We analysed the similarities between theory of The Inner Canon of Yellow Emperor （《黄帝内经》） and modern sleep medicine on sleep and wakefulness， and initially constructed the "eye-brain" sleep regulation system. The similarities between the sleep theories in The Inner Canon of Yellow Emperor and modern sleep medicine research are described from three perspectives： the anatomical basis of sleep physiology， the pathogenesis of sleep disorder pathology， and the mechanism of sleep disorder treatment. It is found that the regulation of sleep and wakefulness in both medicine theories is based on the "eye" and "brain" as the main control centres， and there exists a "eye-brain" pathway to regulate sleep and wakefulness in the human body. Based on this， the "eye-brain" sleep regulation theory is constructed， in order to find an effective way to solve the pathogenesis and treatment strategy of sleep disorders.

OBJECTIVE: To conduct anatomical study on the iliac crest chimeric tissue flap and summarize its effectiveness of clinical application in repairing limb wounds. METHODS: Latex perfusion and anatomical study were performed on 6 fresh adult cadaver specimens with 12 sides, to observe the initial location, distribution, quantity, and direction of the common circumflexa iliac artery, the deep circumflexa iliac artery, and the superficial circumflexa iliac artery, and to measure their initial external diameter. Between December 2020 and September 2022, the iliac crest chimeric tissue flap repair was performed on 5 patients with soft tissue of limbs and bone defects. There were 3 males and 2 females, with an average age of 46 years (range, 23-60 years). Among them, there were 3 cases of radii and skin soft tissue defects and 2 cases of tibia and skin soft tissue defects. The length of bone defects was 4-8 cm and the area of skin soft tissue defects ranged from 9 cm×5 cm to 15 cm×6 cm. The length of the iliac flap was 4-8 cm and the area of skin flap ranged from 12.0 cm×5.5 cm to 16.0 cm×8.0 cm. The donor sites were directly sutured. RESULTS: Anatomical studies showed that there were 10 common circumflex iliac arteries in 5 specimens, which originated from the lateral or posterolateral side of the transition between the external iliac artery and the femoral artery, with a length of 1.2-1.6 cm and an initial external diameter of 0.8-1.4 mm. In 1 specimen without common circumflexa iliac artery, the superficial and deep circumflex iliac arteries originated from the external iliac artery and the femoral artery, respectively, while the rest originated from the common circumflex iliac artery. The length of superficial circumflex iliac artery was 4.6-6.7 cm, and the initial external diameter was 0.4-0.8 mm. There were 3-6 perforator vessels along the way. The length of deep circumflex iliac artery was 7.8-9.2 cm, and the initial external diameter was 0.5-0.7 mm. There were 3-5 muscular branches, 4-6 periosteal branches, and 2-3 musculocutaneous branches along the way. Based on the anatomical observation results, all iliac crest chimeric tissue flaps were successfully resected and survived after operation. The wounds at recipient and donor sites healed by first intention. All patients were followed up 8-24 months, with an average of 12 months. The tissue flap has good appearance and soft texture. X-ray film reexamination showed that all the osteotomy healed, and no obvious bone resorption was observed during follow-up. CONCLUSION The common circumflex iliac artery, deep circumflex iliac artery, and superficial circumflex iliac artery were anatomically constant, and it was safe and reliable to use iliac crest chimeric tissue flap in repairing the soft tissue and bone defects of limbs.
Adult ; Male ; Female ; Humans ; Middle Aged ; Plastic Surgery Procedures ; Ilium/surgery* ; Perforator Flap/blood supply* ; Skin Transplantation/methods* ; Lower Extremity/surgery* ; Soft Tissue Injuries/surgery* ; Treatment Outcome

Objective: To investigate the clinical effects of free superficial femoral artery femoral triangle perforator flap in the repair of skin and soft tissue defects in extremities. Methods: From January 2016 to November 2017, 14 patients (9 males and 5 females, aged 19 to 54 years) with skin and soft tissue defects in extremities accompanied with tendon and bone exposure were admitted to our unit. The size of skin and soft tissue defects after debridement ranged from 7 cm×3 cm to 10 cm×7 cm. The defects were repaired with free superficial femoral artery femoral triangle perforator flaps, with size ranging from 13.0 cm×2.0 cm to 20.0 cm×4.5 cm. The medial femoral cutaneous nerve was applied to the flap. The perforator flap was grafted onto the medial femoral cutaneous nerve in 6 patients. The donor sites were sutured directly. The survival of flaps and the follow-up of patients were observed. Results: All flaps of 14 patients survived successfully. The recipient sites and donor sites were healed completely in 13 patients, and 1 patient with partial skin necrosis at the edge of flap was healed after treatment. All patients were followed up for 6 months to 1 year after the operation. The flaps were in good shape, with nearly normal color and soft texture and no cicatrix contracture deformity. The flaps recovered protective sense in 6 patients who had medial femoral cutaneous nerve grafting, and the sensory recovery of the flap was slightly worse in the remaining 8 patients. There was no significant complications on the appearance and walking of the donor thigh in 14 patients, only a linear scar was left on the inner thigh, and no numbness was felt in the donor sites of patients. Conclusions The free superficial femoral artery femoral triangle perforator flap is an ideal therapy for repairing skin and soft tissue defects in extremities.

