Objective To observe therapeutic effects of early scab-cutting combined with axis-like abdo-men skin flap implanting in patients with wrist deep electrical burns.Methods Retrospective study was employed to analyze 70 patients received axis -like abdomen skin flap implanting for wrist deep electrical burns.All the cases were separated with early scab-cutting group(35 cases)and delayed scab-cutting group(35 cases),according to types of skin flap implanting.The therapeutic effect for the two groups were evaluated with rate of infection,duration of healing,living rate of skin flap,grade of skin burning,and rate of amputate.Results In the early scab -cutting group,the rate of infection was 11%,the duration of healing was(24.0 ±6.0)days,the rate of amputate was 3%,the living rate of skin flap was 97.0%,the wound healing of class A was 94.3%.In the delayed scab-cutting group,the data were respectively 31%,(35.0 ±7.4)days,17.0%,31% and 28.6%.Compared with the data of the two groups,the difference had statistical significance(the chi-square value or T value were respectively 4.151,6.831,3. 968,31.895,3.968.All the P values was less than 0.05).Conclusion Early scab-cutting combined with varied sorts of skin flap implanting shown great benefits for treatment of wounded and facilitate rehabilitation in function of wrist,which suggest decrease rate of complications and minimized hospitalized duration.

Objective To observe the clinical effect of the anterolateral thigh flap in repairing defect caused by resection of malignant melanoma in the heel region.Methods 8 patients with heel malignant melanoma were trea-ted by surgery.The malignant melanoma was further diagnosed by histopathological examination.Their heel defects caused by large resection of malignant melanoma were treated by anterolateral thigh flap.Results All skin flaps sur-vived and all the patients could walk normally 1 month after operation.The recovery of the function and sense was well 6 months after operation.Compared with the another well heel,the flaps had normal texture,color and appearance of heel.8 patients had complete follow -up,ranged form 6 months to 3 years.All cases survived with neither local recur-rence nor distant metastasis.Conclusion The anterolateral thigh flap can achieve good clinical effect in treating heel defect caused by the resection of malignant melamoma.And especially apply in large skin and tissue defect of heel area.The flap can weight,wear -resisting and reduce overheating and over cold damage.The range of resection can not be restricted by local skin flap.The clinical effect is satisfied.

Objective To observe and analyze the clinical curative effect of the platelet rich plasma (PRP) in treatment of chronic difficult to heal the wound.Methods We selected 60 patients with chronic difficult healing wounds and they were divide into two groups at random,30 patients of A group,B group of 30 patients.All patients were given routine debridement,drainage and decompression treatment,B group was given autologous PRP wound injection and follow-up on the basis of conventional treatment.After injection of PRP,platelet count,platelet recovery and application of PRP granulation tissue growth and wound healing were observed.Results The wound healing effect at the 7th,14th,21 st day between the two groups,and compared with the 1 st day,the differences were statistically significant (A group:10.28％,22.16％,43.25％,65.78％;B group:18.75％,37.58％,61.84％,80.26％;X2:7.895,8.934,10.231,9.076,all P ＜ 0.05).Two groups of patients had obvious difference in healing time,in B group the average healing time was (12.6 ± 5.2) d,which in was (17.3 ± 7.4) d,the difference was statistically significant (t =1.932,P ＜ 0.05).Conclusion The PRP can effectively promote the wound repair of soft tissue,to promote healing of chronic difficult wound healing,the curative effect is distinct,it is worthy of clinical popularization and application.

Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO₂), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.

Objective:To clarify the application value of direct cortical electrical stimulation (DES) in locating vestibular functional cortices and the distribution of vestibular functional cortices.Methods:Implantation of stereo-electroencephalography (SEEG) electrodes was performed in 17 drug-resistant epilepsy patients in our hospital from January 2016 to December 2019. The clinical data of these patients were retrospectively analyzed. DES was performed on these patients and stimulation sites eliciting vestibular symptoms were selected to evaluate accurately anatomic locations of stimulation sites eliciting vestibular symptoms in standard Montreal Neurological Institute (MNI) space, and acquired accurate vestibular functional maps in groups.Results:There were 33 stimulation sites eliciting vestibular symptoms, including 9 sites (28%) located in the supramarginal gyrus, 6 sites (18%) located in the precuneus, 6 sites (18%) located in the posterior insular cortex, 1 site (3%) located in the anterior insular cortex, 4 sites (12%) located in the superior temporal gyrus, 2 sites (6%) located in the middle temporal gyrus, 4 sites (12%) located in the precentral gyrus, and 1 site located in cingulate cortex (3%). Stimulation sites eliciting vestibular symptoms induced by lowest intensity located in the insular cortex (average intensity was 2.43 mA), and the average intensity of 6 stimulation sites located in the posterior insular cortex was 2.17 mA.Conclusion:The functional cortex associated with vestibular symptoms defined by DES sites including the insular cortex, superior temporal gyrus, middle temporal gyrus, superior marginal gyrus, precuneus, precentral gyrus, and cingulate cortex.

ObjectiveThe heightened expression of local immunoglobulins is a significant pathological characteristic of chronic rhinosinusitis with nasal polyps （CRSwNP）， particularly in the Asian population. This study is centered on exploring the association between MZB1 and the localized aggregation of immunoglobulins in Asian individuals with CRSwNP. MethodsNasal polyp tissues obtained from 40 CRSwNP patients and inferior turbinates from 6 healthy controls underwent examination for both mRNA and protein levels. The assessments were conducted using polymerase chain reaction， luminex， and immunohistochemical staining. Statistical analyses， including one-way Anova （ANOVA）， independent samples t-test， and Pearson's correlation analysis， were employed for comprehensive data evaluation. ResultsThe mRNA expression levels of MZB1（P < 0.01） and HSP90B1 （P < 0.01） were significantly higher in type 2 CRSwNP patients compared with those in healthy controls. Immunohistochemical staining revealed a significant increase in MZB1 protein expression in type 2 CRSwNP. MZB1 demonstrated correlation with the expression of immunoglobulin E in nasal polyp tissues （P < 0.01， r = 0.52）. Additionally，MZB1correlated with the expression ofIL-5（P < 0.05， r = 0.4） and IL-13 （P < 0.05， r = 0.44） in nasal polyp tissues. Furthermore，MZB1showed correlation with the number of eosinophils in nasal polyp tissues （P < 0.05， r = 0.72）. ConclusionThe expression of MZB1 is notably elevated in Asian CRSwNP， particularly in type 2 CRSwNP， when compared with controls.MZB1expression correlates significantly with high IgE expression and disease severity in nasal polyp tissues.