Objective:To analyze the effects of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis and high-risk bleeding treated with continuous renal replacement therapy (CRRT).Methods:A total of 80 patients with sepsis with high-risk bleeding who received CRRT treatment in the Affiliated Hospital of Jining Medical University from February 2018 to August 2023 were retrospectively selected as the study objects, 40 cases were treated with low molecular weight heparin (control group) and 40 cases were treated with citric acid (observation group).Both groups were treated continuously, and the anticoagulant effect, coagulation function, electrolyte and inflammatory factor levels of the two groups were compared 7 d after medication.Results:The total effective rate of anticoagulation in the observation group after treatment was higher than that in the control group: 97.50% (39/40) vs. 75.00% (30/40), there was statistical difference ( χ2 = 8.54, P<0.05). After treatment, the levels of activated partial thrombin time (APTT), thrombin time (TT) and prothrombin time (PT) in the observation group were lower than those in the control group: (31.08 ± 8.31) s vs. (41.76 ± 8.36) s, (23.41 ± 5.02) s vs. (29.05 ± 5.13) s, (15.47 ± 3.50) s vs. (19.96 ± 4.75) s, there were statistical differences ( P<0.05). There were no statistical differences in the levels of potassium, chloride, sodium and calcium between the two groups after treatment ( P>0.05). After treatment, the levels of C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group :(2.60 ± 0.86) mg/L vs. (4.35 ± 1.12) mg/L, (0.11 ± 0.03) μg/L vs. (0.19 ± 0.05) μg/L, there were statistical differences ( P<0.05). Conclusions:The application of citric acid anticoagulant in patients with sepsis and high-risk bleeding treated with CRRT can achieve significant curative effect, which can not only improve the anticoagulant effect, stabilize coagulation function and electrolyte level, but also down-regulate the level of inflammatory factors.

Objective:To analyze the effects of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis and high-risk bleeding treated with continuous renal replacement therapy (CRRT).Methods:A total of 80 patients with sepsis with high-risk bleeding who received CRRT treatment in the Affiliated Hospital of Jining Medical University from February 2018 to August 2023 were retrospectively selected as the study objects, 40 cases were treated with low molecular weight heparin (control group) and 40 cases were treated with citric acid (observation group).Both groups were treated continuously, and the anticoagulant effect, coagulation function, electrolyte and inflammatory factor levels of the two groups were compared 7 d after medication.Results:The total effective rate of anticoagulation in the observation group after treatment was higher than that in the control group: 97.50% (39/40) vs. 75.00% (30/40), there was statistical difference ( χ2 = 8.54, P<0.05). After treatment, the levels of activated partial thrombin time (APTT), thrombin time (TT) and prothrombin time (PT) in the observation group were lower than those in the control group: (31.08 ± 8.31) s vs. (41.76 ± 8.36) s, (23.41 ± 5.02) s vs. (29.05 ± 5.13) s, (15.47 ± 3.50) s vs. (19.96 ± 4.75) s, there were statistical differences ( P<0.05). There were no statistical differences in the levels of potassium, chloride, sodium and calcium between the two groups after treatment ( P>0.05). After treatment, the levels of C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group :(2.60 ± 0.86) mg/L vs. (4.35 ± 1.12) mg/L, (0.11 ± 0.03) μg/L vs. (0.19 ± 0.05) μg/L, there were statistical differences ( P<0.05). Conclusions:The application of citric acid anticoagulant in patients with sepsis and high-risk bleeding treated with CRRT can achieve significant curative effect, which can not only improve the anticoagulant effect, stabilize coagulation function and electrolyte level, but also down-regulate the level of inflammatory factors.