Objective To understand the distribution characteristics of clinical multi-drug resistant bacteri-a,provide a scientific evidence for control of infection and rational use of antibiotics.Methods The distribu-tion of multi-drug resistant bacteria in the hospital for three years was analyzed retrospectively.Results There were 19 354 non-repeating strains from 2014 to 2016,and 21.9%(4 234)of the total strains were multi-ple resistant strains.Among them,ESBLs-producing Escherichia coli was the most,followed by carbapene-re-sistant Acinetobacter baumannii(MDR-AB),ESBLs-producing Klebsiella pneumoniae,multidrug-resistant Pseudomonas aeruginosa(MDR-AB),Production of carbapene-enzyme Enterobacteriaceae bacteria(CRE), vancomycin-resistant enterococci(VRE),concentrate mainly on the ICU for high-risk areas of infection.The most were from the respiratory system specimens,followed by the urinary system specimens.Conclusion Multiple resistant bacteria are growing critical.There should be more attention to be paid in bacteriological ex-amination for clinic,the clinical isolation of pathogenic microorganisms in the hospital should be grasped.The antimicrobial agents should be rationally applied according to the results of bacterial susceptibility,in addition the management of antimicrobial agents and multi-drug monitoring should be strengthened.

Objective To compare and analyze the influencing factors of the distribution and drug resistance of blood culture positive pathogens in neonatal intensive care unit (NICU) at different altitude areas.Methods The distribution of blood culture positive pathogens and clinical susceptibility of children in NICU of two different altitude hospitals in 2015 were retrospectively analyzed.Results In 2015,children in NICU in upper elevation district hospital mainly infected with 19 strains(18.4％) of epidermis staphylococcus,18 strains(17.5 ％) of Escherichia coli,14 strains(13.6 ％) of Klebsiella pneumoniae,14 strains(13.6 ％) of Hemolysis staphylococcus,12 strains(11.7 ％) of Stenotrophomonas maltophilia;Children in NICU at low altitude hospital mainly infected with 31 strains(19.7％) of epidermis staphylococcus,27 strains(17.2％) of Achromobacter xylosoxidans,18 strains(11.5％) of Hemolysis staphylococcus,14 strains(8.9 ％) of Klebsiella pneumoniae,14 strains (8.9 ％) of Acinetobacter baumannii.The detection rate of Gram-negative bacilli in high altitude hospital was higher,and the detection rate of Gram positive cocci in low altitude hospital was higher.In high-altitude district hospital,the detection rate of methicillin-resistant coagulase negative staphylococci (MRCNS) extended-spectrum β-lactamase (ESBLs),and multidrug-resistant Acinetobacter baumannii(MDRAB) were than low altitude hospital.Conclusion Escherichia coli and Stenotrophomonas maltophilia detection rate and common antibiotics sensitive rate are relatively high at upper elevation areas;Detection rate of coagulase negative Staphylococcus aureus and common antibiotics resistance rate are high in low altitude.Different altitudes environmental factors may play an important role in pathogens distribution and drug resistance from NICU blood culture.

Objective To investigate the clinical application of Carba NP test in detecting carbapenem-resistant enterobacteriaceae.Methods Routine method was adopted to identify the 51 strains from clinical isolates and K-B test was conducted to screen out the carbapenem-resistant enterobacteriaceae and detect antimicrobial susceptibility.E-test was used to detect the minimum inhibitory concentration (MIC)of carbapenems.Modified Hodge test (MHT)and Carba NPⅠ test were used to screen out the phenotypes of carbapenemase,respectively. Then Carba NPⅡ test was used to classify carbapenemase which were positive in Carba NP I test.E-test was used for the detection of metalloenzymes.Polymerase chain reaction (PCR)was used for the detection of resistance genes. Results Totally 41 strains were positive in Carba NP 1 test and classified as B-class by Carba NPⅡ test.They were positive in metalloenzyme by E-test and carried NDM-1 gene by PCR.Conclusion Carba NP test can be used conveniently,has high consistency with PCR method,and the result is easy to determine.Therefore,it can be used as a routine laboratory method.

