With in-depth research and development of dermoscopy, the dermoscopic features including perifollicular pigments, perilesional pigments, pigment network structure, satellite phenomenon and "tapioca sago" appearance, micro-Koebner phenomenon and comet tail-like phenomenon have provided a basis for the evaluation of vitiligo activity. This review summarizes progress in the evaluation of vitiligo activity with dermoscopy in recent years, aiming to promote the application of dermoscopy in the assessment of vitiligo activity.

Objective:To analyze the perioperative clinical characteristics of patients with oral cancer underwent radical resection and flap reconstrution and the nursing managements.Methods:From January 2020 to December 2020, 658 patients with oral cancer underwent radical resection and flap reconstrution in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University were retrospectively analyzed. All patients were divided into the elderly group (≥60 years) and the younger group (< 60 years), including 279 cases in the elderly group and 379 cases in the younger group. The perioperative clinical data of the patients were collected, and the perioperative general situation, postoperative complications and influencing factors of complications were analyzed.Results:There were differences between the two groups in the aspects of sex ( χ2 = 12.38, P<0.001), preoperative BMI ( t = 2.43, P = 0.015), smoking history ( χ2 = 18.34, P<0.001), preoperative anesthesia grade ( χ2 = 25.61, P = 0.001), preoperative coexisting disease ( χ2 = 46.97, P<0.001), whether oral floor or tongue cancer ( χ2 = 16.68, P<0.001), whether free flap ( χ2 = 6.81, P = 0.003), operation time ( t = 2.19, P = 0.029), preoperative test index hemoglobin ( t = 4.96, P<0.001), albumin ( t = 5.44, P<0.001), D-dimer( Z = -13.52, P<0.001), calcium levels ( t = 4.07, P<0.001) and postoperative complications ( χ2 = 14.55, P<0.001). Multivariate analysis of postoperative complications showed that the age ( OR = 1.021, 95% CI = 1.005-1.037, P = 0.011), preoperative D-dimer ( OR = 1.219, 95% CI = 1.026-1.447, P = 0.024) and the preoperative coexisting disease ( OR = 1.642, 95% CI = 1.108-2.432, P = 0.013) were the risk factors for the postoperative complications. Multivariate analysis of discharge with tube showed that the age ( OR = 1.017, 95% CI = 1.003-1.031, P = 0.017), preoperative BMI ( OR = 0.917, 95% CI = 0.873-0.963, P = 0.001), whether oral floor or tongue cancer ( OR = 2.135, 95% CI = 1.475-3.091, P<0.001), and operation time ( OR = 1.220, 95% CI = 1.120-1.328, P<0.001) were the related factors for the discharge with tube. Conclusion:In view of the above risk factors, it is beneficial for the physical and mental recovery of patients to pay attention to preoperative evaluation, make adequate preoperative preparation, postoperative nursing and observation, improve swallowing function training, prepare for discharge, pay attention to continuous nursing, and establish a tertiary hospital-community-family rehabilitation system.

