ObjectiveTo investigate the changes of arterial base deficits (BD) in the early stageof extensive burned patients. MethodsWe perform a retrospective review of 126 patients with a totalbody surface area (TBSA) over 30% whose resuscitations were initiated with the Ruijin formula to ob-serve the BD changes and analyze the relationship of BD and TBSA at different postburn time intervals insurvivors and deaths. ResultsWithin 48h after burn injury, the BD value improved gradually. Thedifference between survivors and nonsurvivors was significant at 4 to 8h interval after burn injury ( P <0.05). BD was correlated with TBSA strongly during 4 to 16h after burn injury ( P ≤0.05)in nonsur-vivors, but not in survivors. The incidence of the shock－ related complications in survivors was higherthan in nonsurvivors. ConclusionBD could be one of monitor index in the shock stage after severeburM injury.

BACKGROUND:Lysophosphatidic acid (LPA) had 3 kinds of receptors in vitro. Some researches had showed that LPA1, LPA2 and LPA3 receptors distributed widely in mouse cerebral cortex, nephritic external medulla layer and internal medulla layer, spermary, thymus, heart, lung, stomach, spleen, whereas less in liver, small intestine and skeletal muscles. Whether there are various LPA receptors in mouse VSMC membrane deserves further study.OBJECTIVE: To observe the mRNA expression of LPA receptors in vascular smooth muscle cells (VSMC).DESIGN: Observational comparative experiment.SETTING: Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: A total of 24 C57BL/6 mice aged 7-8 weeks, of either sex, with the body mass of approximately (25±3) g,were purchased from the Animal Department of Tongji Medical College, Huazhong University of Science and Technology. Trizol was purchased from America Invitrogen; dNTP Mix, Rnasin were obtained from TaKaRa; M-MLV reverse transcriptase and buffer system were from Promega; Taq DNA-polymerase and buffer system were from Biostar.Oligo(dT)18 primer were from Sangon, Shanghai. Primer sequences were designed referring to literature and nucleotide sequence database and synthesized by Sangon, Shanghai.METHODS: The experiment was conducted at the Comprehensive Laboratory, Tongji Medical College, Huazhong University of Science and Technology between August 2005 and January 2006. Mice were anaesthetized by abdominal cavity with 20 g/L ketamine (5 mL/kg). Thoracic aorta was obtained sterilely, and VSMC was cultured with adherence method. The 4th-6th passage cells were used in the trial. Cell purity was over 95%. Reverse transcriptase-polymerase chain reaction (RT-PCR) was applied to determine the mRNA expression of LPA receptors gene in mouse VSMC.MAIN OUTCOME MEASURES: Detection of mRNA expression of LPA receptors in mouse VSMC and comparison of receptor types.RESULTS: There were no significant differences between the expressions of LPA1 receptors and LPA2 receptors (P ＞ 0.05). Compared with LPA1 receptors and LPA2 receptors (0.79±0.05,0.82±0.06), the LPA3 receptor expression was lower (0.53±0.05, q =23.78,26.53, P＜ 0.01 ).CONCLUSION: There are 3 kinds of LPA receptors in VSMC, and their molecular masses are 600 bp, 463 bp and 899 bp,respectively. There are no differences for the expressions between LPA1 receptors and LPA2 receptors, while the LPA3 receptor expression is less.

Objective: To study the antihyperglycemic effect of flavonoids from seed (FSH) and fruit(FFH) of Hippophae rhamnoides L.on diabetic rats induced by streptozotocin (STZ). Methods: The STZ-induced diabetic rats were randomly divided into four groups and were given intragastrically (ig) water, metformin, FSH and FFH respectively once a day. After four weeks, the levels of serum glucose, fructosamine, lipid, protein, GSH and lactic acid (LD) were assayed. Results: FSH could reduce the levels of serum glucose, fructosamine and triglyceride significantly, increase the contents of serum total protein and albumin obviously, enhance the ability of antioxidation in STZ-induced diabetic rats. FSH also could decrease food and water intake of diabetic rats evidently. But FSH had little effect on LD, LDH, glycogen and body weight in diabetic rats. FFH was not as good as FSH. Conclusion: FSH is antihyperglycemic , and can improve the metabolic derangements of STZ- induced diabetic rats.

Objective To explore the impact of healthcare-associated septicemia (HAS)on hospitalization expense as well as length of hospital stay,so as to optimize the allocation of healthcare resources,and provide scientific basis for reducing the economic burden caused by septicemia.Methods Hospitalized patients with confirmed HAS in a tertiary first-class teaching hospital between June 1 ,2012 and May 31 ,2015 were investigated retrospectively,con-trol group was set up in a 1 :1 ratio,hospitalization expense and length of hospital stay between two groups were compared.Results A total of 285 cases and 285 controls were enrolled in the study,the median of hospitalization expense in case group was higher than control group (￥19 718.39 vs ￥9 289.04,P <0.05);the median of length of hospital stay in case group was longer than control group (14.89 days vs 9.22 days,P <0.05).The disease bur-den caused by septicemia in different age groups and departments were different.The improvement rate of case group was lower than control group (76.49% [218/285 ]vs 83.51 % [238/285 ],χ2 = 2.562,P = 0.009 ). Conclusion As the common blood stream infection in hospitalized patients,septicemia not only increased the ex-pense of diagnosis and treatment,but also affected turnover rate of hospital bed.Rapid and effective diagnosis and treatment is significant o prevent and control septicemia.