Objective To determine the triterpenoid content in Loquat leaf by using HPLC method and to explore the feasibility of ursolic acid and oleanolic acid as the quantitative markers for determination of Loquat leaf and its preparations.Methods Two desugaring methods of Loquat leaf extracts were compared.The contents of ursolic acid and oleanolic acid in Loquat leaf as well as preparations were measured based on a system of HPLC,with a Dumas Diamonsil C18 column (250 mm×4.6 mm,5 μm) was used as analytical column.The mobile phase was consisted of acetonitrile-0.1% phosphoric acid (95∶5) with the flow rate of 0.5 mL·min-1.The column temperature was 30 ℃,the injection volume was 10 μL, the detective wavelength was 210 nm.Results Ursolic acid and oleanolic acid were measured in both Loquat leaf and its preparations,and their contents were fairy stable and comparable.Conclusion Ursolic acid and oleanolic acid can be served as quantitative markers for the determination of Loquat leaf and its preparations.

Objective:To screen the optimal formula and technology of demethoxycurcumin nano-structured lipid carriers. Meth-ods:The encapsulation efficiency as the main investigation index, the single factor exploration and orthogonal design were used to study the main factors affecting the quality of the nanoparticles. The optimal formula and technology were obtained. Results:The optimized parameters were as follows:the ratio of drug to lipid materials was 1 ∶40, the ratio of liquid lipid to total lipid materials was 10%, the amount of surfactants was 4% and the amount of lecithin was 2%. The prepared nanoparticles were spheric and regular. The size dis-tribution of the nanoparticles was narrow with the average particle size of 110nm and PDI of 0. 199. Conclusion:The optimized formula and technology of demethoxycurcumin nano-structured lipid carriers are stable and practicable,which provide reference for the further research of demethoxycurcumin.

Objective To study the drug resistance of Staphylococcus aureus in 2006 -2011 ,and to provide the evidence for treatment infection .Methods The isolated bacteria were identified and antibiotic sensitivity were tested by automated system in 503 Staphylococcus aureus collected from 2006 to 2011 .Methicillin resistant Staphylococcus aureus(MRSA) was screened by oxacillin disk diffusion .Results 503 strains mainly derived from secretion and sputum .The incidence of MRSA was 44 .9% during 6 years . Detection rate of MRSA was decreased year by year .The difference was statistically significant between 2009 ,2010 ,2011 and 2006 , 2007 ,2008(P<0 .05) .No resistance to quinupristin/dalfopristin ,linezoiid ,vancomycin and nitrofurantoin was found .The resistance of Staphylococcus aureus was below 30% to levofloxacin ,imipenem ,compound sulfamethoxazole and rifampicin ,above 80% to ce-fazolin and penicillin .Although the resistant to cefazolin ,levofloxacin ,imipenem was risen ,the resistant rate of rest antibiotics was downed year after year .Conclusion Monitoring of drug resistance should be strengthened .The antimicrobial therapy should be de-fined on the basis of drug-sensitive test in order to control the incidence of infection and to delay the growth of clinical resistant strains of Staphylococcus aureus .

ObjectiveTo explore the effect of simvastatin on the level of serum adiponectin and asymmetric dimethylarginine (ADMA) in patients with acute stroke.MethodsNinety patients with acute stroke were selected and divided by random digits table method into common treatment group and intervention treatment group with 45 cases each.The volume of cerebral infarction and the evaluation score of clinical neurological impairment degree were calculated.The levels of serum adiponectin and ADMA before and after treatment were detected by erzyme-linked immunosorbent assay.The changes of serum adiponectin and ADMA before and after treatment in two groups were compared and their correlations with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree were analyzed.Results The level of serum adiponectin and ADMA in two groups before treatment had no statistical differences (P ＞ 0.05 ).The levels of serum adiponectin in two groups after treatment increased and ADMA decreased significantly,which had significant differences compared with those before treatment ( P ＜ 0.05 ).The level ofserum adiponectin in intervention treatment group was significantly higher than that in common treatment group and ADMA was obviously lower than that in common treatment group after treatment [(5.92 ± 0.15)mg/L vs.( 4.51 ± 0.13 ) mg/L,( 0.96 ± 0.13 ) μ mol/L vs.( 1.08 ± 0.15 ) μ mol/L ] ( P ＜ 0.05 ).Rank correlation analysis showed that the level of serum adiponectin before treatment was negatively correlated with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree ( r ＝ -0.75,-0.59,P ＜ 0.05).The level of ADMA before treatment was positively correlated with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree ( r =0.68,0.71,P ＜ 0.05 ).Conclusion Simvastatin can increase the level of serurm adiponectin and decrease the level of ADMA efficiently in patients with acute stroke,and improve the prognosis of the patients.