Objective:To evaluate the effects of two dressing methods on wound healing and patient satisfaction after cosmetic suturing for pediatric facial trauma.Methods:A prospective randomized controlled trial was conducted at Dongying People′s Hospital from October 2022 to October 2023. A total of 180 pediatric patients [105 males, 75 females, aged 3-7 (3.9±1.4) years] with facial trauma requiring cosmetic suturing were enrolled in this study. Participants were randomly divided into the study group ( n=91) and control group ( n=89) using a random number table. During the first postoperative dressing change at 24 hours, the study group received saline cleaning followed by erythromycin ointment coverage, while the control group underwent iodine disinfection with gauze coverage. Pain intensity during the second dressing change was assessed using the Chinese version of the Children′s Hospital of Eastern Ontario pain scale (CHEOPS). Wound healing at 6-7 days post-suturing was evaluated using the Chinese version of the redness, edema, ecchymosis, discharge, and approximation (REEDA) scale. Scar appearance at 14 days was measured via the Stony Brook scar evaluation scale (SBSES). Complication rates (infection, dehiscence) and satisfaction rates were statistically analyzed. Results:During the second dressing change, the CHEOPS score was significantly lower in the study group (6.27±1.32) than that in the control group (6.89±1.21) ( P=0.001). At 6-7 days, the REEDA score in the study group (2.26±1.91) was significantly lower than that in the control group (3.07±2.13) ( P=0.008). At 14 days, the SBSES score was significantly lower in the study group [2.60±1.42) vs (3.89±1.50), P<0.001]. The infection rate was 1.09% (1/91) in the study group and 1.12% (1/89) in the control group, with two cases of epidermal dehiscence observed in the control group. The satisfaction rate in the study group was 93.41% (85/91), which was higher than that in the control group [85.49% (76/89), P=0.020]. Conclusion:Saline cleaning combined with erythromycin ointment coverage reduces pain during wound dressing change, facilitates early wound healing, and improves patient′s satisfaction.

Objective:To explore the specific mechanism of Baijiesan on microangiogenesis of wound after perianal abscess in rats by regulating RAS signal pathway.Methods:A total of 72 SD rats were divided into control group,model group,Baijiesan group and Baijiesan+farnesylthiosalicylic acid(FTS)group,with 18 rats in each group.Cut off the whole layer of skin on the back of rats.The model group,Baijiesan group and Baijiesan+FTS group were treated with fecal supernatant,while the control group was treated with normal saline.After the successful establishment of the model,Baijiesan+FTS group were treated with Baijiesan and received in-traperitoneal injection of FTS,while Baijiesan group were treated with Baijiesan only.The back wound images of rats were taken after successful modeling(day 0),4 days,8 days and 12 days after treatment,and the wound healing rate was calculated.After 4 days,8 days and 12 days of treatment,6 rats in each group were randomly selected and killed,the new wound healing tissue was removed,and the blood of abdominal aorta of rats after treatment for 12 days was collected.Histopathological morphology of wound tissue was observed by HE and Masson staining.Immunohistochemistry was used to detect the number of microvessels.ELISA was used to detect serum inflammatory markers.RAS signal pathway and angiogenesis-related molecules were detected by qRT-PCR and Western blot.Results:Compared with control group,the wound healing rate of model group,Baijiesan group and Baijiesan+FTS group decreased at each time point(P<0.05),while the number of microvessels,the levels of TNF-α,IL-1β,IL-6,RAS and Raf-1,VEGF,VEGFR2 mRNA and protein,ERK1,ERK2 mRNA,p-MEK1/2,p-ERK1/2 protein expressions were increased(P<0.05).Compared with model group and Baijiesan+FTS group,the wound healing rate,the number of microvessels,RAS,Raf-1,VEGF,VEGFR2 mRNA and protein,ERK1,ERK2 mRNA,p-MEK1/2,p-ERK1/2 protein expressions were further increased in Baijiesan group(P<0.05),while the levels of TNF-α,IL-1β and IL-6 were decreased(P<0.05).Conclusion:Baijiesan can reduce the level of wound inflamma-tion after operation of perianal abscess,and may enhance the ability of wound angiogenesis and wound healing by promoting RAS signal pathway.

