were significant differences in patients with multi drug resistant bacteria infection between different clinical pathological characteristics. Logistic regression analysis showed that the acute exacerbation duration (days), long time use of antimicrobial drugs, and high frequency of corticosteroids and antibiotics use were independent risk factor of multi drug resistant bacteria infection in COPD patients. Conclusion Prevention and treatment of multiple drug resistant bacteria infection in COPD patients should pay attention to the combination of community and hospital, and take effective measures to prevent and control the risk factors.

Objective:To investigate research topics and management methods for hospital pharmacy in order to promote the devel -opment of hospital pharmacy researches .Methods:The basic principles , main research fields , strategies and approaches of topic se-lection in hospital pharmacy , as well as the main points of research management were discussed .Results:The main research fields of hospital pharmacy included experimental studies and soft science researches .The principles of selected topics should follow practicabil-ity, scientificity, innovation, feasibility and effectiveness , and the topics should set off from the thinking path of pharmacy , be for the purpose of translational medicine and be based on the practical problems of clinical drug use .The quality evaluation of generic drugs , druggability research and so on could take advantage of close to clinics of hospital pharmacy , which may be the focus aspects .It is nec-essary to establish a continuous improvement of performance inspection system , improve the construction of echelon personnel and drive mechanism, and strengthen the scientific research cooperation inside and outside the team in hospital pharmacy researches .Conclu-sion:The scientific researches on hospital pharmacy are very important to develop pharmacy , which are worthy of further exploration .