Objective:To establish a model for predicting cesarean delivery after failure of trial of labor among low-risk term primipara.Methods:This study retrospectively analyzed the clinical data of low-risk primiparas, with singleton cephalic full-term fetus, who delivered in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Soochow University from January 1, 2011 to August 31, 2017. Women experienced cesarean delivery(CS) following failed trial of labor were grouped as CS group, while those successfully delivered normally as vaginal delivery group(VD group). Chi-square test, t-test and multivariate logistic regression analysis were used for statistical analysis. Influencing factors of CS after a failed trial of labor were screened to establish the prediction model. The area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow goodness-of-fit test were used to assess the performance of the model. A nomogram was established using R programming language based on the predictive model. Results:(1) This study recruited 6 551 subjects and among them, 576 (8.8%) women experienced CS after a failed trial of labor and the rest 5 975(91.2%) delivered vaginally. (2) The women in CS group were older [(27.5±3.1) vs (26.8±3.0) years, t=-4.963, P<0.01] and shorter in height [(159.5±4.2) vs (161.7±4.6) cm, t=11.548, P<0.01] , had higher pre-pregnancy body mass index (BMI) [(21.5±2.6) vs (20.8±2.5) kg/m 2, t=-6.743, P<0.01] and higher weight gain during pregnancy [(14.8±4.2) vs (14.1±4.2) kg, t=-3.446, P<0.01] and delivered later [(282±7) vs (278±7) d, t=-10.499, P<0.01] compared with those in VD group. The incidence of premature rupture of membranes (PROM) [26.4% (152/576) vs 20.7% (1 238/5 975) , χ2=10.101, P<0.01], labor induction [oxytocin: 26.4% (152/576) vs 16.3% (976/5 975), artificial rupture of membranes: 46.5% (268/576) vs 36.6% (2 189/5 975), application of cervical dilator balloon: 2.6% (15/576) vs 1.1% (65/5 975) and Propess: 4.7% (27/576) vs 2.5% (149/5 975), χ2=134.918, P<0.01], and the proportion of cases with meconium-stained amniotic fluid [ Ⅰ: 5.2% (30/576) vs 3.5% (209/5 975), Ⅱ: 5.7% (33/576) vs 2.5% (150/5 975), Ⅲ/bloody: 13.7% (79/576) vs 1.8% (105/5 975), χ2=307.664, P<0.01] were all higher in CS group than in VD group. There were more male infants [58.0% (334/576) vs 49.1% (2 934/5 975), χ2=16.576, P<0.01] and higher neonatal birth weight [(3 528±389) vs (3 344±368) g, t=-11.431, P<0.01] in the CS group as well. (3) Multivariate logistic regression analysis showed that maternal age and height, pre-pregnancy BMI, weight gain during pregnancy, gestational age at delivery, PROM, labor induction with oxytocin, artificial rupture of membrane, application of cervical dilator balloon and Propess, meconium-stained amniotic fluid, and fetal gender were all independent factors for CS. Two prediction models and nomograms were established according to fetal gender was involved or not. (4) The AUC of the prediction model not involving fetal gender was 0.774 (95% CI: 0.763-0.784) and the cut-off value was >8.7% with the sensitivity and specificity of 0.707 and 0.706, while that involving fetal gender was 0.782 (95% CI: 0.771-0.791) with the sensitivity and specificity of 0.785 and 0.645, respectively, when the cut-off value was >7.4%. The Hosmer-Lemeshow goodness-of-fit test showed that the two models fitted well (both P>0.05). Results of the internal validation using Bootstrap method indicated that the CS rates predicted by both models were consistent with the real data. Conclusions:The established models could effectively and accurately predict CS in term, singleton, cephalic, and low-risk primipara after failure of trial of labor, which might be a tool for clinicians to inform pregnant women to choose an appropriate delivery mode, thus improving maternal and infant outcomes.

Objective To investigate the effect of radial artery calcification (RAC) on survival of arteriovenous fistula (AVF) and the patients in end?stage renal disease. Methods Adult ESRD patients undergoing AVF surgery between January 2013 and January 2016 at the Eighth Affiliated Hospital of Sun Yat?sen University were enrolled in this study. The clinical and biochemical data were collected. Segment of radial artery were obtained from the operation of AVF. RAC at the site of anastomotic were observed by alizarin red S and hematoxylin and eosin staining. According to RAC, the patients were divided into calcification group and non?calcification group. Kaplan?Meier analysis was performed to analyze the survival rates of the two groups, and Cox proportional hazards regression——model was used to estimate the risk factors of AVF dysfunction and all?cause mortality in ESRD patients. Results Among 180 cases of ESRD patients, 38 cases (21.1％) were developed RAC at the site of anastomotic in different degrees. Compared with the non?calcification groups, the calcification groups had a longer dialysis vintage, a higher proportion of diabetes and higher level of HbAlc (all P﹤0.05). Binary logistic regression analysis showed that dialysis vintage>5 years and diabetics were two independent risk factors of RAC at the site of anastomotic. Kaplan?Meier survival analysis demonstrated that there were no statistical differences between two groups in AVF survival (χ2=0.009, P=0.926). Calcification group had higher all?cause mortality than non?calcification groups (χ2=9.809, P=0.002). Multivariate Cox regression analysis demonstrated that homocysteine was independent risk factor for AVF dysfunction (HR=1.027, 95％CI: 1.003-1.051, P=0.027). Age was independent risk factor for all?cause mortality (HR=1.078, 95％CI: 1.035-1.122, P=0.000). Conclusions Dialysis vintage>5 years and diabetes were two independent risk factors of RAC at the site of anastomotic in ESRD patients. RAC at the site of anastomotic had no effect on AVF survival, but increased all?cause mortality.

