Calcification of silicone rubber is a pathologic mineralization phenomenon which occurs on the surface after it is implanted in vivo,and there is no effective prevention method.The important process of calcification including these steps:phosphate ions combined with calcium ions to promote nucleating aggregation,slow increasing,fusion,and gradually form a larger accumulation of hydroxyapatite calcium.The research had been developed to the level of cells and genes,such as matrix Gla protein clusters is a calcification inhibitor of the tissues around silastic prosthesis.It is necessary to obtain a theoretical breakthrough in the aspect of organic template modulation of inorganic crystals.Silicone elastomer having its own local anti-calcification property had been paid more attention.Fully revealing the mechanism of calcification and calcification-resistant of silicone rubber will probably provide the basis for building a new anti-calcification material.

Objective To investigate the methods and effects of anterolateral thigh flap reconstruction of the complicated hip decubitus.Methods The study contained 24 cases of grade Ⅳ hip decubitus reconstructed with anterograde pedicled anterolateral thigh flaps through May 2010 to July 2014.There were 13 males and 11 females,aged 26-64 years (mean 54 years).Defects ranged in size from 12 cm×6 cm to 24 cm× 12 cm.Dimensions of flaps harvested were 14 cm ×8 cm to 30 cm× 14 cm.Eighteen cases of the donor sites were directly sutured and six covered with full thickness skin.Results Twenty-two flaps survived completely,and wound was healed by the first intension.Two flaps developed partial distal necrosis,and wound was healed after dressing treatment.Period of follow-up was 6 months to 2 years.Shape,texture and color of the flaps were well matched with the recipient area.Conclusion The anterolateral thigh flap transplantation has advantages of similarity to the recipient area,large enough flap area and sound expected effective and is a good method for repair of hip decubitus.

Amputation, Traumatic ; Ear ; surgery ; Humans ; Replantation

With the rapid development of tumor subjects and the advance of medical technology,tumor mortality is declining in spite of the increase in tumor incidence.The male survivors pay more and more attention to their prognosis to improve the quality of their life.In the meantime,whether they could produce their own offspring become the main concern of tumor patients with good prognosis.However,until now,male tumor patients,their relatives,different social sectors and even some of our health workers,havent noticed the importance of fertility preservation and long-term fertility desires of male patients with tumor which will lead to declined or even irreversible sterility induced by the lack of fertility preservation before anti-tumor therapy.It's an important way to do fertility counseling,learn the risk of their treatment plans and choose the appropriate technique of fertility preservation which will improve prognosis quality of life of male tumor patients.This article will review the effects of tumor and the treatment on male fertility,their subjective needs and concerns,main methods for fertility preservation and the domestic and foreign research present situation.

Objective To investigate the phenotype and function of CD8+T cells cultured with SK-OV-3. Methods Transwell coculture experiments were conducted in 24-well plates with inner wells to separate CD8+ T cells and SK-OV-3. After 5 days of culture, CD8+ T cells were washed, and 1 × 106 cells were collected for Foxp3, CD25, CD28, CTLA-4 and GITR mRNA analysis and 2 × 106 cells were collected to detect expression of Foxp3, CD25, CD28, CTLA-4 and GITR in CD8+ T cells by flow cytometry. CD8+T cells that cultured alone or with SK-OV-3 were added at ratios of 1∶0 , 1∶1 , 1∶5 , 1∶10 , and 0∶1 to na?ve CD4+ T cells in 96-well plates. All wells were cultured with the presence of irradiated PBMCs and anti-CD3 antibody. After 72 h, [3H]-thymidine was added for 16 h prior to the determination of proliferation by scintillation counting. Results Compared with CD8+ T cells cultured without SK-OV-3 , the expression of Foxp3 and CTLA-4 was increased and CD28 expression was decreased in CD8+ T cells cultured with SK-OV-3 (both P < 0.001). We found that CD8+T cells cultured with SK-OV-3 significantly suppressed the na?ve CD4+ T cell proliferation induced by the anti-CD3 stimulation in a dose-dependent manner. In contrast, CD8+ T cells cultured without SK-OV-3 did not suppress na?ve CD4+ T cell proliferation. Conclusion Ovarian cancer cell can induce the suppressive CD8+Treg, which is an important link of the immunosuppressive microenvironment in ovarian cancer.

