OBJECTIVE: To study the feasibility of using biodegradable chitosan nanoparticles as new type carriers for controlled GM-CSF delivery system. METHODS: GM-CSF and BSA loaded chitosan nanoparticles were prepared by ion cross linking method using tripolyphosphate as cross-linking agent with its morphology observed by transmission electron microscope. The encapsulating efficiencies of GM-CSF and BSA were determined respectively by fluorescence scanning and ultraviolet spectrophotometer. The in vitro drug release properties of chitosan nanoparticles were studied as well. RESULTS: Morphologically, the nanoparticles were spherical with mean particle size of 201nm. The encapsulating efficiencies of GM-CSF and BSA were 62.1% and 58.5%, respectively, and their in vitro accumulative drug release rates on the 3rd day were 69% and 82% respectively. CONCLUSION: The ion cross linking method is fit for the preparation of GM-CSF loaded chitosan nanoparticles.

Objective To observe the clinical efficacy using curette and stripping wire method in treating diabetic foot. Methods 36 hospitalized patients diagnosed as diabetic foot were enrolled, and 18 of them were chosen as the experimental group according to random digital table method who was treated with medical therapy plus curette and stripping wire method in treating diabetic foot. The other 18 patients were named as the control group who were treated by medical treatment and routine treatment. The granulation tissue maturity, wound healing, and the differences on curative effect were compared. Results 10 cases′wound granulation tissue maturity in the experimental group got++and+++on the 10th day while 4 cases in control group. Wound healing rate of the experimental group at the 10th and 14th day were (78.6±10.5)%and (82.7±8.4)%while the control group were (43.2±8.7)%and (66.2±10.1)%. Cure rate of the experimental group was 14/18 four weeks after treatment, the inefficiency was 0, while the control group was 6/18 and 3/18. Conclusions Curette and stripping wire method is a good method to promote the dressing diabetic foot wound healing. It is superior to traditional methods, worthy of clinical application.

Objective Through the exploration of virtual simulation surgery to find a way to treat lumbar spinal metastases. Methods Based on 64 row spiral CT continuous 2-dimensional images of lumbar segments, normal lumbar vertebral, destruction of disease, abdominal aorta and kidneys were reconstructed by the Mimics software. 3D visualization structure was contemplated by anterior lesions clear, titanium mesh of bone cement support, and posterior pedicle screw fixation. Results The three-dimensional reconstruction distinctly displayed the structures of lumbar and its adjacent organs, and the entire virtual simulation surgery was intuitive. Conclusion The application of virtual simulation surgery ensures more accurate 3D model of lumbar establishment and its adjacent organs, and it provides an objective basis for in-dividualized treatment programs.

Objective To compare the effectiveness of controlling blood loss in the treatment of complex acetabular fracture between temporary occlusion of abdominal aorta by interventional balloon (TOAAIB),temporary occlusion of common iliac artery by interventional balloon (TOCAIIB) and internal iliac artery ligation (IIAL).Methods Included for this study were 113 complex acetabular fractures which had been treated at Department of Orthopaedic Trauma,Shaoguang Hospital Affiliated to Southern Medical University from January 2000 through January 2017.There were 68 males and 45 females,aged from 23 to 61 years (average,42.3 years).According to the Letournel classification,all of them belonged to complex fractures,including 10 T-type,24 double-column,16 posterior column & posterior wall,46 transverse & posterior wall and 15 anterior & posterior half-transverse ones.They were all treated by open reduction and internal fixation but differed in surgical hemostasis techniques:TOAAIB was used in 37cases,TOCAIIB in 31 and IIAL in 45.Fracture reduction was evaluated by Matta criteria.Intraoperative bleeding and postoperative wound drainage,fracture union and complications related to interventions were recorded.Hip function was evaluated by Modified d'Aubigne & Postal clinical grading system after fracture healing.Results The 3 groups (TOAAIB,TOCAIIB and IIAL) were comparable because there were no significant differences in gender,age,time from injury to surgery,Letournel classification or surgical approaches between the patients in the 3 groups (P ＞ 0.05).Anatomical reduction was achieved in 91.15％ of the patients (103/113) and satisfactory reduction in 8.85％ (10/113).Intraoperative hemorrhage was 1,631.5 ±675.5 mL in the HAL group,892.6 ±217.7 mL in the TOCAIIB group and 648.0 ± 170.2 mL in the TOAAIB group,showing significant differences between the 3 groups (P ＜ 0.05).One case of femoral artery thrombosis occurred in the TOAAIB group at the end of operation but was cured by symptomatic treatment of anticoagulation.There were no interventional complications in the other 2 groups.There were no significant differences between the 3 groups in postoperative wound drainage,fracture union time,hip function score or complications (P ＞ 0.05).Conclusions In controlling intraoperative bleeding in the surgery for complex acetabular fracture,TOAAIB may be the best,followed by TOCAIIB,and IIAL may be the worst.However,choice of a proper surgical hemostasis technique should also depend on the specific intraoperative condition of a specific patient.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

OBJECTIVE To study the toxicity of the extract from Mi ao medicine Wikstroemia indica to zebrafish . METHODS Zebrafish embryo model was used as the object ，after exposure to W. indica extract （10，20，40 μg/mL），the number of spontaneous twitching within 1 min，heart rate within 10 s，the occurrence of malformation and death were detected and recorded . Zebrafish was used as the object ，after exposure to W. indica extract（10-100 μg/mL）for 24，48 and 72 h，and the median lethal concentration（LC50）of W. indica extract to zebrafish at different time points were calculated . After exposure to low ，medium and high concentration （27，37，51 μg/mL）of W. indica extract，the liver phenotype ，hepatocyte apoptosis and lipid deposition of zebrafish were observed ，and the activities of alanine aminotransferase （ALT），aspartate aminotransferase （AST）and lactate dehydrogenase（LDH）in liver tissue were detected . RESULTS Compared with blank group ，the number of spontaneous twitching ， malformation rate （except for 10 μg/mL group ）and mortality of embryos increased significantly in 10，20，40 μg/mL groups of W. indica extract，and the heart rate （except for 10，20 μg/mL group ）of embryos decreased significantly （P＜0.05）. LC50 of W. indica extract to zebrafish at 24，48 and 72 h were 39.850，28.300 and 21.490 μg/mL，respectively. After drug treatment ，the transparency of liver area of zebrafish in low ，medium and high concentration groups of W. indica extract reduced and their shape were enlarged；apoptosis and lipid deposition increased ；the activities of ALT ，AST and LDH in liver tissue were significantly increased （P＜0.05）. CONCLUSIONS Miao medicine W. indica extract had develop mental toxicity to zebrafish embryos and he patotoxicity to zebrafish .