Objective:To prepare the chitin/hyaluronic acid/collagen hydrogel loaded with mouse adipose-derived stem cells and to explore its effects on wound healing of full-thickness skin defects in rats.Methods:The research was an experimental research. Chitin nanofibers were prepared by acid hydrolysis and alkaline extraction method, and then mixed with hyaluronic acid and collagen to prepare chitin/hyaluronic acid/collagen hydrogels (hereinafter referred to as hydrogels). Besides, the hydrogels loaded with mouse adipose-derived stem cells were prepared. Thirty male 12-week-old guinea pigs were divided into negative control group, positive control group, and hydrogel group according to the random number table, with 10 guinea pigs in each group. Ethanol, 4-aminobenzoic acid ethyl ester, or the aforementioned prepared hydrogels without cells were topically applied on both sides of back of guinea pigs respectively for induced contact and stimulated contact, and skin edema and erythema formation were observed at 24 and 48 h after stimulated contact. Adipose-derived stem cells from mice were divided into normal control group cultured routinely and hydrogel group cultured with the aforementioned prepared hydrogels without cells. After 3 d of culture, protein expressions of platelet-derived growth factor-D (PDGF-D), insulin-like growth factor-Ⅰ (IGF-Ⅰ), and transforming growth factor β 1 (TGF-β 1) were detected by Western blotting ( n=3). Eight male 8-week-old Sprague-Dawley rats were taken and a circular full-thickness skin defect wound was created on each side of the back. The wounds were divided into blank control group without any treatment and hydrogel group with the aforementioned prepared hydrogels loaded with adipose-derived stem cells applied. Wound healing was observed at 0 (immediately), 2, 4, 8, and 10 d after injury, and the wound healing rate was calculated at 2, 4, 8, and 10 d after injury. Wound tissue samples at 10 d after injury were collected, the new tissue formation was observed by hematoxylin-eosin staining; the concentrations of interleukin-1α (IL-1α), IL-6, IL-4, and IL-10 were detected by enzyme-linked immunosorbent assay method; the expressions of CD16 and CD206 positive cells were observed by immunohistochemical staining and the percentages of positive cells were calculated. The sample numbers in animal experiment were all 8. Results:At 24 h after stimulated contact, no skin edema was observed in the three groups of guinea pigs, and only mild skin erythema was observed in 7 guinea pigs in positive control group. At 48 h after stimulated contact, skin erythema was observed in 8 guinea pigs and skin edema was observed in 4 guinea pigs in positive control group, while no obvious skin erythema or edema was observed in guinea pigs in the other two groups. After 3 d of culture, the protein expression levels of PDGF-D, IGF-I, and TGF-β 1 in adipose-derived stem cells in hydrogel group were significantly higher than those in normal control group (with t values of 12.91, 11.83, and 7.92, respectively, P<0.05). From 0 to 10 d after injury, the wound areas in both groups gradually decreased, and the wounds in hydrogel group were almost completely healed at 10 d after injury. At 4, 8, and 10 d after injury, the wound healing rates in hydrogel group were (38±4)%, (54±5)%, and (69±6)%, respectively, which were significantly higher than (21±6)%, (29±7)%, and (31±7)% in blank control group (with t values of 3.82, 3.97, and 4.05, respectively, Pvalues all <0.05). At 10 d after injury, compared with those in blank control group, the epidermis in wound in hydrogel group was more intact, and there were increases in hair follicles, blood vessels, and other skin appendages. At 10 d after injury, the concentrations of IL-1α and IL-6 in wound tissue in hydrogel group were significantly lower than those in blank control group (with tvalues of 8.21 and 7.99, respectively, P<0.05), while the concentrations of IL-4 and IL-10 were significantly higher than those in blank control group (with tvalues of 6.57 and 9.03, respectively, P<0.05). The percentage of CD16 positive cells in wound tissue in hydrogel group was significantly lower than that in blank control group ( t=8.02, P<0.05), while the percentage of CD206 positive cells was significantly higher than that in blank control group ( t=7.21, P<0.05). Conclusions:The hydrogel loaded with mouse adipose-derived stem cells is non-allergenic, can promote the secretion of growth factors in adipose-derived stem cells, promote the polarization of macrophages to M2 phenotype in wound tissue in rats with full-thickness skin defects, and alleviate inflammatory reaction, thereby promoting wound healing.

