Objective To explore the application effect of family-community-hospital linked care in patients with chronic hepatitis B. Methods A total of 118 patients with chronic hepatitis B were selected and randomly divided into control group and observation group using a random number table method, with 59 patients in each group. The control group received routine health education, while the observation group received family-community-hospital ternary linked care on the basis of the control group received family-community-hospital linked care. The social support, treatment adherence, quality of life, and fear of disease progression between the two groups were compared before intervention and 2 months after the intervention. Results Two months after the intervention, the scores of the Social Support Rating Scale (SSRS), the Treatment Adherence Scale for chronic hepatitis B patients, and the Chronic Liver Disease Questionnaire (CLDQ) increased in both groups compared with those before the intervention, and the above scores were higher in the observation group than in those in the control group (P < 0.05). The scores of social family and physical health on the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) decreased in both groups compared with those before the intervention, and the scores were lower in the observation group than those in the control group (P < 0.05). Conclusion Family-community-hospital linked care can improve social support, treatment adherence, and quality of life in patients with chronic hepatitis B and alleviate their fear of the disease.

This article reported a case of kaposiform lymphangiomatosis (KLA) identified in the fetal stage and diagnosed at the neonatal stage. A routine ultrasound examination at 19 weeks of gestation showed multiple masses in the whole body of the fetus (involving neck, chest wall and armpit) complicated by pleural and peritoneal effusion. Shunting was performed to drain pleural effusion from the right chest in another hospital at 26 +5 weeks of gestation. The patient was born at 34 +3 weeks of gestation by cesarean section due to "intrauterine distress" and required invasive ventilator assisted ventilation support after birth because of respiratory distress. A large amount of hemorrhagic effusion was drained out during the shunting. Coagulation dysfunction and thrombocytopenia occurred on the 3rd day after birth and KLA was suspected. Empirical treatment with sirolimus turned out to be ineffective. Biopsy was taken on postnatal day 7. However, the patient died on the 12th day after birth due to respiratory and circulatory failure. Pathological findings obtained the day after death were consistent with the features of KLA. The diagnosis of KLA was confirmed based on the clinical manifestations and pathological results.

Objective:To explore the complications and nutritional outcomes of Home Enteral Nutritional (HEN) in newborn surgical patients.Method:The medical records of neonates with HEN after surgery between 2017 and 2020 were retrospectively reviewed and complications of HEN and the nutritional status before and after HEN were analyzed.Results:A total of 66 neonates were included. The average gestational age at delivery and birth weight were (35.7 ± 3.0) weeks and (2426 ± 709) g, respectively. Diagnoses were mainly congenital esophageal atresia and intestinal diseases, such as intestinal atresia, intestinal torsion and necrotizing enterocolitis. The median age at HEN initiation was 92 (50, 112) days and HEN duration was 64 (41,95) days. HEN was conducted with tube feeding, with 14 patients (21.2%) through gastrostomy, 52 (78.8%) through nasal feeding tube, 20 (30.3%) through intermittent bolus infusion and 46 (69.7%) through continuous infusion. As for the formulas, 19 patients (28.8%) were given whole protein formula, 33 (50%) extensively hydrolyzed formula and 14 (21.2%) free amino acid-based formula. During the follow-up, 10 patients (71.4%) in gastrostomy group experienced 18 cases of catheter-related complications, including accidental removal (6 patients, 42.8%), catheter displacement (4 patients, 18.6%) and excessive granulation tissue at the gastrostomy site (4 patients, 18.6%). In nasal tube feeding group, 14 patients (26.9%) experienced 21 cases of catheter-related complications, including accidental tube removal (19 cases in 12 patients, 23.1%) and tube breakage (2 patients, 3.8%). Both the weight for age Z score and the height for age Z score were improved after HEN.Conclusions:HEN can help to improve the nutrition status in postoperative neonates. Management of catheter-related complications is challenging and warrants team work to improve the outcome of HEN.

Objective:To study the incidences of postoperative complications and nutritional status following different timings of stoma reversal in necrotizing enterocolitis (NEC).Method:From January 2017 to December 2019, NEC patients receiving enterostomy surgery and later stoma reversal in our hospital were retrospectively analyzed. They were assigned into three groups according to the timing of stoma reversal: early group (reversal within 8 weeks of stoma formation), middle group (reversal at 8~12 weeks from stoma formation) and late group (reversal after 12 weeks from stoma formation). Weight-for-age-Z-score (WAZ) was used to evaluate nutritional status.Result:A total of 56 infants were enrolled, including 6 cases in the early group, 11 cases in the middle group, and 39 cases in the late group. The gestational age and birth weight were (33.4±3.4) weeks and (1 894±640) g, respectively. The median age of stoma formation and the interval between stoma formation and reversal were 16.5 (8.0, 28.2) days and 94.0 (76.5, 126.5) days. No significant differences existed on gestational age, birth weight, age of stoma formation and complications of stoma reversal among the three groups ( P>0.05). The incidence of growth retardation (WAZ<-2) was 14.3% at stoma formation, and significantly increased to 62.5% at stoma reversal ( P<0.05). The WAZ at stoma reversal in early, middle and late groups were (-3.2±1.9), (-3.0±1.6) and (-2.3±1.5), without significant differences( P>0.05). The WAZ gradually increased to (-0.7±1.2), (-0.1±2.0) and (-0.1±0.8) at 42~48 weeks after reversal, respectively. Conclusion:The timing of stoma reversal may not influence the complications of reversal. Growth retardation are common in NEC infants with stoma formation and stoma reversal may improve the nutritional status of the infants. Early reversal of stoma is suggested to improve the nutritional status of patients with poor weight gain after stoma formation.