Objective To investigate the therapeutic effect of inhaled budesonide suspension combined with psychological intervention on children with asthma. Methods 64 children with asthma were enrolled in our hospital from October 2015 to December 2016. They were divided into experimental group and control group, 32 cases in each group. The control group was treated with inhaled budesonide suspension.The experimental group was treated with inhalation with budesonide suspension combined with psychological intervention, the treatment efficiency and symptom improvement were compared and analyzed in the two groups. Results The effective rate of the experimental group was 96.87%, which was higher than that of the control group 84.37%, the difference was statistically significant (P<0.05). The symptoms of cough, wheezing, wheezing and dyspnea in the experimental group was obviously better than that in the control group, the difference was statistically significant (P<0.05). Conclusion The effect of inhalation with budesonide suspension combined with psychological intervention in the treatment of children with asthmais pbvious.It can effectively improve the clinical symptoms, and promote recovery of children.

OBJECTIVETo compare the perioperative outcome between the endovascular repair (EVAR) and open surgical repair (OSR) for ruptured abdominal aortic aneurysm.

METHODSFrom January 2006 to January 2013, totally 66 patients with ruptured abdominal aortic aneurysm (rAAA) treated by surgery were retrospectively analyzed in Department of vascular surgery, People's Liberation Army General Hospital. According to the repair method, all the subjects were divided into EVAR group and OSR group. EVAR group included 40 patients, 30 patients were male, 10 patients were female, aged from 47 to 78 with a mean of (71 ± 7) years. OSR group included 26 patients, 21 patients were male, aged from 45 to 87 with a mean of (72 ± 9) years. The difference of the operation time, the amount of suspended red blood cells, ICU stay time, case fatality rate, adverse event rate and the difference of the two intervention rate were compared between the 2 groups by χ(2) test and t test.

RESULTSThere were significant differences between the 2 groups in operation time, the amount of suspended red blood cells, ICU stay time, case fatality rate, adverse event rate ((183 ± 44) minutes vs. (384 ± 108) minutes, t = -10.59, P = 0.00; (0.4 ± 0.8) units vs. (1.1 ± 1.8) units, t = -2.19, P = 0.03; (3.0 ± 1.8) d vs. (8.5 ± 5.1) d, t = -6.34, P = 0.00; 20.0% (8/40) vs. 46.2% (12/26), χ(2) = 5.10, P = 0.02; 25.0% (10/40) vs. 53.8% (14/26), χ(2) = 5.67, P = 0.02). There were no significant differences in frozen plasma quantities and the two intervention rate between the 2 groups (t = -1.98, P = 0.05; χ(2) = 0.49, P = 0.48).

CONCLUSIONSEVAR decreases the perioperative mortality and adverse event of rAAA compared with OSR. More studies are necessary to compare the middle and long-outcome between EVAR and OSR of rAAA.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Aortic Rupture ; surgery ; Endovascular Procedures ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period ; Retrospective Studies ; Treatment Outcome ; Vascular Surgical Procedures ; methods

OBJECTIVETo evaluate the outcome after endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAA) in single center.

METHODSA total of 711 AAA patients treated by EVAR in Department of Vascular Surgery, People's Liberation Army General Hospital and met the inclusion criteria from January 2004 to June 2014 were followed-up and analyzed. There were 612 male and 99 female patients, with a mean age of (69±13) years in this study group. The primary outcome of the study was all-cause mortality, secondary outcome included procedural data, intervention-related morbidity and secondary therapeutic procedures. The endpoint was death. Kaplan-Meier survival analysis were used to analyze long-term survival and cumulative probability of intervention related morbidity. Cox proportional hazards regression was used to analyze factors influenced the survival. Multivariable analysis were adjusted for covariates.

RESULTSThere were 74.8% of total patients followed up. The longest follow-up period was 10.4 years (mean 3.8 years). For the primary outcome of all-cause mortality, 140 deaths occurred. Intervention related morbidity was 9.3%, secondary therapeutic procedures was 5.3%.The Kaplan-Meier survival curve showed that cumulative survival is 78% (95% CI: 74% to 82%) in 5 years, 67% (95% CI: 61% to 74%) in 10 years and the cumulative probability of intervention related morbidity is 10.5% (95% CI: 7.3% to 13.7%) in 5 years, 19.3% (95% CI: 11.9% to 26.0%) in 10 years. Cox proportional hazards regression showed that age>75 years, American Society of Anesthesiologists classification III or IV, smoking, diabetes significantly increase the risk of long-term all-cause mortality, while hypertension significantly decreases the risk.