Objective:To explore the specific mechanism of Baijiesan on microangiogenesis of wound after perianal abscess in rats by regulating RAS signal pathway.Methods:A total of 72 SD rats were divided into control group,model group,Baijiesan group and Baijiesan+farnesylthiosalicylic acid(FTS)group,with 18 rats in each group.Cut off the whole layer of skin on the back of rats.The model group,Baijiesan group and Baijiesan+FTS group were treated with fecal supernatant,while the control group was treated with normal saline.After the successful establishment of the model,Baijiesan+FTS group were treated with Baijiesan and received in-traperitoneal injection of FTS,while Baijiesan group were treated with Baijiesan only.The back wound images of rats were taken after successful modeling(day 0),4 days,8 days and 12 days after treatment,and the wound healing rate was calculated.After 4 days,8 days and 12 days of treatment,6 rats in each group were randomly selected and killed,the new wound healing tissue was removed,and the blood of abdominal aorta of rats after treatment for 12 days was collected.Histopathological morphology of wound tissue was observed by HE and Masson staining.Immunohistochemistry was used to detect the number of microvessels.ELISA was used to detect serum inflammatory markers.RAS signal pathway and angiogenesis-related molecules were detected by qRT-PCR and Western blot.Results:Compared with control group,the wound healing rate of model group,Baijiesan group and Baijiesan+FTS group decreased at each time point(P<0.05),while the number of microvessels,the levels of TNF-α,IL-1β,IL-6,RAS and Raf-1,VEGF,VEGFR2 mRNA and protein,ERK1,ERK2 mRNA,p-MEK1/2,p-ERK1/2 protein expressions were increased(P<0.05).Compared with model group and Baijiesan+FTS group,the wound healing rate,the number of microvessels,RAS,Raf-1,VEGF,VEGFR2 mRNA and protein,ERK1,ERK2 mRNA,p-MEK1/2,p-ERK1/2 protein expressions were further increased in Baijiesan group(P<0.05),while the levels of TNF-α,IL-1β and IL-6 were decreased(P<0.05).Conclusion:Baijiesan can reduce the level of wound inflamma-tion after operation of perianal abscess,and may enhance the ability of wound angiogenesis and wound healing by promoting RAS signal pathway.

Objective:To evaluate the effects of two dressing methods on wound healing and patient satisfaction after cosmetic suturing for pediatric facial trauma.Methods:A prospective randomized controlled trial was conducted at Dongying People′s Hospital from October 2022 to October 2023. A total of 180 pediatric patients [105 males, 75 females, aged 3-7 (3.9±1.4) years] with facial trauma requiring cosmetic suturing were enrolled in this study. Participants were randomly divided into the study group ( n=91) and control group ( n=89) using a random number table. During the first postoperative dressing change at 24 hours, the study group received saline cleaning followed by erythromycin ointment coverage, while the control group underwent iodine disinfection with gauze coverage. Pain intensity during the second dressing change was assessed using the Chinese version of the Children′s Hospital of Eastern Ontario pain scale (CHEOPS). Wound healing at 6-7 days post-suturing was evaluated using the Chinese version of the redness, edema, ecchymosis, discharge, and approximation (REEDA) scale. Scar appearance at 14 days was measured via the Stony Brook scar evaluation scale (SBSES). Complication rates (infection, dehiscence) and satisfaction rates were statistically analyzed. Results:During the second dressing change, the CHEOPS score was significantly lower in the study group (6.27±1.32) than that in the control group (6.89±1.21) ( P=0.001). At 6-7 days, the REEDA score in the study group (2.26±1.91) was significantly lower than that in the control group (3.07±2.13) ( P=0.008). At 14 days, the SBSES score was significantly lower in the study group [2.60±1.42) vs (3.89±1.50), P<0.001]. The infection rate was 1.09% (1/91) in the study group and 1.12% (1/89) in the control group, with two cases of epidermal dehiscence observed in the control group. The satisfaction rate in the study group was 93.41% (85/91), which was higher than that in the control group [85.49% (76/89), P=0.020]. Conclusion:Saline cleaning combined with erythromycin ointment coverage reduces pain during wound dressing change, facilitates early wound healing, and improves patient′s satisfaction.