Objective To compare the prognosis of different surgical procedures and to find the relatively safe and effective treatment for severe jejunoileal atresia(sJA).Method From January 2007 to June 2018,children with sJA receiving different surgical procedures in our hospital were retrospectively reviewed.Their clinical data were analyzed,including the survival rate,complication rate,unplanned re-operation rate and postoperative nutritional status.Result A total of 130 patients were enrolled in this study.According to the different types of surgical procedures,the patients were assigned into primary anastomosis group (58 cases,44.6％),Mikulicz double barrel ileostomy group (17 cases,13.1％) and Bishop-Koop anastomosis group (55 cases,42.3％).The overall mortality rate was 6.2％ (8/130).No significant differences existed in mortality rates among the three groups (P＞0.05).The incidences of gastrointestinal complications in primary anastomosis group (70.6％,12/17) and Mikulicz group (70.6％,12/17) were both higher Bishop-Koop group (34.5％,19/55),the differences were statistically significant (P＜0.05).The unplanned re-operation rates were 34.5％ (20/58) in the primary anastomosis group and 17.6％ (3/17) in the Mikulicz group,both higher than the Bishop-Koop group (3.6％,2/55),the differences were also statistically significant (P＜0.05).Multivariate analysis showed that the risk of complications in the primary anastomosis group (OR=3.434,95％CI 1.392～8.471) and Mikulicz group (OR=5.933,95％CI 1.467～23.991) were higher than the Bishop-Koop group.The risk of unplanned re-operation in the primary anastomosis group was 12.422 times as the Bishop-Koop group (95％CI 2.535～60.877).No significant differences existed between the Mikulicz group and the Bishop-Koop group in the risk of unplanned re-operation (P＞0.05).The weight for age (Z-score) in the Bishop-Koop group (-1.4,95％CI-2.0～-0.8) at the stoma closure time was better than the Mikulicz group (-3.2,95％CI-4.4～-2.0),the difference was statistically significant (P＜0.01).Conclusion Bishop-Koop anastomosis has lower complication rate and lower unplanned re-operation rate in the treatment of sJA.The nutritional status of children who received Bishop-Koop anastomosis is better than Mikulicz double barrel ileostomy at the stoma closure time.Bishop-Koop anastomosis is relatively safe and effective for sJA patients.

Objective To study the nutritional status and risk factors in neonates receiving enterostomy.Method From January 2015 to July 2017,patients who had enterostomy during neonatal period and had the stoma closed in our hospital were retrospectively studied.Z score (weight-for-age) was used to evaluate their nutritional status.The patients were divided into two groups according to the nutritional status when the stoma closed:the malnutrition group and the normal nutrition group.The differences in gender,premature birth,low birth weight,primary disease,ostomy methods,length of proximal small intestine and high output diarrhea through stoma were compared between the two groups.Multivariate Logistic regression analysis was used to determine the risk factors of malnutrition at the closure of the stoma.Result A total of 75 infants with various primary diseases were included.Among them,23 patients were diagnosed with neonatal necrotizing enterocolitis,27 patients jejunoileal atresia,5 patients meconium ileus,15 patients meconium peritonitis and 5 patients Hirschsprung's disease.The median age of enterostomy was 3 (2,8) days,and the median hospital stay after enterostomy was 26 (20,40) days.The median age of stoma closure was 6.0 (5.0,8.5) months.The median Z score at discharge and stoma closure were -1.6 (-2.9,-0.9) and-1.5 (-2.6,-0.5) respectively.No statistically significant differences existed between the two groups (P ＞ 0.05).28 infants (37.3％) were malnutrition when the stoma was closed.The incidence of low birth weight and high output diarrhea through stoma in malnutrition group were significantly higher than the normal nutrition group (35.7％ vs.10.6％,32.1％ vs.10.6％,P ＜0.05).No significant differences in gender,premature birth rate,primary disease,ostomy method and length of proximal intestine between the two groups (P ＞ 0.05).Multivariate Logistic regression analysis indicated that low birth weight,high output diarrhea and jejunoileal atresia were risk factors for malnutrition.Conclusion Malnutrition is common in neonates after enterostomy,and the risk factors for malnutrition are low birth weight,high output diarrhea through stoma and the primary disease jejunoileal atresia.

