OBJECTIVE To optimize the venipuncture disinfection procedures for the patients with psoriasis by modifying the skin pretreatment,number of times of disinfection and action time,evaluate the disinfection effects before and after the modification and observe the impact on skin barrier function.METHODS A total of 78 patients with psoriasis who were hospitalized in Air Force Medical Center of Special Medicine from Jan.2024 to Mar.2025 were enrolled in the study and were randomly divided into the control group and the study group,with 39 cases in each group.Both groups were disinfected with povidone iodine swabs.The control group was treated with a single clockwise spiral wipe centered on the puncture site,and the total time of embrocation and drying time was 60 s;the study group was treated with the modified disinfection method'pretreatment-bidirectional disinfec-tion-120-second drying',which was unidirectional wiping of puncture site skin of hand back with sterile swab in-filtrating with normal saline,a single clockwise spiral wipe centered on the puncture site,counter-clockwise wipe for two times,the total time of embrocation and drying 120 s in total.The skin specimens were collected from the puncture sites for culture and identification of pathogens before the disinfection and after the drying,and the trans-epidermal water loss(TEWL)volume was detected by TewameterTM 300 instrument.RESULTS Totally 16 types of pathogens were isolated from the two groups of patients before the disinfection,among which Staphylococcus spp was dominant.The bacterial colony counts were[26.00(8.00,74.00)]CFU/cm2 in the study group before the disinfection,[41.00(13.00,94.00)]CFU/cm2 in the control group,and there was no significant difference(P=0.081).The bacterial colony counts of the two groups were lower after the disinfection and drying than before the disinfection(P＜0.001),and the bacterial colony counts of the study group were[0.00(0.00,1.00)]CFU/cm2,lower than[1.00(0.00,4.00)]CFU/cm2 of the control group(P=0.042).The TEWL value of the two groups was greater after the disinfection than before the disinfection(P＜0.001),however,there was no between-group difference(P=0.933).CONCLUSION The modified disinfection procedure has more advantages in eradicating pathogens without increasing damage to skin barrier,it provides safer disinfection plans for the patients with psoriasis and is worthy to be promoted in the hospital.

OBJECTIVE To optimize the venipuncture disinfection procedures for the patients with psoriasis by modifying the skin pretreatment,number of times of disinfection and action time,evaluate the disinfection effects before and after the modification and observe the impact on skin barrier function.METHODS A total of 78 patients with psoriasis who were hospitalized in Air Force Medical Center of Special Medicine from Jan.2024 to Mar.2025 were enrolled in the study and were randomly divided into the control group and the study group,with 39 cases in each group.Both groups were disinfected with povidone iodine swabs.The control group was treated with a single clockwise spiral wipe centered on the puncture site,and the total time of embrocation and drying time was 60 s;the study group was treated with the modified disinfection method'pretreatment-bidirectional disinfec-tion-120-second drying',which was unidirectional wiping of puncture site skin of hand back with sterile swab in-filtrating with normal saline,a single clockwise spiral wipe centered on the puncture site,counter-clockwise wipe for two times,the total time of embrocation and drying 120 s in total.The skin specimens were collected from the puncture sites for culture and identification of pathogens before the disinfection and after the drying,and the trans-epidermal water loss(TEWL)volume was detected by TewameterTM 300 instrument.RESULTS Totally 16 types of pathogens were isolated from the two groups of patients before the disinfection,among which Staphylococcus spp was dominant.The bacterial colony counts were[26.00(8.00,74.00)]CFU/cm2 in the study group before the disinfection,[41.00(13.00,94.00)]CFU/cm2 in the control group,and there was no significant difference(P=0.081).The bacterial colony counts of the two groups were lower after the disinfection and drying than before the disinfection(P＜0.001),and the bacterial colony counts of the study group were[0.00(0.00,1.00)]CFU/cm2,lower than[1.00(0.00,4.00)]CFU/cm2 of the control group(P=0.042).The TEWL value of the two groups was greater after the disinfection than before the disinfection(P＜0.001),however,there was no between-group difference(P=0.933).CONCLUSION The modified disinfection procedure has more advantages in eradicating pathogens without increasing damage to skin barrier,it provides safer disinfection plans for the patients with psoriasis and is worthy to be promoted in the hospital.