OBJECTIVE: To investigate the effectiveness of comprehensive rhinoplasty with autogenous costal cartilage grafting and prosthesis augmentation rhinoplasty in the treatment of secondary nasal deformity with saddle nasal deformity after cleft lip surgery. METHODS: The clinical data of 96 patients with secondary nasal deformity with saddle nasal deformity after cleft lip surgery between September 2008 and January 2019 were retrospectively analyzed. There were 17 males and 79 females with an average age of 25.6 years (range, 17-38 years). Autogenous costal cartilage grafts were used to construct stable nasal tip framework and enhance the strength of alar cartilage. Nasal dorsum prostheses (39 cases of bulge, 45 cases of silicone prosthesis) or autogenous costal cartilage (12 cases) were used for comprehensive rhinoplasty. Visual analogue scale (VAS) score was used to evaluate the postoperative satisfaction subjectively, and nasal alar height symmetry index, nasal alar width symmetry index, nasal dorsum central axis deviation angle, and nasal columella deviation angle were calculated to evaluate objectively before and after operation. RESULTS: All patients were followed up 6 months to 8 years, with an average of 13.4 months. Nasal septal hematoma occurred in 3 patients after operation, which was improved after local aspiration and nasal pressure packing. Two cases had mild deformation of the rib cartilage graft of the nasal dorsum, one of which had no obvious deviation of the nasal dorsum and was not given special treatment, and one case underwent the cartilage graft of the nasal dorsum removed and replaced with silicone prosthesis. The incisions of the other patients healed by first intention, and there was no complication such as postoperative infection and prosthesis displacement. The nasal alar height symmetry index, nasal alar width symmetry index, nasal dorsum central axis deviation angle, and nasal columella deviation angle significantly improved after operation when compared with preoperative ones ( P<0.05). Postoperative subjective satisfaction evaluation reached the level of basic satisfaction or above, and most of them were very satisfied. CONCLUSION Comprehensive rhinoplasty using autologous rib cartilage grafting to construct a stable nasal tip support, combined with dorsal nasal prosthesis or autologous cartilage implantation, can achieve good effectiveness on secondary nasal deformity with saddle nasal deformity after cleft lip surgery.
Male ; Female ; Humans ; Adult ; Rhinoplasty ; Cleft Lip/surgery* ; Retrospective Studies ; Nose/surgery* ; Nasal Septum/surgery* ; Nasal Cartilages/surgery* ; Silicones ; Treatment Outcome

Objective To observe the clinical effect of water-assisted liposuction system using in the breast augmentation surgery.Methods From 2015 to 2017,we received 30 new patients who were diagnosed as small breast disease.The water-assisted liposuction system (Body-jetTM) was used to harvest autologous fat,and then autologous fat grafting was preformed in the breast augmentation surgery.The follow-up was conducted one year after operation to observe the change of breast size,fat survival rate,and the occurrence of postoperative complications.Results There was no any serious complication happened in all the 30 cases.The breasts got a good shape and soft feeling after long-term follow up.Conclusions The application of body-jetTM water-assisted liposuction system is safe;the survival rate of autologous fat transplantation is high,and the clinical effect is satisfactory.

Objective To study the clinical effects of sailboat resection of nasal alar flap combined with catgut embedding in the treatment of severe hypertrophy of the nasal alar.Methods Patients with severe alar hypertrophy were photographed before operation,and the length of alar,the height of nasal ala,the length of nostrils and the width of nostrils were measured.After one month and half a year follow-up,the length of alar,nasal alar height,nostril length,nostril width and nasal width were measured,and the local scar condition was scored according to Vancouver scar scale (VSS).Results Through the combination of two kinds of surgical treatment of severe nasoalar hypertrophy,the surgical effect of satisfaction showed that,with the comparison before and after surgery,nose length and height,length and width of the nostril and the nasal base width were significantly reduced (P＜0.05) after half a year and one month after operation.The data showed no significant changes (P＞0.05),and so the postoperative effect could be sustained;local scar scale,after half a year and one month after operation,were significantly decreased (P＜0.05),and the postoperative long-term scar was not obvious.Conclusions The effect of alar sailboat-resection combined with catgut embedding therapy is satisfactory for the treatment of severe alar hypertrophy.It is one of the ways to treat severe alar hypertrophy.

OBJECTIVETo compare the clinical effects of different surgical methods for the epicanthus corrective surgery.

