Objective To investigate the application of synchronized immersion course(SIC)in teaching of clinical practice of surgery for eight-year program students.Methods A total of 94 eight-year program students in French class and 4+4 class who received SIC in the study of surgery in Ruijin Clinical School,Shanghai Jiao Tong University from September 2017 to June 2019 were selected as the pilot group.A total of 91 students in English class who were taught in the traditional way in the same period were selected as a horizontal control group.A total of 84 students in French class and 4+4 class who were studying from September 2015 to June 2017 were selected as the longitudinal control group.Teaching satisfaction evaluation,examination results and specialization choice were compared among students in each group to assess teaching effectiveness.Results The total score(3.8±0.3)and satisfaction rate(98.9%)of the questionnaire in the pilot group were better than those in the horizontal control group(3.6±0.4,90.1%)(P=0.001,P=0.008).For the case analysis station in objective structured clinical examination(OSCE),the mean score(86.2±6.9)and pass rate(97.9%)in the pilot group were better than those in the horizontal control group(79.7±11.4,89.0%)(P=0.001,P=0.014),as well as better than those in the longitudinal control group(79.5±13.5,88.1%)(P=0.001,P=0.009).For the history inquiry station,the mean score(86.3±10.7)and pass rate(96.8%)in the pilot group were better than those in the horizontal control group(81.4±11.6,86.8%)(P=0.003,P=0.013).The proportion of students choosing the surgical specialty was higher in the pilot group(55.3%)than in the horizontal control group(46.2%)and the longitudinal control group(44.0%)without statistically significant difference.Conclusions SIC can help eight-year program students strengthen their clinical thinking and practice skills.Meanwhile,SIC can increase students'satisfaction with teaching and their interest in surgery.

Objective:To investigate the clinical effects of free transplantation of inguinal flap in repairing electrical burn wounds of mice in the limbs.Methods:A retrospective observational study was conducted. From January 2012 to May 2023, 24 male patients with electrical burns in the limbs meeting the inclusion criteria, aged 20 to 69 years, were admitted to the Department of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital. Totally 27 limbs were involved, including 18 upper limbs and 9 lower limbs. After debridement, the wound area in the limbs proposed to be repaired with the inguinal flap was 5.0 cm×1.5 cm-20.0 cm×9.0 cm. A total of 26 operations were performed in 24 patients, and 27 free inguinal flaps with area being 5.0 cm×3.5 cm-22.0 cm×12.0 cm were resected, including 6 for lobed transplantation, 2 for chimeric transplantation with iliac bone graft, 3 for conjoined transplantation with pedicled latissimus dorsi myocutaneous flap, and 1 for conjoined transplantation with free paraumbilical perforator flap. Indocyanine green angiography was used to evaluate the blood supply of the inguinal flap during operation, to guide arterial supercharge during transplantation. Among the transplanted inguinal flaps, 5 were pedicled with the common trunk of the superficial circumflex iliac artery and the superficial abdominal wall artery, 13 were pedicled with the superficial circumflex iliac artery alone, 6 were pedicled with the superficial abdominal wall artery alone, and the remaining 3 were simultaneously anastomosed with the superficial circumflex iliac artery and the superficial abdominal wall artery for arterial supercharge. In another patient, the deep branch of the superficial circumflex iliac artery was used as a bridging vessel to recanalize the proper artery of the index finger in the distal segment. The wound in the donor area were sutured directly. The blood supply status of the inguinal flap immediately after resection but before cutting off blood vessels and after transplantation and vascular anastomosis was recorded. The survival of the tissue flap, the fixation of the iliac bone graft, and the healing of secondary defect in the donor area were observed after surgery. The appearance of the inguinal flap and the functional recovery of the recipient area were followed up. At the last follow-up, the function of the affected upper limb was scored using the Arm, Shoulder, and Hand Disability (DASH) scoring scale, and the satisfaction of patients with the efficacy of each surgical treatment was investigated by referring to the 5-level Likert scale.Results:Totally 27 inguinal flaps showed good arterial blood perfusion and venous return immediately after resection but before cutting off blood vessels and after transplantation and vascular anastomosis. Except for one inguinal flap that developed necrosis 12 days after operation and was repaired by split-thickness skin graft from the head, the remaining 26 inguinal flaps and conjointly transplanted tissue flaps survived completely without vascular crisis. The iliac bone graft was fixed securely after operation. All secondary defects in donor area healed well after operation. After 6 to 36 months of follow-up, the inguinal flap was soft in texture, without obvious swelling, the function of the recipient area was significantly improved as compared with that before surgery, and the protective feeling of the inguinal flap was restored. At the last follow-up, the functional scores of DASH scoring scale of the 18 affected upper limbs ranged from 0 to 100 (with a mean of 27). The patients were very satisfied with the efficacy of 17 surgical treatments and relatively satisfied with the efficacy of 9 surgical treatments.Conclusions:The donor area of the inguinal flap is concealed, and the damage resulted from flap resection in this area is small. This flap has a rich blood supply. In the electrical burn wounds of mice in the limbs repaired with lobed transplantation, chimeric transplantation, and conjoined transplantation with other flaps, the appearance and function of the recipient area are well restored, and the patients' satisfaction with the efficacy of surgical treatment is high, which is worthy of clinical promotion.