Objective To explore the risk factors of lung cancer in non-smoking Chinese women and to provide evidence for lung cancer prevention and control.Methods Information was collected on case-control studies published in the journals,both nationally and internationally from January,1995 to November,2014 that reported correlations between lung cancer and risk factors.Pooled odds ratio (OR) and 95％ confidence interval (CI) of risk factors on lung cancer in non-smoking Chinese women were calculated,using the Meta-analysis method,with sensitivity and publication bias tested.Results Information on 24 case-control studies was selected including 11 946 cumulative cases and 12 596 controls.Pooled ORs (95％CI) were shown as:history of lung diseases 1.89 (1.57,2.27),history of tuberculosis 1.86 (1.53,2.27),history of chronic bronchitis 1.51 (1.04,2.19),family history of cancers 2.02 (1.67,2.44),family history of lung cancers 2.45 (1.80,3.34),passive smoking (at workplace in adult period 1.47 (1.28,1.69),at home in adulthood 1.22 (1.09,1.36),in all life's time 1.52 (1.29,1.79),kitchen smog while cooking 2.21 (1.27,2.96),position of kitchen 1.76 (1.48,2.09),and frequency of deep frying per week 2.24 (1.61,3.12) etc.respectively.Conclusion Major risk factors related to lung cancer in non-smoking Chinese women would include lung diseases,family history of cancers,and passive smoking (tobacco smog and cooking smog).Particularly,the combination of family history and the degree of cooking presented stronger correlation effects,indicating that genetic and environmental factors jointly played an important role in the development of lung cancer.

According to a document issued by the General Office of National Health Commission, "one person, one diagnosis, and one room" is required in the process of outpatient consultation. However, the patient will need to go to another room for dressing change after the doctor checks the wound if sticking to the conventional layout of current wound repair specialist outpatient clinic in hospitals and following the regulation of "separation of diagnosis and treatment". To allow a patient walking back and forth with the exposed wounds to different clinics or going to another clinic for dressing change with the original dressing reapplied to the wound is against the regulation of nosocomial infection control and the principle of sterility. To ensure that the layout of the outpatient clinic in the wound repair outpatient department not only conforms to the principle of "one person, one diagnosis, and one room", but also meets the characteristics of the diagnosis and treatment process of chronic wounds, this paper proposes the layout of "large space and small partition" in the wound repair clinic.

Objective:To analyze the distribution and drug resistance of wound pathogenic microorganisms in outpatients of wound healing center so as to provide a basis for the standardized construction of wound healing centers.Methods:A retrospective case series study was used to analyzed the data of 365 outpatients treated at Ruijin Hospital, Shanghai Jiaotong University School of Medicine from December 2017 to October 2019. There were 220 males and 145 females, aged (58.8±18.9)years (range, 18-98 years). The patients included 92 first-visit patients and 273 re-visit patients. The culture results (positive rate of pathogenic microorganisms, bacterial species, bacterial distribution) and drug sensitivity results of the wound secretions were compared and analyzed.Results:(1) Among 365 samples of wound secretions, 198 patients were positive for pathogenic microorganisms with a positive rate of 54.3%. A total of 107 strains (51.0%) of Gram-positive bacteria were detected, mainly Staphylococcus aureus (70 strains, 33.3%); 95 strains (45.2%) of Gram-negative bacteria were detected, mainly Escherichia coli (20 strains, 9.5%), followed by Pseudomonas aeruginosa (17 strains, 8.1%); 8 strains (3.8%) of fungi were detected. (2) A total of 26 (28.3%) first-visit patients were positive for pathogenic microorganisms, and 172 (63.0%) re-visit patients were positive for pathogenic microorganisms. The rate of positive microorganism detection had significant differences between first-visit and re-visit patients ( P<0.05). (3) A total of 29 strains were detected in first-visit patients, including 16 strains (55.2%) of Gram-positive bacteria, 11 strains (37.9%) of Gram-negative bacteria and 2 strains (6.9%) of fungi. A total of 181 strains were detected in re-visit patients, including 91 strains (50.3%) of Gram-positive bacteria, 84 strains (46.4%) of Gram-negative bacteria and 6 strains (3.3%) of fungi. The microbial distribution was significantly different between first-visit and re-visit patients ( P<0.05). (4) Compared with first-visit patients, the resistance of Staphylococcus aureus isolated from the re-visit patients to spenicillin, oxacillin, ciprofloxacin, tetracycline, clindamycin, moxifloxacin, erythromycin, and levofloxacin were increased variably. No vancomycin-resistant Staphylococcus aureus was detected, indicating that the staphylococcus aureus presented in the wound was highly sensitive to vancomycin. Conclusions:Staphylococcus aureus is the most common microorganism in wound secretions in outpatients of wound healing center. The rate of positive pathogenic microorganisms in wound secretions of re-visit patients is significantly higher than that of first-visit patients, and the distribution of pathogenic microorganisms of first-visited and revisited patients differs significantly. The Staphylococcus aureus detected in re-visit patients has a higher resistance to common antibiotics compared with first-visit patients. It is suggested that timely detection of pathogenic microorganisms in outpatients and effective control and supervision of outpatient infections are important contents that cannot be ignored in the construction of wound healing center.

