OBJECTIVE: To investigate the effects of combined platelet-rich plasma (PRP) and arterial supercharging technique on the survival rate and functional restoration of cross-body region skin flaps in rabbits. METHODS: Twelve healthy 6-month-old New Zealand White rabbits were randomly assigned to 4 groups ( n=3): sham group, PRP group, anastomosis group, and combined treatment group. An axial skin flap with an area of 12 cm×6 cm on the inner side of the hind limbs of all animals were prepared, with the saphenous artery as the main blood supply. Following the ligation of both the proximal and distal ends of the saphenous artery across all groups, the sham group received no further intervention, the PRP group was subjected to PRP injection, the anastomosis group underwent in situ end-to-end anastomosis of the distal saphenous artery, and the combined treatment group received both in situ distal saphenous artery anastomosis and PRP administration. Flap survival was evaluated and recorded on postoperative days 1, 3, and 7, with survival rates calculated accordingly. On day 7, flap tissue samples were harvested for HE staining to assess basal tissue morphology. Additionally, immunohistochemical staining was conducted to detect the expression of α-smooth muscle actin (α-SMA), vascular endothelial growth factor (VEGF), and CD31 in the flap tissues. RESULTS: At postoperative day 1, no significant difference in flap survival rates were observed among the 4 groups ( P>0.05). At day 3, the PRP group showed no significant difference compared to the sham group ( P>0.05); however, both the anastomosis and combined treatment groups exhibited significantly higher survival rates than the sham group ( P<0.05), the combined treatment group further demonstrated superior survival rates compared to both the PRP and anastomosis groups ( P<0.05). At day 7, the combined treatment group maintained significantly higher survival rates than all other groups ( P<0.05), while both the PRP and anastomosis groups exceeded the sham group ( P<0.05). HE staining at day 7 revealed persistent inflammatory cell infiltration, sheet-like erythrocyte deposition, and disordered collagen fibers in the sham group. The PRP group showed nascent microvessel formation and early collagen reorganization, whereas the anastomosis group displayed mature microvasculature with resolved interstitial edema. The combined treatment group exhibited differentiated microvessels with densely packed collagen bundles. Immunohistochemical analysis at day 7 demonstrated significantly larger relative area percentages of α-SMA, VEGF, and CD31 positive cells in the combined treatment group compared to all other groups ( P<0.05). Both the PRP and anastomosis groups also showed significantly higher values than the sham group ( P<0.05). CONCLUSION The combination of PRP and arterial supercharging techniques significantly enhances flap healing, potentially through mechanisms involving augmented angiogenesis and improved blood supply.
Animals ; Rabbits ; Platelet-Rich Plasma ; Surgical Flaps/blood supply* ; Graft Survival ; Anastomosis, Surgical/methods* ; Ischemia/surgery* ; Arteries/surgery* ; Skin/blood supply* ; Vascular Endothelial Growth Factor A/metabolism* ; Male ; Skin Transplantation/methods*

Objective:To investigate the risk factors of wet ear status and its impact on the efficacy of endoscopic type Ⅰ tympanoplasty. Methods:A retrospective analysis was conducted at the Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chinese People's Liberation Army（PLA）Air Force Medical University, on 160 ears that underwent endoscopic type Ⅰ tympanoplasty; these were assigned to a dry-ear group （n= 118） and a wet-ear group （n= 42）.Univariate analysis and binary logistic regression were used to identify risk factors for wet ear status. Postoperative outcomes, including tympanic meoombrane healing rate and hearing improvement across frequencies, were compared between groups. Results:①Significant intergroup differences were observed in age, residual tympanic membrane status, external auditory canal condition, mastoid pneumatization（MC0）, and middle ear ventilation dysfunction（P<0.05）; ②The degree of mastoid pneumatization being MC0 is an independent risk factor for wet ear（P<0.05）; ③No significant difference in tympanic membrane healing rates was found（P>0.05）; ④The wet ear group showed significantly higher pre-and postoperative air-conduction（AC） and bone-conduction（BC） thresholds at 2 kHz and 4 kHz compared to the dry ear group（P<0.05）, though the postoperative air-bone gap（ABG） improvement was comparable. Conclusion:Poor mastoid pneumatization is a risk factor for wet ears. The wet ear state has no effect on tympanic membrane healing and air-bone conduction gap, but patients in the wet ear group may have more severe inner ear or auditory nerve pathway damage.
Humans ; Retrospective Studies ; Tympanoplasty/methods* ; Adult ; Risk Factors ; Male ; Female ; Young Adult ; Endoscopy ; Adolescent ; Middle Aged ; Treatment Outcome ; Child ; Logistic Models ; Tympanic Membrane/surgery*

