Objective:To observe the efficacy of cosmetic suturing techniques combined with topical recombinant human basic fibroblast growth factor (rh-bFGF) in repairing facial trauma.Methods:A prospective study was conducted on 140 patients with facial trauma admitted to the Department of Burn and Plastic Surgery, Northern Jiangsu People＇s Hospital from January to December 2022. Patients were divided into two groups based on different treatment methods using a random number table method: treatment group (70 cases), including 38 males and 32 females aged 3 to 54 (23.1±8.2) years, received cosmetic suturing techniques combined with topical rh-bFGF for wound repair; control group (70 cases), including 36 males and 34 females aged 2 to 49 (22.3±7.5) years, only received cosmetic suturing techniques for wound repair. Patients were followed up 2 weeks post-surgery to evaluate wound healing quality. Patient satisfaction was assessed using the visual analogue scale (VAS). Six months post-surgery, scar conditions were evaluated using the Vancouver scar scale (VSS).Results:In the treatment group, 65 cases were directly sutured, and 5 cases were repaired with skin flaps, with a first-class healing rate of 100% (70/70). In the control group, 66 cases were directly sutured, and 4 cases were repaired with skin flaps, with a first-class healing rate of 91.4% (64/70). The first-class healing rate in the treatment group was higher than that in the control group, with a statistically significant difference ( P=0.037). Two weeks post-surgery, the VAS score for surgical satisfaction in the treatment group was (1.13±0.52) scores, which was lower than that in the control group (2.56±1.32) scores, with a statistically significant difference ( P<0.001). Six months post-surgery, the VSS score for the treatment group was (2.49±1.27) scores, which was lower than that in the control group (4.67±1.93) scores, with a statistically significant difference ( P<0.001). Conclusions:In repairing facial trauma, the combination of cosmetic suturing techniques and topical rh-bFGF can improve wound healing quality, reduce wound scarring, and enhance patient satisfaction with surgery.

Objective To observe the effect of vacuum sealing drainage on the healing quality of cosmetic suture incision for large body surface masses.Methods From January 2020 to June 2023,60 patients with large surface mass hospitalized in the Department of Burns and Plastic Surgery of Northern Jiangsu People's Hospital were recruited as participants,and they were divided into study group and control group by block random method.Patients in the control group were treated with cosmetic suture technique to suture the surgical incision,while patients in the study group were treated with vacuum sealing drainage technique on the basis of cosmetic suture to further improve the quality of incision healing.The postoperative numerical rating scale(NRS)score,visual analogue scale(VAS)score,Vancouver Scar Scale(VSS)score,Patient Scar Assessment Scale(PSAS)score and other indicators were compared between the two groups.Results One week after surgery,the NRS score in the study group was(2.15±0.46)points,significantly lower than that in the control group(3.79±0.68)points,and the pain in the study group was less than that in the control group(P＜0.05).Two week after surgery,the VAS score in the study group(1.57±0.63)points was also lower than that in the control group(3.62±0.96)points(P＜0.05).The incision in the study group was smoother,and patients reported higher satisfaction with the incision compared to the control group.Six months post-operation,the VSS score in the study group(2.31±1.13)points was lower than that in the control group(3.49±1.46)points,while the PSAS score in the study group(7.68±1.65)points was significantly lower than that in the control group(11.33±1.92)points(P＜0.05).In the study group,the incision scar was lighter and the scar condition was better.Conclusion The application of vacuum sealing drainage technology in the cosmetic suture incision for large body surface masses can further improve the quality of incision healing,reduce incision scar,and improve patient satisfaction.

