Objective To evaluate an improved modification of TTC staining method for measuring myocardial in-farct size after ischemia-reperfusion in rats.Methods Twenty healthy SPF male 8-week-old SD rats were randomly divided into two groups:Group A with conventional TTC staining, and group B with the modified TTC staining method for measuring myocardial ischemia-reperfusion injury.The infarct size was caculated and the serum cTnI levels were determined.Results The infarcted myocardium was well detected in both groups A and B.There were no significant differences in the myocardial infarct sizes measured in the groups A and B (48.69 ±5.37 %vs.47.41 ±3.28%, P>0.05).There were no significant differences in the serum cTnI levels assayed in the groups A and B (4.51 ±0.88 ng/mL vs.4.70 ±0.71 ng/mL, P>0.05). But compared with the group A, the color contrast of stained myocardial slice and the distinguishing infarction area and non-infarction area were much clearer in the group B.Conclusions Our modified TTC staining technique using in vivo staining is an economic, convenient, fast and efficient method, being easy to control, time-saving and inexpensive, and enhances the staining effect in evaluating the size of myocardial ischemia/reperfusion injury more accurately.

Objective To observe the efficacy of Chinese herbal fumigant sitz bath for different exposure durations on patients for the complicatiors after mixed hemorrhoidectomy.Methods One hundred and twenty patients with mixed hemorrhoidectomy were randomized into four groups(2 treatment groups and 2 control groups) with 30 cases in each group.The treatment groups were treated with the Chinese Herbal fumigant sitz bath for 10 minutes and 15 minutes respectively;while the control groups were treated with the hemorrhoids lotion for 10 minutes and 15 minutes respectively.The severity of pain,edema,bleeding,constipation and urinary disturbance were scored on the second,seventh and fourteenth days after treatment.Data were analyzed statistically.Results Chinese herbal fumigant Sitz baths for 10 minutes could significantly reduce postoperative pain,edema and bleeding symptoms[(1.72±1.23) points,(0.72±1.25) points,(0.91±1.37) points,respectively,P ＜0.05],followed sequentially by groups of Chinese herbal fumigant Sitz baths for 15 minutes [(1.79±1.21)points,(0.89±1.28) points,(1.03±1.24) points]; The hemorrhoids lotion for 10 minutes ((1.86±1.25) points,(1.14±1.47) points,(1.49±1.56)) and 15 minutes[(2.03±1.48) points,(1.05±1.29) points,(1.39±1.47) points,respectively,P ＜ 0.05]With the successful cases of 27,21,18,and 6 in the groups,respectively.Though the overall response rates of for the groups of 10 min's treatment,15min's treatment and 10 min's control were not significantly different between each other(P =0.0634,P =0.2560),they showed a superior efficacy in the overall response rate to the 15 min's control group(P =0.0064,P =0.0365,P =0.0089),respectively.Conclusion Chinese herbal fumigant Sitz baths for 10minutes have a success rate of 100％ on alleviating complications after mixed hemorrhoidectomy.It has a prominent efficacy on reducing postoperative edema and bleeding symptoms than other treatments studied in this program.

Objective:To explore the effect of setting up an internal-cross disciplinary team (ICDT) in the intensive care unit (ICU) on a new model of overall treatment for patients with chronic critical illness (CCI).Methods:A 60-year-old male patient with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to ICU in the Second Affiliated Hospital of Fujian Medical University was introduced. The role of ICDT composed of physicians, nurses, respiratory therapists, physiotherapists, clinical dietitians and patients' family members in ventilator withdrawal and super-early rehabilitation was analyzed in this case.Results:The patient was diagnosed as AECOPD, type Ⅱ aspiration penumonia respiratory failure, septic shock. The ICDT in ICU carried out early rehabilitation treatment for the patient on the basis of traditional infection control and supportive treatment. Under the care of the ICDT, peripheral blood white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), arterial partial pressure of carbon dioxide (PaCO 2), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), right excursion of diaphragm, sputum viscosity, tidal volume (VT) and respiratory rate (RR) were improved. Subsequently, the ventilator mode was gradually changed and the ventilator parameters were down-regulated. The ventilator was successfully weaned on the 10th day of treatment. After weaning, the patient's bedside pulmonary function indicators improved, and he was transferred out of ICU on the 15th day of treatment and discharged on the 20th day. The mental state of the patients was good and the quality of life was greatly improved in CCI outpatient follow-up. Conclusions:ICDT cooperation is very important for monitoring and treatment of CCI patients, which is beneficial to the super-early rehabilitation and prognosis improvement of critically ill patients.