Objective:To analyze the clinical characteristics of eosinophilic lung diseases(ELD) in children to enhance pediatricians′ understanding of ELD.Methods:In this retrospective cross-sectional study, a total of 149 children with ELD were recruited from Beijing Children′s Hospital, Capital Medical University between April 1, 2007 and March 31, 2022.Chi-square test, Fisher′s exact test, Mann-Whitney U test and Kruskal-Wallis test were used to analyze data and conclude clinical characteristics.Spearman correlation was used to analyze the correlation between eosinophils in peripheral blood and bronchoalveolar lavage fluid.Chi-square test and Kappa consistency test were used to compare the differences and consistency in diagnostic results between bronchoalveolar lavage fluid or lung biopsy and eosinophil elevation with chest imaging abnormalities. Results:(1)The isolated lung involvement was mostly caused by allergic bronchopulmonary aspergillosis(9 patients), and other system involvement by idiopathic hypereosinophilic syndrome(89 patients).(2)The main respiratory manifestations included coughing(90 cases, 60.4%) and expectoration(41 cases, 27.5%), while 23.5%(35 cases) of patients had no respiratory symptoms; 50.3% had digestive system involvement, and 40.9% had skin involvement.These were the two most commonly affected organs.(3)Spearman correlation was performed between eosinophils in peripheral blood and bronchoalveolar lavage fluid( r=0.3, P<0.05).Chi-square test was performed to compare ELD diagnosed by bronchoalveolar lavage fluid or lung biopsy with peripheral blood eosinophilia accompanied by abnormal chest imaging( P<0.05).Kappa consistency test(Kappa<0.2) showed poor consistency between the two diagnostic methods. Conclusions:ELD are present in children, and multiple etiologies may be pathogenic.Among children with ELD, the isolated lung involvement is mainly caused by allergic bronchopulmonary aspergillosis.The digestive system and skin are the most commonly affected organs, except for lungs.The correlation between eosinophil levels in peripheral blood and bronchoalveolar lavage fluid is poor.

Objective:To understand the clinical characteristics of empyema caused by Streptococcus pneumoniae in children. Methods:The clinical manifestations, imaging characteristics, treatment and prognosis of 49 children with pneumococcal empyema admitted to Beijing Children′s Hospital, Capital Medical University from March 2007 to February 2018 were retrospectively analyzed.Results:Among the 49 children, 26 were male and 23 were female, with a median age of 2.63 years old.All the cases had cough and fever, 46 cases of them had high fever, 2 cases had moderate fever and 1 case had ultrahyperpyrexia.The course of disease before admission was 2-90 days, with a median of 10 days.All cases had toxic symptoms and signs of pleural effusion; 26 patients had dyspnea; 23 patients had moist rales, while 8 cases of whom had wheezing sounds.Eleven cases had extrapulmonary complications, including purulent meningitis in 6 cases, purulent pericarditis 1 case, 2 cases of hemophagocytic syndrome and hemolytic uremic syndrome respectively.The medians of leukocytes in the whole blood, white blood cells in pleural effusion and multinuclear cell percentage were 26.97×10 9/L, 32×10 9/L and 0.85, respectively.The average C-reactive protein (CRP) was 177.79 mg/L.The drug sensitivity test of Streptococcus pneumoniae showed that 68.89% strains were insensitive to Penicillin and all strains were resistant against Erythromycin.Chest image showed bilateral consolidation in 32 cases and pneumothorax in 31 cases.Besides antimicrobial therapy, 34 patients were treated with chest drainage, and 7 cases underwent surgery.Ten of the 49 cases were treated with nasal continuous positive airway pressure, tracheal intubated was used in 6 cases, and 1 case was given cardiopulmonary resuscitation.Forty-five cases discharged with improvement, 3 cases were not cured and 1 case died. Conclusions:Pneumococcal empyema is more common in children under 5 years old.Children with pneumococcal empyema usually have poor mental status, high fever, cough accompanied by dyspnea, high peripheral white blood cells and CRP.Their radiographic findings are usually serious, and the insensitive rate to Penicillin is high.The main treatment is anti-infection therapy and closed thoracic drainage.The prognosis of most patients is good, but there are still dead cases.

Objective: To investigate the effects of family-integrated care (FIC) on postoperative outcomes in children with enterostomy and their caregivers. Methods: From August 2017 to August 2018, 50 children with enterostomy and 50 family members of the Children′s Hospital of Hunan Province were selected as subjects. According to the random number table, the children and their families were divided into control group and the observation group, each group was 25 cases. The control group was given a routine nursing mode to intervene, and the observation group was given an FIC mode for intervention. Postoperative outcomes were evaluated using the incidence of ostomy complications and readmission rates. The pre-intervention and outpatient follow-up were used to assess the psychological status of the family members using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), and to assess the postoperative care of the family's intestines using the postoperative evaluation of the postoperative intestines. The level of knowledge mastery. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used to assess the psychological state of the family members, and the postoperative care knowledge evaluation form for the postpartum was used to evaluate the postoperative care of the family. Results: The incidence of ostomy complications in the observation group was 8.70% (2/23), which was lower than that in the control group (34.78% (8/23) (P<0.05). The readmission rate of the observation group was 0(0/23), which was lower than the control group 17.39% (4/23) (P<0.05). After intervention, the SAS scores and SDS scores of the families of the two groups were lower than those before the intervention, and the SAS scores and SDS scores of the observation group were lower than the control group(P<0.05). Before discharge and 3months of follow-up, the scores of postoperative care knowledge evaluation scores of the observation group were higher than those of the control group(P<0.05). Conclusions FIC mode can effectively reduce the incidence of complications and readmission rate in children with enterostomy. It has positive significance for improving the negative emotions of children′s family members and improving the mastery of postoperative care.

