Objective To investigate the effect of ReCell technique on diabetic foot and explore main nursing measures. Methods Forty patients with diabetic foot were divided into control group(n=20)and experiment group(n=20)according to admission time. With wound bed prepared, the control group received only free skin flap grafting and the observation group was managed with ReCell technique plus free skin flap grafting.The skin flap survival and treatment time in two groups were observed and compared. Result The skin flap survival in the experiment group was better than the control group and the treatment time was shorter. Conclusion ReCell technique is effective in raising the survival rate of skin flap in diabetic foot and shortening treatment time.The improvement of nursing measures is critical for the success of ReCell technique.

Objective To evaluate the efficacy of intratympanic steroid therapy compared with systemic ster‐oid therapy on the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) patients with damaged glu‐cose tolerance .Methods Fifty first -diagnosed unilateral ISSNHL patients with damaged glucose tolerance were randomized devided equally to the intervention group (intratympanic steroid therapy) or the control group (systemic steroid therapy) ,all patients received conventional drug therapy simultaneously .Pure-tone hearing threshold tests were performed in all patients every 3 days after the first time ,and repeated measures anova was used to assess effects of hearing recovery accompanied with time .Results The mean hearing threshold in the control group de‐creased from 85 .4 ± 5 .6 dB to 48 .2 ± 4 .9 dB ,while in the intervention group it decreased from 84 .8 ± 5 .6 dB to 31 .7 ± 4 .6 dB .Total effective rate in the intervention group (84 .00% ,21/95) was higher than that in the control group (68 .00% ,17/25)(P<0 .05) .Conclusion The intratympanic steroid therapy is more effective than systemic steroid therapy in the treatment of ISSNHL patients with damaged glucose tolerance .

Objective Explore the safe nursing method of the plasma infusion for patients with extraordinarily severe burn in shock stage,ensure patients inputing plasma safely and timely,tide over shockstage smoothly.Method 68 patients with severe burn shock stage were randomly divided into experimental group and control group,both with 34 cases?The experimental group input plasma take regular blood transfusion methods and special nursing care,control group take usual care only.Result to take special nursing care for patients with severe burn in shockstage inputing plasma can reduce the incidence of adverse transfusion reactions,tide over shockstage smoothly,improve cure rates and reduce mortality?

BACKGROUND:The number of hematopoietic stem cel s in the peripheral blood is very low at normal physiological state. So it is critical to mobilize hematopoietic stem cel s from donor’s bone marrow into the peripheral blood.
OBJECTIVE:To study the combination effect of AMD3100 and dexamethasone on the mobilization of hematopoietic stem cel s in mice, thereby laying the foundation for clinical application.
METHODS:C57BL/6 mice were injected with AMD3100 and dexamethasone alone or in combination. Then, hematopoietic stem cel s in the peripheral blood and bone marrow were col ected. CD34+cel concentration in the peripheral blood and bone marrow was determined by flow cytometer and the content of leucocytes in the peripheral blood was counted by a normal method. The CFU-Mix colony formation ability of hematopoietic stem cel s was identified by cel colony forming assay.
RESULTS AND CONCLUSION:The concentration of CD34+cel s in the peripheral blood and bone marrow, the content of leukocytes in the peripheral blood and the CFU-Mix colony formation ability of hematopoietic stem cel s were al improved by both AMD3100 and dexamethasone and especial y their combined use. This indicates that both AMD3100 and dexamethasone could mobilize hematopoietic stem cel s to migrate from the bone marrow to the peripheral blood, and when used in combination, the mobilization effect is better than that of single drug.

Objective To explore the effect of invigorating splcen and kidney methods on the pregnancy outcome of the intrauterine insemination (IUI) in infertile men with asthenospermia.Methods a total of 78 male infertility patients with spleen and kidney deficiency type were collected,all cases were randomly allocated into three groups,group A using methods of invigorating spleen and kidney,group B using Antioxidant therapy,and group C as the blank group.There are 26 cases in each group.One course of treatment lasts for 12 weeks.Before and after treatment,the changes of sperm quality index were analyzed by computer assisted sperm analysis (CASA) and sperm morphology.The pregnaucy outcome after IUI was followed up.Results After the treatment,sperm motility and sperm forward movement (PR) difference before and after treatment in group A with was statistically significant (P ＜ 0.05).The differences between patients with semen volume,sperm concentration,sperm morphology and sperm motility parameters before and after treatment in three groups were not statistically significant (P ＞ 0.05).Clinical pregnancy rate and cumulative pregnancy rate and the live birth rate in group A were higher than that of group B and group C,but the difference was not statistically significant (P ＞ 0.05).Conclusion Invigorating spleen and kidney method can improve the sperm motility and forward movement speed of the type of patients for the treatment of male infertility patients with asthenospermia,and it is helpful to improve the pregnancy outcome of the IUI.