METHODSCanthoplasty with asymmetric Z-flap is applied in 46 cases, Y-V advancement procedure for epicanthoplasty is applied in 42 cases. The epicanthus aesthetic measurement were measured and calculated by software before and after surgery, the diameter of the iris was measured as a reference value,and the postoperative scar was assessed by VSS scale. At the same time, by measuring the lateral canthal distance, the accuracy of the measurement method can be verified.

RESULTSAll patients were satisfied with the long-term results and there were no recurrences of the epicanthal fold. The shortening ratio of the ICD is 8.36% in the group with the Z-plasty, and 5.88% in Y-V plasty. the lateral canthal distance have no diffrence before and after surgery.

CONCLUSIONSTwo surgical methods can get good results. The magnitude of correction in Z-plasty may larger than Y-V plasty, but postoperative retraction may existed in Z plasty.

Blepharoplasty ; methods ; Cicatrix ; Esthetics ; Eyelids ; surgery ; Humans ; Recurrence ; Software ; Surgical Flaps

Objective To investigate the influencing factors for trauma-induced tibia1 infection in underground coal mine.Methods A retrospective analysis was performed for the clinical data of 1 090 patients with tibial fracture complicated by bone infection who were injured in underground coal mine and admitted to our hospital from January 1995 to August 2015,including the type of trauma,injured parts,severity,and treatment outcome.The association between risk factors and infection was analyzed.Results Among the 1 090 patients,357 had the clinical manifestations of acute and chronic bone infection,219 had red and swollen legs with heat pain,and 138 experienced skin necrosis,rupture,and discharge of pus.The incidence rates of tibial infection from 1995 to 2001,from 2002 to 2008,and from 2009 to 2015 were 31％,26.9％,and 20.2％,respectively.The incidence rate of bone infection in the proximal segment of the tibia was significantly higher than that in the middle and distal segments (42.1％ vs 18.9％/27.1％,P＜0.01).As for patients with different types of trauma (Gustilo typing),the patients with type Ⅲ fracture had a significantly higher incidence rate of bone infection than those with type Ⅰ/Ⅱ infection (52.8％ vs 21.8％/24.6％,P＜0.01).The incidence rates of bone infection after bone traction,internal fixation with steel plates,fixation with external fixator,and fixation with intramedullary nail were 20.7％,43.5％,21.4％,and 26.1％,respectively,suggesting that internal fixation with steel plates had a significantly higher incidence rate of bone infection than other fixation methods(P＜0.01).The muhivariate logistic regression analysis showed that the position of tibial fracture and type of fracture were independent risk factors for bone infection.Conclusion There is a high incidence rate of trauma-induced tibial infection in workers in underground coal mine.The position of tibial fracture and type of fracture are independent risk factors for bone infection.Vacuum sealing drainage and Ilizarov technique can achieve a satisfactory therapeutic effect.

Objective To investigate the influencing factors for trauma-induced tibia1 infection in underground coal mine.Methods A retrospective analysis was performed for the clinical data of 1 090 patients with tibial fracture complicated by bone infection who were injured in underground coal mine and admitted to our hospital from January 1995 to August 2015,including the type of trauma,injured parts,severity,and treatment outcome.The association between risk factors and infection was analyzed.Results Among the 1 090 patients,357 had the clinical manifestations of acute and chronic bone infection,219 had red and swollen legs with heat pain,and 138 experienced skin necrosis,rupture,and discharge of pus.The incidence rates of tibial infection from 1995 to 2001,from 2002 to 2008,and from 2009 to 2015 were 31％,26.9％,and 20.2％,respectively.The incidence rate of bone infection in the proximal segment of the tibia was significantly higher than that in the middle and distal segments (42.1％ vs 18.9％/27.1％,P＜0.01).As for patients with different types of trauma (Gustilo typing),the patients with type Ⅲ fracture had a significantly higher incidence rate of bone infection than those with type Ⅰ/Ⅱ infection (52.8％ vs 21.8％/24.6％,P＜0.01).The incidence rates of bone infection after bone traction,internal fixation with steel plates,fixation with external fixator,and fixation with intramedullary nail were 20.7％,43.5％,21.4％,and 26.1％,respectively,suggesting that internal fixation with steel plates had a significantly higher incidence rate of bone infection than other fixation methods(P＜0.01).The muhivariate logistic regression analysis showed that the position of tibial fracture and type of fracture were independent risk factors for bone infection.Conclusion There is a high incidence rate of trauma-induced tibial infection in workers in underground coal mine.The position of tibial fracture and type of fracture are independent risk factors for bone infection.Vacuum sealing drainage and Ilizarov technique can achieve a satisfactory therapeutic effect.

