Objective To introduce a new technique of one-stage auricular reconstruction by using the retroauricular fascial flap. Methods The retroauricular fascial flap was designed to cover a cartilage framework for auricular reconstruction. Results Seventeen cases who had injured over two years and received no surgical treatment, underwent auricular construction. In 3-month to 2-year follow-up, all patients obtained satisfactory appearance of the reconstructed ears that possess delicate structure and close color to adjacent skin. Conclusion For retroauricular fascial flap has adequate blood supply, it makes operating procedure simple and the occurrence rate of complication reduced. It is proven that this is a good method of auricular reconstruction.

Objective To analyze the level of satisfaction and its influencing factors in emergency patients, and to improve the satisfaction level of emergency patients. Methods The patients who visited the emergency department with the triage number ended with 1 from August 1 to August 15, 2015 in Second Affiliated Hospital of Zhejiang University School of Medicine were selected by the method of convenience and equidistant sampling, to take the Press Ganey′s Patient Satisfaction Questionnaires which were collected and analyzed at the end of the patient's emergency treatment. Results A total of 200 cases were investigated. Patient experience overall satisfaction was (91.64 ± 8.74) points. There were no significant differences in satisfaction between the gender, age, place of residence, the investigator, the clinic department, the time to wait, whether the first visit and the previous stay in hospital (P>0.05). The correlation between the satisfaction score and the patient's education, prognosis was less (r=-0.251,0.262, P =0.009,0.018) , but more higher correlated with the service attitude of ancillary hospital staff, nursing staff in the provision of nursing instructions, nursing staff can protect the privacy, the waiting time of the triage and the doctor′s explanation of the treatment of the disease (r=0.79-0.84, P<0.05). Conclusions The service attitude of the ancillary hospital staff, nursing staff in the provision of care instructions and privacy protection, and the waiting time of the triage and the doctor′s explanation of the treatment are the most important factors influencing the patients′ satisfaction in emergency department which also will be the key content for us to improve the patients′experience and satisfaction inemergency patients.

BACKGROUND: Human umbilical cord blood stem cells have been widely used in the study of spinal cord injury, but in vitro differentiation of human umbilical cord blood stem cells (hUCBSCs) has been limited by various factors. Mongalian medicine axillary choerospondias fruit extract has protective effects on neural cells, but the action mechanisms are unclear. OBJECTIVE: To observe promoting effects of 3 kinds of Mongalian medicine axillary choerospondias fruit extracts on in vitro differentiation of hUCBSCs. METHODS: Fresh umbilical cord blood was obtained from healthy puerperants to prepare hUCBSC suspension. The purified hUCBSCs were incubated in 40 petri dishes. The Mongalian medicine axillary choerospondias fruit extracts were divided into: sample 1 group: ethanol extraction, ethyl acetate extraction, crude drug mass concentration was 8.25 g/mL; sample 2 group: ethanol extraction, NKA resin isolation, 10% ethanol eluting concentration, crude drug mass concentration was 1.72 g/mL; sample 3 group: ethanol extraction, NKA resin isolation, 70% ethanol eluting concentration, crude drug mass concentration was 2.41 g/mL; control group: incubation of 80% DMEM containing 20% calf serum. Effects of various mass concentrations of Mongalian medicine axillary choerospondias fruit extract on hUCBSCs proliferation were observed. Proportion in S phase was measured using flow cytometry at 24 and 72 hours. RESULTS AND CONCLUSION: The proliferation of hUCBSCs was not significant in the sample 3 group. At day 10, the proliferation was significantly greater in the sample 1 and 2 groups compared with the sample 3 and control groups (P < 0.01). The number of hUCBSCs was significantly increased at 24 and 72 hours in S phase in the sample 1 and 2 groups. Mongalian medicine axillary choerospondias fruit extract (crude drug mass concentration 8.25, 1.72 g/mL) could promote in vitro proliferation of hUCBSCs.

Objective To explore the influence of smoking upon the level of the serum interleukin and TNF-? in patients with bronchial asthma.Methods Sixty-five patients with bronchial asthma,grade 3 or 4 as asthma group and 50 healthy examinees as control group were selected.According to the smoking history,each group was divided into the smoking subgroup and the non-smoking subgroup.For each group,the level of cytokines in serum were detected,and at the same time,their smoking history and general condition were collected.The differences between the groups were compared and the relationship of all indexes was analyzed.Results Compared with the control group,the level of IL-2、IL-6、IL-8 and TNF-? of the asthma group was significantly higher(P0.05).The level of IL-2、IL-8 and TNF-? of the smoking asthma subgroup was significantly higher than the smoking control subgroup(P0.05).Conclusion The influence of smoking upon the level of cytokines of asthma patients is significant.The level of IL-8、TNF-? in serum of a smoking asthma patient increases.The level of five cytokines in serum of 65 asthma patients in our research is related to patient's condition severity.

OBJECTIVE To strengthen the hospital infection control to realize the potency feeling among malignant tumor patients under the conduct of psychological nurses and other medical staff.METHODS The related hospital infection control system and the psychological countermeasure of nursing were formulated,we used two groups of comparisons methods around implements,counting and analyzing the effect of the hospital infection control among malignant tumor patients.RESULTS The psychologically healthy instruction enabled the patient positively to coordinate the treatment,the ratio of hospital infection from the original 21.33% dropped to 15.41%,and make the certain dynamic function to the self-realization of the patients' potency feeling.CONCLUSIONS The hospital infection control is an essential and important link to the nursing of the malignant tumor patients;the psychologically healthy instruction is an effective way to promote the self-realization of patients potency feelings.

