Objective To evaluate the use of the kite flap (als o known as subcutaneous pedicled V-Y advancement flap)for the repair of moderate -sized anterior lamellar skin defects of eyelid. Methods Since 1994, kite flaps have been used to repair anterior lamellar skin defects of eyelids in 14 patients. Six patients were male and eight female, with a mean age of 43 years (range 15-64 years). The diameter of the largest defect reache d 1/3 length of the eyelid. The flaps were designed adjacent to the defects and the incision line corresponding to natural winkle lines on the eyelid. We underm ined the flap under the orbicular muscle, and advanced the flap to cover the def ect. The incisions were closed with 7-0 suture. Results After operation, all flaps survived with primary healing. Follow-up for 3 to 12 months showed that all cases had achieved satisfactory cosmetic effects without secondary deformity. Conclusions It is a simple, safe, an d reliable method to use kite flap for the repair of moderate-sized anterior la mellar eyelid skin defects that are too large to achieve primary approximation. Because kite-flap covers the defect through a direct advancement way without ro tation and twist, there are no dog-ear deformitys present at the pedical area a nd the repaired area looks smoothly. Because of its widely based muscle pedicle which incorporates venous and lymphatic drainage over most of its length, the un desirable pigment deposition is avoided.

Type 2 diabetes mellitus (T2DM) is a common chronic metabolic disorder,it results from an interaction of environmental as well as genetic factors.There were several kinds of oral antidiabetic drugs (OADs),including biguanides,sulfonylureas,thiazolidinediones,and meglitinides,etc.Several genes have been identified to be associated with disease development and therapeutic outcomes.Inter-individual variations in the human genome affect both,risk of T2DM development and personalized response to identical drug therapies.Pharmacogenomics approaches focus on single nucleotide polymorphisms and their influence on individual drug response,efficacy and toxicity.Therefore,pharmacogenomics in T2DM is of great importance towards precision medicine which will greatly improve the efficacy of diabetes treatment.In this paper,antidiabetic drugs and related gene polymorphism researches are reviewed.

Chinese materia medica (CMM) has double complexity in bioactive ingredient and its mechanism. It is difficult to explain by the modern biomedicine theory So it seriously restricts the modernization of CMM The modern CMM should have the high quality standard to meet the needs of international standard It can be guaranteed by spreading the GAP for Chinese medicinal materials and GMP for standard production The mechanism depends on using the DNA microarray to set up “the gene expression difference chart”, to study on the combination of CMM and gene expression difference chart Meanwhile, we can establish a totally new method of screening modern CMM based on the gene expression difference chart, it can really make the modernization and internationalization of CMM

Objective To study the adjustment principle and optimizing methods of the image processing parameters of Computed Radiography(CR), including the image density, contrast degree, tissue equalization, spatial frequency, LUT curve,etc. Methods Konica REGIUS MODEL170 CR was applied to adjust various image processing parameters on its CS-1 console. Results Images of all parts of body could be optimized and improved. Conclusion High-quality medical images are available only if the adjustment methods of image processing parameters are completely comprehended and reasonably applied.

Objective To explore the effects of finasteride therapy on the expressions of heat shock protein 70(HSP70)mRNA,heat shock protein 22 (HSP22)mRNA,tumor necrosis factor-alpha (TNF-a),interleukins-1β (IL-1β) in elderly patients with benign prostatic hyperplasia (BPH).Methods Totally 68 elderly men patients with BPH were divided into two groups:regular treatment group (n=34) and finasteride treatment group(n=34),30 elderly men patients without BPH were as control group.The blood samples of patients after treatment were collected for the detections of HSP70mRNA and HSP22mRNA with RT-PCR,meanwhile,the levels of TNF-α,IL-1β were measured by radioimmunoassay (RIA).Effect of treatment was evaluated in accordance with International Prostate Symptom Score (IPSS).Results The expressions of HSP70 mRNA and HSP22 mRNA,TNF-α,IL-1β in BPH patients were higher in finasteride group than in control group (P＜0.01).After 12 weeks therapy,the levels of HSP70mRNA,HSP22mRNA,TNF-α and IL-1β were decreased in finasteride group (P＜0.01 or P＜0.05) but no significantly difference in regular treatment group.Compared with regular treatment group,the expressions of HSP70 mRNA,HSP22mRNA and TNF-α were reduced in the finasteride group after treatment (P＜0.01 or P＜0.05),IPSS was more improved (P＜0.05),but IL-1β was not distingished between two groups (P＞0.05).IPSS was positively related to the levels of HSP70 mRNA,HSP22 mRNA,TNF-α and IL1β (r=0.4251,0.4976,0.4562,0.3627,P＜0.01 or P＜0.05).Conclusions The occurrence and development of BPH are closely related with immunoinflammatory factors.Finasteride not only affects the levels of dihydrotestosterone but also can inhibit the expression of immunoinflammatory factors to improve symptom by reducing the volume of benign prostatic hyperplasia.

The mode of action of V-type organophosphate poisons on acetylcholinesterase has been studied. It shows that the leaving group of V-type poisons is dialkylamino-ethyl-thio radical,and the phosphonyla-ting site on the enzyme molecule is similar to that of the G-type poison soman, as shown by the competition experiments.

