Objective To investigate the effect of tissue adhesive glue in the repairment of eyelid lacerations and surgical incisions in children.Methods Retrospective comparison trial in paediatric ophthalmology department.Children who presented for laceration and surgical incision repair between November 2015 and October 2016 were evaluated.Patients from 11 months old to 12 years old with a total of 458 patients were randomly allocated to either glue (258 cases) or sutures (200 controls) to repair their wound.Cases and controls were similar in age,wound length and width involved.Those with wound seriously infected and longer than 5 cm were excluded.Length of time to perform procedure,pain assessment of procedure by doctor,parent and child and cosmetic outcome in 3 months and 1 year were measured.Results Time taken to repair the wound was faster in the glue group (P<0.01).Doctors and parents and the children themselves rated glue repair as less distressing (P<0.01).Complications (wound dehiscence,infection and corneal damage) were the same in both groups (P>0.05).Cosmetic outcome was better in the glue group in 3 months and 1 year (P<0.05).Conclusion Tissue adhesive glue is faster and easier and less painful than suturing.Tissue adhesive glue has better cosmetic outcomes than suturing when used for the repair of eyelid lacerations and surgical incisions in children.

Objective To explore the function and mechanisms of Wnt7a in bone msenchymal stem cells (BMSCs) osteogenic differentiation.Methods BMSCs were isolated and cultured.After transfection of siRNA-Wnt7a and mock in BMSCs and induction by osteogenic medium for 3 d,Western Blot were employed to detect the silencing effect of siRNA-Wnt7a.Then the effect of silencing Wnt7a on the expression of osteocyte marker osteocalcin and osteogenesis regulator protein Runx2 were detected by Western Blot after culture by osteogenic medium for 10 d.Finally,Alizarin S Red staining was used to detect the effect of silencing siRNA-Wnt7a on osteogenesis after culture by osteogenic medium for 2 weeks.Results The silencing effect of siRNA-Wnt7a was confirmed by Western Blot after transfection of oligocleotides siRNA-Wnt7a and mock into mesechymal stem cells.The silencing Wnt7a decreased the expression of osteocalcin and Runx2 after culture by osteogenic medium for 10 d.Alizarin S red staining results showed that silencing Wnt7a blocked bone differentiation.Conclusions The results demonstrated that Wnt7a could promot osteocyte marker osteocalcin expression by upregulating osteogenesis regulator protein Runx2 expression,which played a key role in BMSCs osteogenic differentiation.

Objective To explore the survival rate and early-term effects of sensory reconstruction of the modified first dorsal metacarpal artery (FDMCA) flap in treatment of thumb distal soft tissue defect.Methods From March 2004 to October 2007, 65 patients with soft tissue defects of the thumb underwent the FDMCA flap in our department. Forty-nine cases with complete data were included in the study. There were 37 males and 12 females, with an average age of 32 years (ranged, 18-65 years). The conventional surgical methods were used in 18 cases while the improved surgical methods were in 31 cases. The distal necrosis, the vascular crisis rate and the sensory recovery were recorded. Results The mean follow-up period was 2 years (ranged, 20 months to 3 years). Forty-six flaps survived completely. Vascular crisis occurred in five cases harvested by the conventional methods. Eventually, three of them had a partial distal necrosis.Improved FDMCA flap survived well in all 31 patients. Flaps in these patients with nerve anastomosis restored satisfied sense and all sense were located in the thumb. Eighteen cases of nerve transfer group had different levels of mixed feelings (33%) or ectopic sensory (62%). Sense was located in the thumb completely in 1 case. Conclusion The modified FDMCA flap significantly increased the survival rate. Neurorrhaphy could make the sense of the flap locate in the thumb; however it had not been proved that its impact on the recovery of two-point discrimination and stereognosis.

Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.

Objective To explore the effect of enteral nutrition applied to bowel preparation of diabetes patients before electronic colonoscopy. Methods A total of 172 diabetes patients were randomly allocated to the experimental group and the control group with 86 patients in each group. The experimental groups executed no dietary restriction within 3 days before the examination, and received Ensure 1h before colonoscopy. However,the control group was given low residue diet within 3 days before the examination, and received no Ensure before colonoscopy. The enteral cleanness and incidence of hypoglycemic reaction, abdominal pain and horror was compared between the two groups. Results 72 cases(83.72%) of the experimental group and 70 cases (81.40%) of the control group had better enteral cleanness, and there was no statistical difference in intestinal cleanness between the two groups. In the experimental group the incidence of hypoglycemic reaction, abdominal pain, horror was significantly lower than those in the control group. Conclusions Bowel preparation with unrestricted diet and ingested ensure before colonoscopy can not only ensure intestinal cleanness but also enhance endurance of colonoscopy.