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

Objective To isolate the Japanese encephalitis virus carried by Culex tritaeniorhynchus in Dongchuan District of Yunnan Province and analyze its molecular characteristics, so as to provide insights into the prevention and control of Japanese encephalitis in Yunnan Province. Methods Mosquito specimens were collected using mosquito-trapping lamps from pig farms in Batang Village and Xiaoxin Village, Dongchuan District, Kunming City, Yunnan Province in July 2016, and the mosquito species was identified according to the mosquito morphology. Then, 60 to 100 mosquitoes of each species served as a group and were ground. Baby hamster kidney-21 (BHK-21) cells and Aedes albopictus clone C6/36 cells were used for virus isolation, and positive isolates were identified using flavivirus primers. The positive isolates were amplified using reverse transcription polymerase chain reaction (RT-PCR) assay with 15 pairs of specific primers covering the full length of the genotype I Japanese encephalitis virus, and DNA sequence assembly was performed using the software SeqMan in the DNASTAR package. The obtained sequences were aligned with the complete sequences of 38 Japanese encephalitis virus downloaded from the GenBank with the software MegAlign, and the nucleotide and amino acid homology analyses of the obtained sequences were performed. The difference in amino acid sites was analyzed with the software GeneDoc, and phylogenetic trees were created based on the sequences of the coding region and E protein of the isolated Japanese encephalitis virus with the software Mega X. In addition, the secondary and tertiary structures of the E protein of the Japanese encephalitis virus were predicted using the online tool SOPMA and the software Swiss-Model. Results A total of 5 820 mosquitoes were collected and 3 843 Cx. tritaeniorhynchus (66.03%) were identified according to the mosquito morphology. A positive virus isolate, termed YNDC55-33, was isolated from Cx. tritaeniorhynchoides following batches of virus isolation from mosquito specimens, and cytopathic effect was observed following inoculation into BHK-21 and C6/36 cells. The YNDC55-33 virus isolate was successfully amplified with the flavivirus primes, and a long sequence containing 300 nucleotides was obtained. Following sequence alignment using the BLAST tool, the sequence of the YNDC55-33 virus isolate had high homology with that of the genotype I Japanese encephalitis virus. A long sequence with 10 845 nucleotides in length, which encoded 3 432 amino acids, was obtained by splicing the full sequence of the YNDC55-33 virus isolate. Phylogenetic analysis based on the whole-genome sequence and E gene sequence of the YNDC55-33 virus isolate showed that the new YNDC55-33 virus isolate was most closely related to the genotype I Guizhou isolate (GenBank accession number: HM366552), with nucleotide homology of 98.5% and amino acid homology of 99.4%, and the YNDC55-33 virus isolate shared 97.96% ± 0.33% nucleotide homology and 99.35% ± 0.08% amino acid homology with other genotype I Japanese encephalitis virus isolates, and < 90% nucleotide homology and < 98% amino acid homology with other genotypes of Japanese encephalitis virus. The YNDC55-33 virus isolate and the live attenuated virus vaccine candidate SA14-14-2 isolate differed at 16 amino acid sites on E gene, and 7 out of 8 key amino acid sites related to neurovirulence. The secondary and tertiary structures of the E protein of the YNDC55-33 virus isolate were predicted to be characterized by random coils. Conclusions A genotype I Japanese encephalitis virus was isolated from Cx. tritaeniorhynchus in Dongchuan District, Kunming City. This virus isolate and the live attenuated virus vaccine candidate SA14-14-2 isolate does not differ at antigenic epitopes-related key amino acid sites, and the major protein structure of the virus isolate is random coils. This study adds new data for the epidemiological distribution of Japanese encephalitis virus in Yunnan Province, which may provide insights into the prevention and control of Japanese encephalitis in the province.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