Objective:To summarize the establishment and management experience of extracorporeal membrane oxygenation (ECMO) rapid response team, and explore a more efficient rescue mode.Methods:From January 2015 to September 2020, 85 patients treated with ECMO in Affiliated Hospital of Qingdao University were selected as the research objects. Thirty-eight patients treated with conventional ECMO from January 2015 to December 2019 were selected as the control group, and 47 patients treated with ECMO rapid response team from January 2020 to September 2020 were selected as the experimental group. The differences in team preparation time, catheterization time, treatment success rate, incidence of complications and equipment failure frequency between the two groups were compared.Results:There were no significant differences in gender, age or disease types between the two groups. The team preparation time and catheterization time of the experimental group were significantly shorter than those of the control group [team preparation time (minutes): 31.79±6.10 vs. 67.16±30.49, catheterization time (minutes): 40.62±7.13 vs. 84.89±19.29], and the incidence of complications was significantly lower than that of the control group [4.3% (2/47) vs. 21.1% (8/38)], and the differences were statistically significant (all P < 0.05). Conclusion:ECMO rapid response team can shorten the rescue preparation time, reduce the occurrence of complications, improve the team treatment efficiency, and provide ideas for emergency and critical patients.

OBJECTIVE To investigate the bacterial infection and drug susceptibility of 91 victims wounded in Wenchuan earthquake from Sichuan and provide the laboratory evidences for sequential treatment.METHODS The specimens such as sputum,wound secretion,urine,blood,stool and necrotic tissue from the wounded were cultured on different kinds of culture medium under the aerobic or the anaerobic condition.The isolated bacteria were identified by VITEK GN analyzer or GP cards and API 20C analyzer for fungus.The drug susceptibility tests were carried out by the K-B method.RESULTS 91 wounded(58.7%) were infected,most of them were more than 60 years old.Respiratory tract(49.5%),wound(30.0%) and urinary tract(6.6%) were the main infectious sites.Among 91 strains of isolated bacteria,56 strains were G-bacilli(61.5%),20 were G+ bacteria(22.0%) and 12 strains were fungi(13.2%).The most common species among them were Escherichia coli(13.2%),fungi(13.2%),Acinetobacter(11.0%),Burkholderia cepacia(11.0%),Enterococcus(9.9%) and Staphylococcus aureus(9.9%).Drug susceptibility results showed that except the Pseudomonas aeruginosa and B.cepacia,the most G-bacilli were sensitive to imipenem,but resistant to the first and second-generation cephalosporins.The most G+ cocci were sensitive to VAN,LNZ and QDA antibiotics,and the fungus were sensitive to antibiotics used commonly in clinical treatment.CONCLUSIONS The pathogenic culture and the drug susceptibility analysis of the victims wounded in Wenchuan earthquake are inportant to guide the anti-infectious treatment.

Objective To investigate the management and prevention of the complications of sigmoid rectal pouch for urinary division after radical cystectomy. Methods The clinical data of 34 patients who underwent a sigmoid rectal pouch procedure were analyzed retrospectively, and the clinical experience was summarized in the management and prevention of the complications of sigmoid rectal pouch for diversion. Results Twenty-six patients were followed up for 2 months to 11 years, and 10 patients lost in follow-up. The early follow-up results were as follows:3 patients had postoperative high fever with unilateral the kidney water, 1 patient had retropubic bleeding and need to stop bleeding, 3 patients suffered from wound split open and were performed relaxation suture, and 1 patient had sigmoid colon rectum bladder fistula 10d after operation. The late follow-up results were as follows:1 patient had urethral neoplasms recurrence, 5 patients developed distance metastases, and 5 patients developed nocturnal incontinence and worn safety pad. There were no hyperchloremic acidosis requiring clinical treatment, hydronephrosis as well as retrograde pelvis infection. Conclusions The operation of sigmoid rectal pouch for urinary division is fairly simple, with no serious complication. It is a better alternative diversion procedure, and should be accepted gradually by patients and surgeons.

Objective To evaluate the application of clinical cases related problem-based-learning (PBL) method in critical care medical standardized resident training program. Methods 84 residents were randomly divided into experimental group (n=42) and control group (n=42) by lottery way. The experimental group received PBL process during clinical case analysis while the control group learned completely through traditional teaching method . The residents' clinical competence were assessed by multiple scale mixed method including question bank examination (QBE), case-based discussion (CBD), direct observation of procedural skills (DOPS), simulation etc, and Likert-type scale questionnaire was used to evaluate the feedback of training residents. SPSS 17.0 was used to do line t test to the data of both groups. Results Finally 84 residents finished the study. There were no difference in the general conditions in two groups. The PBL group achieved higher examination score during QBE [(80.26 ±8.89) vs. (86.10 ±9.32)], CBD [(84.83±5.43) vs. (75.36±6.06)], DOPS [(88.81±6.68) vs. (82.70±6.98)], simulation [(79.86±10.09) vs.(72.71±9.30)]. Except two groups residents all gave high scores in enhancing cross connection in clinical knowledge [(4.786±0.470) vs. (4.571±0.859), P=0.16], and the questionnaire results showed that the resi-dents of PBL group gave higher points in exciting autonomous learning, improving clin-ical analysis ability, accelerating clinical thinking establish, developing independent thinking habits, improving the clinical communication skills and teamwork ability (P<0.05). Conclusion The clinical cases related PBL method can improve the training effects during critical care medical standardized resident training program. It can be used broadly after adapting modification in critical care medical education.