Objective:To evaluate the volume changes of cervical longus and cervical extensor after anterior cervical discectomy and fusion (ACDF), and the correlation with the clinical efficacy of patients.Methods:All of 57 patients with cervical spondylotic myelopathy who underwent single-segment ACDF surgery from January 2013 to December 2018 were analyzed. The follow-up time was 23.0±4.8 months (range 16-34 months). All included subjects underwent MR examination within 1 week before operation and 3rd, 12th months after operation and at the last follow-up. The axial section cross section area (AxCSA) of the cervical longus and the ratio of length to short diameter line (RLS) at the level of each disc of C 2-C 7 were measured on the axial T2WI. Calculate the volume of the cervical longus based on the layer thickness. At the same time, measure the cervical extensor cross-sectional area (CESA) of the same level including the multifidus, cervical semispinous muscle, semispinous head, splinter head, and cervical splinter muscles, and compare CESA with the corresponding vertebral cross-sectional area (VBA). The ratio is analyzed as the volume of the neck extensor muscle, namely CESA/VBA. At the 3rd and 12th months after operation and at the last follow-up, the axial pain was assessed by visual analogue scale (VAS) for assessing pain, and the modified Japanese Orthopedic Association score (mJOA) and the neck dysfunction index (NDI) were used to assess the functional status of the cervical spine. Analyze the morphological changes of thecervical longus and extensor cervical muscles before and after the operation and during the follow-up period, and analyze the correlation with VAS, mJOA, and NDI. Results:Compared with the preoperative period, the average AxCSA of the surgical segment decreased at the 3rd and 12th months after the operation and at the last follow-up. The difference was statistically significant ( F=24.113, P<0.05), which was changed from 140.84±19.51 mm 2 respectively reduce to 117.74±17.15 mm 2 ( t=6.714, P<0.05), 116.37±18.67 mm 2 ( t=6.841, P<0.05) and 116.27±18.65 mm 2 ( t=6.873, P<0.05). Compared with preoperatively, they were reduced by 16.40%, 17.37% and 17.45%, respectively, while the average RLS of surgical segments increased slightly, and the difference was statistically significant ( F=22.612, P<0.05), which increased from preoperative 1.97±0.67 to 2.73±0.60 (38.58% increased, t=6.380, P<0.05), 2.82±0.64 (43.15% increased, t=6.926, P<0.05) and 2.74±0.62 (39.09% increased, t=6.368, P<0.05). The volume of thecervical longus of the patients decreased after the operation, and the difference was statistically significant ( F=64.511, P<0.05), which decreased from 8853.48±458.65 mm 3 before the operation to 7834.53±461.59 mm 3 (11.51% decreased, t=11.822, P<0.05), 7926.42±456.24 mm 3 (10.47% decreased, t=10.819, P<0.05), 7892.38±450.78 mm 3 (10.86% decreased, t=11.283, P<0.05). There were no statistically significant differences in the non-surgical segment AxCSA, RLS and the volume of thecervical longus at the 3rd and 12th months after surgery and the last follow-up ( P>0.05). There was no statistically significant difference of CESA and CESA/VBA compared to preoperative in the surgical segment and non-surgical segment ( P>0.05). Pearson correlation analysis showed that the volume of cervical longus and VAS at the 3rd month ( r=-0.308, P<0.05), the 12th month ( r=-0.210, P<0.05) and the last follow-up ( r=-0.404, P<0.05) were negatively correlated; Among the volume of cervical longus and NDI in the 3rd month ( r=-0.511, P<0.05), 12th month ( r=-0.518, P<0.05) and the last follow-up ( r=-0.352, P<0.05), there was a negative correlation; However, there was no statistically significant correlation between the cervical longus muscle volume and mJOA at each follow-up time point ( P>0.05); There was no significant correlation between CESA/VBA and VAS, NDI, and mJOA at the 3rd, 12th and last follow-up ( P>0.05). Conclusion:The volume and morphology of cervical longus after ACDF was significantly reduced compared with that before the operation, but the volume and morphology of the cervical extensor muscle did not change significantly. ACDF surgery mainly affects the cervical longus corresponding to the surgical segment, and the volume is negatively correlated with the VAS and NDI during follow-up.

