Incised wounds were made in rabbits, and some of the wounds were dressed with chitosan, and others with gauze. After bleeding stopped, hemoglobin in dressings was measured to determine the hemostaic effect. Wounds were redressed, and healing process was studied histologically. The results showed that less Hb was detected in chitosandressing than in gauze. On day 9 after wounding, the content of granulation tissue and collagen formation in the chitosan dressed wounds was more than that in Vaseline gauze dressed group. It suggests that chitosan dressing is effective in hemostasis for incised wounds and may be helpful in wound healing process.

In experimental teaching of oral histological pathology,we made full use of the heuristic teaching,observing sectioning, practice and CAI teaching effect and meaning and reached the conclusion that the comprehensive teaching is helpful to students’autonomous learning, cultivating their observation analysis ability,deepening their understanding and at the samen timehelping them improve their practical capability,so as to improve greatly both the oral experiment teaching quality and students’comprehensive practice ability.

OBJECTIVETo discuss the operation method and characteristic of correcting upper eyelid depression by transposition of orbital septum fat.

METHODSDuring the double eyelid surgery, we set.the lateral orbital septum fat completely free, while the bottom is still connected with the middle orbital septum fat. We separate a tunnel from the middle to the inner side in orbital septum, and the separated orbital septum fat is transposed to the inner side of orbital septum by the tunnel with suturing fixation.

RESULTSFrom March 2008 to October 2013, 51 cases with upper eyelid depression were treated successfully. Patients were followed up for 3 months to 3 years (average, 7. 5 months) with sustained aesthetic results.

CONCLUSIONSOrbital septum fat transposition can successfully correct the upper eyelid depression. It should become a regular procedure in blepharoplasty.

Adipose Tissue ; transplantation ; Blepharoplasty ; methods ; Esthetics ; Eyelids ; abnormalities ; surgery ; Humans ; Orbit

Background Diabetic retinopathy (DR) has become the main cause of blindness in the world,But the etiology of DR is still not clear,and the results of the studies on the risk factors of DR are not completely consistent.Fully understanding the risk factors of DR has an important clinical value for the prevention and treatment of DR.Objective This study was to analyze the prevalence rate and risk factors of DR inpatients with type 2 diabetes and provide a basis for the establishment of ophthalmic intervention programs and measures for diabetic inpatients.Methods Cross sectional study was performed.Four hundred and seventy three patients with type 2 diabetes in the department of endocrinology,Dongguan People's Hospital from July 2011 to July 2012 were included.The patients were divided into DR group and non diabetic retinopathy (NDR) group.The DR group was subdivided into mild,moderate and severe non-proliferative DR (NPDR) group and proliferative DR (PDR) group.The sex and age of patients,course of diabetes,body mass index (BMI),systolic blood pressure,diastolic blood pressure,fasting blood glucose (FBG),2 hours postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1 c),fasting insulin,2 hours postprandial insulin,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A1 (APOA1),APOB,alpha lipoprotein,total cholesterol,three glycerol,urea nitrogen,creatinine,uric acid,percentage of neutrophil,24 hours urinary albumin total (ALBU-24 h) and ALBU were detected.Logistic regression was used to analyze the relationship between DR and various factors,and the risk factors of DR were screened out.Results The prevalence of DR inpatients with type 2 diabetes was 28.33％,the prevalence of mild,moderate and severe NPDR were 2.54％,16.28％ and 4.23％,respectively,the prevalence of PDR was 5.29％.The prevalence of DME was 10.36％ in the DR patients.The course of diabetes,the levels of serum lipoprotein,creatinine,ALBU-24 h and ALBU were statistically significant between DR group and NDR group (all at P＜0.05).By stepwise Logistic regression analysis,the course of disease,FBG were identified as the independent risk factors of DR (course of disease:odds ratio [OR] =1.155,95 ％ confidence interval [CI]:1.067-1.251;FBG:OR =1.313,95％ CI:1.071-1.610).Conclusions The course of diabetes,lipoprotein,creatinine,ALBU-24h,ALBU are closely related to the occurrence and development of DR.The course of diabetes and FBG are the independent risk factors of DR.

