Objective To observe the clinical efficacy of improved Gudaofang at different concentrations for the treatment of soft tissue damage so as to determine its optimal concentration.Methods 150 patients with open soft tissue damage treated in our hospital from June 2014 to June 2016 were randomly divided into treatment Group A (n=40) and Group B (n=40), Group C(n=30)and control Group D (n=40).Group A, Group B and Group C were treated with 10%, 20%, 30% of improved Gudaofang respectively, while the control Group D was treated with 75% of alcohol.Its clinical efficacy was evaluated by tenderness score and swelling degree.Results Compared with post-treatment, different concentrations of improved Gudaofang significantly reduced the tenderness score and swelling degree (P<0.05).The total effective rate of Group A, Group B, Group C were 92.5%, 97.5% and 97.5%, respectively, were significantly better than the control Group D with 77.5% (P<0.05).Conclusion Different concentrations of improved Gudaofang has a certain clinical efficacy on treating open soft tissue damage.20% concentration of improved Gudaofang has the best cost-effective and is optimal drug concentration.

Objective To discuss nicardipin′s influence on post operation cognitive dysfunction (POCD) in senior patient after hip joint replacement operation.Methods 180 senior patient, who received selective unilateral hip joint replacement operation between October 2015 and October 2016 under the condition of combined spinal-epidural anesthesia (CSEA) were randomly divided into Group A (with nicardipine) and Group B (without nicardipine).Nicardipine was only appropriately pumped into vein in time in Group A.MAP was observed and recorded 30 minutes after starting the operation and at the end of the operation.Mini-mental state examination (MMSE) was applied to score the patient one day before, one day, three days and five days after operation, and the number of POCD was recorded.Results Compared with Group B, Group A was obviously lower in MAP level (P<0.05) after 30 minutes.MMSE score of Group A was obviously higher (P<0.01) one day after operation.The number of POCD in Group A was 8 (8.89%) significantly lower than than that of Group B (19, 21.11%).Conclusion Nicardipine could maintain hemodynamic stability of senior patients receiving selective unilateral hip joint replacement operation under the CSEA and prevent POCD to a certain extent.

Objective To explore the clinical effects and application value of VSD combined with continuous hypoperfusion of ozone water in treating deep bedsore.Methods 40 patients with deep bedsore admitted to our hospital from June 2014 to December 2016 were randomly divided into the observation group (n=20) and the control group (n=20).The control group was treated with VSD while the observation group was treated with VSD combined with continuous hypoperfusion of ozone water.Results Compared with the control group, the wound healing time in the observation group was shortened significantly (P<0.001).The positive rate of bacteriology inspection about the wounds was decreased significantly (P<0.05).The density of capillary blood under microscope was increased significantly (P<0.05).Conclusion The clinical effects of VSD combined with continuous hypoperfusion of ozone water in treating deep bedsore is better than VSD alone apparently.It is worth clinically popularizing.

Objective To observe the clinical efficacy of micro plasma in the treatment of acne atrophic scar on face.Methods 82 cases with facial acne atrophic scar were randomly divided into the observation group and the control group.Each group had 41 cases.The observation group received micro plasma treatment while the control group were treated with ultrapulsed fractional CO2.The treatment was carried out 6 weeks interval, in total 3 times.After each treatment, the curative effect and the side effects were compared between the two groups.Results The total effective rates had no statistical difference between two groups, and the more treatment times, the better effect.The observation group had less adverse effects, which the duration of main side effects was shorter in the observation group than in the control group, with statistically significant difference.Conclusion The micro plasma technology on treating facial acne atrophic scar was an effective skill with less adverse reactions and worth of wide use.

Objective To analyze the correlation between brain atrophy and cognitive impairment in patients with Alzheimer.Methods 45 cases of Alzheimer in recent years in our hospital were selected as the observation group, and 45 patients without Alzheimer in the same period in our hospital as control group.The relationship between brain atrophy and cognitive impairment in patients with Alzheimer was analyzed.Results The width of temporal and anterior horn of lateral ventricle, three ventricle, quadrigeminal and the average width of lateral fissure, the body and occipital lateral cerebral ventricle and sulci in the observation group were significantly bigger than that in the control group.The memory, orientation, problem solving ability, social function, family life, the degree of self-care ability impairment of the observation group were significantly higher than that of the control group (P<0.05).Conclusion Brain atrophy is a specific marker of Alzheimer, which may lead to cognitive impairment.