Objective:To observe the changes in the related indicators of bone formation and bone resorption in severely burned rats.Methods:The experimental research method was adopted. Thirty female Sprague-Dawley rats aged 6 to 8 weeks were divided into sham injury group, 12% total body surface area (TBSA) full-thickness burn group, and 24%TBSA full-thickness burn group according to the random number table, with 10 rats in each group. The rats were treated on the back correspondingly, after which, the burned rats were rehydrated by intraperitoneal injection according to the Parkland formula, and the wound was coated with 20 g/L iodophor until wound healing. On post injury day (PID) 28, the tibia tissue of rats in each group was collected. The new bone tissue and the number of osteoclasts were observed after staining with Masson and tartrate-resistant acid phosphatase, respectively. The abdominal aortic blood of rats in each group was harvested for serum preparation. The bone metabolism indexes of serum calcium ion and phosphorus ion concentration were determined by the methyl thymol blue colorimetric method and phosphomolybdic acid method, respectively. The serum levels of bone formation marker of aminoterminal propeptide of type 1 procollagen (P1NP) and bone resorption marker of beta-carboxy-terminated peptide of type Ⅰ collagen (β-CTX) were determined by enzyme-linked immunosorbent assay. The first lumbar spine tissue of rats in each group was collected, and the mRNA expression levels of osteoprotegerin, receptor activator of nuclear factor-κB ligand (RANKL), tumor necrosis factor receptor-associated factor 6 (TRAF-6), nuclear factor of activated T cell 1 (NFATC1), c-Fos, and c-Src were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were statistically analyzed with one-way analysis of variance, Bonferroni method, Welch test, Games-Howell test, Kruskal-Wallis test, Mann-Whitney U test, and Bonferroni correction. Results:On PID 28, compared with that in sham injury group, the formation of new bone tissue in the tibia tissue of rats in the two burn groups was decreased, and the larger the burn area, the more obvious the decrease. The numbers of osteoclasts in the tibia tissue of rats in the two burn groups were similar, both significantly more than the number in sham injury group. On PID 28, the serum calcium ion concentration and serum level of β-CTX of rats in the three groups were similar ( P>0.05). The serum phosphorus ion concentration of rats in 24%TBSA full-thickness burn group was significantly higher than that in 12%TBSA full-thickness burn group ( P<0.05), and the serum phosphorus ion concentrations in the two burn groups were significantly higher than the concentration in sham injury group ( P<0.01). The serum level of P1NP of rats in 24%TBSA full-thickness burn group was significantly lower than that in sham injury group ( P<0.01). On PID 28, the mRNA expression levels of osteoprotegerin in the first lumbar spine tissue of rats in sham injury group, 12%TBSA full-thickness burn group, and 24%TBSA full-thickness burn group were 1.01±0.20, 1.71±0.83, and 2.24±0.51, respectively, and that in 24%TBSA full-thickness burn group was significantly higher than that in sham injury group ( P<0.01). The mRNA expression level of RANKL in the first lumbar spine tissue of rats in 24%TBSA full-thickness burn group was 1.31±0.17, which was significantly higher than 1.00±0.14 in sham injury group and 0.97±0.10 in 12%TBSA full-thickness burn group ( P<0.01). The mRNA expression levels of TRAF-6, NFATC1 ( Z=3.141, 3.782), and c-Src in the first lumbar tissue of rats in 12%TBSA full-thickness burn group and 24%TBSA full-thickness burn group and the mRNA expression level of c-Fos in the first lumbar tissue of rats in 12%TBSA full-thickness burn group were significantly higher than those in sham injury group ( P<0.05 or P<0.01). The mRNA expression levels of c-Fos and c-Src in the first lumbar spine tissue of rats in 12%TBSA full-thickness burn group were significantly higher than those in 24%TBSA full-thickness burn group ( P<0.01). Conclusions:Severe burns can cause a decrease in the generation of new bone tissue, an increase in the number of osteoclasts and the serum phosphorus ion concentration, and a decrease in the serum level of P1NP in rats. The level of osteoprotegerin, RANKL, TRAF-6, NFATC1, c-Fos, and c-Src in bone tissue showed an increasing trend while the level of NFATC1, c-Fos, and c-Src showed a decreasing trend with the increase of burn area.

Objective:To investigate the early changes in serum osteoprotegerin/receptor activator of nuclear factor-κB ligand (RANKL) and related indexes of calcium and phosphorus in severe burn patients.Methods:Thirty severe burn patients who met the inclusion criteria and were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital within 8 hours post injury from June 2017 to December 2018 were recruited into severe burn group (24 males and 6 females, aged (38±13) years). Ten healthy volunteers with normal physical examination results in the Physical Examination Center of the same hospital in the same period of time were recruited into healthy control group (7 males and 3 females, aged (37±8) years). A prospective controlled study was conducted. The fasting venous blood of 5 mL was taken from each patient in severe burn group on post injury day (PID) 1, 7, 14, 21, and 28, respectively, and the fasting venous blood of 5 mL was taken from each volunteer in healthy control group. The serum osteoprotegerin, RANKL, 25 hydroxyvitamin D, and parathyroid hormone (PTH) levels were determined by enzyme-linked immunosorbent assay, and the RANKL/osteoprotegerin ratio was calculated. Serum albumin, serum calcium, and serum phosphorus levels were determined by bromocresol green method, methylthymol blue method, and phosphomolybdic acid method, respectively. Data were statistically analyzed with Fisher′s exact probability test, analysis of variance for repeated measurement, Mann-Whitney U test, independent sample t test, and Bonferroni correction. Results:(1) The serum osteoprotegerin levels of patients in severe burn group on PID 1, 7, 14, 21, and 28 were 155.11 (102.91, 187.02), 170.07 (84.60, 196.86), 174.95 (59.09, 208.35), 190.01 (47.08, 214.52), and 188.85 (58.73, 223.13) pg/mL, respectively, which were significantly higher than 33.34 (28.59, 45.68) pg/mL of volunteers in healthy control group, Z=-3.436, -4.311, -3.248, -2.811, -4.217, P<0.01. The serum levels of RANKL of patients in severe burn group on PID 1, 7, 14, 21, and 28 were (1 869±791), (1 746±857), (1 781±713), (2 015±825), and (2 272±583) pg/mL, respectively, significantly higher than (49±16) pg/mL of volunteers in healthy control group, t=12.600, 10.844, 13.294, 13.041, 20.880, P<0.01. The ratios of RANKL/osteoprotegerin of patients in severe burn group on PID 1, 7, 14, 21, and 28 were 12.23 (8.10, 24.73), 11.40 (8.25, 16.96), 11.15 (6.91, 38.32), 12.98 (9.22, 49.68), and 13.91 (10.29, 40.68), respectively, which were significantly higher than 1.17 (0.91, 1.74) of volunteers in healthy control group, Z=-4.560, -4.529, -4.529, -4.560, -4.623, P<0.01. (2) The serum level of 25 hydroxyvitamin D of patients in severe burn group on PID 1 was significantly lower than that of volunteers in healthy control group ( Z=-2.749, P<0.01). Compared with those of volunteers in healthy control group, the serum levels of albumin of patients in severe burn group on PID 1, 7, 14, 21, and 28 were significantly lower ( t=-4.374, -7.689, -8.257, -7.651, -6.259, P<0.01), the serum levels of PTH were significantly elevated ( Z=-4.685, -4.685, -4.685, -4.654, -4.685, P<0.01), and the serum levels of phosphorus were not changed significantly. The serum levels of calcium of patients in severe burn group on PID 1, 7, 14, and 21 were significantly lower than the level of volunteers in healthy control group ( Z=-2.375, -3.455, -2.442, -2.016, P<0.05 or P<0.01). Conclusions:The serum osteoprotegerin, RANKL, RANKL/osteoprotegerin ratio, and PTH are increased, and the serum 25 hydroxyvitamin D, albumin, and calcium are decreased in the early stage of severe burn patients, which may be the mechanism leading to bone loss in patients.

Objective: To analyze application and funding projects of National Natural Science Foundation of China (NSFC) in the discipline of burns and plastic surgery over the years, so as to provide reference for subsequent fund application and the search for new research directions in the discipline. Methods: Annual statistical reports on funding projects and Internet-based Science Information System of NSFC were used to search the application and funding situation of the science foundation projects related to the discipline of burns and plastic surgery during 1986-2018. The relevant situation was statistically analyzed during 2009-2018, including the amount of applications and grant, funding rate, and appropriation. The amount of the application and grant, funding rate, appropriation, and funding strength of multiple series (Exploration, Talent, Tools, Integration) during 2009-2018 were statistically analyzed. Main granted projects in each year during 2009-2018 were statistically analyzed. Funding situation of research direction in the discipline of burns and plastic surgery was analyzed. Results: (1) During the past 33 years, the amount of application and funding in the discipline of burns and plastic surgery were on increase trend generally. (2) During 2009-2018, the total funding rate of the science foundation was 18.63% (611/3 279), with a total appropriation of 26 167.5 ten thousand yuan. (3) During 2009-2018, the more funding projects in the discipline of burns and plastic surgery were General Program of Exploration series and Young Scientists Fund, and Fund for Less Developed Regions of Talent series in turn, their funding rates were respectively 19.11% (330/1 727), 17.72%(216/1 219), and 19.26%(47/244), with appropriations of 18 115.0, 4 450.0, and 1 780.0 ten thousand yuan and funding strength of 54.89, 20.60, and 37.87 ten thousand yuan per project respectively. In addition, the funding rate of the Key Program of Exploration series was 6.82% (3/44) with appropriation of 828.0 ten thousand yuan, and funding strength for each was 276.00 ten thousand yuan. The International (Regional) Cooperation and Exchange Programs received 15 applications, and 4 projects were funded with appropriation of 524.5 ten thousand yuan and the funding strength of 131.13 ten thousand yuan for each. National Science Fund for Distinguished Young Scholars of Talent series received 12 applications, and 1 project was funded with appropriation of 200.0 ten thousand yuan. Tools and Integration series projects received only a few or no application, and none of the application was funded. (4) The funding amount of General Programs was the most, peaking at 50 in 2012, and was decreased slightly in the past 6 years. The funding amount of Young Scientists Fund was relatively less, but it was on increase trend year by year. The funding amount of Fund for Less Developed Regions was the least relatively, with a steady increase trend in general. (5) The amount of funding projects according to the research direction in the discipline of burns and plastic surgery in the order from more to less were H1507 wound healing and scar (219, 35.84%), H1505 burns (168, 27.50%), H1508 body tissue and organs deformity, damage and repair, and regeneration (143, 23.40%), H1509 body surface tissue organ transplantation and reconstruction (53, 8.67%), H1510 cranial and maxillofacial deformities and correction (27, 4.42%), H1506 frostbite (1, 0.16%). Conclusions In recent years, the amount of science foundation projects in the discipline of burns and plastic surgery was on the rise, mainly including General Programs, Young Scientists Fund, and Fund for Less Developed Regions. In the process of science foundation application in the discipline of burns and plastic surgery, it is necessary to provide more ability training and policy support for young outstanding scientific and technological talents. At the same time, we should attach importance to international and regional academic exchanges, and provide a favorable platform for cooperative projects. Besides, research on new hotspots such as chronic wounds and prevention and treatment of scar or not in popular research such as frostbite should be strengthened.

Objective To investigate the expression of Ki-67and NF-κB in cervical lesion and their correlation with HPV infec tion.Methods 70 cases with surgically resected or cervical biopsy (70 cases cervical specimens) were selected as the research object from January 2015 to January 2017 in our hospital.The expression of Ki-67,NF-κB and PCNA were detected by immune cell chemical dyeing method,and making the correlation analysis by Spearman.Results The expression rate of Ki-67,NF-κB and PCNA in CIN and cervical invasive squamous carcinoma tissues were significantly higher than that of chronic cervicitis tissues.Spearman rank correlation analysis showed,there was a positively correlation of Ki-67 and PCNA(r=0.582,P＜0.05),there was a positively correlation of NF-κB and PCNA(r=0.603,P＜0.05),there was a positively correlation of Ki-67 and HPV infection (r=0.601,P＜ 0.05),there was a positively correlation of NF-κB and HPV infection (r=0.596,P＜0.05),here was a positively correlation of PCNA expression and HPV infection(r=0.647,P＜0.05).Conclusion There is a difference of positive expression rate of Ki-67,NFκB in different cervical lesions organizations,and Ki-67,NF-κB are associated with HPV infection,they might be involved in cervical lesions in the process,could be used as indexes for identification of cervical disease,diagnosis and evaluation.

