Objective To evaluate the clinical value of a modified Cancer and Aging Research Group(CARG)model in guiding anticancer drug dose adjustments for elderly cancer patients in China.Methods This prospective study enrolled patients aged≥65 years with solid tumors at the Department of Oncology,Peking Union Medical College Hospital from September 1,2022 to October 29,2023.All patients underwent comprehensive geriatric assessment(CGA)and CARG risk scoring,and were stratified into low-,intermediate-,and high-risk groups.Anti-cancer drug doses(including chemotherapy,targeted therapy or immunotherapy)were reduced proportionally based on CARG risk stratification and treatment intent(curative vs.palliative).Treatment outcomes and adverse events(AEs)were recorded regularly.Fisher's Exact Test compared AE incidence between the CARG-guided dose adjust-ment group(experimental)and the physician-experience-guided dose adjustment group(control).Receiver operating characteristic(ROC)curve analysis was used to assess the predictive value of the CARG model for severe toxicity.Results Among 166 enrolled patients(median age:71 years[range:65-90];78.3%were male;68.7%had gastro-intestinal cancers;69.3%had stageⅣ),95 were assigned to the experimental group(CARG low-risk:24[25.3%],intermediate-risk:51[53.7%],high-risk:20[21.0%])and 71 were included into the control group.By December 31,2024,81 patients experienced disease progression and 10 patients died.Overall AE rates was 92.6%in the ex-perimental group and 94.4%in the control group,while grade≥3 AEs were recorded in 45.3%vs.43.7%,respec-tively(both P＞0.05).Conclusions The modified CARG model-guided dose adjustment strategy achieved comparable safety to empirical dose adjustment,which is in line with the individualized treatment paradigm for elderly cancer pa-tients,representing a structured framework for optimizing therapeutic decision-making in geriatric oncology.

Objective:To study the clinical effect of vacuum sealing drainage in the treatment of chronic traumatic subcutaneous hematoma.Methods:Patients of chronic traumatic subcutaneous hematoma who were admitted to the Department of Burns and Plastic Surgery of Jiaozhou Central Hospital of Qingdao from June 2018 to June 2021 were included and randomly divided into the control group and the experimental group according to the random number table method. The subcutaneous hematoma was incised for debridement, and the blood clots, exudates, necrotic tissues, and pseudosynovium in the cavity were removed. The control group was treated with vaseline oil gauze filling drainage and dressing change method, and the experimental group was treated with vacuum sealing drainage and dressing change method. During the treatment, the closing time of subcutaneous hematoma cavity was observed and compared between the two groups.Results:A total of 42 patients with chronic traumatic subcutaneous hematoma were enrolled, 21 in the control group and 21 in the experimental group, including 11 males and 10 females in the control group, aged (46.2±12.4) years; 13 males and 8 females in the experimental group, aged (44.3±10.6) years. After treatment, all the subcutaneous hematoma spaces were closed in the 42 patients. The closing time of subcutaneous hematoma cavity in the experimental group was (15.52±1.69) days, which was significantly shorter than that in the control group (24.14±2.57) days. There was a significant difference between the two groups ( P<0.01). Conclusions:After incision and debridement of chronic traumatic subcutaneous hematoma, vacuum sealing drainage and dressing change can actively and fully drain the exudate in the cavity, residual blood clots, necrotic tissues, and pseudosynovium, promote the growth of new granulation tissue, which is more conducive to the closure of the cavity of subcutaneous hematoma, and shorten the clinical treatment cycle.

Objective:To study the clinical effect of vacuum sealing drainage in the treatment of chronic traumatic subcutaneous hematoma.Methods:Patients of chronic traumatic subcutaneous hematoma who were admitted to the Department of Burns and Plastic Surgery of Jiaozhou Central Hospital of Qingdao from June 2018 to June 2021 were included and randomly divided into the control group and the experimental group according to the random number table method. The subcutaneous hematoma was incised for debridement, and the blood clots, exudates, necrotic tissues, and pseudosynovium in the cavity were removed. The control group was treated with vaseline oil gauze filling drainage and dressing change method, and the experimental group was treated with vacuum sealing drainage and dressing change method. During the treatment, the closing time of subcutaneous hematoma cavity was observed and compared between the two groups.Results:A total of 42 patients with chronic traumatic subcutaneous hematoma were enrolled, 21 in the control group and 21 in the experimental group, including 11 males and 10 females in the control group, aged (46.2±12.4) years; 13 males and 8 females in the experimental group, aged (44.3±10.6) years. After treatment, all the subcutaneous hematoma spaces were closed in the 42 patients. The closing time of subcutaneous hematoma cavity in the experimental group was (15.52±1.69) days, which was significantly shorter than that in the control group (24.14±2.57) days. There was a significant difference between the two groups ( P<0.01). Conclusions:After incision and debridement of chronic traumatic subcutaneous hematoma, vacuum sealing drainage and dressing change can actively and fully drain the exudate in the cavity, residual blood clots, necrotic tissues, and pseudosynovium, promote the growth of new granulation tissue, which is more conducive to the closure of the cavity of subcutaneous hematoma, and shorten the clinical treatment cycle.