Objective:To investigate the effects of exosomes of human nucleus pulposus cells (NPCs) on the differentiation of urine derived stem cells (USCs) into nucleus pulposus-like cells.Methods:USCs and NPCs were isolated and cultured in vitro. The exosomes of NPCs were extracted and detected by Western-blot. USCs cytoplasm was transfected with GFP lentivirus, while nucleus was transfected with DAPI dye. The NPCs exosomes were transfected with PKH26 dye. After co-incubation for 12 h, USCs and NPCs exosomes were observed by macroscopy. USCs differentiation was induced by NPCs exosomes and non-contact co-culture methods. The relative expression of marker gene mRNA of nucleus pulposus cells in each group and the absorbance at 450 nm wavelength were detected.Results:The isolated USCs had the ability to differentiate into osteocytes, adipocytes and chondrocytes with high expression of marker CD29 (99.57%), CD44 (97.46%) and CD73 (97.71%) and with low expression of negative proteins CD31 (0.59%) and CD45 (0.19%). The isolated NPCs highly expressed nuclear pulposus cell marker COL2A1, ACAN and SOX-9. The exosomes extracted from NPCs showed high expression of exosome marker CD63, CD81 and Tsg101. After 12 h co-incubation, NPCs exosomes fused with USCs membrane and appeared in the cytoplasm of USCs. At 3, 5 and 7 days of co-culture, the absorbance value of USCs cells in exosome group (0.44±0.004, 0.76±0.004, 0.82±0.006) was higher than that in co-culture group (0.39±0.022, 0.63±0.035, 0.69±0.012) ( P<0.05). The mRNA relative expression of USCs nucleus pulposus marker genes ACAN (1.80±0.31, 3.50±0.21, 5.35±0.31, 7.46±0.12), COL2A1 (1.43±0.15, 4.33±0.23, 6.89±0.22, 8.11±0.31), SOX-9 (2.21±0.13, 3.13±0.11, 3.96± 0.14, 4.52±0.26) and HIF-1α (1.45±0.16, 2.14±0.21, 4.31±0.41, 4.01±0.25) in exosomes group were significantly higher than those in the control group ( P<0.05) at the 3rd, 7th, 14th and 21st days. The mRNA relative expression of USCs nucleus pulposus marker genes ACAN (5.69±0.21, 6.69±0.13), COL2A1 (6.33±0.17, 7.89±0.15), SOX-9 (4.19±0.29, 4.38±0.12), HIF-1α (4.49±0.32, 4.96±0.26) in exosomes group were significantly higher than those ACAN (3.69±0.35, 5.13±0.23), COL2A1 (3.40±0.16, 6.79±0.19), SOX-9 (2.26±0.32, 3.69±0.26), HIF-1α (2.39±0.11, 3.96±0.13) in non-contact co-culture group ( P<0.05) at the 14th and 21st days. Conclusion:Human nucleus pulposus exosomes could induce differentiation of human USCs into nucleus pulposus-like cells in vitro. Compared with non-contact co-culture, exosomes have higher induction efficiency and can better maintain the proliferation activity of nucleus pulposus-like cells

Background and Objectives: With the growing incidence of acute myocardial infarction (MI), angiogenesis is vital for cardiac function post-MI. The role of bone marrow mesenchymal stem cells (BMSCs) in angiogenesis has been previously confirmed. Irisin is considered a potential vector for angiogenesis. The objective of the present study was to investigate the potential role of irisin in the angiogenesis of BMSCs. Methods: and Results: In vivo, irisin-treated BMSCs (BMSCs＋irisin) were transplanted into an MI mouse model. On day 28 post-MI, blood vessel markers were detected, and cardiac function and infarct areas of mice were evaluated. In vitro, paracrine effects were assessed by examining tube formation in human umbilical vein endothelial cells (HUVECs) co-cultured with the BMSCs＋irisin supernatant. The scratch wound-healing assay was performed to evaluate HUVEC migration. Western blotting was performed to determine PI3k/Akt pathway activation in the BMSCs＋irisin group. Transplantation of BMSCs＋irisin promoted greater angiogenesis, resulting in better cardiac function in the MI mouse model than in controls. In the BMSC＋irisin group, HUVECs demonstrated enhanced tube formation and migration. Activation of the PI3k/Akt pathway was found to be involved in mediating the role of irisin in the angiogenesis of BMSCs. Conclusions In cardiovascular diseases such as MI, irisin administration can enhance angiogenesis of BMSCs and pro-mote cardiac function via the PI3k/Akt pathway, optimizing the therapeutic effect based on BMSCs transplantation.

