BACKGROUND:The resorption and unprediction of fat transplantation directly influence the clinical application. The technology of reducing graft resorption by using various cytokines to promote early revascularization of fat transplantation needs to be improved. But the effect is not stable, as the cytokines losing with the bleeding and exudation thus cannot long-term affect the vascular endothelial cells. OBJECTIVE:To investigate the effect of alkaline recombinant basic fibroblast growth factor-dextran formed sustained-release system on the early revascularization of fat grafts. METHODS:The recombinant basic fibroblast growth factor solution 2 mg/L and basic fibroblast growth factor-dextran sustained-release granules were prepared. The fat tissues were selected from the inguinal region of 12 Sprague-Dawley rats for fat transplantation. The left backs of the rats were treated with subcutaneously injection of fat pearl plus recombinant basic fibroblast growth factor solution (control group), and the right backs of rats were treated with subcutaneously injection of fat pearl plus basic fibroblast growth factor-dextran sustained-release granules (sustained-release system group). At 7 and 14 days after treatment, one rat in each group was sacrificed randomly, then ink perfusion microvascular imaging was used to observe the inside of the graft and the density of early formed coated vessels. At 90 days after transplantation, the rest rats were sacrificed, and the grafts were obtained to measure the volume. RESULTS AND CONCLUSION:At 7 and 14 days after transplantation, the number of vessels in the capsule and grafts of the sustained-release system group was higher than that in the control group (P<0.01). At 90 days after transplantation, the volume of grafts in the sustained-release system groups was bigger than that in the control group (P<0.05). The recombinant basic fibroblast growth factor-dextran delivery system could better promote the early revascularization of fat grafts. The experimental results suggest that recombinant basic fibroblast growth factor-dextran sustained-release system can help to reduce the absorption of fat grafts after surgery.

Objective To determine the factors responsible for failed postnatal immunoprophylaxis for hepatitis B virus(HBV) in Qidong, China. Methods Eleven children who developed into chronic HBV infection after receiving HBIG and HBV recombinant vaccines were recruited into the study. Eleven paired mothers with chronic hepatitis and other 6 mothers whose children successfully generated anti-HBs after im-munoprophylaxis were included as the control in the study. Full-length HBV DNA was amplified through ser-um sample by PCR method and underwent cloning and sequencing. HBV DNA level was quantified by real-time PCR. Results The mean levels of HBV DNA in mothers who had HBV DNA positive children and healthy children were ( 1.2 ×107± 3.1 × 106 ) copies/ml and ( 1.6× 107±8.8×106 ) copies/ml, respec-tively. There was no significant difference between the groups (P >0.05). Meanwhile, viral load in chil-dren was unrelated to that in their mothers (r2 =0.2429). In 11 HBV DNA positive children, 4(36.4% ) demonstrated amino acid substitutions in HBsAg "a" determinant region with 6 different types, I.e. T125A, I126T, Q129H, M133V, D144V and G145A. All of the mothers showed the wild-type sequence in "a" epitope, indicating surface escape mutants were not acquired from the initial infection, but developed under the immune pressure. The mutation rates after immunoprophylaxis for preS1, preS2, S, X, preC/C and P genes were 0.38%, 0. 22%, 0.27%, 0.17%, 0.11%, and 0.11%, respectively, nt2999-3157 in preS1, nt529-677 in S, nt1955-2016 in C, nt923-1001 and nt2489-2602 in P genes were among the hottest muta-tional spots throughout the HBV genome. Conclusion HBV mutation may occur in all the open readingframes after passive and active immunoprophylaxis. In addition to S gene, HBV preS and P genes could alsoassociate with the escape mutants.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.