Objective To investigate the effect of ReCell technique on diabetic foot and explore main nursing measures. Methods Forty patients with diabetic foot were divided into control group(n=20)and experiment group(n=20)according to admission time. With wound bed prepared, the control group received only free skin flap grafting and the observation group was managed with ReCell technique plus free skin flap grafting.The skin flap survival and treatment time in two groups were observed and compared. Result The skin flap survival in the experiment group was better than the control group and the treatment time was shorter. Conclusion ReCell technique is effective in raising the survival rate of skin flap in diabetic foot and shortening treatment time.The improvement of nursing measures is critical for the success of ReCell technique.

Objective To investigate the effect of clinical nursing paths on function rehabilitation guiding of burn patients. Methods 90 burn patients were randomly divided into observation group (n=45) and control group (n=45). The observation group was guided rehabilitation with clinical nursing paths, while the control group with routine way. Results The scores of Barthel index, and physiological factors,psychological factors, social relations and environmental factors of World Health Organization Quality of Life-BREF improved more in the observation group than in the control group (P<0.001). Conclusion Application of clinical nursing paths to guiding function rehabilitation of burn patients can improve the activities of daily living and quality of life of burn patients.

Aim To establish phlegm and blood stasis, qi-stag-nation and blood stasis, phlegm turbid+qi-stagnation and blood stasis model in rats and to study the characteristics of animal models with different blood stasis. Methods SD rats were ran-domly divided into normal group, high fat diet group, chronic unpredictable mild stress group ( CUMS ) and high fat diet +chronic unpredictable mild stress group. Different states of blood stasis rat models were established by corresponding factors for 6 weeks. Indexes of weight, open field behavior, serum lipids and corticosterone were monitored dynamically at the 2 nd, 4 th, 6 th weeks. At the end of the experiment(6th week), the heart func-tion was detected by small animal ultrasound and the left ventric-ular intubation. The blood rheology indexes were detected by the viscosity tester and red blood cell deformation/aggregation test instrument. Results Compared with the normal group, blood stasis could be induced by high fat diet and chronic unpredicta-ble mild stress, introducing the influence of different degree on animal behavior, blood lipids, heart function and blood viscosi-ty. When the two factors were superimposed, the changes of the indexes about blood stasis were the most significant. Perform-ance as: compared with normal control group, a significant re-duction was observed in body weight ( P < 0. 01 ); horizontal movement, vertical movement and movement time were reduced (P<0. 01 or P<0. 05) at the 2 nd week;at the 2 nd and 4 th week, serum corticosterone was increased ( P <0. 01 or P <0. 05) as well as TG at the 4 th and 6 th week (P<0. 01); at the 6 th week, velocity of blood was slowed down ( P<0. 01 );left ventricular anterior wall and posterior wall thickness at end-systolic was increased ( P<0. 01 or P<0. 05 ); left ventricular diastolic index was increased ( P<0. 01 ); the maximum rate of myocardial contraction was decreased ( P < 0. 05 ); the whole blood viscosity was increased ( P<0. 01 ) . Conclusions Blood stasis could be formed by high fat diet and chronic unpredictable mild stress, which has different characteristics. When the two factors are superimposed, the abnormal behavior, blood viscosi-ty, heart function, blood lipid and other indexes of the animal could obviously appear, which can provide the basis for the stud-y of blood stasis syndrome and related drugs.

Objective Explore the safe nursing method of the plasma infusion for patients with extraordinarily severe burn in shock stage,ensure patients inputing plasma safely and timely,tide over shockstage smoothly.Method 68 patients with severe burn shock stage were randomly divided into experimental group and control group,both with 34 cases?The experimental group input plasma take regular blood transfusion methods and special nursing care,control group take usual care only.Result to take special nursing care for patients with severe burn in shockstage inputing plasma can reduce the incidence of adverse transfusion reactions,tide over shockstage smoothly,improve cure rates and reduce mortality?