Objective:To investigate the long-term efficacy and safety of alternating double balloon occlusion combined with intra-aneurysm injection of human fibrin binder in the endovascular repair of ruptured abdominal aortic aneurysm (rAAA).Methods:The clinical data of 28 patients with rAAA admitted to Department of Vascular Surgery, the Fourth Affiliated Hospital of Guangxi Medical University from January 2015 to December 2019 were retrospectively analyzed. There were 23 males and 5 females, aged (62±5) years (range: 46 to 88 years).The maximum diameter of the tumors was (65.2±10.5) mm (range: 47.3 to 100.5 mm), all of which were subrenal rAAA. The intraoperative EVAR for abdominal aortic aneurysm was successfully performed under the emergency green channel procedure, and this surgery was assisted used the double balloon occlusion technique in aorta of inferior renal and superior renalcombined with intraoperative human fibrin binder injection technique. Observation indexes included: patients with preoperative preparation, operation time, hospitalization days, surgical treatment success rate and the incidence of postoperative complications, and aortic stent form during the follow-up period, the incidence of leakage, branch stents patency rate and infection rates.Results:The preoperative preparation time of 28 patients was (45.5±8.5) minutes (range:20 to 100 minutes). The operation time was (100.0±15.5) minutes (range:85 to 210 minutes), the ICU stay time was (7±2) days(range:1 to 17 days). The length of hospitalization was (13.5±2.5) days(range:5 to 43 days). The success rate of surgical treatment was 92.9% (26/28). Two patients died, 1 case died of postoperative multifocal lacunar cerebral infarction and massive gastrointestinal hemorrhage, and another elderly patient (84 years old) died of massive abdominal fluid due to preoperative abdominal aortic aneurysm rupture, postoperative complicated with significant abdominal compartment syndrome, and secondary multiple organ failure. Balloon occlusion of the upper renal aorta took (13±2)minutes (range:12 to 30 minutes). The intraoperative injection of fibrin adhesive was (14±2) ml(range:6 to 28 ml) in 22 cases. The incidence of major postoperative complications was 57.1% (16/28). Among the 26 patients who survived the surgery, 69.2% (18/26) completed the 3-year follow-up, and the follow-up time was (30±3) months(range:13 to 36 months). During the follow-up, the aortic stent was in good shape without obvious displacement. The incidence of leakage within 6 months after the operation was 10.7% (3/28), and there was no internal leakage in the patients who were followed up for 36 months after the operation. The patency rate of renal artery and iliac artery branch stents was 16/18. The incidence of stent infection was 7.7% (2/26), 1 case occurred at 1 month and another case at 6 months, respectively. All patients recovered after prolonged intensive anti-infection therapy.Conclusions:Under the standard emergency treatment process, the double balloon alternating occlusion technique combined with the intra-aneurysm injection of human fibrin adhesive technique can assist the successful completion of the endovascular repair of rAAA, effectively improve the success rate of treatment for patients, and reduce the incidence of postoperative leakage and serious complications. The mid-term and long-term results of EVAR for rAAA are good, safe and reliable.

Objective:To investigate the long-term efficacy and safety of alternating double balloon occlusion combined with intra-aneurysm injection of human fibrin binder in the endovascular repair of ruptured abdominal aortic aneurysm (rAAA).Methods:The clinical data of 28 patients with rAAA admitted to Department of Vascular Surgery, the Fourth Affiliated Hospital of Guangxi Medical University from January 2015 to December 2019 were retrospectively analyzed. There were 23 males and 5 females, aged (62±5) years (range: 46 to 88 years).The maximum diameter of the tumors was (65.2±10.5) mm (range: 47.3 to 100.5 mm), all of which were subrenal rAAA. The intraoperative EVAR for abdominal aortic aneurysm was successfully performed under the emergency green channel procedure, and this surgery was assisted used the double balloon occlusion technique in aorta of inferior renal and superior renalcombined with intraoperative human fibrin binder injection technique. Observation indexes included: patients with preoperative preparation, operation time, hospitalization days, surgical treatment success rate and the incidence of postoperative complications, and aortic stent form during the follow-up period, the incidence of leakage, branch stents patency rate and infection rates.Results:The preoperative preparation time of 28 patients was (45.5±8.5) minutes (range:20 to 100 minutes). The operation time was (100.0±15.5) minutes (range:85 to 210 minutes), the ICU stay time was (7±2) days(range:1 to 17 days). The length of hospitalization was (13.5±2.5) days(range:5 to 43 days). The success rate of surgical treatment was 92.9% (26/28). Two patients died, 1 case died of postoperative multifocal lacunar cerebral infarction and massive gastrointestinal hemorrhage, and another elderly patient (84 years old) died of massive abdominal fluid due to preoperative abdominal aortic aneurysm rupture, postoperative complicated with significant abdominal compartment syndrome, and secondary multiple organ failure. Balloon occlusion of the upper renal aorta took (13±2)minutes (range:12 to 30 minutes). The intraoperative injection of fibrin adhesive was (14±2) ml(range:6 to 28 ml) in 22 cases. The incidence of major postoperative complications was 57.1% (16/28). Among the 26 patients who survived the surgery, 69.2% (18/26) completed the 3-year follow-up, and the follow-up time was (30±3) months(range:13 to 36 months). During the follow-up, the aortic stent was in good shape without obvious displacement. The incidence of leakage within 6 months after the operation was 10.7% (3/28), and there was no internal leakage in the patients who were followed up for 36 months after the operation. The patency rate of renal artery and iliac artery branch stents was 16/18. The incidence of stent infection was 7.7% (2/26), 1 case occurred at 1 month and another case at 6 months, respectively. All patients recovered after prolonged intensive anti-infection therapy.Conclusions:Under the standard emergency treatment process, the double balloon alternating occlusion technique combined with the intra-aneurysm injection of human fibrin adhesive technique can assist the successful completion of the endovascular repair of rAAA, effectively improve the success rate of treatment for patients, and reduce the incidence of postoperative leakage and serious complications. The mid-term and long-term results of EVAR for rAAA are good, safe and reliable.