Objective:To analyze the factors influencing the success rate of external cephalic version (ECV) and to create a preoperative scoring scale for stratified management of pregnant women who were preparing for ECV.Methods:This prospective study was conducted on singleton pregnant women who underwent ECV without anesthesia in Fujian Maternity and Child Health Hospital from January 1, 2017, to December 31, 2019. Univariate (two independent samples t-test, Mann-Whitney U test, and Chi-square test) and multivariate logistic regression were used to screen the clinical characteristics affecting the success of ECV, and receiver operating characteristic (ROC) curve was used to determine the cut-off value and convert quantitative variables into dichotomous variables. The independent variables were scored according to the regression coefficient in multivariate logistic regression analysis, and then a preoperative scoring scale was created. The ROC curve was used to calculate the cut-off value for the scoring scale. The subjects were divided into low and high score groups according to the cut-off value. The area under the ROC curve was used for evaluating the effectiveness of the scale in predicting the success of ECV. The success rate of ECV, difficulty of the operation and mode of delivery were compared between the two groups. Results:A total of 1 338 pregnant women met the inclusion criteria during the study period. After the exclusion of 885 women, 165 refused ECV in favor of direct cesarean section, 27 spontaneously converted to cephalic position before ECV, 261 who voluntarily accepted ECV were finally enrolled. ECV succeeded in 202 cases and failed in 59. (1) Favorable factors for ECV without anesthesia were the distance between the fetal breech and ischial spine <－3.5 cm ( OR=0.177, 95% CI: 0.071-0.438, P=0.009), the sum of the fundal height and the station of the fetal breech based on the ischial spine <30.25 cm ( OR=0.225, 95% CI: 0.094-0.537, P=0.001), amniotic fluid index ≥12 cm ( OR=0.399, 95% CI: 0.164-0.969, P=0.042), the surgeon's ability to hold the fetal head or breech with one hand ( OR=0.241, 95% CI: 0.098-0.589, P=0.002; OR=0.219, 95% CI: 0.087-0.546, P=0.001), and the fetal head located on the right or left upper abdomen of the mother ( OR=0.184, 95% CI: 0.059-0.568, P=0.003; OR=0.253, 95% CI: 0.084-0.760, P=0.014). (2) The area under the ROC curve of the preoperative score for predicting the success of ECV was 0.881 (95% CI: 0.821-0.941) and the cut-off value was 5.5. The subjects were divided into low (0-5 scores) and high (6-11 scores) score groups and the area under the ROC curve for predicting the success of ECV by grouping was 0.843 (95% CI: 0.774-0.912). Compared with the low score group, the high score group had a shorter ECV duration [2.0 min (0.5-10.0 min) vs 10.0 min (0.9-25.8 min), Z=－6.83, P<0.001], less attempts [1.0 times (1.0-4.0 times) vs 3.0 times (1.0-5.0 times), Z=－8.41, P<0.001], higher success rate [92.7% (190/205) vs 21.4% (12/56), χ2=127.64, P<0.001], higher rate of vaginal birth [75.4% (147/195) vs 18.5% (10/54)] and lower cesarean section rate [24.6% (48/195) vs 81.5% (44/54)] ( χ2=58.70, P<0.001). Conclusions:Preoperative scoring based on the factors influencing the success rate of ECV (the distance between the fetal breech and ischial spine, the sum of the fundal height and the station of the fetal breech based on the ischial spine <30.25 cm, amniotic fluid index ≥12 cm, the surgeon's ability to hold the fetal head or breech with one hand, and the fetal head locating on the right or left upper abdomen of the mother) is conducive to the individualized evaluation of the difficulty and the success rate of ECV as well as the success rate of vaginal delivery after ECV, which can provide a reference for clinical stratified management of ECV patients.

Objective: To identify and characterize the 4 strains of Prototheca isolated from the clinical samples of skin or ascites samples in China. Methods: The taxonomic position of 4 yeast-like organisms was revealed by polyphasic taxonomic approach, i.e., cultural and morphologic characteristics, commercial biochemical systems of Vitek 2 (YST kit) and Vitek matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry (MS) systems in combination with phylogenetic analysis based on the gene sequences of 16S and 28S rRNA. Results: The 4 strains of Prototheca were characterized as cream-white, smooth, moist yeast-like colonies on Sabouraud gentamicin chloramph agar after incubation for 3 days. However, round, oval-shaped or elliptical sporangiums with mulberry-like or strawberry-like endospores were observed by optical microscope, which showed distinct differences from the general yeast species. The 4 isolates were identified as Prototheca wickerhamii with Vitek YST kits by Vitek 2 systems and Vitek MALDI-TOF MS systems. The genome for the 4 isolates was characterized with the existence of the prokaryotic 16S rRNA gene and eukaryotic 28S rRNA gene. The 16S rRNA gene sequence of the 4 strains showed more than 99.7% similarity to that of P. wickerhamii. Sequence analysis of 28S rRNA gene showed that the organisms included multiple copies of different sequences, which showed sequence similarities of 91.9% to 100% even in the same strain. The phylogenetic dendrogram based on 16S rRNA and 28S rRNA gene sequences showed that the 4 strains of Prototheca formed a cluster along with P. wickerhamii. Conclusion The 4 yeast-like organisms could be identified as P. wickerhamii, and 16S rRNA gene should be the suitable molecular target for the identification.