Objective To investigate the risk factors of radiation-induced oral mucositis (ROM) and to provide evidence for the prevention of ROM. Methods The severity of ROM was observed and recorded in 56 patients with nasopharyngeal carcinoma. The association of the severity of mucositis with age , sex, clinical stage, concurrent chemoradiotherapy, white blood cell count,BMI index, smoking, alcohol intake, and history of diabetes were assessed by using multivariate logistic regression analysis. Results The severity of ROM was significantly associated with a decrease in leucocyte count (P<0.05), and it was not markedly correlated with the other eight factors (P>0.05). Conclusions Leukopenia was one of the risk factors for the development of ROM. In clinical pratice,leukopenia should be corrected in patients with bone marrow depression due to radiotherapy in a timely manner.

Objective To investigate the effect of anti-syphilis treatment on the perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis.Methods One hundred and ninety eight pregnant women complicated with syphilis were collected from Chengdu Hospital of Infectious Diseases during January 2010 and January 2012,including 98 cases received standard treatment,59 cases received nonstandard treatment and 41 cases did not receive treatment.Pearson x2 and partition of chi-square were used for the comparison of pregnant outcomes,neonatal prognosis and negative rates of rapid plasma circle card test (RPR) among 3 groups.Results The incidence of adverse pregnancy outcomes,including miscarriage,prematurity,still birth and congenital malformation were 4.08％,27.12％ and 63.41％ in three groups,respectively.The incidence of congenital syphilis,low birth weight,asphyxia in infants and neonatal death raised in from standard-treatment group,nonstandard-treatment group to untreated group.Congenital syphilis rates were 2.04％,18.75％ and 35.29％ in three groups,respectively.RPR titers in newborns from mothers with high RPR titer (≥ 1 ∶ 8) in standard-treatment group were significantly lower than those in nonstandard-treatment group and untreated group (x2 =37.122,P ＜ 0.01).RPR negative rates were 100.00％,59.26％ and 25.00％ in three groups,respectively (x2 =18.839,P ＜ 0.01).Conclusion Standard anti-syphilis treatment can improve pregnant outcome,neonatal prognosis and reduce the incidence of congenital syphilis.

OBJECTIVE:To provide reference for rational use of antibiotics to treat Pseudomonas aeruginosa (PA) infection in the clinic. METHODS:Resistant rate of PA in our hospital during 2011-2015 were analyzed retrospectively. Antibiotics use densi-ty(AUD)of 10 commonly used antibiotics were analyzed statistically,and the correlation of resistant rate with AUD was investi-gated by Spearman correlation analysis. RESULTS:One thousaud and eleven strains of PA were isolated in our hospital during 2011-2014,detection rate of PA always occupied the top 5 place. Top 3 antibiotics in the list of AUD were levofloxacin,ceftazi-dime,cefoperazone sodium and tazobactam sodium. AUD of piperacillin sodium and tazobactam sodium,levofloxacin,ciprofloxa-cin and meropenem were positively correlated with resistant rate of PA(r were 1.000,0.900,1.000,1.000,P<0.05). AUD of ce-foperazone sodium and tazobactam sodium were negatively correlated with resistant rate of PA(r=-0.900,P<0.05). AUD of imi-penem and cilastatin sodium,ceftazidime,gentamicin,aztreonam and amikacin had no correlation with resistant rate of PA(P>0.05). CONCLUSIONS:There is correlation between AUD of antibiotics and resistant rate of PA. It is of important significance to detect resistant rate of PA and the use of antibiotics regularly. Antibiotics should be selected cautiously in accordance with bacterial monitoring data,results of drug sensitivity tests,the amount and resistant rate of antibiotics,etc,in order to reduce resistant PA.

OBJECTIVETo discuss the operation method and characteristic of correcting upper eyelid depression by transposition of orbital septum fat.

METHODSDuring the double eyelid surgery, we set.the lateral orbital septum fat completely free, while the bottom is still connected with the middle orbital septum fat. We separate a tunnel from the middle to the inner side in orbital septum, and the separated orbital septum fat is transposed to the inner side of orbital septum by the tunnel with suturing fixation.

RESULTSFrom March 2008 to October 2013, 51 cases with upper eyelid depression were treated successfully. Patients were followed up for 3 months to 3 years (average, 7. 5 months) with sustained aesthetic results.

CONCLUSIONSOrbital septum fat transposition can successfully correct the upper eyelid depression. It should become a regular procedure in blepharoplasty.