OBJECTIVE To investigate and analysis of hearing status and characteristics of China civil aviation air traffic controllers(ATC). METHODS With cluster random sampling, air conduction threshold data of 1498 ATC, who had finished the class Ⅲa medical assessment this year in a certain area were studied. The subjects were tested by pure tone audiometry, the prevalence rate of speech and high frequency hearing loss between gender groups were compared; After age correction, the threshold of different frequencies were compared between age groups. RESULTS The prevalence rate of hearing loss at speech frequency was 6.68％ in male and 1.97％ in female. The result of high frequency was 7.87％ and 1.23％ respectively. Both the threshold and prevalence rate of hearing loss of every frequency were higher in male(P<0.05); The threshold of 3000 Hz

Objective: To analyze the clinical characteristics, diagnosis and treatment of bronchopulmonary foregut malformation(BPFM). Method: The clinical manifestations, imaging findings and treatment of 8 patients with BPFM were analyzed retrospectively from January 2006 to May 2016 in Beijing Children′s Hospital. Result: The age of children varied from 2 months to 7 years and 3 children were male while 5 female. Symptoms showed cough in 6 cases, fever in 4 cases, bucking when intaking of fluids or foods in 3 cases, tachypnea in 1 case, wheezing in 1 case, vomiting in 1 case, haematemesis in 1 case Pulmonary signs were decreased breath sounds in 4 cases, phlegm rale in 3 cases, shortness of breath in 2 cases, wheeze in 1 case, and retraction in 1 case. The upper gastrointestinal series showed abnormal fistulous tracts arising from the esophagus or the gastric fundus and extending into the mass in the lung. CT showed pulmonary sequestration and prompted the tube between lung and esophagus. Six children underwent pneumonectomy and esophageal fistula repair. They were discharged and their symptoms were improved. Two cases of children were discharged from a hospital without surgery. Conclusion Bronchopulmonary foregut malformation usually has its onset in early stage of life. The most common symptoms include recurrent pneumonia or bucking when intaking of fluids or foods. CT can demonstrate the bronchopulmonary sequestration and evaluate the communication with the gastrointestinal tract. The upper gastrointestinal series can demonstrate the abnormal tract directly. Pneumonectomy and esophageal fistula repair are the treatment of this disease.

Objective To evaluate the effect of sedation with regional anesthesia with dexmedeto-midine on postoperative cognitive function in elderly patients with diabetes mellitus. Methods A total of 180 elderly patients of either sex with diabetes foot, aged 65-80 yr, weighing 45-90 kg, of American So-ciety of Anesthesiologists physical status ⅡorⅢ, with preoperative Mini-Mental State Examination score>24, undergoing elective débridement, were divided into 2 groups(n=90 each)using a random number table: sedation with dexmedetomidine group(group D)and routine sedation control group(group C). Lumbar plexus block and sciatic nerve block were performed, after the reliable efficacy was achieved, dexmedetomidine was intravenously infused in a dose of 0.5 μg∕kg for 10 min followed by an infusion of 0.5 μg·kg-1·h-1until the end of surgery. Midazolam 0.02-0.04 mg∕kg was intravenously injected and mid-azolam 1 mg was injected intermittently during operation in group C. Ramsay sedation scores were main-tained between 2 and 4. At 30 min before surgery(T1), 1 h after the beginning of surgery(T2), at the end of surgery(T3), 6 h after the end of surgery(T4), and 24 h after the end of surgery(T5), venous blood samples were collected for determination of the level of blood glucose and plasma cortisol(Cor)con-centrations. Mini-Mental State Examination scores were assessed at 1 day before surgery and 1 and 3 days after surgery, and the occurrence of postoperative cognitive dysfunction was recorded in a short time period after operation. Results Compared with the baseline at T1, the level of blood glucose at T2-5and plasma Cor concentrations at T3,4were significantly increased in group C, and plasma Cor concentrations were sig-nificantly increased at T3,4(P<0.05), and no significant change was found in the level of blood glucose at T2-5in group D(P>0.05). Compared with group C, the level of blood glucose at T3-5and plasma Cor con-centrations at T3,4were significantly decreased, Mini-Mental State Examination scores were increased at 1 and 3 days after operation, and the incidence of postoperative cognitive dysfunction in a short time period after operation was decreased in group D(P<0.05). Conclusion Sedation with regional anesthesia with dexmedetomidine can improve postoperative cognitive function in elderly patients with diabetes mellitus.