Objective To conduct the calibration and comparative analysis on the Mindray BC 5800 automated hematology analy-zer in our department for ensuring the traceability and consistency of experimental results .Methods The mating calibrator of the Mindray company was used to conduct the calibration in the Mindray BC5800 automated hematology analyzer ,after calibration ,the calibration verification was performed .After passing the calibration verification ,the fresh blood was conduct the fixed value ,then the Mindray BC5800 and BC5180 automated hematology analyzers were calibrated ,after calibration ,the calibration verification was conducted ,after passing the calibration verification ,with the BC5800 as the standard instrument and BC5180 as the comparison in-strument ,the comparison experiment of fresh blood was performed .Results The Mindray BC5800 ,BC5300 and BC5180 automated hematology analyzers were passed the calibration verification after calibration ,in the comparison experiment of fresh blood ,the rela-tive deviation coincidence rates of WBC ,RBC ,Hb ,MCV ,PLT ,HCT ,MCH and MCHC between BC5800 and BC5300 and between BC5800 and BC5180 all exceeded 80% ,the comparison tests were passed .Conclusion The hematology analyzer should be per-formed the calibration verification and comparison test after calibration ,and the comparison test must be passed for ensuring the traceability of results and comparability among the test results in order to meet clinical needs .

This study aims to construct the core outcome set for the clinical trials of adhesive capsulitis treated with acupuncture and moxibustion. Using systematic review, semi-structured interview, Delphi questionnaire survey, analytic hierarchy process and expert consensus meeting, the primary outcomes are obtained, i.e. local tenderness, pain degree during movement, range of motion, changes in range of motion, function score, and score of local symptoms of shoulder joint. The secondary outcomes are myofascial thickness, thickness of the inferior wall of the joint capsule, health status, activity of daily living, incidence of adverse events, laboratory indexes, vital signs, cost-effectiveness, total effective rate, and patient satisfaction. It is expected to provide a reference for the outcome selection in clinical trials and the generation of medical evidences in the treatment of adhesive capsulitis with acupuncture and moxibustion.
Humans ; Acupuncture Therapy ; Bursitis/therapy* ; Consensus ; Moxibustion ; Outcome Assessment, Health Care

OBJECTIVE:To study the effect of Wenyang zhenshuai granules on myocardial MEF2 in model rats with chronic heart failure(CHF). METHODS:10 rats were randomly selected in 60 rats as normal control group(normal saline),the remain-ing 50 rats were randomly divided into model control group (normal saline),positive control group [enalapril,1.8 mg/(kg·d)], Wenyang zhenshuai granules low-dose,medium-dose,high-dose groups [0.72,1.44,2.88 g/(kg·d)] after induced to CHF models by adriamycin,intragastrically administrated twice a day,for 4 weeks. After administration,heart function indexes [left ventricular ejection fraction (LVEF),left ventricular fractional shortening (LVFS),left ventricular end-diastolic diameter (LVSD) and left ventricular end-diastolic diameter(LVDD)] of rats in each group were detected,protein expressions of myocardial MEF2 and phos-phorylated MEF2 (p-MEF2) and mRNA expression of MEF2 were determined. RESULTS:Compared with normal control group, LVEF,LVFS of rats in model control group and each administration group were significantly reduced (P<0.05),LVSD,LVDD were significantly increased (P<0.05);protein expression of myocardial p-MEF2 was significantly down-regulated (P<0.05), and there were no statistical significances in protein or mRNA expressions of MEF2 (P>0.05). Compared with model control group,heart function indexes of rats in each administration group were significantly improved (P<0.05);protein expression of myocardial p-MEF2 was significantly up-regulated (P<0.05),and there were no statistical significances in protein or mRNA ex-pressions of MEF2(P>0.05). CONCLUSIONS:Wenyang zhenshuai granule can antagonize the down-regulation effect of adriamy-cin-induced MEF2 protein phosphorylation,which may be one of the mechanisms of its treatment for CHF.

Objective To explore the effect of trauma control concept on severe multiple injuries.Methods From March 2016 to March 2018,74 emergency patients with severe multiple injuries were selected in Yiwu Central Hospital.The patients were divided into the observation group and the control group according to the digital table method,with 37 cases in each group.The control group was treated with one-time surgical treatment,and the observation group was given treatment measures for severe multiple trauma in emergency department under the concept of trauma control.The recovery time of body temperature,the recovery time of prothrombin (PT),the time of shock correction,the occurrence of complications,and the therapeutic effect were compared between the two groups.Results The body temperature recovery time,PT recovery time and shock correction time in the observation group were (6.73 ± 3.29) h,(5.18 ± 1.89) h and (5.84 ± 3.14) h,respectively,which were shorter than those in the control group [(9.85 ± 1.62) h,(9.86 ± 2.41) h,(8.45 ± 0.87) h],and the differences were statistically significant (t =5.175,9.295,4.873,all P ＜0.05).The incidence rate of complications in the observation group was 8.11％ (3/37),which was lower than that in the control group [32.43％ (12/37)],the difference was statistically significant(x2 =6.773,P ＜ 0.05).The cure rate of the observation group was 97.30％ (36/37),which was higher than that of the control group [91.89％ (34/37)],but there was no statistically significant difference (P ＞ 0.05).Conclusion The treatment effect of severe multiple injuries under the concept of trauma control is obvious.It is an effective and feasible method,which can effectively reduce the complications and fatality rate.