Adipose Tissue ; transplantation ; Blepharoplasty ; methods ; Esthetics ; Eyelids ; abnormalities ; surgery ; Humans ; Orbit

Objective To observe the influencing of Yiqi Huayu Jiedu Prescription on the growth of HepG2 nude mice transplantation tumor and the expression of related factors of vascular mimicry. Methods Models of transplanted tumors, which were made by HepG2 cells in nude mice, were randomly divided into 7 groups, Yiqi Huayu Jiedu Prescription group, Astragali Radix group, Curcumae Rhizoma group, Paridis Rhizoma group, Gecko group, cis-platinum group, and model group. Except for the model group, the rest groups were given relevant medicine for intervention. 21 days later. HIF-1α, MMP-2, MMP-9, and E-cad were detected by immunohistochemistry, and Twist1 and Bcl-2 were detected by fluorescence quantitative PCR. Results Compared with the model group, tumor volume in the rest groups decreased (P<0.05), and the effect in the Yiqi Huayu Jiedu Prescription group was more obvious than the Astragali Radix group, Paridis Rhizoma group and Gecko group (P<0.05);The expression of vasculogenic mimicry structure was rare in each group, and the model group and cis-platinum group were the most obvious;Except for the Astragali Radix group, the expressions of HIF-1α, MMP-2, and MMP-9 showed statistical significance compared with model group (P<0.05);The expression of E-cad in the Yiqi Huayu Jiedu Prescription group and Astragali Radix group showed statistical significance (P<0.05);The expression of Bcl-2 in the Yiqi Huayu Jiedu prescription group, Paridis Rhizoma group, and Gecko group decreased significantly compared with the model group (P<0.05);The expression of Bcl-2 in the Yiqi Huayu Jiedu prescription group was much better than the other groups (P<0.05);The expression of Twist1 showed statistical significance in the Yiqi Huayu Jiedu Prescription group, Curcumae Rhizoma group, Paridis Rhizoma group, and cis-platinum group (P<0.05). Conclusion Yiqi Huayu Jiedu Prescription can reduce expression of HIF-1α, Twist1, Bcl-2, MMP-2, and MMP-9, and increase expression of E-cad, thereby inhibiting the formation of vascular mimicry.

Objective:To construct an evaluation index system of operation quality and effectiveness of compact urban medical groups and provide references for evaluation of compact urban medical groups.Methods:The evaluation index system was constructed by Delphi method,and the weight was determined by analytic hierarchy process.Results:The evaluation index system consisted of 5 primary indexes,12 secondary indexes and 40 tertiary indexes.Providing assessment methods for the construction of medical groups,the evaluation index system is scientific and authoritative.Conclusion:At the initial stage,policy support should be strengthened,innovative governance mechanisms should be explored,and measures such as implementing a community of responsibilities,strengthening information interconnection,and improving profit distribution mechanisms should be taken to gradually promote the construction of close urban medical groups.

Objective:To investigate the efficacy of intelligent visualization system (HoloSight Intelligent Visualization System) assisted reduction and screw fixation in the treatment of elderly pelvic fragility fracture.Methods:From January 2016 to December 2022, clinical data of 18 elderly patients aged over 75 years with pelvic fragility fractures surgically treated by our team were retrospectively analyzed. Among them, 11 cases were treated with closed reduction and hand-inserted percutaneous screw fixation to fix the posterior pelvic ring (control group), and 7 cases were treated with the assistance of the HoloSight intelligent visualization system for reduction and minimally invasive fixation (experimental group). In the control group, there were 3 males and 8 females with an age range of 75-94 years (mean age, 82±12 years). The pelvic fractures were classified as FFP type IIIa in 5 cases, IIIb in 2 cases, IIIc in 3 cases, and IV in 1 case. In the experimental group, there were 1 male and 6 females with an age range of 76-100 years (mean age. 83±14 years). The pelvic fractures were classified as FFP type IIIa in 4 cases, IIIc in 2 cases, and IV in 1 case. The surgical time, blood loss, effective intraoperative fluoroscopy times, fracture reduction quality (according to Matta standards), visual analogue scale (VAS), limb function rehabilitation (Majeed score) and postoperative complications were recorded and evaluated in both groups.Results:All patients underwent surgery successfully and were followed up for 6 months to 3 years(12 months on average), all pelvic fractures healed. Among the 7 cases of experimental group, a total of 13 screws were placed, and the adjustment times of guide pin for each screw were 3±1 times (range, 1-5 times), while 18 screws of the control group with the adjustment times of 7±2 times (range, 4-10 times), statistical difference was present ( t=6.99, P<0.001). The surgical time in experimental group (63±12 min) was shorter than that in control group 88±23 min, while effective intraoperative fluoroscopy times in experimental group (9±3 times) was less than that in control group (35±7 times), the difference were both statistically significant ( t=2.69, P=0.016; t=9.22, P<0.001). The intraoperative blood loss was 38±12 ml in the experimental group and 55±26 ml in control group, with no significant difference ( t=1.61, P=0.127). According to Matta's reduction criteria after surgery, the results of experimental group were excellent in 4 cases, good in 2, and fair in 1, while the result of control group were excellent in 5 cases, good in 3, fair in 2, and poor in 1. At the last follow-up, among the patients in experimental group, the Majeed score was 84±11, excellent in 3 cases, good in 2, and fair in 2. In control group, the score was 79±17, with excellent in 5 cases, good in 3, fair in 3. No statistical difference was observed in two groups ( t=0.69, P=0.501). The VAS was 6.4±2.6 preoperatively and 2.4±0.8 postoperatively in the experimental group, while in the control group was 6.9±3.1 preoperatively and 2.7±1.3 postoperatively, the data suggested an improvement in both groups ( t=3.89, P=0.002; t=4.14, P<0.001), while no statistical significant was observed in two groups at last follow-up ( t=0.55, P=0.593). Two cases of experimental group had loosening or withdrawal of the fixation screws in 9 and 12 months, but the fractures healed. Four cases of control group loose fixation screws in 4, 6, 9, and 12 months, two cases underwent revision surgery and other two cases healed. Conclusion:Intelligent visualization system assisted reduction and screw fixation in the treatment of elderly pelvic fragility fractures have the advantages of good reduction, accurate nail placement, less bleeding, less effective fluoroscopy, which improves the safety of surgery.