Objective To assess the improvements of left ventricular systolic function by three‐dimensional speckle tracking imaging ( 3D‐STI) in type 2 diabetes mellitus ( T2DM ) patients after short‐term insulin pump intensive therapy . Methods Thirty‐five T2DM patients complicated with microangiopathy and thirty‐two healthy volunteers were studied ,underwent the dynamic image of the four‐chamber view ,three‐dimensional images of left ventricle were obtained for all the individuals . The left ventricular global longitudinal strain ( LVGLS) ,left ventricular global circumferential strain ( LVGCS) ,left ventricular ejection fraction (LVEF) ,peak basal and apical rotation (LV‐ProtB ,LV‐ProtA) ,peak LV twist ( LV‐tw ) were calculated using TomTec software .After insulin pump intensive therapy for two weeks ,all the indexes were reexamined in T2DM patients . Results Compared with control group ,the LVGLS , LVGCS ,LV‐tw and LV‐ProtA were significantly decreased in diabetes mellitus group before and after treatment ( P < 0 .01 or P < 0 .05) . Compared with diabetes mellitus patients before treatment ,the LVGLS ,LVGCS had significant higher level after treatment( P <0 .05) . The LVGLS ,LVGCS ,LV‐tw and LV‐ProtA were significantly correlated with LVEF in type 2 diabetes mellitus patients and normal controls . Conclusions Insulin pump intensive treatment could improve left ventricular systolic function in type 2 diabetes patients complicated with microangiopathy . 3D‐STI can be sensitive to accurately assess the therapeutic effect and has the important clinical value .

The study reports the detection of neuroprotective effect of 10 kinds of coumarin derivatives and explores their possible mechanism. MTT method was used to screen the neuroprotective effect of 10 coumarin derivatives on neurotoxic agents (Aβ25-35 and rotenone) or OGD (oxygen-glucose deprivation). A compound with better protective effect was obtained. Then the effect of this compound on neurotoxic agents on PC12 was detected by the morphological observation. Furthermore, the effect of compound 3 on microglia with lipopolysaccharide (LPS) induced inflammation was detected. And the inflammatory factor was tested. Finally, direct free radical scavenging ability was detected. Compound 3 was found to be the best compound through three neurons toxic models. Not only compound 3 ameliorated cell viability reduced by three neurons toxic models, but also significantly inhibited the production of inflammatory factor (TNF-α and IL-1β). And its free radical scavenging ability is very good, especially the effect on superoxide anion, which is comparable with vitamin C. The significant scavenging effect of compound 3 on superoxide anion might be the mechanism of the neuroprotection. Compound 3 as a potential neural cell protective agent merits further investigation.

Objective To explore effect of different withdrawal time of dexmedetomidine (DEX) on the quality of general anesthesia recovery.Methods Eighty patients of ASA Ⅰ or Ⅱ undergoing lymph surgery were randomly assigned to four groups (n =20).Groups D1,D2 and D3 received DEX 0.5 μg/kg as bolus before induction,continued with 0.5 μg/(kg · h) by infusion until one hour,30 min before the end of operation and the end of operation,respectively.Group C received equal volume of normal saline.Mean artery pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) were observed during and after operation.Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time,observer's assessment of alertness/sedation score (OAA/S),restlessness score (RS),and visual analogue scales (VAS) were observed after operation.Results For MAP and HR in Groups D2 and D3,there were no statistically significant difference during extubation compared to those at preoperation,but at the same time point,they were lower than those in group C (P ＜ 0.05).For groups C and D1,MAP and HR at extubation and 5 min after extubation were higher than those at preoperation (P ＜0.05).Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time in group D3 were significantly longer than those in Group C (P ＜ 0.05),while there were no statistically significantly difference between groups D1,D2,and group C.OAA/S in group D3 was significantly lower than that in group C (P ＜ 0.05) at extubation.Incidence of restlessness,VAS,and cases given analgesic 2 hours after operation in groups D2 and D3 were significantly lower than those in groups C and D1.Compared to those in group C,dosages of propofol and remifentanil in groups D2 and D3 were significantly lower.Conclusions Dexmedetomidine administered of 0.5 μg/kg before induction,continued with infusion of 0.5 μg/(kg · h) until 30 min before the end of operation,may improve emergence,without influencing the awakening time of patients,and prolong the duration time of analgesia which comfort the patients.