Objective To observe the effect of vacuum sealing drainage on the healing quality of cosmetic suture incision for large body surface masses.Methods From January 2020 to June 2023,60 patients with large surface mass hospitalized in the Department of Burns and Plastic Surgery of Northern Jiangsu People's Hospital were recruited as participants,and they were divided into study group and control group by block random method.Patients in the control group were treated with cosmetic suture technique to suture the surgical incision,while patients in the study group were treated with vacuum sealing drainage technique on the basis of cosmetic suture to further improve the quality of incision healing.The postoperative numerical rating scale(NRS)score,visual analogue scale(VAS)score,Vancouver Scar Scale(VSS)score,Patient Scar Assessment Scale(PSAS)score and other indicators were compared between the two groups.Results One week after surgery,the NRS score in the study group was(2.15±0.46)points,significantly lower than that in the control group(3.79±0.68)points,and the pain in the study group was less than that in the control group(P＜0.05).Two week after surgery,the VAS score in the study group(1.57±0.63)points was also lower than that in the control group(3.62±0.96)points(P＜0.05).The incision in the study group was smoother,and patients reported higher satisfaction with the incision compared to the control group.Six months post-operation,the VSS score in the study group(2.31±1.13)points was lower than that in the control group(3.49±1.46)points,while the PSAS score in the study group(7.68±1.65)points was significantly lower than that in the control group(11.33±1.92)points(P＜0.05).In the study group,the incision scar was lighter and the scar condition was better.Conclusion The application of vacuum sealing drainage technology in the cosmetic suture incision for large body surface masses can further improve the quality of incision healing,reduce incision scar,and improve patient satisfaction.

ObjectiveTo investigate the influencing factors for stent obstruction after endoscopic retrograde biliary drainage (ERBD) for refractory common bile duct stones. MethodsA total of 126 patients who underwent ERBD for refractory common bile duct stones in Renmin Hospital of Wuhan University from January 2014 to May 2019 and were readmitted for stent removal at 6 months after surgery were enrolled, and according to the condition of stent removal, they were divided into obstruction group and unobstructed group. General data and related indices were compared between the two groups. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; a multivariate logistic regression analysis was used to investigate the influencing factors for stent obstruction after surgery. ResultsAmong the 126 patients, 28 were found to have stent obstruction during removal, with a stent obstruction rate of 22.2%. The univariate analysis showed that there were significant differences between the two groups in white blood cell count (WBC), percentage of neutrophils (Neu%), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase, leucine aminopeptidase, endoscopic sphincterotomy (EST), infection, aspirin, and stent type (all P＜005). The multivariate logistic regression analysis showed that WBC［OR(95%CI):1.232(1.033-1.470)］, Neu%［OR(95%CI):1.263(1.021-1.562)］, ALP［OR(95%CI):1.013(1.004-1.022)］, EST［OR(95%CI):5.890(1.114-31.139)］, infection［OR(95%CI):17317(1.349-222.349)］, and stent type［OR(95%CI):0.144(0.022-0.937)］ were independent influencing factors for postoperative stent occlusion (all P＜0.05). ConclusionPatients with elevated WBC/Neu%/ALP, intraoperative EST, and preoperative secondary infection have a high risk of postoperative stent obstruction, and close follow-up and early prevention should be performed for such patients. The double pigtail stent can effectively reduce the rate of postoperative stent obstruction.

When severe diabetic foot gangrene occurs, the surgical incision is often difficult to heal due to poor blood supply of distal limbs and severe local infection. The method of moist?expose?burn?ointment? (MEBO) combined with vacuum sealing drainage was applied to the wound of diabetic foot after amputation. The wound of 8 patients with diabetic foot after amputation was completely healed, the wound was repaired well, and the length of limb was retained to a large extent, and the function of affected limb was restored well.

Acute suppurative cholangitis (ASC) is an acute infectious disease of the biliary tract caused by bacterial infection and biliary obstruction. Common bile duct stone is the most common cause of biliary obstruction. Due to the characteristics of rapid onset, rapid progress, various complications, and high mortality of ASC, it has attracted more and more attention in clinical practice. The treatment of ASC includes anti-infective therapy and relief of obstruction, and early relief of obstruction is the key to successful treatment. Endoscopic therapy has long been regarded as the first choice for the relief of obstruction, and with the development of medical technology, various new endoscopic techniques are gradually applied in the treatment of ASC and have thus become the new choices for surgeons and patients. With reference to the advantages and disadvantages of different treatment techniques, this article reviews the endoscopic therapies for ASC caused by common bile duct stones.