Objective:To investigate the cognition and attitude of nephrology nurse to palliative care for patients with end-stage renal disease, and to provide reference for the promotion and application of palliative care in patients with end-stage renal disease.Methods:Using the phenomenological research method, the purpose sampling method and the principle of data saturation, the semi-structured interviews were conducted among 12 nurses from the Department of Nephrology in Xiang Yang NO.1 People ′s Hospital, Hubei University of Medicine in November 2021. The data were analyzed, summarized and extracted by Colaizzi 7-step analysis method. Results:The cognition and attitude of nephrology nurses to palliative care of patients with end-stage renal disease were summarized into three themes. They were: different cognition of palliative care; attitudes towards palliative care for end-stage renal disease patients (positive feelings, negative feelings); difficulties in the implementation of palliative care (difficult decision-making, unknown timing and effect, lack of social policy support, traditional thought constraints).Conclusions:Interviewees lacked cognition to palliative care and have different attitudes. In order to promote the application of palliative care in patients with end-stage renal disease, relevant publicity and education should be strengthened, the palliative care system of end-stage renal disease should be improved, and social support for palliative care should be enhanced.

Objective To explore the pathogenesis of ovarian cancer by investigating the function of Toll-like receptor 1 (TLR1),TLR2 and TLR6 in peripheral blood mononuclear cell(PBMC) from patients with ovarian cancer.Methods PBMC,SK OV 3 co culture system and anti-TLR1,anti-TLR2,anti-TLR6 mAb blocking experiment were used to explore the relationship between TLR1,TLR2 or TLR6 signaling and inflammation in ovarian cancer.Quantitative real time PCR was used to measure interleukin(IL)-1β,IL-6,IL-8,and tumor necrosises factor(TNF)-α in the PBMC.MyD88,TRAF6,TANK,NF-κB and P-NFκB were observed by Western blotting.Results In the PBMC and SK-OV-3 coculture system,we found the activation of TLR signaling pathways,including significantly increased MyD88,TRAF6,TANK and P-NF-κB levels following cocultured with SK-OV-3 in PBMC from ovarian cancer patients.PBMC derived from ovarian cancer patients led to a increase in IL-1β,IL-6 and IL-8 mRNA levels after 24 hours of co-incubation with SK-OV-3 (Fold=1.74,Fold=1.92,Fold=1.65,P＜0.05),though there was no difference of TNF-a mRNA expression.In contrast to the ovarian cancer patients,coculture of PBMC derived from benign diseases controls and healthy normal controls decreased IL-1β at the mRNA level (Fold=0.71,P＜0.05;Fold=0.72,P＜0.05),furthermore the expression of MyD88,TRAF6,TANK,P-NF-κB,and NF-κB showed no changes.PBMC which treated with anti-TLR1,anti-TLR2 or-TLR6 mAb could inhibite inflammatory IL-1β (Fold=0.16,Fold=0.31,Fold=0.29,P＜0.05) and IL-6 (Fold=0.14,Fold=0.20,Fold=0.28,P＜0.05).Conclusion TLR1/TLR2/TLR6 in PBMC of ovarian cancer patients participate in the recognition of the factors.