Objective To explore the application value of platelet parameters detection in early diagnosis of breast cancer.Methods Platelet parameters of intravenous blood from 103 breast cancer patients and 117 fibroadenoma patients within 24 hours of admission between January 2015 and December 2015 were collected and retrospectively analyzed,including platelet count(PLT),plateletcrit(PCT),mean platelet volume(MPV),mean platelet component concentration(MPC),mean platelet component mass (MPM),platelet distribution width(PDW),and compared with control group of 100 healthy women.The diagnostic efficiency of platelet parameters were assessed using receiver operating characteristic(ROC) curve.Results PLT and PCT in breast cancer group and fibroadenoma group were significantly higher than those in control group(P＜0.01);MPC,PMM and PDW were significantly lower than those in control group(P＜0.01);MPV had no significant statistically difference(P＞0.05).The levels of MPC in breast cancer group were obviously lower than that in fibroadenoma group(P＜0.01).The diagnostic efficiency of MPC in breast cancer had the highest area under curve(AUC=0.835).While the cutoff value of MPC was 249.5 g/L,sensitivity and specificity were 82.5 ％ and 73.6 ％,respectively.Conclusion The detection of platelet parameters,especially MPC,have certain application value in early diagnosis of breast cancer.

Objective To investigate the the clinical effect and immune regulatory mechanism of red-blue light combined with Niuhuang Shangqing capsules for the moderate-severe acne.Methods A total of 180 patients with moderate to severe acne treated in People's Hospital of Nanhai District in Foshan City from June 2014 to June 2016 were randomly divided into 2 groups with each group 90 patients. The control group was treated with red and blue light, and observation group was treated with the combination of red and blue light andNiuhuang-Shangqingcapsules. The levels of SP(Substance P), IL-1 and IL-6 in peripheral blood were observed and analyzed. The recurrence rates and adverse events were observed.Results After treatment, the SP (657.4 ± 36.6 pg/mlvs.799.9 ± 60.2 pg/ml,t=19.188), IL-1(61.8 ± 24.7pg/L vs.92.1 ± 23.5 pg/L,t=8.431), IL-6 (38.7 ± 10.3pg/mlvs.66.7 ± 14.1pg/ml, t=12.421) of the observation group were significantly better than those of the control group (allPs<0.01). The total effect rate of the observation group were 91.11% (82/90), which were significantly higher than 70.00% (63/90) of control group (χ2=12.804,P<0.01). Conclusions The Red-blue light combined withNiuhuang-Shangqing capsules for treating moderate-severe acne, has significant effect and can reduce the serum levels of SP, IL-1 and IL-6, with fewer adverse events and lower recurrence rates. They can be used as a safe and effective treatment of acne.

Objective To investigate the clinical efficacy of photodynamic therapy with red and blue light in the treatment of facial acne. Methods Ninety-two cases of facial acne in dermatology outpatient hospital were randomly divided into the test group and the control group, with 46 cases in each group. Patients in the test group received the photodynamic therapy, and patients in the control group received red plus blue light treatment for eight weeks, respectively. Results Before treatment, patients in the test group and the control group had no significant differences in acne, papules, pustules, nodules, cysts and gags score. After 8-week treatment, the comedones, papules, pustules, nodules cyst number, gags score of patients in the test group were significantly less than or lower than those of patients in the control group (P < 0.05, respectively). The healing rate was 84.78% in the test group, which was higher than that of 65.22%in the control group of (P<0.05). The total efficiency was 97.83%in the test group and 93.48% in the control group, with no significant difference. The adverse reaction rate was 10.87% in the test group and was 23.91% in the control group, with no significant difference. Conclusion The effect of photodynamic therapy for facial acne is better than red plus blue light treatment ,with a less incidence of adverse reactions.

BACKGROUND:Previous studies have found that human platelet-derived growth factor-B (PDGF-B)-transfected gingival fibroblasts are capable of rapid proliferationin vitro, which can secrete platelet-derived growth factor BB proteins. OBJECTIVE:To explore the ability of PDGF-B-modified gingival fibroblasts in the acelular dermal matrixin vivo to form periodontal tissue engineering compound. METHODS: Gingival fibroblasts from Beagle dogs transfected with or without PDGF-B gene were implanted into the acelular dermal matrix. Cel growth on the acelular dermal matrix was observed. PDGF-B gene-transfected gingival fibroblasts/acelular dermal matrix composite (experimental group), gingival fibrobalsts/acelular dermal matrix composite (control group) and acelular dermal matrix (blank group) were implanted subcutaneously into the nude mice, respectively. At 2, 4, 8 weeks after implantation, skin tissues were taken and observed histologicaly. RESULTS AND CONCLUSION: PDGF-B gene-modified gingival fibroblasts and non-transfected gingival fibroblasts both grew and proliferated wel in the acelular dermal matrix. At 8 weeks after implantation, in the blank group, the surrounding cels largely entered into the acelular dermal matrix, but produce less new colagen fibers, and the cels only grew on the original colagen scaffold; in the control group, a great amount of colagen fibers formed, the original colagen fibers in the acelular dermal matrix were replaced by newly formed colagens, but the original colagen structure was reserved; in the experimental group, a large scale of permineralization formed, and mineralized nodes were arranged along the original colagen scaffold. These findings indicate that PDGF-B gene modified gingival fibroblasts can acquire osteoplastic abilities in the acelular dermal matrix in vivo.