Objective To investigate the effects of rotavirus ( RV) on the expression and bioactiv-ity of Na+-H+ exchanger 3 ( NHE3 ) in Caco-2 cells and the possible regulatory mechanism. Methods Caco-2 cells expressing NHE3 were constructed and divided into four groups as follows: control ( CTL ) group, RV group, BAPTA-AM ( a Ca2+ chelator) group and BAPTA-AM+RV group. Na+-H+ exchanger ac-tivity and NHE3 expression on cell surface were determined using BCECF-AM and biotinylation assay, re-spectively. Expression of Cdc42 at protein level was measured by Western blot. Results Compared with the control group, RV infection significantly decreased the activity of NHE3 and its expression on cell surface. BATPA-AM antagonized the inhibitory effects on NHE3. Moreover, the expression of Cdc42 at protein level was increased following RV infection, which was also antagonized by BATPA-AM. Conclusions Intracellu-lar Ca2+-mediated Cdc42-dependent endocytosis pathway might be involved in regulating the expression and bioactivity of NHE3 during RV infection.

Background::Understanding willingness to undergo pulmonary function tests (PFTs) and the factors associated with poor uptake of PFTs is crucial for improving early detection and treatment of chronic obstructive pulmonary disease (COPD). This study aimed to understand willingness to undergo PFTs among high-risk populations and identify any barriers that may contribute to low uptake of PFTs.Methods::We collected data from participants in the "Happy Breathing Program" in China. Participants who did not follow physicians’ recommendations to undergo PFTs were invited to complete a survey regarding their willingness to undergo PFTs and their reasons for not undergoing PFTs. We estimated the proportion of participants who were willing to undergo PFTs and examined the various reasons for participants to not undergo PFTs. We conducted univariable and multivariable logistic regressions to analyze the impact of individual-level factors on willingness to undergo PFTs.Results::A total of 8475 participants who had completed the survey on willingness to undergo PFTs were included in this study. Out of these participants, 7660 (90.4%) were willing to undergo PFTs. Among those who were willing to undergo PFTs but actually did not, the main reasons for not doing so were geographical inaccessibility ( n = 3304, 43.1%) and a lack of trust in primary healthcare institutions ( n = 2809, 36.7%). Among the 815 participants who were unwilling to undergo PFTs, over half ( n = 447, 54.8%) believed that they did not have health problems and would only consider PFTs when they felt unwell. In the multivariable regression, individuals who were ≤54 years old, residing in rural townships, with a secondary educational level, with medical reimbursement, still working, with occupational exposure to dust, and aware of the abbreviation "COPD" were more willing to undergo PFTs. Conclusions::Willingness to undergo PFTs was high among high-risk populations. Policymakers may consider implementing strategies such as providing financial incentives, promoting education, and establishing community-based programs to enhance the utilization of PFTs.

Objective:To explore the clinical effects of pedicled omental flap transplantation in repairing secondary rejection wounds after brain pacemaker implantation.Methods:A retrospective observational study was conducted. From January to August 2021, 5 patients with secondary rejection wounds after brain pacemaker implantation who met the inclusion criteria were admitted to the Wound Repair Center of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine, including 3 males and 2 females, aged 56-69 years, with the wound developed at the pulse generator implantation site in the chest in 2 cases, at the connection site of the wire and electrode behind the ear in 2 cases, and at both the chest and the back of the ear in 1 case. All the wounds were repaired by pedicled omental flap transplantation. The wound area after debridement was 2-15 cm 2. After operation, the wound healing and related complications (pain, infection, incisional hernia, omental flap necrosis, etc.) were observed. During follow-up, the recurrence of the wound was observed. Results:The wounds of all 5 patients healed within 2 weeks after operation, without related complications. During follow up of 12-18 months, 1 patient got a recurrence of rejection wound behind the left ear 4 months after surgery and eventually had the brain pacemaker removed; the other 4 patients had no recurrence of wounds.Conclusions:Pedicled omental flap transplantation can repair the secondary rejection wounds after brain pacemaker implantation safely and effectively, with few postoperative complications.