Objective : To investigate the occupational exposure to blood-borne pathogens among medical workers in a tertiary general hospital in Hangzhou City from 2010 to 2022, so as to provide the evidence for improving occupational protective measures among medical workers. Methods: The registration and follow-up data of occupational exposure to blood-borne pathogens among medical workers from 2010 to 2022 were collected from the blood-borne occupational exposure monitoring system in a tertiary general hospital in Hangzhou City. The population distribution, occurrence, protection and disposal of occupational exposure to blood-borne pathogens were analyzed using a descriptive epidemiological method. Results: A total of 1 230 cases were reported with occupational exposure to blood-borne pathogens among medical workers in the study hospital from 2010 to 2022, with the highest incidence in 2021 (4.67%) and the lowest incidence in 2010 (0.99%). The incidence of occupational exposure to blood-borne pathogens appeared a tendency forwards a rise from 2010 to 2022 (P<0.05). Of all cases with occupational exposure to blood-borne pathogens, there were 934 women (75.93%), 656 nurses (53.33%), and 514 cases with working experiences of one year and shorter (41.79%). Hand was the predominant site of occupational exposure to blood-borne pathogens (92.03%) and ward was the predominant place of exposure (35.37%), while scalp needle was the predominant mode of exposure (32.68%), and removal of needle was the predominant procedure of exposure (32.36%). A total of 1 106 cases were tested for the blood-borne pathogens in the exposure sources, and 448 cases were tested positive for blood-borne pathogens, with a detection rate of 40.51%. Hepatitis B virus, treponema pallidum and human immunodeficiency virus were the three most common blood-borne pathogens, and there were 739 cases (60.08%) with personal protective equipment during exposure. Following the follow-up surveillance for more than 6 months post-exposure, no infections occurred. Conclusions Junior nurses and hand exposure were predominant among medical workers with occupational exposure to blood-borne pathogens in the study hospital from 2010 to 2022, and hepatitis B virus was the predominant blood-borne pathogen. No post-exposure infections occurred.

Objective To explore the expression of osteopontin (OPN) in mucosal epithelium of oral local lesion in patients with oral lichen planus(OLP). Methods Forty patients with pathologically-confirmed OLP (erosive OLP,n=15; reticular OLP,n=25) were investigated,among whom 17 were complicated with mild dysplasia. Mucosal epithelium of oral local lesion was examined for the expression of OPN by immunohistochemical method. Forty healthy subjects were served as normal controls. Results The positive expression rates of OPN were 65.4% and 82.4%,respectively in patients with OLP and those complicated with mild dysplasia,and both were significantly higher than that in normal controls (10.0%) (P0.05),while both were significantly higher than that in normal controls (P

OBJECTIVETo evaluate a knitted polypropylene mesh used for mammapexy in correcting the breast ptosis.

METHODSTwenty-one patients with the mild or moderate breast ptosis were undergoing the mammapexy with a knitted polypropylene mesh. The operation was performed through the periareolar incision and a monofilament knitted polypropylene mesh was subcutaneously implanted on the surface of the gland and fixed upward.

RESULTSAll of the patients were satisfactory of the appearance with the follow-ups from 2 to 16 months. No secondary ptosis, hypertrophic scars and foreign body reactions were found.

CONCLUSIONThe above-mentioned technique could be a good, safe and reliable method for correcting breast ptosis.

Humans ; Mammaplasty ; instrumentation ; methods ; Polypropylenes ; Surgical Mesh

OBJECTIVETo introduce a new method for enlarging the survival area of an expanded flap.

METHODSAfter the skin expander was inflated with enough injection, the first delaying was performed. In the operation, two incisions were made in the skin and subcutaneous tissue superficial to the expander capsule on both sides of the long axis of the expanded flap. After 10 to 14 days, the second delaying followed, in which one pedicle was divided to form a unilateral-pedicled, super-long random flap. When the flap was transferred to the recipient Since 2000,this technique has been used in 16 patients. All the area, the door site was closed directly.

RESULTSflaps survived completely.

CONCLUSIONSThe technique of twice delaying can enlarge the survival area of the expanded skin flap.