Objective:To systematically evaluate and compare the efficacy and safety of oxcarbazepine and carbamazepine in the treatment of vestibular paroxysmia (VP).Methods:Randomized controlled trials (RCTs) of oxcarbazepine versus carbamazepine in the treatment of VP, in which the outcome measures included response rate, visual analogue scale for vertigo and the attack frequency, and incidence of adverse events/reactions were collected by searching relevant databases at home and abroad (up to March 2023). The Cochrane Collaboration′s tool for assessing risk of bias was used to evaluate the quality of the included studies. RevMan 5.3 software was used for meta-analysis. The effect sizes of counting data were odds ratio ( OR) and its 95% confidence interval ( CI), and those of the measurement data were mean difference ( MD) and its 95% CI. Results:A total of 7 RCTs and 476 patients were entered in the analysis, including 236 in the oxcarbazepine group and 240 in the carbamazepine group. Meta analysis showed that there were no significant differences in the total effective rate of oxcarbazepine and carbamazepine in the treatment of VP [85.7% (168/196) vs. 85.0% (170/200), OR=1.07, 95% CI: 0.61-1.86], the decrease of visual analogue scale for vertigo after treatment ( MD=0.40, 95% CI: -0.52-1.32) or the reduction of vertigo frequency after treatment ( MD=1.15, 95% CI:-1.78-4.08). However, compared to the carbamazepine group, the overall incidence of adverse events/reactions, the incidence of dizziness/ataxia, and incidence of nausea/vomiting in oxcarbazepine group was significantly lower [13.6% (32/236) vs. 30.8% (74/240), OR=0.34, 95% CI: 0.22-0.55, P<0.001; 2.1%(5/236) vs. 7.9%(19/240), OR=0.32, 95% CI: 0.13-0.76, P=0.01; 2.4%(5/211) vs. 7.1%(15/211), OR=0.38, 95% CI: 0.15-0.95, P=0.04]. Conclusion:Oxcarbazepine and carbamazepine have similar efficacy in the treatment of VP, but oxcarbazepine has better safety with lower incidence of adverse reactions in the nervous system and digestive system.

Objective:To systematically evaluate and compare the efficacy and safety of oxcarbazepine and carbamazepine in the treatment of vestibular paroxysmia (VP).Methods:Randomized controlled trials (RCTs) of oxcarbazepine versus carbamazepine in the treatment of VP, in which the outcome measures included response rate, visual analogue scale for vertigo and the attack frequency, and incidence of adverse events/reactions were collected by searching relevant databases at home and abroad (up to March 2023). The Cochrane Collaboration′s tool for assessing risk of bias was used to evaluate the quality of the included studies. RevMan 5.3 software was used for meta-analysis. The effect sizes of counting data were odds ratio ( OR) and its 95% confidence interval ( CI), and those of the measurement data were mean difference ( MD) and its 95% CI. Results:A total of 7 RCTs and 476 patients were entered in the analysis, including 236 in the oxcarbazepine group and 240 in the carbamazepine group. Meta analysis showed that there were no significant differences in the total effective rate of oxcarbazepine and carbamazepine in the treatment of VP [85.7% (168/196) vs. 85.0% (170/200), OR=1.07, 95% CI: 0.61-1.86], the decrease of visual analogue scale for vertigo after treatment ( MD=0.40, 95% CI: -0.52-1.32) or the reduction of vertigo frequency after treatment ( MD=1.15, 95% CI:-1.78-4.08). However, compared to the carbamazepine group, the overall incidence of adverse events/reactions, the incidence of dizziness/ataxia, and incidence of nausea/vomiting in oxcarbazepine group was significantly lower [13.6% (32/236) vs. 30.8% (74/240), OR=0.34, 95% CI: 0.22-0.55, P<0.001; 2.1%(5/236) vs. 7.9%(19/240), OR=0.32, 95% CI: 0.13-0.76, P=0.01; 2.4%(5/211) vs. 7.1%(15/211), OR=0.38, 95% CI: 0.15-0.95, P=0.04]. Conclusion:Oxcarbazepine and carbamazepine have similar efficacy in the treatment of VP, but oxcarbazepine has better safety with lower incidence of adverse reactions in the nervous system and digestive system.