Objective:To explore the clinical application of vacuum sealing drainage (VSD) in the treatment of skin abscess caused by methicillin-resistant staphylococcus aureus (MRSA) infection. Methods:From January 2017 to December 2019, patients with skin abscess caused by MRSA admitted to the Department of Burns and Plastic Surgery of Qingdao Jiaozhou Central Hospital were selected. The patients were randomly divided into control group and experimental group according to the random number table method. Control group was treated with vaseline gauze packing, drainage and dressing change. Experimental group was treated with VSD and dressing change. During the treatment, the lacunar closure of skin abscess in the two groups was observed comparatively, pus bacteria culture and antibiotic sensitivity test were conducted regularly to observe the wound infection control situation.Results:A total of 68 patients with skin abscess caused by MRSA were enrolled, including 43 males and 25 females, the average age was 47.66±15.71 years old. There were 20 males and 14 females in the control group(mean age 46.96±16.23 years old), 23 males and 11 females in the experimental group(mean age 48.35±15.18 years old). The healing time of skin abscess lacuna in control group was (27.79±1.97) d, (15.74±1.31) din experimental group. Bacterial culture of pus and drug sensitivity test detect the growth time from MRSA to non-pathogenic bacteria in control group was (18.65±1.47) d, (9.76±1.28) din experimental group. The difference between the two groups was statistically significant ( P<0.05). Conclusions:After incision and debridement, VSD and drainageand dressing change may serve as an alternative option for the skin abscess infected by MRSA. By actively and fully draining pus, the microenvironment of pathogenic bacteria reproduction and growth is changed, and the growth of fresh granulation tissue in the lacuna is promoted, the infection of MRSA can be more effectively controlled, the lacuna closure of skin abscess is promoted, and the clinical treatment cycle is shortened.

Objective:To explore the clinical application of vacuum sealing drainage (VSD) in the treatment of skin abscess caused by methicillin-resistant staphylococcus aureus (MRSA) infection. Methods:From January 2017 to December 2019, patients with skin abscess caused by MRSA admitted to the Department of Burns and Plastic Surgery of Qingdao Jiaozhou Central Hospital were selected. The patients were randomly divided into control group and experimental group according to the random number table method. Control group was treated with vaseline gauze packing, drainage and dressing change. Experimental group was treated with VSD and dressing change. During the treatment, the lacunar closure of skin abscess in the two groups was observed comparatively, pus bacteria culture and antibiotic sensitivity test were conducted regularly to observe the wound infection control situation.Results:A total of 68 patients with skin abscess caused by MRSA were enrolled, including 43 males and 25 females, the average age was 47.66±15.71 years old. There were 20 males and 14 females in the control group(mean age 46.96±16.23 years old), 23 males and 11 females in the experimental group(mean age 48.35±15.18 years old). The healing time of skin abscess lacuna in control group was (27.79±1.97) d, (15.74±1.31) din experimental group. Bacterial culture of pus and drug sensitivity test detect the growth time from MRSA to non-pathogenic bacteria in control group was (18.65±1.47) d, (9.76±1.28) din experimental group. The difference between the two groups was statistically significant ( P<0.05). Conclusions:After incision and debridement, VSD and drainageand dressing change may serve as an alternative option for the skin abscess infected by MRSA. By actively and fully draining pus, the microenvironment of pathogenic bacteria reproduction and growth is changed, and the growth of fresh granulation tissue in the lacuna is promoted, the infection of MRSA can be more effectively controlled, the lacuna closure of skin abscess is promoted, and the clinical treatment cycle is shortened.

Objective: To evaluate the outcome of negative pressure closed drainage with chitosan membrane in the treatment of multiple drug-resistant bacterial infections. Methods: From January 2015 to December 2017, 108 patients with skin ulcer wound complicated by multiple drug-resistant bacterial infection were admitted in the department of burn and plastic surgery, Qingdao Jiaozhou Central Hospital. Among them, 36 patients had pressure ulcers, 40 cases had diabetic foot wounds, and 32 were traumatic skin ulcer wounds. Patients were divided into group A or group B for different treatments. In group A, besides the basic surgical dressing change, patients were treated by negative pressure closed drainage with chitosan membrane. The patients in Group B were only treated with basic surgical dressing change. The changes of wound were closely observed during the phases, and the wound bacterial culture and antimicrobial drug sensitivity test were performed regularly. The therapeutic effects of the 2 groups were compared. The changes of bacterial species of wound infection and the healing time were recorded. Results: In group A, the healing time of wound infection was: pressure ulcers (14.00±1.28) days, diabetic foot wounds (13.40±1.27) days, traumatic skin ulcer wounds (12.44±1.55) days. In group B, the wound healing time was: pressure ulcers (25.17±2.73) days, diabetic foot wounds (23.85±1.73) days, traumatic skin ulcer wounds (19.81±1.94) days. The wound healing time of group A was shorter than group B. In group A, the multiple drug-resistant bacteria was replaced by non-multiple drug-resistant bacteria, or there was no pathogenic bacterial growth. The differences between the two groups was statistically significant (all P<0.05). Conclusions Additional to the basic surgical dressing change, negative pressure closed drainage with chitosan membrane could promote wound healing, when it′s associated with multiple drug-resistant bacteria infection. This method has benefits in efficient drainage, preventing the formation of bacterial biofilm and changing local microenvironment for the dominant propagation. Therefore, it could effectively control the multiple drug-resistant bacterial infections, promote wound healing and save treatment time.