Objective To investigate the effects and potential mechanisms of ultrasound-guided thoracic paravertebral block(TPVB)combined with general anesthesia in patients undergoing thoraco-scopic surgery.Methods A total of 122 patients undergoing thoracoscopic surgery were selected and randomly divided into control group and tudy group,with 61 patients in each group.The control group received general anesthesia,while the study group received ultrasound-guided TPVB combined with general anesthesia.Clinical data and perioperative indicators were recorded and compared between the two groups.Mean arterial pressure(MAP),heart rate(HR),Visual Analogue Scale(VAS)scores before surgery,24 hours and 72 hours after surgery,and inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],oxidative stress indicators[malondialde-hyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)]levels before surgery and 72 hours after surgery were compared between the two groups.Postoperative adverse reactions were recorded.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of key molecules mRNA in the Nrf2/Keap1/ARE pathway in the peripheral blood of pa-tients in the two groups.Results There were no statistically significant differences in operative time and intraoperative blood loss between the two groups(P＞0.05).The study group had shorter extu-bation time and indwelling time of drainage tube,less total drainage volume,and less total PCIA drug consumption within 36 hours after surgery and times of patient controlled intravenous analgesia(PCIA)effective compression compared to the control group(P＜0.05).At 24 and 72 hours after surgery,MAP,HR,and VAS scores were higher than preoperative levels in the control group,while VAS scores were higher than preoperative levels in the study group,but MAP,HR,and VAS scores were lower in the study group compared to the control group(P＜0.05).At 72 hours after surgery,serum levels of IL-6,IL-10,TNF-α,and MDA were higher than preoperative levels,while SOD and GSH-Px levels were lower than preoperative levels in both groups.Additionally,the study group had lower serum levels of IL-6,TNF-α,and MDA and higher levels of IL-10,SOD,and GSH-Px compared to the control group(P＜0.05).The total incidence of postoperative adverse re-actions was 4.92％(3/61)in the study group,which was lower than 21.31％(13/61)in the con-trol group(P＜0.05).At 72 hours after surgery,the expression levels of Nrf2 mRNA and ARE mRNA in the peripheral blood of patients in the study group were lower than those in the control group,while the expression level of Keap1 mRNA was higher(P＜0.05).Conclusion Compared with general anesthesia,ultrasound-guided TPVB combined with general anesthesia can significantly improve hemodynamic stability and analgesic effects in patients with early-stage lung cancer after thoracoscopic surgery,relieve inflammatory and oxidative stress responses,and decrease the inci-dence of postoperative adverse reactions.The molecular mechanism may be related to the inhibition of Nrf2/Keap1/ARE signaling pathway activation.