Objective:To investigate the safety and early and mid-term efficacy of upper sternal mini-incision with debranching technique in B aortic dissection involving the arch.Methods:18 patients with B aortic dissection involving the arch who were admitted into our center from November 2017 to January 2019 were enrolled, to evaluate the intraoperative and postoperative conditions, including special intraoperative treatment, time of operation、poseoperative drainage、time of use ventilators, time of staying in ICU, complications etc, 12-24 months follow-up were performed after operation.Results:No death occurred, 1 case with acute renal failure, 1 case with type I endoleak, 1 case with paraplegia occurred during hospitalization, 1 patient with sudden vomiting of blood 30 days after discharge from hospital who was found aortoesophageal fistula, underwent emergency surgery to replace thoracic aortic and repair esophageal fistula, all of them were cured and discharged, the rate of complication was 22.2%(4/18). none of the other patients had any phenomena such as agnail、distal rupture、twisted or displaced of the stents、ischemic of coronary artery、cerebrovascular accident, etc.Conclusion:The result of upper sternal mini-incision with debranching technique in B aortic dissection involving the arch is satisfied, the early and mid-term survival rate is significantly improved, the patient's prognosis are improved.

Objective    To investigate the application of ascending aorta cannulation and brachiocephalic trunk cannulation in acute type A aortic dissection. Methods    We screened 183 patients with acute type A aortic dissection from January 2017 to January 2020 in our hospital. They were divided into 2 groups according to the cannulation strategy: ascending aorta cannulation and brachiocephalic trunk cannulation (a DAC group, n=42, 33 males and 9 females with a median age of 50 years) and the single axillary artery cannulation (an AAC group, n=141, 116 males and 25 females with a median age of 51 years). The general clinical data, intraoperative data and early postoperative results of the two groups before and after matching with propensity scores were compared. Results    Before propensity-score matching, the operation time, cardiopulmonary bypass time, aortic occlusion time and ICU stay in the DAC group were all shorter than those in the AAC group (P<0.05). The early postoperative mortality, and rates of brain complications, renal failure and pulmonary complications in the DAC group were significantly lower than those in the AAC group. After propensity-score matching, the operation time in the DAC group was significantly shorter than that in the AAC group (P<0.05). The early postoperative mortality, and rates of brain complications and pulmonary complications in the DAC group were significantly lower than those in the AAC group. Conclusion    Ascending aorta cannulation and brachiocephalic trunk cannulation can provide a safe, fast and effective method of establishing cardiopulmonary bypass for some acute type A aortic dissection patients, and significantly shorten the operation time without increasing surgical complications.