Objective:To analyze the terminal survey data of hospice care services in a district of Beijing in 2020, and discuss its current situation and existing problems of hospice care services in this district for countermeasures, hence providing reference for the development of hospice care services.Methods:Data were collected from the " Terminal Survey Forms of the Second Batch of Hospice Care Pilot Areas in China in 2020" , which were reported by 4 tertiary hospitals and 5 community health service centers in a district of Beijing. The reporting timeframe ranged from January to December 2020. Text analysis method was used to analyze the hospice care mode, relevant security policies, hospice care team, case diagnosis categories, average hospitalization days and patient cost burden. All the data were subject to descriptive analysis.Results:In 2020, only 4 tertiary hospitals carried out outpatient, consultation and inpatient services of hospice care among the 9 medical institutions in a certain district of Beijing, and none of them carried out home hospice care services. The number of doctors and nurses engaged in hospice care in the four hospitals was 35 and 40 respectively; There were 267 inpatient cases of hospice care, including 121 cases of malignant tumors, accounting for 45.32%; The average hospitalization days of hospice patients (40.0 days) was more than that of the hospital (7.8 days); The average daily hospitalization cost of hospice patients (3 428.7 yuan) was lower than that of the hospital (3 605.6 yuan); Hospice care services had not been included in the scope of medical insurance payment, and the relevant security policies were not perfect.Conclusions:The work of hospice care service in a district of Beijing remains at an initial stage, and the professional team building and supporting policies for hospice care fail to catch up with the demand in this district. The authors suggest to speed up the development of hospice care in primary medical institutions, build a network of " hospital -community-family" levels, enhance training of professionals and technical personnel of hospice care, as well as establish and improve the medical security system, so as to promote the rapid development of hospice care services in this district.

Objective:To explore the role of tripartite motif-containing protein 21(TRIM21)in chronic apical periodontitis(CAP)and its potential mechanism.Methods:Human CAP tissue and normal periodontal tissue were collected.The expression of inflamma-tory factors(IL-1 β,IL-6,TNF-a,TGF-β1),osteoclast related genes(TRAP,RANKL,CTSK),macrophage polarization related genes(CD86,iNOS,CD206,Arg1)and TRIM21 were detected by RT-qPCR.TRIM21 protein was detected by immunohistochemical staining,and the osteoclasts was detected by tartrate resistant acid phosphatase(TRAP)staining.The inflammation cell model was es-tablished by stimulating Raw264.7 cells with lipoteichoic acid(LTA)or lipopolysaccharide(LPS),and the expression of the above factors was detected.The bone marrow-derived macrophages(BMDMs)extracted from wild-type and TRIM21-/-mice stimulated by LPS were used to verify the expression of the above factors by RT-qPCR,the osteoclasts were detected by TRAP staining,and the po-larization of macrophages was detected by immunofluorescence staining.Results:In CAP tissue the expression of inflammatory factors,osteoclast related genes,CD86,iNOS and TRIM21 increased,while CD206 and Arg1 decreased,and osteoclasts were more than that in normal tissue.The stimulation of LTA/LPS promoted the proliferation of Raw264.7 cells,and the expression of these factors in cells was consistent with that in tissues.After LPS stimulation,BMDMs of TRIM21-/-mice had lighter inflammation,lower expression of os-teoclast specific genes,fewer osteoclasts and lower M1 polarization than those of wild type mice.Conclusion:TRIM21 might promote the progress of CAP by promoting M1 polarization of macrophages.

Liver failure has various clinical types, a complex pathogenesis, and rapid disease progression, as well as a high mortality rate. Liver failure caused by hepatitis B virus infection is the most common type in China with severe conditions, various complications, and a mortality rate as high as 40%-90%. Invasive fungal disease secondary to acute-on-chronic liver failure can affect patients’ prognosis and increase mortality rate. This article introduces the research advances in hepatitis B-related liver failure, artificial liver, and invasive fungal disease secondary to acute-on-chronic liver failure in 2016.