Objective To explore the treatment protocols and the occurrence and developmental rule of subcutaneous multiple inflammation and indurations by facial injection lipolysis,and to summarize the treatment experience.Methods Six cases of subcutaneous indurations were females patients with facial injection lipolysis,and the lesions increased slowly after about one month.The local temperature raised and pinching pain appeared in the facial area.The other secondary post-traumatic swelling and scleroma areas were treated with piercing or cutting,spread to the surrounding tissues.Red scleroma became osmosis,by local open decompression,debridement,irrigation and drainage lasting almost 3 months.The area had burst out mucoid funicular materials gradually.Results The facial injection lipolysis caused regionally red swelling and scleroma gradually with 1 month of continuous irrigation drainage.The red scleroma area was limited with debridement again after maturation,closed incision after discharge mucus-shape substance by its organization.In the redness induration period,pathological results showed the homogeneous materials without structure could be seen in the fibrous tissue,with surrounding hyperemia,hemorrhage associated with inflammation.Festering burst period showed that local tissue presented suppurative inflammation,multiple abscesses and granuloma formation.Conclusions Conservative treatment can lead to swelling,bursting and developing into deep tissues.Surgical treatment can spread redness scleroma area and lead to a large area of skin depression,soft tissue scar and deformity.

BACKGROUND:Expanded polytetrafluoroethylene is a kind of porous polymer materials which is commonly used as clinical implants, and it has good biocompatibility, and is not easy to deformation or metamorphism. There is no existence of inflammation absorption reaction, and it al ows the cel migration and tissue ingrowth.
OBJECTIVE:To study the biocompatibility of expanded polytetrafluoroethylene scaffold and human adipose-derived stem cel s.
METHODS:The passage 4 human adipose-derived stem cel s were co-cultured with expanded polytetrafluoroethylene scaffold in vitro. The morphology and function of cel s adhered to the scaffold were observed by inverted phase contrast microscope, and cel adhesive rates and proliferation rates were also calculated by MTT assay.
RESULTS AND CONCLUSION:The inoculated cel s were round and bright, distributed on the surface of scaffolds uniformly, with good cel viability. After 3 hours a large number of adherent cel s were observed from the micrograph;after 24 hours there were a smal amount of short-spindle adipose-derived stem cel s. After cultured for 3 days, the short fusiform or polygon cel s could be seen clearly. After cultured for 7 days, the number of cel s increased significantly, few cel s fel off from the scaffold, and cel adhesion rate was up to an average of 95.7%. Meanwhile, the cel s revealed normal splitting proliferation rate. These findings indicate that human adipose-derived stem cel s are able to attach, grow and proliferate wel on the scaffold. Expanded polytetrafluoroethylene reveals excel ent cel ular compatibility and can be used as a vehicle for adipose tissue engineering.

BACKGROUND:The establishment of a good blood supply is a key mechanism for successful implantation of engineered tissues. OBJECTIVE:To observe the effect of basic fibroblast growth factor on the migration of human adipose-derived stem cells via implanting the human adipose-derived stem cells and sodium hyaluronate composite graft at the subcutaneous site of BALB/C mice, in order to explore an optimal scheme for soft tissue reconstruction. METHODS:Human adipose-derived stem cells were isolated from the adipose tissue of healthy cosmetic patients which received liposuction, and the cells were subcultured. Then 5×109/L passage 3 cellsuspension labeled by cm-dil was prepared. The working solution containing 2 mg/L basic fibroblast growth factor was prepared. Composite tissue al-lografts which were the mixtures of 0.25 mL sodium hyaluronate, 0.2 mL cellsuspension and 0.05 mL working solution or DMEM were implanted into the subcutaneous site of both sides of the mouse back. Specimens were taken at 6 weeks after operation and were evaluated histological y after hematoxylin-eosin and vascular immunofluorescent staining. RESULTS AND CONCLUSION:No necrosis, liquefaction, nodular tissue or gel remained in operated position. The hematoxylin-eosin staining showed the main components of the specimens were the adipose tissue and the loose connective tissue. The immunofluorescence staining showed the overlaps between the cm-dil fluorescence from human adipose-derived stem cells and the FITC fluorescence from the vascular endothelium in the experimental group were more than those in the control group (P<0.05). Basic fibroblast growth factor promotes the migration and the differentiation of human adipose-derived stem cells in the sodium hyaluronate scaffold into vascular endothelium.