Objective To evaluate the application value of three-dimensional (3D) reconstruction technique in laparoscopic hepatectomy.Methods The retrospective cohort study was conducted.The clinicopathological data of 189 patients with liver cancer who were admitted to the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from January 2014 to December 2018 were collected.There were 142 males and 47 females,aged from 27 to 86 years,with an average age of 60 years.According to the difficulty score of surgery,50 of 189 patients underwent laparoscopic complex hepatectomy,including 23 with preoperative 3D reconstruction in the complex reconstruction group and 27 with no preoperative 3D reconstruction in the complex control group;other 139 patients underwent laparoscopic non-complex hepatectomy,including 25 with preoperative 3D reconstruction in the non-complex reconstruction group and 114 with no preoperative 3D reconstruction in the non-complex control group.Observation indicators:(1) vascular assessment of patients who received 3D reconstruction;(2) surgical and postoperative situations;(3) typical case analysis.Measurement data with normal distribution were presented as Mean±SD,and comparison between groups was done using the t test.Measurement data with skewed distribution were presented as M (range),and comparison between groups was done using the Mann-Whitney U test.Count data were represented as absolute number or percentage,and comparison between groups was analyzed using the chi-square test or Fisher exact probability.Results (1) Vascular assessment of patients who received 3D reconstruction:48 of 189 patients were performed preoperative 3D reconstruction.Vascular assessment of 48 patients showed 41 of hepatic arterial Michels Ⅰ type,4 of Michels Ⅱ type,1,1,and 1 of Michels Ⅲ,Ⅳ,Ⅷ type,respectively.There were 35 belonging to hepatic venous Ⅰ type and 12 belonging to hepatic venous Ⅱ type and 1 with unclear distribution of hepatic vein.There were 5 and 3 belonging to portal venous Ⅰ type and Ⅱ type,38 with normal distribution of portal vein,and 2 with unclear distribution of portal vein,respectively.(2) Surgical and postoperative situations:50 of 189 patients underwent laparoscopic complex hepatectomy,and 139 underwent laparoscopic non-complex hepatectomy.The operation time and volume of intraoperative blood loss were (234±64)minutes and 200 mL (range,100-408 mL) in the complex reconstruction group,and (289±80)minutes and 500 mL (range,400-800 mL) in the complex control group,respectively,showing statistically significant differences between the two groups (t=-2.474,Z=-2.981,P＜ 0.05).Cases with postoperative complications and duration of postoperative hospital stay of complex reconstruction group were 8 and 6 days (range,4-12 days),respectively,versus 13 and 8 days (range,6-13 days) of complex control group.There was no significant difference (x2=0.911,Z =-1.634,P＞0.05).The operation time,volume of intraoperative blood loss,cases of postoperative complications and duration of postoperative hospital stay were 160.0 minutes (range,117.5-221.0 minutes),100 mL (range,75-200 mL),8,5 days (range,4-8 days) in the non-complex reconstruction group,157.5 min (range,100.0-222.5 minutes),100 mL (range,50-200 mL),43,6 days (range,4-7 days) in the non-complex control group,showing no significant difference between the two groups (Z=-0.525,-0.797,x2 =0.289,Z=-0.011,P＞0.05).(3) Typical case analysis:one 48-year-old male patient with primary liver cancer developed a personalized hepatectomy plan through simulation function of vascular drainage area in 3D reconstruction.One 49-year-old female patient achieved indirect intraoperative navigation through emulation function of 3D reconstruction.Conclusions The 3D reconstruction of liver in preoperative assessment is beneficial to choice of surgical options and personalized surgical plan in the precise hepatectomy.Especially in the laparoscopic complex hepatectomy,preoperative 3D reconstruction can shorten operation time,and reduce volume of intraoperative blood loss.

Objective To study the optimal timing of preoperative injection of indocyanine green in laparoscopic liver tumor resection under indocyanine green fluorescent navigation to obtain the most satisfactory fluorescence imaging effects.Methods 60 patients with liver tumors who underwent laparoscopic hepatectomy from April 2017 to October 2018 were retrospectively studied on the intraoperative fluorescence imaging effects.A simple grading of the fluorescence imaging effects was developed.The ICG R15 and preoperative injection times of ICG were correlated with the intraoperative fluorescence imaging effects.Results Of 60 patients with liver tumors,59 patients underwent laparoscopic liver resection and one patient was converted to open surgery.The overall satisfaction rate of intraoperative fluorescence imaging was 73.4％ (44/60).In the patients with an ICG R15 rate ≤ 7％,it was easier to obtain good fluorescence imagings when the preoperative administration time was longer than 48 hours.Even when the preoperative administration time was longer than 5 days,satisfactory fluorescence imaging effect could still be obtained in these patients.In the patients with an ICG R15 rate ＞ 7％,intraoperative fluorescence imagings were unsatisfactory when the administration time was less than 6 days.Relative better imagings were obtained in these patients when the preoperative administration time was more than 6 days.Conclusions When the pre-operative ICG injection dose was not changed,the preoperative administration time should be adjusted according to the value of the ICG R15 to obtain better intraoperative fluorescence imaging effects of the liver tumors.The optimal timing needs to be further studied by a large case study.