Objective: To investigate the clinical effects of the " rectangle plus triangle flaps" methods to repair the post-burn pseudo anal stenosis. Methods: From Oct. 2014 to Jan. 2017, five cases of pseudo anal stenosis were hospitalized and the durations of their scar contraction were 0.5 to 2 years. Flaps were located: at 3 o′clock and 9 o′clock directions of anus with prone position. Flaps were designed as one rectangle flap plus two triangle flaps. Rectangle flap was located from the exit of the diverticulum (pedicle) to the anus (distal end). Triangle flaps were located between the anus and the distal end of the rectangle flap, perpendicular to the rectangle flap. Flap transfer: ① the rectangle flap was advanced to the anus direction and sutured with the incision edge of the triangle flap closer to the anus; ② the two triangle flaps were rotated by 90 degrees and transferred to the two longitudinal incisions of the rectangle flap. Results: This design could enlarge the diverticulum exit and shorten its distance to the anus. All flaps survived and were well-healed. The follow-ups at 0.5 to 2 years presented favorable clinical results. No flap contracture, recurrent stenosis, unobstructed defecation or cleaning convenience occurred. Conclusions The " rectangle plus triangle flaps" methods was an effective way to repair the post-burn pseudo anal stenosis, which could enlarge the diverticulum exit and relocate the anus by making use of the perianal scar tissue.

Objective To study on the psychological health and related influencing factors of military nurses who take part in the Tibetan hospital supporting operation.Methods Symptom checklist 90 (SCL-90), coping style questionnaire and personal evaluation questionnaire were employed in the survey of 75 military nurses who took part in the Tibetan hospital supporting operation.Results The scores of Tibetan hospital nurses in high altitude areas were significantly higher than normal person and soldiers in each factors of SCL-90. The correlation analysis showed that the coping factor of problem resolving in coping style had negative relationship with fear factor in SCL-90 (r=-0.231,P<0.01). Remorse factor had positive correlation with all factors of SCL-90 (r=0.301-0.432;P<0.01),while the total score of personal evalation had negatively related to all factors of SCL-90 (r=-0.308--0.423;P<0.01).Conclusions The military nurses who take part in the Tibetan hospital supporting operation are in a poor mental state which is greatly influenced by the coping style and personal evaluation.

Objective To evaluate the possible correlation between anxiety state and serum angiontensin Ⅱ levels in patients with vitiligo.Methods Sixty patients with progressive vitiligo and 30 normal human controls were included in this study.Self-rating anxiety scale (SAS) was used to evaluate the anxiety state,and enzyme linked immunosorbent assay was performed to determine the serum level of angiontensin Ⅱ,in these subjects.Results SAS score was significantly increased in patients compared with the controls (46.13 ±11.72 vs.36.73 ± 12.59,t =3.50,P ＜ 0.01),and 48.3％ of the patients were affected by anxiety.The SAS score and prevalence of anxiety were statistically higher in female than in male patients (t =2.47,x2 =4.58,both P ＜ 0.05),in unmarried than in married patients (t =2.59,P ＜ 0.01; x2 =6.17,P ＜ 0.05),in patients with lesions on exposed areas than in those with lesions on unexposed areas (t =3.60,P ＜ 0.01; x2 =5.84,P ＜0.05).In patients affected by anxiety,the level of serum angiontensin Ⅱ was significantly elevated compared with patients without anxiety (63.83 ± 10.92 vs.40.74 ± 8.70 ng/L,t =9.09,P ＜ 0.01 ).Conclusions Patients with vitiligo are usually affected by anxiety.The serum level of angiontensin Ⅱ is closely correlated with anxiety state in patients with vitiligo as well as with the development of vitiligo,and may have an impact on the initiation and progression of vitiligo.

AIM: To investigate the intraocular growth characteristics of mice embryonic stem (ES) cells in nude mice.METHODS: Murine embryonic stem cells (D3 cell lines) were cultured and maintained in an undifferentiated state in vitro, then transplanted into the eyes of nude mice. In 6-45 d, the nude mice were executed for Morphological and immunohistochemical examinations.RESULTS: ES cells were developed into masses which enlarged gradually in the anterior chamber and vitreous cavity. Morphological examination showed different component: cysts, sheets and cords of medullary epithelium and rosettes in the eyes of the nude mice. Most of cells were highly stained by NSE, and some cells were moderately stained by GFAP.CONCLUSION: The embryonic stem cells(D3 cell lines) could differentiated into medulloepithelioma-like tissue in the anterior chamber and vitreous cavity of the Balb/c nude mice.