Objective To investigate the status of self-care ability and cognition among disabled elderly,and to analyze the relationship between self-care ability and cognition,then analyze their influencing factors.Methods A total of 813 disabled elderly accepted long-term care at community or facility were recruited by stratified sampling method and investigated by socio-demographic questionnaire,activities of daily living and short portable mental status questionnaire.Results The total scores of self-care ability of the long-term care disabled was 32.01±11.59,and the total points of cognition was 3.77±3.24.Disabled elderly with severe disorders of self-care ability had a higher obstacle rate in every cognition ability than those with mild disabilities (P＜0.001).There were differences in orientation and memory function with different persistent disabled time (x2 =11.875,14.758,P＜0.01).Disabled elderly with cognition obstacles have a higher obstacle rate in every self-care aspect than those with normal cognition (P＜0.01).The multiple regression analysis showed that the educational level (β=-0.067),arital status (β=-0.071),disabled persistence time (β=0.121),orientation ability (β=0.403),the amount of cognition obstacles (β=0.443) were the influence factors of Basic Activities of Daily Living(BADL) among disabled elderly ; and disabled persistence time (β=0.116),orientation ability (β=0.417),recalled ability (β=0.275),memorial ability (β=0.189),calculative ability (β=0.257),the amount of cognition obstacles (β=0.358) were the important factors influence Instrumental Activities of Daily Living(IADL).Conclusion The self-care ability and cognition of the long-term care elderly were declining sharply,and influencing each other.It is advisable to offer them direct long-term care service combined with the laws and characteristics of cognition and self-care ability.

Objective To preliminarily discuss the technical points and clinical efficacy of the pressure cooker technique (PCT)for embolization of intracranial arteriovenous malformation (AVM). Methods From April 2015 to May 2015,7 patients with AVM were treated at the Department of Neurosurgery, Shanghai Deji Hospital. The AVMs of 2 patients were embolized with PCT. (both were Spetzler-Martin gradeⅡ). A sonic and an echelon microcatheter were implanted side by side into the same blood supply artery of an AVM. A coil + α-isobutyl cyanoacrylate (NBCA)plug was formed between the sonic microcatheter tip and the detachable point through the echelon microcatheter in order to prevent Onyx reflux when the glue was injected into a nidus via a sonic microcatheter,achieving the embolization effect of sustained,rapid and high efficient. Results Two patients achieved complete embolization immediately. The symptoms of the patients improved or disappeared within 1 month. The whole brain DSA showed the AVM of one patient did not have recurrence at 4 month after embolization. Two patients did not have any complications or sequelae at the follow-up study. Conclusion PCT can improve the efficiency of embolization. It is suitable for small, medium,superficial,non-major functional area,less feeding artery AVMs,and AVMs with less blood flow in nidus. Its safety and clinical effect still need to be observed with more samples.

Objective To observe the growth of human adipose stem cells (hADSCs) co-culture with expanded polytetrafluoroethylenee (ePTFE) scaffold in vivo.Methods hADSCs were isolated from healthy human liposuction fat.The hADSCs were seeded onto the ePTFE scaffold as Group A,while the ePTFE scaffold without hADSCs as Group B,and the two groups were randomly implanted under the back skin of 10 SD rats.The transplant compound in two groups was harvested at 4 weeks after implantation.Wet weight of transplanted compound was measured.After HE and immunofluorescence CD31 staining,blood vessel density and fibrous proliferation were observed and evaluated.Results Primary cultured hADSCs were spindle-shaped cells.The histological study found that after cultured in vivo,hADSCs could grow in the space of the ePTFE scaffold,several cells were found at the edge of the scaffolds and parts of cells had grown into the inside even the whole layer of the scaffolds.The wet weight of transplanted compound in group A (511.62±32.82) mg was significantly higher than that in group B (363.56±34.74) mg,(P＜0.05).Histological and immunofluorescence analysis showed the blood vessel density was (29.50±2.63)/HPL in group A,(12.00±2.26)/HPL in group B.Compared with group B,group A had significantly higher blood vessel density and lower fibrosis counts (P＜0.05).Conclusions hADSCs have a good biocompatibility with ePTFE scaffold.ePTFE scaffold has no negative effect on the proliferation of hADSCs.

Chronic hepatitis B(CHB)is one of the most commom cause of liver fibrosis. Accurate assessment of liver fibrosis is essential for the strategy of treatment and judgement of prognosis . Liver biopsy is the gold standard for staging fibrosis,but it is invasive with high cost,low reproducibility and poor acceptance by patients. Therefore,it is urgent to explore a noninvasive modality for the assessment of liver fibrosis. Recent evidence highlights that elastographic techniques, biochemical markers and the diagnostic model consisted of several serum markers have the potential for the diagnosis of liver fibrosis. This article reviewed the progress in noninvasive assessment of liver fibrosis in patients with CHB.