Objective To investigate the effects and potential mechanisms of ultrasound-guided thoracic paravertebral block(TPVB)combined with general anesthesia in patients undergoing thoraco-scopic surgery.Methods A total of 122 patients undergoing thoracoscopic surgery were selected and randomly divided into control group and tudy group,with 61 patients in each group.The control group received general anesthesia,while the study group received ultrasound-guided TPVB combined with general anesthesia.Clinical data and perioperative indicators were recorded and compared between the two groups.Mean arterial pressure(MAP),heart rate(HR),Visual Analogue Scale(VAS)scores before surgery,24 hours and 72 hours after surgery,and inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],oxidative stress indicators[malondialde-hyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)]levels before surgery and 72 hours after surgery were compared between the two groups.Postoperative adverse reactions were recorded.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of key molecules mRNA in the Nrf2/Keap1/ARE pathway in the peripheral blood of pa-tients in the two groups.Results There were no statistically significant differences in operative time and intraoperative blood loss between the two groups(P＞0.05).The study group had shorter extu-bation time and indwelling time of drainage tube,less total drainage volume,and less total PCIA drug consumption within 36 hours after surgery and times of patient controlled intravenous analgesia(PCIA)effective compression compared to the control group(P＜0.05).At 24 and 72 hours after surgery,MAP,HR,and VAS scores were higher than preoperative levels in the control group,while VAS scores were higher than preoperative levels in the study group,but MAP,HR,and VAS scores were lower in the study group compared to the control group(P＜0.05).At 72 hours after surgery,serum levels of IL-6,IL-10,TNF-α,and MDA were higher than preoperative levels,while SOD and GSH-Px levels were lower than preoperative levels in both groups.Additionally,the study group had lower serum levels of IL-6,TNF-α,and MDA and higher levels of IL-10,SOD,and GSH-Px compared to the control group(P＜0.05).The total incidence of postoperative adverse re-actions was 4.92％(3/61)in the study group,which was lower than 21.31％(13/61)in the con-trol group(P＜0.05).At 72 hours after surgery,the expression levels of Nrf2 mRNA and ARE mRNA in the peripheral blood of patients in the study group were lower than those in the control group,while the expression level of Keap1 mRNA was higher(P＜0.05).Conclusion Compared with general anesthesia,ultrasound-guided TPVB combined with general anesthesia can significantly improve hemodynamic stability and analgesic effects in patients with early-stage lung cancer after thoracoscopic surgery,relieve inflammatory and oxidative stress responses,and decrease the inci-dence of postoperative adverse reactions.The molecular mechanism may be related to the inhibition of Nrf2/Keap1/ARE signaling pathway activation.

Objective:To detect serum levels of vitamin A (Vit A), vitamin D(Vit D)25-hydroxy vitamin D[25-(OH)D] and vitamin E(Vit E) in children aged 0-6 years in Tibetan Plateau of Garzi Prefecture, thus providing references for physical examinations and prevention of 4 key diseases (rickets, malnutrition anemia, pneumonia and diarrhea) in children in plateau areas by relevant government departments.Methods:A total of 2 122 children who participated in physical examination in 12 townships of Xiangcheng County and 14 townships of Daocheng County, Garzi Tibetan Autonomous Prefecture, Sichuan Province from April 2017 to April 2019 with 0-6 years old were recruited for surveying physical measurements and collection of venous blood.Serum Vit A and Vit E levels were detected by high performance liquid chromatography.Serum levels of 25-(OH)D were detected by high performance liquid chromatography tandem mass spectrometry.The relationship between Vit A, Vit E and 25-(OH)D levels with the gender, age, seasonal change and altitude was analyzed.Results:The serum Vit A level, subclinical Vit A deficiency rate and marginal vitamin A deficiency rate were(1.05±0.27) μmol/L, 8.15%(173/2 122 cases) and 45.99%(976/2 122 cases), respectively in 2 122 children with 0-6 years old.There were significant differences in the serum Vit A level, the subclinical Vit A deficiency rate and the marginal vitamin A deficiency rate in children with different ages, seasons and altitudes (all P<0.05). The serum level of 25-(OH)D and 25-(OH)D deficiency rate insufficient rate were (24.65±6.45) ng/L, 6.03%(128/2 122 cases) and 16.59%(352/2 122 cases), respectively.There were significant differences in the serum level of 25-(OH)D, 25-(OH)D deficiency rate and 25-(OH)D insufficient rate in children with different ages and seasons (all P<0.05). The mean serum Vit E level, Vit E deficiency rate and Vit E insufficient rate were (7.81±1.74) mg/L, 2.78%(59/2 122 cases) and 29.59%(628/2 122 cases), respectively.There were significant differences in serum Vit E level, Vit E deficiency rate and Vit E insufficient rate in children with different ages and seasons (all P<0.05). The mean serum levels of Vit A and Vit D remained the lowest before the age of 1 year, and their deficiencies at this age were the most significant.The mean serum level of Vit E remained the lowest in >1-2 years old, and its deficiency and insufficient at this age were the most significant.Vit A, D and E levels were significantly affected by seasonal changes, which were significantly higher in the summer than in the spring, autumn and winter.In addition, Vit A and 25-(OH)D were significantly affected by the altitude, which were the lowest above 4 km altitude. Conclusions:The overall serum levels of Vit A, 25-(OH) D and E in children with 0-6 years old in Tibetan Plateau areas of Ganzi Prefecture are lower than those in plain areas.Vit A, 25-(OH) D and Vit E levels significantly differed in the age, season and altitude, which are related to the lack of local resources, insufficient maternal nutrition during pregnancy and insufficient intake after birth, as well as temperature and light caused by changes in local seasons and altitude.Therefore, it is necessary to make reasonable supplements during pregnancy to prevent vitamin deficiency.