Objective To establish a rapid and convenient method for determination of genomic DNA methylation in cells.Methods Five standard substances (dC, mdC, dA, dT and dG) were separated by high-performance capillary electrophoresis.Bare fused-silica capillary was used and eletrophoresis buffer was 48 mmol/L NaHCO3 with 60 mmol/L SDS, pH 9.6.The temperature of separation was controlled at 25 ℃ and a voltage of 20 kV was applied.The separation of the mixture was performed at a wavelength of 256 nm with UV-Vis detection and injection time was 5 seconds at 0.7 psi.Under optimal condition,genomic DNA methylation in methotrexate drug-resistant A549 cells was detected.Results The optimal condition was made by adjusting SDS concentration(40, 60, 80 mmol/L), pH value of running buffer(9.4,9.6, 9.8), voltage(15, 17, 19, 20, 22 kV), injection time(5, 10, 15, 20, 30 s) and capillary temperature(15, 20, 25, 30 ℃).The method for determination of genomic DNA methylation in cells was established.Five substances were completely separated by high-performance capillary electrophoresis in 10 mins.Intra-day coefficient of variation was less than 0.2% and inter-day coefficient of variation was less than 2%.The minimal detection limit was 2 μmol/L.Percentage of mdC in A549 parent cells was (4.80 ±0.52) %.Percentage of mdC in 15, 30, 40 μmol/L methotrexate drug-resistant A549 cells were (4.20±0.44) %, ( 3.70 ± 0.36 ) %, (3.10±0.35 ) %, respectively.Conclusions Genomic DNA methylation can be quantificated by high-performance capillary electrophoresis efficiently, rapidly, conveniently and sensitively.Genomic DNA methylation in methotrexate drug resistance cells decreases significantly.

OBJECTIVE:To optimize the preparation technology for enteric-coated changbiqing granules.METHODS:The concentration of acrylic resin and the four factors like the quantity of castor oil,pulvis talci and methylsilicone oil on the yield of changbiqing enteric-coated granules were determined by orthogonal test design;The effects of the enteric-coated granule plasticizer on the quantity of castor oil and the weight increment of the coating were determined by the release rate test.RESULTS:The optimized formula of the coating solution was described as follows:the concentration of acrylic resin was5%,the relative amount of castor oil to acrylic resin was35%,the dosages of pulvis talci and methylsilicone oil were3%and1%,respectively,the weight increment of the coating was30%.CONCLUSION:Changbiqing enteric-coated granules pre?pared on the optimized technology are in line with the quality requirements and which have ideal enteric soluble drug releasing characteristics.

Objective To summarize the experience of cannulation for extracorporeal membrane oxygenation (ECMO) in infants less than 5 kg. Methods Eleven infants with ECMO support who weighed less than 5 kg were admitted to critical care medicine of Guangzhou Women and Children's Medical Center from June 2016 to June 2018 were enrolled. Retrospective analysis of support type, configuration, site of cannula and complication of ECMO was performed. Results The 11 infants consisted of 9 males and 2 females. The weight on ECMO of 1.96-4.60 kg, with an average of (3.14±0.65) kg; age 0.1-30.0 days, with a median of 5.6 (1.5, 8.3) days. Four cases were given ECMO because of congenital diaphragmatic hernia with severe pulmonary hypertension and other 7 cases were cannulated due to complication of congenital cardiac surgery. All infants were received veno-arterial (V-A) ECMO. In 4 cases, the cannulas were placed in the right internal jugular vein for drainage (8-10 French catheter with 6.0-7.5 cm depth) and the right carotid artery for infusion (6-8 French catheter with 2.5-3.5 cm depth); the average time of cannulation in right carotid and jugular vessels was (73±20) minutes (range 55-100 minutes). In other 7 cases, the cannulas were inserted into the right atrium (12-14 French catheter with 2.8-3.0 cm depth) for draining blood and returning it to the ascending aorta (6-8 French catheter with 1.0-2.0 cm depth); the average time of cannulation in central vessels was (64±31) minutes (range 35-110 minutes) with exclusion of 2 cases intraoperative cannulation. There were three infants with complications. One episode was shown in vascular rupture, one in catheter site hemorrhage and one in cannula malposition with later repositioning. There was no case of insertion site infection, cannula-related bloodstream infection and accident detached cannula. Conclusion Cannulation for ECMO can be performed in infants less than 5 kg with a high rate of success and a low rate of complication owing to appropriate catheter and skillful cannulation.