With the increasing prevalence of chronic kidney disease, the incidence of renal secondary hyperparathyroidism (SHPT) has also reached a high level. At the beginning of the course of SHPT, medical treatment is the main method, but nearly 10% of patients eventually need to undergo parathyroidectomy. The perioperative management of such operations requires comprehensive consideration of the influence of primary disease, secondary pathophysiological changes and surgical factors, which poses a challenge to anesthesiologists. This article summarizes the pathophysiological characteristics, treatment status and anesthesia points of SHPT, with the aim of providing reference for the implementation of safer and better anesthesia management for SHPT patients.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

ObjectiveTo observe the clinical efficacy and safety of Shugan Bushen Yulin Decoction （疏肝补肾毓麟汤， SBYD） in the treatment of asthenospermia and infertility with liver constraint and kidney deficiency. MethodsA multicenter， randomized， controlled clinical study was conducted in three hospitals in central China. Totally 95 patients with asthenospermia and infertility were controlled. According to random number table， the patients were divided into treatment group （47 cases） and control group （48 cases）. The control group was given vitamin E soft capsules （100 mg per time， twice daily） orally， and the treatment group was given SBYD （one dose daily， 30 min after breakfast and dinner， about 200 ml each time） orally. The course of treatment was 12 weeks in both groups. After the treatment， the sperm concentration， percentage of forward motile sperm （PR）， and percentage of total sperm activity， that is PR + percentage of non-progressively motile sperm （NP） were compared between groups， and the clinical efficacy was judged. Traditional Chinese medicine （TCM） syndrome score （inlcuding 6 single symptom scores and total symptoms score） and 21-item depression， anxiety， and stress scale （DASS-21） scores （including depression， anxiety and stress scores） were compared between the two groups before and after treatment. The patients were followed up for 6 months， and the pregnancy status of spouse between groups was compared. The occurrence of adverse events and vital signs during the trial were recorded for safety assessment. ResultsTwo cases in the treatment group and three cases in the control group dropped out. Finally， 45 cases in each group were included in the statistical analysis. The total effective rate was 86.67% （39/45） in the treatment group， significantly higher than 73.74% （33/45） in the control group （P＜0.05）. After treatment， PR and PR + NP significantly increased in both groups， and were much higher in the treatment group than in the control group （P＜0.05）. The scores of lumbar and knee soreness， emotional disturbance， cold sperm， chest and rib-side and lesser abdomen distension and pain， frequent sighing， and the total TCM syndrome score in the treatment group decreased after treatment （P＜0.05）； and except for cold sperm， the scores of other symptoms mentioned above as well as the total TCM syndrome score in the treatment group were lower than those in the control group （P＜0.05）. The scores of depression， anxiety and stress of DASS-21 in the treatment group decreased after treatment， and were lower than those in the control group （P＜0.05）. After 6 months of follow-up， the spouses of 5 patients in the treatment group and 3 patients in the control group got pregnant （P＞0.05）. No adverse events occurred in both groups during the treatment， and their vital signs were stable. ConclusionSBYD can obviously improve sperm vitality and effectively improve the clinical symptoms， anxiety and depression， and is safe in treating asthenospermia and infertility with liver constraint and kidney deficiency.

OBJECTIVE To discuss the participation of clinical pharmacists in rational drug use management by informatization clinical pathway under diagnosis related groups(DRGs) background by taking glycyrrhizic acid injection as an example. METHODS Based on the PDCA cycle theory, the evaluation scheme was established to find the problems in the use of glycyrrhizic acid injection in Jinhua Municipal Central Hospital, and the necessity of glycyrrhizic acid injection in the pathway was determined according to the needs of diagnosis and treatment, and the elimination and maintenance were carried out. The rational rate of drug use and the changes of monitoring indexes were compared before and after intervention in the same period(Q2 2021 vs Q2 2022). RESULTS Compared with the same period in 2021, the rational use rate of glycyrrhizic acid injection increased to a certain extent in the second quarter of 2022, and the utilization rate, the number of intravenous administration per capita per day, the intensity of use and the average drug cost per case all decreased. CONCLUSION Under the background of DRGs, the participation of clinical pharmacists in rational drug use by informatization clinical pathway can reduce the irrational use of glycyrrhizic acid injection and reduce the hospital monitoring index.