Objective To explore tolerance-related factors of enteral nutrition(EN) by nasogastric (NG) tube in ICU patients, and to provide several nursing strategies for improving the patients' tolerance. Methods 83 patients using EN with NG tube in ICU were collected.Tolerance-related factors of EN were analyzed by multivariate Logistic regression analysis. Results Among the 83 patients, 36 patients (43.3%) could tolerate very well, 47 patients (56.6%) couldn't tolerate.After treatment 27 patients' tolerance was fair, the other was poor.Multivariate Logistic regression analysis showed that age, APACHE-Ⅱ score, the time of beginning EN, albumin level, drug administration by NG tube or not were the major factors affecting tolerance of NG tube feeding. Conclusions Patients' feeding with NG tube was well-tolerated in ICU.Besides the factors from patients as the severity of disease status and level of serum albumin,the time of beginning EN, drug administration by NG tube were significantly correlated with tolerance.

Objective To explore the expression levels of immune-related microRNA-146b (miR-146b),microRNA-155 (miR-155) and microRNA-30b(miR-30b) in human breast milk and its relationship with maternal and infant's health.Methods One hundred and thirty-four mothers and their infants from obstetrical department were recruited in the study after delivery.The subjects were divided into 2 groups,breast feeding group(n =86) and formula-feeding group(n =48),and were followed up 3 months after delivery.Breast milk samples were collected at 2-5 days after delivery(colostrum) and 3 months after delivery(mature milk).The expression levels of microRNAs in milk samples were detected by real-time PCR.The relationship between levels of microRNAs and maternal and infant-related factors was analyzed.Results 1.MiR-146b,miR-155 and miR-30b expressions were abundant both in human colostrums (5.950 ± 0.823,3.899 ± 0.920,4.057 ± 0.604) and mature milk (4.840 ± 0.805,2.128 ± 0.969,4.929 ± 0.566).The levels of miR-146b and miR-155 were higher in colostrum than that of mature milk (t =7.716,10.215,all P ＜ 0.01),while the level of miR-30b was higher in mature milk than that of colostrums(t =-8.626,P ＜ 0.0l).2.Additionally,the level of miR-30b was negatively correlated with maternal pre-pregnancy body mass index (r =-0.298,P ＜ 0.01).3.The levels of miR-146b and miR-30b were higher in mothers giving birth by vaginal delivery than those who underwent cesarean section(t =2.356,3.108,all P ＜0.05).4.The levels of miR-146b and miR-155 were higher in colostrum-fed girls than boys (t =-2.204,-2.985,all P ＜ 0.05).5.The level of miR-146b in mature milk was negatively correlated with 3-month-old infant' s Z score of body weight (r =-0.425,P ＜ 0.05) and body length (r =-0.569,P ＜ 0.01).6.During follow-up,the incidence of baby eczema in breast feeding group (8.82％,3/34 cases) was lower than that in formula milk feeding group(29.17％,14/48 cases) (x2 =5.012,P =0.025).Conclusions The levels of immunocompetent microRNAs in human milk are influenced by the lactation period,maternal prepregnancy body mass index,mode of delivery and infant sex.The immune-related microRNAs in human milk could be involved in the regulation of infant's immunity and growth.

Objective To get the information about the geriatric syndromes in the elderly with different age and gender so as to provide the basis for management of the geriatric syndromes.Methods A questionnaire survey was used to investigate and analyze the geriatric syndromes in 2 778 older subjects aged 60 years and above from Zhejiang and Jiangsu province.Results Among all 2 778 old adults,(3.4 ± 1.8)geriatric syndromes in average were found.The difference in geriatric syndromes number between different age groups showed a statistical significance(F =145.135,P＜ 0.001),but a significant difference in geriatric syndromes number between male and female group was not found(t=0.817,P=0.414).On the top incidence rate of geriatric syndromes were daily life ability defects 2 199 cases(79.2％),falls 1 828 cases(65.8％),urinary incontinence 1 356 cases(48.8％),sleeping disorder 1 023 cases(36.8 ％),cognitive impairment 908 cases (32.7 ％) and visual impairment 896 cases (32.3 ％).Among above six geriatric syndromes,the incidence of daily life ability defects,falls,urinary incontinence,sleeping disorder and cognitive impairment seemed to increase with ageing (P＜0.001).The incidence of daily life ability defects,falls and urinary incontinence was higher in males than in females (P＜ 0.05).The incidence of sleeping disorder and cognitive impairment was higher in females than in males(P＜0.05).The elderly patients with 3 or more geriatric syndromes exceeded about 66.4 ％.The most common clusters of geriatric syndromes were daily life ability defects combined with falls and urinary incontinence,which seemed to significantly increase along with ageing (x2=202.523,P＜0.001).Conclusions Geriatric syndromes are common in the elderly,medical care workers should pay attention to the management of the geriatric syndromes,and promote the development of the elderly healthcare.