At present,splenectomy and extensive esophagogastric devascularization is one of the effective treatments for relieving hypersplenism in patients with cirrhosis,relieving portal hypertension,and reducing upper gastrointestinal bleeding caused by rupture of esophagogastric varices.However,portal vein thrombosis is one of the most common serious complications of splenectomy and devascularization in patients with cirrhosis.Because of its high incidence and mortality of PVT,it has become the focus of disputes in the surgical field.In recent years,with the improvement of medical technology,many domestic and foreign scholars have conducted high-quality researches on the prevention of PVT in the perioperative period of splenectomy and devascularization.This paper summarized the research progress during recent years in combination with relevant literature.

Objective To investigate the significances of PAMP and NT-proBNP in predicting coronary artery injury in Kawasaki disease(KD).Methods A total of 196 cases of KD in this hospital from February 2014 to August 2015 were selected and divided into the KD injury group and KD non-injury group according to with orwithout coronary arterial injury.Contemporaneous 50 healthy children in the Child Health Care Center were selected as the control group.The plasma levels of PAMP and NT-proBNP were detected in 3 groups.Results Compared with the control group,the plasma levels of PAMP and NT-proBNP in the childrenpatients with KD were increased,moreover the KD injury group was higher than the KD non-injury group(P＜0.05).The plasma PAMP levels in KD children patients were positively correlated with NT-proBNP,white blood cell(WBC) count,neutrophil percentage and erythrocyte sedimentation rate(ESR)(P＜0.05),while were negatively correlated with the value of serum sodium and albumin(P＜0.05),the plasma levels of NT-proBNP were positively correlated white blood cell count,neutrophil percentage,C-reactive protein(CRP) and ESR(P＜0.05),while were negatively correlated with the levels of serum sodium and albumin(P＜0.05).The area under the curve(AUC) of plasma PAMP and NT-proBNP levels in predicting coronary artery damage in children patients with KD was 0.989,the sensitivity was 93.24％ and specificity was 93.65 ％.Conclusion The plasma levels of PAMP and NT-proBNP in children patients with acute phase of KD are elevated,which can serve as the predictive indicators of coronary artery lesion.

BACKGROUND:After the initial hip replacement, aseptic or infective loosening and subsidence of the prosthesis, acetabular wear, pain, osteolysis and other factors may lead to the loss of prosthesis stability and loss of joint function, which are the common cause of hip arthroplasty. Among the hip arthroplasty, acetabular lateral reconstruction is essential and largely determines the success or failure of revision surgery. ＜br> OBJECTIVE:To explore the present situation of reconstructing acetabulum after total hip arthroplasty. ＜br> METHODS:A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) between January 1998 and March 2014, and CNKI database (http://www.cnki.net/) from January 2003 to March 2014 was undertaken for the articles about reconstructing acetabulum after total hip arthroplasty. The key words were“artificial joint, reconstruction, acetabular lateral reconstruction, current situation”in Chinese and“reconstructed acetabulum, total hip arthroplasty”in English. Article about hip reconstruction, acetabyular reconstruction, bone defect reconstruction, prosthesis choice and reconstruction, and soft tissue balance were also selected. Repetitive researches were excluded. ＜br> RESULTS AND CONCLUSION:According to inclusion criteria, 26 articles were involved in this study. A perfect acetabular revision should achieve the fol owing goals:stabilize acetabular prosthesis after acetabular revision;recover hip rotation center and biomechanical properties;repair acetabular bone defects and increase hip bone. Adequate preparation before surgery is an important prerequisite for the success of surgery and good results, aseptic and septic loosening or subsidence of the prosthesis, as wel as acetabular wear and tear are common causes of hip revision. Intraoperative reconstruction of acetabular anteversion and camber angles, acetabular rotation center reconstruction, reconstruction of acetabular bone defects, selection of reconstruction of acetabular prosthesis, and reconstruction of soft tissue balance are the core technologies of reconstructing acetabulum after total hip arthroplasty.