Objective:To examine the surgical treatment of Stanford type A aortic dissection (type A dissection) after thoracic endovascular aortic repair (TEVAR).Methods:The data of 58 patients with reoccurrence of type A dissection after TEVAR admitted into the Department of Cardiovascular Surgery, Henan Chest Hospital from February 2012 to January 2020 were analyzed retrospectively. There were 40 males and 18 females, aged (57.0±6.7) years (range: 31 to 71 years). The time between recurrence of type A dissection and TEVAR ( M( Q R)) was 37 days (72.8 months) (range: 1 h to 14 years). Forty-eight cases underwent emergency operation, 9 cases underwent sub-emergency operation, and 1 case died of dissection rupture on the way to the operating room. All 57 patients underwent radical treatment. Fifty-four cases underwent the frozen elephant trunk technique under deep hypothermia circulatory arrest and selective cerebral perfusion, and 3 cases (>65 years old) underwent arch debranch anastomosis+ascending aorta replacement+descending arch covered stent implantation under mild hypothermia. Results:The operation time was (445±32) minutes (range: 382 to 485 minutes), the aortic crossclamp time was (103±19) minutes (range: 89 to 133 minutes), the cardiopulmonary bypass time was (189±27) minutes (range: 162 to 221 minutes), and the intraoperative blood loss was (665±343) ml (range: 450 to 1 750 ml). Postoperative ICU stay time was 5 (6) days (range: 2 to 27 days), and postoperative hospital stay was 14.0 (4.5) days (range: 2 to 36 days). Three cases died, including 2 cases with severe brain complications and 1 case with systemic multiple organ failure caused by severe liver insufficiency and gastrointestinal hemorrhage. Postoperative follow-up was 0.5 to 7.0 years, which showed that 1 case had left coronary artery anastomotic stoma fistula 3 months after operation and underwent reoperation, 2 cases underwent thoracoabdominal aortic replacement again, and the rest of patients had no anastomotic stoma fistula and incomplete stent distortion and expansion on CT angiography. Four cases died during follow-up, and 1 case died of sudden cerebral infarction 2 years after operation.Conclusion:The recurrent type A dissection after TEVAR is mostly related to stent graft, and the patients can undergo operation actively with good prognosis.

Objective:To examine the surgical treatment of Stanford type A aortic dissection (type A dissection) after thoracic endovascular aortic repair (TEVAR).Methods:The data of 58 patients with reoccurrence of type A dissection after TEVAR admitted into the Department of Cardiovascular Surgery, Henan Chest Hospital from February 2012 to January 2020 were analyzed retrospectively. There were 40 males and 18 females, aged (57.0±6.7) years (range: 31 to 71 years). The time between recurrence of type A dissection and TEVAR ( M( Q R)) was 37 days (72.8 months) (range: 1 h to 14 years). Forty-eight cases underwent emergency operation, 9 cases underwent sub-emergency operation, and 1 case died of dissection rupture on the way to the operating room. All 57 patients underwent radical treatment. Fifty-four cases underwent the frozen elephant trunk technique under deep hypothermia circulatory arrest and selective cerebral perfusion, and 3 cases (>65 years old) underwent arch debranch anastomosis+ascending aorta replacement+descending arch covered stent implantation under mild hypothermia. Results:The operation time was (445±32) minutes (range: 382 to 485 minutes), the aortic crossclamp time was (103±19) minutes (range: 89 to 133 minutes), the cardiopulmonary bypass time was (189±27) minutes (range: 162 to 221 minutes), and the intraoperative blood loss was (665±343) ml (range: 450 to 1 750 ml). Postoperative ICU stay time was 5 (6) days (range: 2 to 27 days), and postoperative hospital stay was 14.0 (4.5) days (range: 2 to 36 days). Three cases died, including 2 cases with severe brain complications and 1 case with systemic multiple organ failure caused by severe liver insufficiency and gastrointestinal hemorrhage. Postoperative follow-up was 0.5 to 7.0 years, which showed that 1 case had left coronary artery anastomotic stoma fistula 3 months after operation and underwent reoperation, 2 cases underwent thoracoabdominal aortic replacement again, and the rest of patients had no anastomotic stoma fistula and incomplete stent distortion and expansion on CT angiography. Four cases died during follow-up, and 1 case died of sudden cerebral infarction 2 years after operation.Conclusion:The recurrent type A dissection after TEVAR is mostly related to stent graft, and the patients can undergo operation actively with good prognosis.