Objective To establish a model for preparation of tissue-engineered skin grafts with hTERT cells carrying human papillomavirus type 6 (HPV 6) genome in vitro, so as to lay a foundation for studying HPV life cycle. Methods The full-length linear HPV6 genome and plasmid pEGFP-▲EGFP were electrophoretically cotransferred into hTERT cells. After selection using G418 resistance, Southern blotting was performed to determine the viral load of HPV6 in transfected cells. 3T3 J2 trophoblastic cells, type I rat-tail collagen and hTERT cells containing the full-length HPV6 genes (HPV6.hTERT cells)were mixed and cocultured on metal meshes to form skin graft-like structures. Hematoxylin and eosin (HE)staining was performed to observe the structure of formed skin grafts, an immunohistochemical assay to measure the expression of HPV6 L1 protein, and electron microscopy to observe virus particles in the skin grafts. Results The linear HPV6 gene was successfully transferred into hTERT cells, and Southern blotting showed the presence of HPV6 DNA in the transferred hTERT cells. The HPV6.hTERT cells, which were cocultured with 3T3 J2 trophoblastic cells and type I rat-tail collagen, proliferated and differentiated over time, and gradually formed skin grafts giving the appearance of verrucous hyperplasia. HE staining showed that the cocultured HPV6.hTERT cells could form typical stratified structure of skin after 7 days of cultivation, and histopathologic features of HPV infection, including obvious papillomatous hyperplasia, presence of vesicular cells, hyperkeratosis and parakeratosis, could be observed after 21 days. The immunohistochemical assay showed the expression of HPV6 L1 protein in the upper portion of skin grafts, and electron microscopy revealed the presence of HPV6 virus particles in skin grafts. Conclusions The established model for preparation of tissue-engineered skin grafts using HPV 6 genome-carrying cells provides a basis for biological studies of HPV, but its application is limited to some degree.

Objective To study the association between human papillomavirus (HPV) genotypes and viral load and clinical features of verruca vulgaris.Methods Tissue samples were collected from 48 outpatients with verruca vulgaris,and DNA was extracted from these tissue samples.To determine the genotype of HPV,PCR was performed to amplify the L1 fragment of HPV with universal primers followed by bidirectional sequencing and BLAST.The genotyping results were validated by PCR with type-specific primers.Real-time fluorescence-based quantitative PCR was conducted to measure the viral load of HPV,and hematoxylin and eosin (HE) staining to observe histological changes in these tissue specimens.Results The L1 fragment of HPV was amplified from 35 out of the 48 tissue specimens.Of the 35 L1-positive specimens,32 harbored HPV 7,1 harbored HPV 57,and 2 harbored both HPV 2 and HPV 7.Multiple lesions were observed on extremities in the patient infected with HPV 57,but on the head,face and trunk in the patients coinfected with HPV 2 and HPV 7.There were no significant differences in HPV viral load or vacuolated cell number between patients with single lesions and those with multiple lesions,or between patients with a clinical course of ＜ 6 months and those with a clinical course of 6-12 months.However,HPV viral load tended to decrease one year after the onset,and there was pronounced hyperkeratosis and less vacuolated cells in lesions of long duration (more than 2 years) compared with those of short duration (less than 2 years).Conclusions HPV 7 appears to be the most common HPV genotype associated with verruca vulgaris,and HPV 7 infection usually occurs on the head and face.For verruca vulgaris of less than 1 year,neither HPV viral load nor vacuolated cell number is associated with the count or clinical course of warts.