Objective:To investigate the surgical method and clinical effect of free medial plantar flap (MPF) combined with anterolateral thigh flap (ALTF) in repair of large soft tissue defect in the weight bearing area of sole.Methods:From April, 2017 to August, 2019, 8 patients with large soft tissue defects in plantar weight bearing area were repaired by free MPF combined with ALTF. Four patients had the defects located in the hindfoot and the surrounding area, 3 in the forefoot and 1 in the whole foot. A tandem flap made of free MPF combined with ALTF was used to repair the heel in 5 patients and repair the plantar forefoot in 3 patients. The size of defects ranged from 15.0 cm×10.0 cm to 26.0 cm×22.0 cm. The size of the MPF ranged from 6.0 cm×5.0 cm to 8.0 cm×6.5 cm. The donor sites repaired with full thickness skin graft. The size of ALTF ranged from 15.0 cm×7.0 cm to 27.0 cm×11.0 cm. Two donor sites were sutured directly, and the other 6 were repaired by full-thickness abdominal skin graft. The patients entered follow-up at outpatient clinic and via WeChat for 9 to 18 months.Results:All the 8 tandem flaps and the donor grafts survived. Only 1 ALTF had a distal necrosis and healed after change of dressing. All the flaps had good elasticity and good texture. All the recipient area of MPF achieved sensation recovery of pain and touch. But the ALTF only partially recovered tactile sensation. The weight-bearing and walking function were good. At the last follow-up, all patients were evaluated by Maryland foot score, of which 4 patients were excellent, 3 were good, and 1 was fair.Conclusion:The free MPF combined with ALTF is one of the ideal methods for the repair of plantar soft tissue defect in the weight bearing area of sole. It can better restore the foot weight-bearing and walking function with good clinical effect.

Objective:To explore the application effect of narrative nursing in long-term primary family caregivers of maintenance hemodialysis patients.Methods:Using the convenient sampling method, a total of 120 main family caregivers of maintenance hemodialysis patients who received hemodialysis treatment in Hemodialysis Room of a tertiary general hospital were selected as the research objects from May to August 2020. The patients were randomly divided into the observation group ( n=60) and the control group ( n=60) by random number table method. The observation group was given narrative nursing intervention, while the control group was given routine psychological nursing. Zarit Caregiver Burden Interview (ZBI) , Self-rating Anxiety Scale (SAS) and Beck Depression Scale (BDI-Ⅱ) were used to investigate the situation of caregivers in the two groups. Results:Before the intervention, there was no statistically significant difference in the total scores of ZBI, SAS and BDI-Ⅱ between the two groups ( P>0.05) . After the intervention, the total scores of ZBI, SAS and BDI-Ⅱ in the observation group were respectively 23.50 (15.00, 33.00) , 33.00 (27.00, 41.00) and 11.00 (8.00, 14.75) , which were lower than the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Narrative nursing can effectively reduce the long-term care burden of the main family caregivers of maintenance hemodialysis patients and reduce levels of anxiety and depression, which is worthy of clinical application.

Objective:To translate and culturally adjust Decisional Fatigue Scale (DFS) , and test its reliability and validity.Methods:The Chinese version of DFS was formed through the method of double translation, back translation and expert consultation. Using the convenient sampling method, 247 medical staffs from 16 departments in 76 wards of Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine were selected as the research objects. Content validity, criterion validity and structure validity were used for validity evaluation, and internal consistency reliability, split half reliability and retest reliability were used for reliability evaluation. A total of 247 questionnaires were sent out in this study and 247 were effectively received, with effective recovery of 100.00%.Results:The total Cronbach's α coefficient of Chinese DFS was 0.933, the half-reliability coefficient was 0.849 and the retest reliability coefficient was 0.838 ( P<0.01) . Both the item content validity index and scale content validity index were 1.00, and the correlation coefficient with the total score of SRF-S was 0.729 ( P<0.01) . One common factor was extracted by exploratory factor analysis and 65.64% of the variation was explained cumulatively, which was consistent with the dimensions of the original scale. Confirmatory factor analysis showed that all fitting indexes were up to standard and the fitting degree was good. Conclusions:The reliability and validity of the Chinese version of DFS in medical staffs is good, which can be used to evaluate the degree of decision-making fatigue of Chinese medical staffs.