Adolescent ; Adult ; Child ; Cicatrix ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps

OBJECTIVETo investigate the clinical and histological features of the complications after hydrophilic polyacrylamide gel injection.

METHODSFifty-two patients were included in this study, who had undergone hydrophilic polyacrylamide gel injection in other units from 1998 to 2003 and later came to our department for removal of the injected gel. The tissue samples taken from each cyst were sectioned and stained with hematoxylin and eosin. The sections were investigated and analyzed under light microcopy. The tissue sections of 12 patients who had ever received liquid silicone injection from 1988 to 1994 were used as the control group. The difference in histological features was assessed.

RESULTSThe inflammatory reaction of the hydrophilic polyacrylamide gel was characterized by an increased number of foreign-body giant cells. The mild lymphocyte infiltration was shown in the slides of hydrophilic polyacrylamide gel. On the contrary, there were much more clusters or lymphocyte infiltration in the slides of liquid silicone. The differences between the hydrophilic polyacrylamide gel and liquid silicone were significant in terms of thickness of the fibrous capsule.

CONCLUSIONSThe security of hydrophilic polyacrylamide gel injection for soft tissue augmentation is in doubt.

Acrylic Resins ; adverse effects ; therapeutic use ; Adult ; Breast ; pathology ; Female ; Humans ; Nose ; pathology ; Postoperative Complications ; etiology ; pathology ; Silicone Gels ; adverse effects ; Surgery, Plastic ; adverse effects ; Time Factors

OBJECTIVEto investigate the pattern of the blood supply and the nerve distribution of breast, in order to find a way for short-scar reduction mammaplasty.

METHODSTwelve adult women cadavers were investigated for the vascularture of the anterior thorax and the nerve distribution of the breasts by using the blood vessel casting, specimen transparency technique and the autopsy. Based on the anatomical study, a modified double-circle reduction mammaplasty technique was designed to treat 28 patients with hypertrophical breasts.

RESULTSThere existed two- or three-layers vasculature in the anterior thorax. The extensive vertical vascular anastomoses were found among the three layers. The cutaneous perforators, penetrated out of the pectoralis major muscle, were formed a dense vessel network in the retromammary space. The vertical vessels thereafter emerged from the network, passed through gland and linked to the subcutaneous vessels. These vertical vessels were smaller and denser above the fourth intercostal space, but they were larger and sparser below the fourth intercostal space. The innervation of the nipple-areola mainly came from the lateral deep branches of the 4th intercostal nerve. It appeared S-shape running into the dropped breasts. The 28 patients were successfully treated with the modified technique, except one case with the loss of the nipple-areola sense.

CONCLUSIONThe modified double-circle reduction mammaplasty could maximally fulfill the blood supply to the remained gland and the innervations to the nipple-areola, by keeping the advantages of the traditional technique such as invisible scar, good projection and the long lasting results. It could also be a safe and reliable technique.

Adolescent ; Adult ; Aged ; Blood Vessels ; anatomy & histology ; Breast ; blood supply ; innervation ; surgery ; Cadaver ; Female ; Humans ; Mammaplasty ; methods ; Models, Anatomic ; Nervous System ; anatomy & histology ; Treatment Outcome

OBJECTIVETo investigate the clinical value of spiral CT with multi-planar reconstruction (MPR) and three diamensions reconstruction (3D) in the diagnosis and treatment of pelvic ring fractures.

METHODSFifty-seven patients with pelvic ring fractures were examined with digital radiography and spiral CT in our hospital from April 2004 to April 2009. According to Tile classification, there were thirty-eight cases in type A, twelve in type B and seven in type C. Expectant treatment was used in type A, while surgery, open reduction internal fixation or percutaneous lag screw internal fixation technique for sacroiliac joint due to the displacement of fractures, for type B and C. Three days to twenty-seven months after operation, spiral CT examinations were used to evaluate the location of internal fixation. Cross-check analysis of images of digital radiography and spiral CT was performed before and after operation.

RESULTSFive posterior and three anterior pelvic ring fractures were diagnosed as suspected fractures. Nine posterior and three anterior pelvic ring fractures were missdiagnosed according to plain radiographs, which were corrected by spiral CT examination. According to the postoperative imageology evaluation, the results were excellent in 15, good in 3 and bad in 1. According to clinical evaluation, 16 cases were excellent, 3 good.