Objective To evaluate the reliability of the inhibitor enhanced carbapenem inactivation method (ieCIM) in the detection and preliminary classification of carbapenemase in gram-negative rods.Methods The carbapenem inactivation method (CIM) was modified by adding tazobactam or ethylene diamine tetraacetic acid disodium salt as carbapenemase inhibitors into the reaction system.A total of 198 isolates of Enterobacteriaceae and 35 strains of nonfermenters were collected,and their preliminary classification of carbapenemase was performed by the ieCIM.Meanwhile,their carbapenemase genes were detected by polymerase chain reaction (PCR),and the results were compared with that of the ieCIM.Results Among 198 strains of Enterobacteriaceae,101 were positive for carbapenemase genes,while 99 were detected by the CIM.Among the other 97 strains with negative carbapenemase gene,the results of the ieCIM were also negative.Among 35 strains of nonfermenters,25 were positive for carbapenemase genes,while 24 were detected by the CIM.Among the other 10 strains with negative carbapenemase gene,the results of the CIM were also negative.Using the ieCIM,97.7％ (85/87) of strains producing class A carbapenemase and 88.0％ (22/25) of strains producing class B carbapenemase were detected.Twelve strains producing class D carbapenemase and 2 strains producing both class A and class B carbapenemase were detected by the ieCIM.The total detection sensitivity and specificity of the ieCIM were 96％ and 100％,respectively.Conclusion The ieCIM has the consistent results with the detection method of carbapenemase genes,which may be used to detect and classify carbapenemase in clinical microbiology laboratories.

Objective:To investigate the application and surgical effect of lobed anterolateral femoral chimeric perforator flap in repairing the complex soft tissue defects of limbs.Methods:Clinical materials of 52 cases with complex soft tissue defects of limbs were retrospectively reviewed from October 2013 to October 2020. Thirty-two males and 20 females were reviewed, and the age of them ranged from 6 to 65(mean 39) years old. The injuries include 17 cases of traffic accidents, 15 machine crush injuries, 12 engineering accidents, and 8 extensive resection of malignant tumors. The size of soft tissue defects ranged from 26.0 cm×10.0 cm to 35.0 cm×15.0 cm. Lobed anterolateral thigh chimeric perforator flaps or lobed Flow-through chimeric perforator flaps were designed according to the soft tissue defects and blood circulation of the distal extremities. Start from 8-month post-operation, upper limb function was assessed according to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association and Disability of arm shoulder and hand(DASH) score scale, and Fugl-Meyer score system was used to evaluate the lower limb function. Long-term follow-up was conducted through WeChat video call and outpatient clinic evaluation.Results:All flaps survived. One patient with crush injury got delayed wound healing due to deep hemaetoma after surgery, and the rest were healed at the first stage. All the cases entered followed-up, ranged from 6 to 20(mean 8) months. The appearance of the flaps was satisfactory, and the color of the flaps has no significant difference compared with the recipient area. No recurrence of tumor was reported during the follow-up period. According to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association, there were 21 excellent cases and 8 good cases, and the total excellent and good rate was 100%. The DASH score of upper limbs ranges from 11.5 to 45.1(mean 25.4±13.7), and the Fugl-Meyer score of lower limbs range from 18.6 to 31.8(mean 26.2±11.2) at the last follow-up.Conclusion:The complex soft tissue defect of limbs is a common complication caused by high-energy trauma, which is difficult to repair. The lobed anterolateral thigh chimeric perforator flap through a Decompose-Combine and arrange method for reconstruction, which is flexible in flap design. A variety of tissue flaps can be obtained by anastomosing only one group of blood vessels. It is an ideal choice for repairment of complex soft tissue defects of limbs.