Hematobilia is one of the rare causes of upper gastrointestinal bleeding. It is difficult to diagnose in clinical practice, due to its atypical clinical manifestations, rare Quikle triad (abdominal pain, jaundice, and upper gastrointestinal bleeding), and a lack of specificity. At present, it is believed that iatrogenic injury is the main cause of hematobilia, selective hepatic arteriography is the preferred choice for the diagnosis of hematobilia, and interventional embolization is the main treatment method. With reference to related articles, this article mainly elaborates on the current status of the research on the etiology, clinical manifestations, diagnosis, and treatment of hematobilia.

Objective To analyze the clinical characteristics and risk factors of mortality of acute myocardial infarction induced by gastrointestinal hemorrhage,and improve the diagnosis and treatment of this kind of disease.Methods The clinical data of 28 patients who admitted to renmin hospital of wuhan university between January 2015 and January 2017 was analyzed retrospectively,including general information,clinical features,laboratory examination,the changes of electrocardiogram,the treatment and prognosis of the disease.According to the prognosis,the patients were divided into survival group (13 cases) and death group (15 cases),and the related factors affecting the prognosis were analyzed.Results Among the 28 patients with acute myocardial infarction complicated by gastrointestinal hemorrhage (male 24,female 4),the mean age was (70.8 ± 11.0) years.The clinical symptoms of gastrointestinal hemorrhage included haematemesis in 5 cases,melena in 8 cases,haematemesis concomitant melena in 13 cases and vomiting of coffee-like substance in 2 cases.When acute myocardial infarction occurred,only 6 patients had typical chest pain,4 patients showed palpitation and chest distress and 18 patients had no obvious symptoms.In all patients,21 (75.0％) patients occurred non ST-elevation acute myocardial infarction,and 7 (25.0％) patients occurred ST-elevation acute myocardial infarction,including extensive anterior wall and inferior wall infarction in 2 cases (7.1％),extensive anterior wall infarction in 7 cases (25.0％),inferior infarction in 13 cases (46.4％),anterior wall infarction in 5 cases (17.9％) and posterior wall infarction in 1 cases (3.6％).After treatment,13 cases improved and 15 cases died.Severe anemia and liver cirrhosis had history statistically significant differences in the survival group and death group,logistics regression analysis showed that severe anemia (OR =11.67,P =0.018) was an independent risk factor of mortality.Conclusion Acute myocardial infarction induced by gastrointestinal hemorrhage has no chest pain and other typical symptoms of myocardial infarction,and most of the cases are non ST-elevation myocardial infarction.Such patients are critically ill and have high fatality rate.Severe anemia is an independent risk factor for death in such patients.

Objective To investigate platelet counts and acute obstructive suppurative cholangitis correlation analysis and possible influential factors.Methods Data of 117 patients from October 2012 to October 2015 treated in our hospital,of whom 57 with acute obstructive suppurative cholangitis and 60 with common acute cholangitis were analyzed retrospectively to explore whether there was a correlation between thrombocytopenia (100 × 109/L) and AOSC,then experimental and control groups were established according to thrombocytopenia in the AOSC patients.The patient's age,sex,previous biliary surgery,white blood cells(WBC) count after admission within 6h,the percentage of neutrophils (NEU％),calcitonin (PCT) were retrospectively analyzed to further explore the influence factors of thrombocytopenia in AOSC patients.Results By comparison with the common acute cholangitis group,thrombocytopenia in AOSC group had obvious difference (P =0.01).In experimental group,NEU％,PCT had statistical difference compared with those in control group (P ＜ 0.05),and the patient's age,sex,previous biliary surgery,white blood cells(WBC) after admission within 6h count had no statistical significance.The logistic multivariate regression analysis showed that,NEU％,PCT were the independent predictors.Conclusion Correlated with AOSC,thrombocytopenia can be valued as indicators of the severity of acute cholangitis.In AOSC patients,NEU％,PCT were independent predictors of thrombocytopenia.