Objective:To evaluate the clinical efficacy and safety of fecal microbiota transplantation(FMT)for the treatment of chronic functional constipation in the elderly.Methods:A total of 33 elderly patients with chronic functional constipation were included and given three sessions of FMT.Changes in fecal characteristics, constipation, mood and quality of life in these patients were evaluated using the Bristol stool form scale(BSFS), the constipation assessment scale(CAS), patient assessment of constipation symptoms(PAC-SYM), the Zung self-rating anxiety scale(SAS), the Zung self-rating depression scale(SDS), and the patient assessment of constipation quality of life(PAC-QOL)before and 12 weeks after treatment.The clinical efficacy was based on comparison between pre-and post-treatment results for each patient.Results:Clear improvement was achieved in 33 patients 12 weeks after treatment, compared with before transplantation.Post-treatment scores of the constipation assessment scale and symptom self-assessment questionnaire for patients with constipation were(8.9±1.2)scores and(26.5±2.4)scores, respectively, significantly lower than pre-transplantation scores of(12.2±1.1)scores and(32.4±2.4)scores( t=15.034, 13.904, both P<0.001). Similarly, post-treatment scores were also lower than pre-transplantation levels for the self-rating anxiety scale[(50.4±8.4)scores vs.(57.5±9.0)scores, t=10.333, P<0.001], the self-rating depression scale[(50.6±8.4)% vs.(55.0±10.5)%, t=5.301, P<0.001], and self-assessment questionnaire for quality of life[(88.2±7.3)scores vs.(103.7±7.3)scores, t=23.300, P<0.001]. Conclusions:FMT can improve fecal characteristics and constipation symptoms, relieve anxiety and depression, improve the quality of life, and provide a new option for the treatment for elderly patients with chronic functional constipation.

Objective:To explore the clinical value of the geriatric potentially inappropriate medication(PIM)evaluation system in elderly inpatients.Methods:As a prospective cohort study, 203 elderly inpatients with polypharmacy were randomly divided into the control group and experimental group.Geriatric PIM evaluation system(based on the criteria for judging potential inappropriate drug use in Chinese elderly 2017 edition)on wechat platform was applied to patients of experimental group.During the 6 months, the number of elderly syndromes, types of drugs, the days in hospitalization, readmission rates and all-cause mortality were compared between two groups.Results:The age of 203 elderly inpatients ranged from 60 to 94(77.30±10.34)years, including 121 males and 82 females.The morbidity proportion of top five diseases were 69.95%(142/203)in cerebral infarction(non-acute phase), 62.07%(126/203)in hypertension, 24.14%(49/203)in coronary heart disease, 9.85%(20/203)in atrial fibrillation, and 6.40%(13/203)in cardiac insufficiency.The 97.53%(198/203)of elderly hospitalized patients had at least one senile syndrome, the average was 4.3±2.0.Insomnia, fall and frailty accounted for 32.87%(15/198), 28.45%(56/198)and 13.66%(27/198)respectively.Compared with the control group, the average length of stay in hospital in the experimental group significantly decreased[(16.38±4.29) vs.(21.32±6.10)d, t=2.438、 P=0.025], the number of senile syndrome, the score of fall, weakness and the re-admission rate were also decreased significantly(3.11±2.14 vs.4.32±1.50, t=0.854、 P=0.032; 6.19±1.35 vs.8.61±3.22, t=4.078、 P=0.044; 3.94±1.92 vs.5.65±1.34, t=2.843、 P=0.038; 9.81%(10/102) vs.1.98%(2/101), χ2=4.772、 P=0.029), and the frequency of PIM was significantly different between two groups(417.36±49.21 vs.210.25±38.23, t=2.136、 P=0.034). Conclusions:After making the drug adjustment on the elderly inpatients with multiple drugs, PIM evaluation system for the elderly are able to reduce the incidence of geriatric syndrome, shorten the length of stay in hospital, improve the rational use of drugs, and enhance the quality of life of the elderly patients.