CONCLUSIONSpiral CT with multi-planar reconstruction (MPR) and three diamensions reconstruction (3D) has clinical values for precise diagnosis and treatment for the complex pelvic ring fractures.

Adolescent ; Adult ; Aged ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; diagnosis ; diagnostic imaging ; surgery ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Reconstructive Surgical Procedures ; Tomography, Spiral Computed ; methods ; Young Adult

OBJECTIVETo explore the method of constructing tissue-engineered skin using melanocytes and bone marrow mesenchymal stem cells (BMSCs) in vivo.

METHODSMelanocytes were isolated from human foreskin. BMSCs were isolated from human bone marrow. Both of them were co-cultured at a ratio of 1:10, and then were implanted into the collagen membrane to construct the tissue-engineered skin, which was applied for wound repair in nude mice. The effectiveness of wound repair and the distribution of melanocytes were evaluated by morphological observation, in vivo 4,6-diamidino-2-phenylindole, dihydrochloride (DAPI) fluorescent staining tracing, HE staining, S-100 immunohistochemistry, and transmission electron microscopy.

RESULTSThe wounds were satisfactorily repaired among the nude mice. The melanocytes were distributed in the skin with normal structure, as confirmed by DAPI fluorescent staining tracing, HE staining, S-100 immunohistochemistry, and transmission electron microscopy.

CONCLUSIONMelanocytes and BMSCs, after proper in vitro culture at an appropriate ratio, can construct the tissue-engineered skin with I type collagen membrane.

Animals ; Bone Marrow Cells ; cytology ; Cells, Cultured ; Coculture Techniques ; Collagen Type I ; Humans ; Melanocytes ; cytology ; Mesenchymal Stromal Cells ; cytology ; Mice ; Mice, Nude ; Skin ; injuries ; Skin, Artificial ; Tissue Engineering

OBJECTIVETo investigate the feasibility of bone marrow mesenchymal stem cells(MSC)with the acellular dermal matrix(ADM) biological patch for the treatment of external anal sphincter injury on the animal models.

METHODSThirty Wistar rats with sphincter injury were randomly divided into three groups. Group A underwent end to end sphincteric repair directly, group B underwent end to end repair and then covered by ADM patch, and group C underwent end to end repair and then covered by ADM which was previously seeded with MSC. After six weeks, the whole ring specimens including anal canal and lower rectum were removed. The hematoxylin and eosin stain and Masson trichrome stain were performed to observe the change of histomorphology.

RESULTSTwo weeks later, the majority of rat models presented with moist anus and crissum with loose stools, which indicated that the model was established successfully. Six weeks after repair, in group A and B, the suffusion of fibrous connective tissue and the infiltration of inflammatory cells were observed at the repair site of sphincter. And lots of collagen fiber which was stained into blue deposited dispersedly at the site of repair with no obvious proliferation of capillaries. However, in group C, the blue collagenous fiber which deposited at the sphincter injury site was less than that in groups A and B. Muscle fibers were observed to be stained into red distributed dispersedly at the repair site of sphincter in group C.

CONCLUSIONSTransplantation of ADM biological patch rich in bone MSC can partly improve the regeneration of rat injured anal sphincter and lessen the formation of cicatrix.

Acellular Dermis ; Anal Canal ; injuries ; surgery ; Animals ; Bone Marrow ; Mesenchymal Stem Cell Transplantation ; Rats ; Rats, Wistar ; Wound Healing

OBJECTIVETo find a satisfied and applicable repairing method for big auricle defect.

METHODSan auricular posterior flap with has two subcutaneous pedicles on mastoidea, was applied for repairing of big auricle defect. A framework of rib cartilage was embedding into the flap to shape auricle.

RESULTSatisfied result was abtained in all 12 cs-es.

CONCLUSIONUsing auricular posterior flap with two subcutaneous pedicles to repair big auricular defect is a satisfied and applicable method.

Adolescent ; Adult ; Ear Auricle ; injuries ; surgery ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult