Objective To study the injury percentage of fat cells from human bodies by three methods and four suctioned negative pressures. Methods Fat tissue was removed from lower abdomen by excision, aspiration and suction. A pair of sharp scissors was used to cut excisied adipose tissue into 3mm diameter fat particles. A 4 mm diameter pipet and four negative pressures (-25 kPa, -50 kPa, -76 kPa and -101 kPa) were used to suction fat tissue. The samples were fixed in 10 % buffered formalin, stained with hematoxylin eosin and Wilder's silver methods. The fat cells were observed under light microscope. Results The injury percentage of fat cells removed by three methods were (8.6? 1.8) %, (15.7?2.4) % and (38.4?4.2) % respectively;all of them had significant differences among them. The injury percents of fat cells suctioned under-25 kPa,-50 kPa, -76 kPa and -101 kPa were (26.3?2.5) %, (27.6? 2.6) %, (36.8?3.5) % and (68.9?7.4) % respectively. There were no significant differences between the first two but there were among other groups. Conclusions The injury extent of fat cells has significant differences among 3 methods, in which the excision is the least and the suction is the most serious. The injury extent of fat cells has no significant differences when the pressure is lower than -25 kPa. But when the pressure is higher than -50 kPa, the higher the pressure, the more serious the injury extent.

Objective To retrospectively evaluate the necessity to dissect the recurrent laryngeal nerve in operation of thyroid gland.Methods From Jan 2004 to Jan 2009,there were 512 patients in our hospital who underwent operation of thyroid gland,and they were divided into two groups aecording to whether or not the recurrent laryngeal nerve was dissected during the operation.The rate of injury of recurrent laryngeal nerve between the two groups was compared.Results Among the 189 cases in dissection of recurrent laryngeal nerve group,3 cases(1.59%) had hoarseness after operation,and in the 323 cases without dissection of the recurrent laryngeal nerve group,5 cases(1.55%) had hoarseness after operation,but the difference was not significant(1.59% vs.1.55%).However,in the high risk cases between the two groups,the difference was significant(1.02% vs.3.95%).Conclusions Whether oe not to dissect the recurrent laryngeal nerve should be decided by the specific circumstances.For most benign lesions,one should,if possible,not expose the recurrent laryngeal nerve;but for large thyroid neoplasms,second or multiple operations and thyroid cancer,exposure of recurrent laryngeal nerve is necessary.

Objective:To investigate the recent and long-term efficacy and safety of pancreaticoduodenectomy for pancreatic head carcinoma and periampullary carcinoma.Methods:82 cases of pancreatic cancer combined with periampullary carcinoma patients admit ted in our hospital from August 2009 to June 2013 were selected and randomly divided into the control group and the observation group With 41 patients in each group.The control group received palliative surgical treatment,while the observation group underwent pancreatoduodenectomy.The operation time,hospitalization time,intraoperative bleeding volume and the incidence of complications,1,2,3-year survival rate and the recurrence rate at 1 year after operation and tumor eradication rate were compared between twp groups.Results:The amount of bleeding,operation time of observation group were significantly higher than those of the control group(P＜0.01),no signif icant difference was found in the hospitalization time between the two groups(P＞0.05);the incidence of complications in the observation group (41.46％) was significantly higher than the control group (22.96％)(P=0.03);the 2-year and 3-year survival rate of observation group were significantly higher than those of the control group (P＜0.05),the recurrence rate at 1 year after operation of observation group was significantly lower than that of the control group (P=0.04),the tumor eradication rate was significantly higher in the observation group than that of the control group (P=0.04).Conclusion:Though pancreaticoduodenectomy could prolong the operation time,increase the risk of bleeding and complications for pancreatic head carcinoma and periampullary carcinoma,but it could effectively reduce the possibility of recurrence after operation,significantly improve the long-term survival rate.

Diabetic nephropathy (DN) is one of the major microvascular complications in diabetic patients, and it is also the main global cause of chronic kidney disease(CKD) and end-stage renal disease(ESRD). Albuminuria and estimated glomerular filtration rate (eGFR) are currently recognized as clinically diagnosed early DN, but their sensitivity and specificity are poor. Therefore, it is very important to find new biomarkers to reflect the potential diabetic nephropathy in the clinical silent period.

Objective:To explore and construct the nursing quality standards of spine surgery, provide a scientific basis for improving the nursing quality of spine surgery.Methods:Taking the "structure-process-outcome" three-dimensional quality model as the theoretical framework, through evidenced-based literature search and semi-structured interview, the items pool was formed, and finally the nursing quality standards were determined by two rounds of Delphi method of expert inquiry from May to July 2023.Results:The positive coefficients of the two rounds of inquiries to experts were 0.90 and 1.00, respectively. The authority coefficients were 0.946 and 0.951, respectively. The Kendall coefficients of the first, second and third level standards in the first round were 0.161, 0.095 and 0.108, respectively, and the Kendall coefficients of the first, second and third level standards in the second round were 0.162, 0.088 and 0.100, respectively, the differences were statistically significant (all P<0.05). The final nursing quality standards were finally constructed, including 3 first-level standards (structural quality, process quality and outcome quality), 20 second-level standards and 60 third-level standards.Conclusions:The nursing quality standards of spine surgery based on the three-dimensional quality model of "structure-process-outcome" have high reliability and science, which can provide target incentives for clinical nurses, provide a basis for the quality of specialized spine nursing, and promote the development of nursing specialization and the construction of nursing discipline.

Background Hereditary retinal diseases (HRDs) are a group of retinal degenerative diseases with significant genetic and clinical heterogeneities.Traditional techniques are challenging for detection of pathogenic mutations.Objective This study was to identify the diseasing-causal genes in 20 Chinese families with a variety of HRDs.Methods Family histories and ophthalmic examinations were obtained from all participants in 20 sporadic families.Targeted sequence capture array technique with next-generation sequencing (NGS) was performed to detect pathogenic mutations in 232 identified genes associated with HRDs.Variants detected by NGS were filtered by bioinformatic analysis HRDs.Genotype-phenotype correlation was also assessed.Results We identified 11 patients with pathogenic mutations,including 8 compound heterozygous mutations and 3 homozygous mutations,which were not yet reported.These findings showed genetic diagnoses in 11 of 20 patients,with the positive rate of 55％.Among them,6 patients were autosomal recessive inheritance and 5 were unspecific.Identification of different mutations and divergent phenotypes revealed 5 patients were affected with cone-rod dystrophy,3 patients with Leber congenital amaurosis,1 patient with congenital stationary night blindness,1 patient with Best vitelliform macular dystrophy and 1 patient with Stargardt disease.Conclusions Targeted NGS is an effective approach for the genetic diagnoses of HRDs.These findings provide insights into understanding the genotype-phenotype correlations in HRDs.

Objective:To explore the difference in the therapeutic effect of stamp skin and meek skin on wound repair in patients with extensive burns.Methods:A total of 81 patients with extensive burn from March 2016 to February 2018 in 73th Army Hospital of PLA were selected and divided into group A (stamp skin grafting, 35 cases) and group B (meek skin grafting, 46 cases) according to the choice of wound repair methods before operation. The survival and healing conditions, treatment costs, mortality and rehabilitation of the two groups were compared.Results:There was no significant difference in the survival rate, wound healing rate and mortality between group A and group B (82.86% vs 86.96%, 5.71% vs 8.70%, P>0.05). The survival rate of skin graft in group A was higher than that in group B, and the wound healing time and treatment cost of 1% total body surface area (TBSA) in group A were lower than those in group B [(76.3±5.1)% vs (67.9±6.2)%, (41.5±4.9)d vs (45.8±5.1)d, (1 215.6±235.1)yuan vs (7 689.5±681.0)yuan, P<0.05]. The excellent and good rate of rehabilitation in group A was significantly lower than that in group B (68.57% vs 86.96%, P<0.05). Conclusions:The application of the stamp skin in the repair of wounds in large-area burn patients has a higher flap survival rate than meek skin repair, which can shorten the healing time of the flap and reduce the treatment cost, but the rehabilitation effect is poor.