CONCLUSIONSLong-term outcome after EVAR of AAA in the study is similar to those advanced studies.The management of risk factors would improve the prognosis of these patients.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Risk Factors ; Treatment Outcome

BACKGROUND:In root canal preparation, the clearance effect of sodium hypochlorite for root canal irrigation on the smear layer is associated with the contact time and contact area of irrigation fluid, the amount of irrigation fluid, irrigation fluid temperature, irrigation fluid concentration, flushing methods and so on. OBJECTIVE:To investigate the clearance effect of 3% sodium hypochlorite on the smear layer of root canal under different flushing methods, flushing temperature and flushing time. METHODS:Totaly 180 isolated front teeth with single root were colected and root canal preparation was conducted using motorized ProTaper. The root canal was flushed with 3% sodium hypochlorite. According to different flushing methods, these root canals were randomly and evenly divided into root canal active flushing group, passive ultrasound swished group and side opening flushing needle group. According to the flushing temperature and the flushing time after replacing a file, each group was randomly divided into six subgroups: 20℃ 30 seconds group, 20℃ 60 seconds group, 37 ℃ 30 se group. The clearance effect on the smear layer of root canal was observed using scanning electron microscope. RESULTS AND CONCLUSION:The general clearance effect on the smear layer in the root canal active flushing group was better than that in the passive ultrasound swished group and side opening flush acupuncture group (P< 0.05). At the same time, the clearance effect on the smear layer in the 60℃ group was better that that in the 37 ℃ group and 20℃group (P < 0.05). At a certain temperature, the clearance effect on the smear layer in 60 seconds group was better than that in the 30 seconds group (P < 0.05). The clearance effect on the smear layer in the 1/3 root cap zone was better than that in the 1/3 root and 1/3 apical root zone (P < 0.05). These results show that the best clearance effect on the smear layer can be achieved as folows: 3% sodium hypochlorite irrigation at 60℃ for 60 seconds.

BACKGROUND:It is particularly important to establish an ideal animal model of pulmonary fibrosis to investigate the underlying pathogenesis and screen effective drugs to prevent and control pulmonary fibrosis. OBJECTIVE: To establish a modified scheme of establishing mouse models that can reflect pulmonary fibrosis formation in humans. METHODS: Fifty-six male C57BL/6 mice were randomly divided into two groups: A (a single large-dose injection) and B (multiple smal-dose injections). Mice in group A were subjected to a single intravenous injection of bleomycin 200 mg/kgviathe tail vein; and mice in group B received intravenous injections of bleomycin 50 mg/kg via the tail vein per week, totaly for 6 weeks. 

Objective To evaluate the effects of AIDET ( Acknowledge, Introduce, Duration, Explanation, Thanks ) communication mode in the modified electroconvulsive therapy. Methods Firstly, according to the procedure of the modified electroconvulsive therapy, we established the standard phrases of AIDET communication mode. Secondly, 100 cases of hospitalized psychiatric patients from August to October 2013 accepted the modified electroconvulsive therapy and were divided into the control group and the observation group, with 50 cases in each. The control group used the traditional lecture-style communication, while the observation group was given the AIDET communication processes and standard terms. The anxiety of two groups before and after the treatment was compared by the Hamilton Anxiety Scale ( HAMA ) , in addition with the treatment adherence and the satisfaction of nursing. Results Comparison of the HAMA scores in the two groups before the treatment was not significantly different (P >0. 05). After using the two different communication modes, the HAMA scores of somatic anxiety, mental anxiety and the total score of the observation group were significantly lower than those in the control group (t=5. 99, 6. 51, 10. 87, 10. 23, 6. 19, 7. 94, respectively;P<0. 05). The treatment adherence and the satisfaction with nursing of the observation group were significantly higher than those in the control group (Z =5. 77,χ2 =7. 16, respectively;P <0. 05). Conclusions The AIDET mode of communication can effectively reduce the patient′s anxiety, and improve the patients′adherence, treatment compliance and satisfaction.