In the face of the worldwide threat of severe acute respiratory syndrome (SARS) to human life, some of the most urgent challenges are to develop fast and accurate analytical methods for early diagnosis of this disease as well as to create a safe anti-viral vaccine for prevention. To these ends, we investigated the antigenicity of the spike protein (S protein), a major structural protein in the SARS-coronavirus (SARS-CoV). Based upon the theoretical analysis for hydrophobicity of the S protein, 18 peptides were synthesized. Using Enzyme-Linked Immunosorbent Assay (ELISA), these peptides were screened in the sera from SARS patients. According to these results, two fragments of the S gene were amplified by PCR and cloned into pET-32a. Both S fragments were expressed in the BL-21 strain and further purified with an affinity chromatography. These recombinant S fragments were confirmed to have positive cross-reactions with SARS sera, either by Western blot or by ELISA. Our results demonstrated that the potential epitope regions were located at Codons 469-882 in the S protein, and one epitope site was located at Codons 599-620. Identification of antigenic regions in the SARS-CoV S protein may be important for the functional studies of this virus or the development of clinical diagnosis.
Antigens, Viral ; immunology ; Chromatography, High Pressure Liquid ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Genetic Vectors ; Humans ; Mass Spectrometry ; Membrane Glycoproteins ; genetics ; immunology ; metabolism ; Molecular Weight ; Peptide Fragments ; chemistry ; Recombinant Proteins ; genetics ; immunology ; SARS Virus ; genetics ; immunology ; metabolism ; Spike Glycoprotein, Coronavirus ; Viral Envelope Proteins ; genetics ; immunology ; metabolism

Objective To investigate the characteristics of epidemic and genotype/subtype distribution of hepatitis C virus (HCV) among entry travelers at Tengchong port,to provide references for HCV prophylaxis and treatment.Methods A total of 54 serum samples were collected from anti-HCV positive travelers at Tengchong port from June 2009 to June 2016.HCV NS5B gene was amplified using reverse transcription polyonerase chain reation (RT-PCR) and subsequently sequenced.Based on the obtained sequences and retrieved reference sequences,phylogenetic analysis was conducted to determine HCV genotype/subtype.Results HCV infection rate among entry travelers at Tengchong ports was 0.45 ％ (54/12 059).Forty five samples were successfully genotyped.Phylogenetically,HCV genotype 3b was revealed to be the predominant subtype (28.89 ％,13/45) in this population,followed by genotype 6n (20.0％,9/45),genotype 1b (17.78％,8/45),genotype 3a (13.33％,6/45),genotype 2a (11.11％,5/45),genotype 1a (2.22％,1/45) and genotype 6a (2.22％,1/45).The major genotype in Myanmar travelers was genotype 6,while in Chinese population,genotype 1 predominated.Genotype 6 in the population showed close phylogenetic relationship with strains prevalent in China and Southeast Asia.Genotype 3 was closely clustered with strains prevalent in China.Conclusions The distribution of HCV genotypes among entry travelers at Tengchong port is impacted by HCV epidemic strains both in Yunnan province and neighboring regions.This population serves as a transmitting media which may influence the epidemiological characteristics of HCV in Tengchong and neighboring areas.

Objective : To investigate the clinical efficacy of painless oral anesthesia combined with piezosurgery compared with ordinary cassette syringe combined with high speed turbine handpiece in the Fenestration operation of orthodontic traction of impacted maxillary anterior teeth. Methods : A total of 128 cases of impacted maxillary anterior teeth were treated with Fenestration operation and orthodontic traction, and the patients were randomly divided into two groups. Group A (64 patients) received painless oral anesthesia combined with piezosurgery. Group B (64 patients) received ordinary cassette syringe combined with high speed turbine handpiece. The cooperation of fenestration and the swelling and pain after operation were compared between the 2 groups. Results : The proportion of 0 and Ⅰ in the anesthesia group was 45.3% and 31.3% respectively, and the conventional group 0 and I accounted for 32.8% and 20.3% respectively. The difference between the two groups was statistically significant (Z=-2.676, P < 0.05). The pateints' cooperative degree in group A was better than that in group B (P < 0.05). The ratio of pain and swelling in the anesthesia instrument combined with Piezosurgery group was 81.2%, the conventional group had a grade I ratio of 59.4%, and the anesthesia instrument combined with Piezosurgery group was lighter than the conventional group, The difference was statistically significant (Z=-2.777, P < 0.05); anesthesia combined with Piezosurgery group after surgery accounted for 81.2% of the swelling, the conventional group of pain accounted for 71.9%, There was significant difference between the two groups (Z=-2.097, P < 0.05). Symptoms and signs as swelling and pain degree in group A were relatively minor than those in group B (P < 0.05). Conclusion It is worthy clinical promotion to use Painless oral anesthesia combined with piezosurgery in the fenestration and orthodontic traction of impacted maxillary anterior teeth, for its better cooperation and minor post-surgery reaction.