Objective To investigate the role of a small RNA interference against VEGF in radiation sensitivity in melanoma .Methods A375 human melanoma cell lines were transplanted into nude mice ,which with malignant melanoma were randomly divided into control group , VEGF negative plasmid group and VEGF positive plasmid group, followed by 4Gy irradiation twice a week for 2 weeks.The volume of tumor was calculated twice a week, the area of tumor necrosis was assayed by HE,the expression of VEGF in tumor was determined by Western-blot and Immunohistochemical. ResuIts The expression of VEGF in VEGF positive plasmid group decreased significantly (P<0.05), VEGF positive group had more tissue necrosis, tumor growth was significantly inhibited (P<0.05).ConcIusion siRNA-VEGF in tumor injection liposome encapsulated in malignant melanoma has a role in the radiation sensitization, which provides an experimental basis for the clinical development of targeted therapy combined with radiotherapy for the treatment of VEGF gene.

Objective To investigate the relationship of single nucleotide polymorphism (SNP) on FTO gene rs9939609 with metabolism index and obesity in children. Methods One hundred and fifty-three children (age 7-11 year) were recruited in this study, 102 of them were obese and 51 of them were overweight. One hundred and sixty children with normal body weight were recruited as control. Height, weight and biochemical indicator of liver function were measured. PCR and direct sequence were applied to detect the polymorphism of rs9939609, and the frequency of the allele was calculated. Results TT or TA/AA genotype frequency on FTOgene rs9939609 was significantly different among overweight group, obesity group and normal con-trol group (χ2=23.01, P<0.001);TA/AA genotype frequency in overweight and obesity group was significant higher than that in the control group(P<0.014). The frequencies of T and A allele in overweight group, obesity group and control group was 96.25%and 3.75%, 85.29%and 14.71%, 85.78%and 14.22%respectively. There was significant difference of allelic frequency among overweight group, obesity group and control group (χ2=21.72, P<0.001). The frequency of A allele in overweight and obe-sity group was higher than that in control group (P'<0.014). Subjects with TA/AA allele had significantly higher BMI compared with subjects with TT allele. Conclusions rs9939609 of FTO gene is associated with obesity in children, and allele A on this spot may raise BMI and leads to overweight and obesity.

Objective To evaluate the short-term effects of total knee arthroplasty ( TKA) , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion ( ROM) before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM (0~60 ± 10)°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from (78. 3 ± 18. 6)° preoperatively to (109. 2 ± 19. 9)° postoperative (P<0. 01). Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.

OBJECTIVE: To discuss the clinical efficacy of adenoidectomy and tonsillectomy for the OSAHS children with sinusitis. METHOD: Reviewing 112 cases of children with OSAHS, in which the 80 patients without chronic sinusitis, 32 ones with chronic sinusitis. Among them, 103 cases of children with adenoidectomy, tonsil resection, 9 cases adenoidectomy only. We did questionnaire survey before and after surgeryand also did post-surgery clinical follow-up. RESULT: The effective rate was 90.0% for the OSAHS children without sinusitis after adenoid and tonsil ectomy surgery, while the effective rate was 46.9% for the ones with sinusitis, the efficiency was significant different in the two groups after surgery; the 16.1% children after tonsil ectomy surgery complained the incidence of pharyngeal foreign body sensation and pharyngeal lymphoid hyperplasia in children was 23.2%. CONCLUSION The efficiency was aviable for the OSAHS children without sinusitis after surgery; The efficiency was not aviable enough for the OSAHS children with sinusitis after surgery, so the latter one need adjuvant drug treatment; We also should be attention to the pharyngeal foreign body sensation and the lymphoid hyperplasia in children after tonsillectomy.
Adenoidectomy ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Sinusitis ; complications ; therapy ; Sleep Apnea, Obstructive ; complications ; surgery ; Tonsillectomy ; Treatment Outcome