Objective To summarize the diagnosis and surgical treatment of mesenteric cyst in children.Methods The clinical records of mesenteric cyst cases from January 2011 to December 2015 were reviewed retrospectively.The diagnosis and treatment options were analyzed, and the prognosis of laparoscopic surgery and laparotomy was compared.Results The main clinical symptoms included abdominal mass, abdominal pain, and abdominal distension.Abdominal ultrasound and/or CT scan were the diagnostic tools in all cases.Traditional laparotomy was performed in 14 cases, while laparoscopy in 7 cases (1 case switched to laparotomy).2 cases had emergency surgery due to acute abdomen, laparotomy and laparoscopy in each case.Simple cyst resections were completed in 14 cases, of which 2 cases with a small amount of residual in the mesenteric root.Intestinal resection and anastomosis were required in other 7 cases.The average time of hospital stay for laparotomy group was 12 days, and 10.14 days for laparoscopy group.There was no significant difference.All patients were discharged without postoperative complications.With 1-4 years follow-up, there was no recurrence.Conclusion The operation for mesenteric cysts depends on the relationship between the cyst and the adjacent bowel or organs, and the overall outcome is favorable.The selective use of laparoscopy will benefit more children.

Objective To explore the clinical efficacy of entecavir combined with Vitamin E in treating patients with Chronic hepatitis B complicated with non-alcoholic fatty liver.Methods Retrospective analysis was done by reviewing the clinical data of 103 patients, who suffered with chronic hepatitis B complicated with non-alcoholic fatty liver and treated in our hospital from 2015 to 2016.The patients were divided into the control group with 61 cases and the observation group with 42 cases based on different therapies.The control group was treated with only entecavir while the observation group was treated with entecavir and Vitamin E, and both the courses of treatment lasted for 6 months.The negative conversion ratio of HBV-DNA, levels of ALT, TBIL, ALP, the disease state and the adverse reactions of the two groups were compared before and after treatment.Results The negative conversion ratio of HBV-DNA of the observation group was obviously higher than that of the control group, and the patients of the observation group showed significant improvement.Meanwhile, the levels of ALT, TBIL and ALP in the two groups were both lower than before treatment.Compared with the control group, those indexes in the observation group were significantly lower (P<0.05).Conclusion Entecavir combined with Vitamin E for the treatment of chronic hepatitis B complicated with non-alcoholic fatty liver could significantly decrease the viral infections so that the state of patients can be improved.

Objective To explore a one-time repairing method for defects in palmar skin soft tissue, proper palmar nerves and arteries, and flexor tendon.Methods From March 2011 to June 2016, the defects in palamar skin, nerves, blood vessels or flexor tendons of 21 fingers in 20 cases were repaired by using the resected superficial veins and tendons and nerves of skin soft tissue on axes of indicis proprius tendon (extensor digiti quinti) or forearm-palmaris longus tendon or foot back short tendons of the first or second toes were cut according to the defects in palmar skin soft tissue, nerves, blood vessels and flexor tendon, Results All the vein flaps of the 20 cases were survived.The patients were followed up for 6 to 24 months.Both the shape and function of the fingers recovered well.The flaps were of good quality, with no obvious pigmentation, and good at sensations (The sensation between two points were 9 mm on average).Conclusion It was a simpler and more convenient way to repair defects in palmar skin soft tissue, nerves, blood vessels and flexor tendons using free venous flap with tendons and nerves for transplantation.It also ensures the blood-supply without sacrificing the main vessels, and thus it is an ideal method for repairing simultaneous defects in skin soft tissue, nerves and flexor tendon.

Objective To evaluate the clinical effect of treatment for deep burn wound on finger by proper digital artery flap.Methods From March 2013 to October 2016, 24 patients with deep burn wound on finger were treated by proper digital artery flap.Postoperative observation included wound repair, flap survival, complications and functional recovery of fingers.Results All the 24 flaps survived and no necrosis happened.The marginal abnormal circulation of flap occurred in only 5 cases, which cured by dress changing.All flaps kept well in contour, skin color, temperature and texture.Movement function of donor and recipient fingers was nearly normal.Conclusion Proper digital artery flap avoided the deficiencies distant pedicled flap, so it is a favorite choice for digital soft tissue defect caused by deep burn injury.

Objective To explore risk factors and preventive measurement for early onset VAP(EOP) and late onset VAP(LOP) of elderly patients in the ICU.Methods 189 elderly patients in ICU were divided into EOP group and LOP group, and risk factors of the two groups were analyzed.Results The incidence rates of EOP and LOP were 32.18% and 51.96%.EOP occurred in GCS score from 8 to 12, and LOP in GCS score from 4 to 7.The independent risk factors for EOP group were high APACHE II score, COPD history and prolonged mechanical ventilation time;while for LOP were COPD history, prolonged mechanical ventilation time, albumin<30 g/L and consciousness disorder.The common risk factors of the two groups were prolonged mechanical ventilation time and COPD history.The pathogenic bacteria of the two groups were mainly gram negative bacillus.Conclusion The incidence of VAP in elderly patients is high and various factors contributed to VAP.The incidence of VAP in elderly patients can be reduced by avoiding risk factors for LOP and taking early diagnosis.