Twenty-one compounds were isolated from the rhizomes of Iris germanica by various chromatographic techniques such as silica gel, ODS and Sephadex LH-20 chromatography. Their structures were established on basis of physical properties, MS and NMR spectroscopic data Their structures were identified as ombuin (1), 5, 3, 3'-trihydroxy-7, 4'-dimethoxyflavanone (2), naringenin (3), cirsiliol-4'-glucoside (4), 3beta, 4'-dihydroxy-7,3'-dimethoxyflavonone-5-O-beta-D-glucopyranoside (5), genistein (6), irilin D (7), muningin (8), 5, 7, 4'-trihydroxy-6, 3', 5'-trimethoxyisoflavone (9), tectorigenin (10), irigenin (11), tectoridin (12), iridin (13), mangiferin (14), irisxanthone (15), pyroglutamic acid (16), 2, 4', 6-trihydroxy-4-methoxybenzophenone-2-O-beta-D-glucoside (17), apocynin (18), androsin (19), beta-sitosterol (20), and daucosterol (21). Among them, compounds 1-9, 16, 17 were obtained from this plant for the first time, compounds 8 and 9 were separated from Iris species for the first time, compounds 1, 4, and 17 were obtained from the family for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Iris Plant ; chemistry ; Molecular Structure ; Rhizome ; chemistry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo quantitatively evaluate the metabolic changes of benign prostatic hyperplasia (BPH) and prostate cancer in the transitional zone using magnetic resonance spectroscopic imaging (MRSI), and to analyze the characteristics and differences of the spectra in this zonal area.

METHODSEighteen patients with prostate cancer in the transitional zone underwent magnetic resonance imaging (MRI)/MRSI examinations. The (Choline + Creatine)/Citrate (CC/Ci) ratio and the Choline/Creatine (Cho/Cr) ratio were evaluated in each voxel with cancer or BPH confirmed by pathological results. Discriminant analysis was used to determine the power of the two ratios in differentiation between cancer and BPH.

RESULTSThe CC/Ci ratio and Cho/Cr ratio for cancer voxels were significantly higher than those in the voxels with BPH in the transitional zone (CC/Ci: 2.36 +/- 1.31 vs. 0.85 +/- 0.29, P < 0.01; Cho/Cr: 4.14 +/- 1.79 vs. 1.26 +/- 0.45, P < 0.01). As for the discriminant function with the CC/Ci ratio and the Cho/Cr ratio, the specificity, sensitivity, and accuracy were 98.6%, 85.7%, 92.9% respectively for the differentiation between cancer and BPH.

CONCLUSIONSThe prostate cancer is characterized by higher CC/Ci ratio and Cho/Cr ratio compared to BPH in the transitional zone. Both CC/Ci ratio and Cho/Cr ratio have high specificity, sensitivity, and accuracy in their discriminative power between cancer and BPH in this zonal area.

Adult ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostatic Hyperplasia ; diagnosis ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology

The oral and gastrointestinal opportunistic pathogen contamination was compared between tooth mugs placed upward and down-ward(n=9)for 1 4 days.Selective cultivation of the pathogens was uesd to measure the extent of contamination.The colony forming units (CFU)of colibacillus in group up and group down were 4.25 ±0.71 and 2.84 ±1 .40(P=0.046),S.mutans 89 ±0.31 and 2.84 ±1 .40 (P<0.001 ),Candida 2.28 ±1 .36 and 2.53 ±1 .92(P=0.002),fungus 2.44 ±0.99 and 0,respecitvely.Thus,tooth mug placed open-ing down is superior for health.

Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P < 0.01 or <0.05 ). In DVT group, the activity of antithrombin Ⅲ and the level of protein S decreased (P < 0.05 ), and the level of D-Dimer increased (P < 0.05). Conclusions Long-term bed, smoke and mechanical ventilation requirement are the main risk factors of DVT in patients with AECOPD. Respiratory failure (type Ⅱ ) is easier to combine with DVT. Abnormality of coagulation and fibrinolytic system exists in AECOPD with DVT.

A total of 12 cases with Achilles tendon rupture were repaired by modified Kessler's methods.The sutured tendons were then strengthened with Mitek anchor system with 2 anchors inserted into the calcaneus lateral and medial to insertion of Achilles tendon and the sutures passed through the repaired tendon using Bunnel methods.The healing of skin incision,time to weight bearing,range of motion of the ankles,calcaneal pain and re-ruptures were recorded.The results were evaluated according to Amer-Lindholm criteria.All the patients were followed up with mean 17 months (range from 14 to 25 months).There were no calcaneeal pain or re-rupture cases,neither deep nor superficial wound infection or skin necrosis cases.According to Arner-Lindholm criteria for curative result,the result was excellent in 4 cases and good in 8 cases.The Mitek anchor system can be used successfully to treat Achilles tendon rupture and decrease postoperative complications.Thus,the technique is an ideal option for Achilles tendon rupture repair.