Objective:To explore the clinical effects of combined surgical and high-frequency electro-acupuncture treatment for aesthetic restoration in children with eyelid split nevus.Methods:A retrospective analysis was conducted on the medical records of children treated for eyelid split nevus in the Plastic Surgery Department of the First Affiliated Hospital of Army Medical University from January 2019 to December 2023. All cases underwent combined surgical excision and high-frequency electro-acupuncture vaporization. Surgical removal was used for nevi with significant pigmentation and deep involvement, and high-frequency electro-acupuncture was simultaneously applied to vaporize residual superficial pigmentation layer by layer based on the depth of the pigmentation. The wounds were repaired using either direct suturing or local flap transfer. Postoperative management included the application of growth factors and anti-scar treatments. Postoperative healing, adverse effects, and pigment clearance rate (categorized as healed, significant effect, improved, or ineffective) were observed by comparsons of the pre-treatment and the last follow-up photographs. Eyelid function, appearance, and scar hypertrophy were assessed during follow-up, and family satisfaction (categorized as very satisfied, satisfied, or dissatisfied) was surveyed via telephone.Results:Five children were included, with one male and four females aged between 2 and 10 years (average 7 years). Pigment areas ranged from 0.3 cm × 0.5 cm to 1.7 cm × 1.1 cm, with surgical excision areas from 0.3 cm × 0.4 cm to 1.5 cm × 1.1 cm. All children had good wound healing without complications such as infection, flap ischemic necrosis, wound dehiscence or bleeding. The pigment clearance rate was over 90%, achieving a healed effect. During the follow-up of 14 to 48 months (average 24.2 months), all patients had normal eyelid function without difficulties in opening or closing the eyes, or epiphora. The eyelid appearance was satisfactory without asymmetry, ptosis, ectropion or hypertrophic scars. The aesthetic outcomes and functionality of the eyelids were ideal, and satisfaction was generally rated as very satisfied.Conclusion:Surgical removal combined with high-frequency electro-acupuncture is beneficial for preserving aesthetic appearance while pigmentation in children with eyelid split nevus is removed, offering a new treatment option.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Objective:To explore the clinical effects of combined surgical and high-frequency electro-acupuncture treatment for aesthetic restoration in children with eyelid split nevus.Methods:A retrospective analysis was conducted on the medical records of children treated for eyelid split nevus in the Plastic Surgery Department of the First Affiliated Hospital of Army Medical University from January 2019 to December 2023. All cases underwent combined surgical excision and high-frequency electro-acupuncture vaporization. Surgical removal was used for nevi with significant pigmentation and deep involvement, and high-frequency electro-acupuncture was simultaneously applied to vaporize residual superficial pigmentation layer by layer based on the depth of the pigmentation. The wounds were repaired using either direct suturing or local flap transfer. Postoperative management included the application of growth factors and anti-scar treatments. Postoperative healing, adverse effects, and pigment clearance rate (categorized as healed, significant effect, improved, or ineffective) were observed by comparsons of the pre-treatment and the last follow-up photographs. Eyelid function, appearance, and scar hypertrophy were assessed during follow-up, and family satisfaction (categorized as very satisfied, satisfied, or dissatisfied) was surveyed via telephone.Results:Five children were included, with one male and four females aged between 2 and 10 years (average 7 years). Pigment areas ranged from 0.3 cm × 0.5 cm to 1.7 cm × 1.1 cm, with surgical excision areas from 0.3 cm × 0.4 cm to 1.5 cm × 1.1 cm. All children had good wound healing without complications such as infection, flap ischemic necrosis, wound dehiscence or bleeding. The pigment clearance rate was over 90%, achieving a healed effect. During the follow-up of 14 to 48 months (average 24.2 months), all patients had normal eyelid function without difficulties in opening or closing the eyes, or epiphora. The eyelid appearance was satisfactory without asymmetry, ptosis, ectropion or hypertrophic scars. The aesthetic outcomes and functionality of the eyelids were ideal, and satisfaction was generally rated as very satisfied.Conclusion:Surgical removal combined with high-frequency electro-acupuncture is beneficial for preserving aesthetic appearance while pigmentation in children with eyelid split nevus is removed, offering a new treatment option.

Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected. Six hundred and fifteen patients who were more than 18 years old and less than or equal to 65 years old were included in young and middle-aged group (YM). Eighty-two patients aged more than 65 years old were included in elderly group (E). Data of age, gender, residence, education level, cause of injury, location of injury, season of injury, total burn area, occurrence and area of full-thickness burn injury, wound site, inhalation injury incidence and severity, post burn admission time, proportion of delayed resuscitation, proportion of escharectomy or tangential excision and skin grafting, preinjury systemic disease, system complication during hospitalization, length of hospital stay, outcome of treatment, and reason of abandoning treatment of patients were analyzed. Data were processed with chi-square test and Mann-Whitney U test. The odds ratios of preinjury systemic disease, system complication during hospitalization, and adverse outcome of patients in group YM were compared with those in group E. Results: (1) The majority of patients in the two groups were male, but the proportion of male patients in group YM was higher. There was statistically significant difference in gender distribution of patients between the two groups (χ²=18.727, P<0.001). The majority of patients in the two groups were from rural areas, but the proportion of rural patients in group E was higher. There was statistically significant difference in residence distribution of patients between the two groups (χ²=9.306, P=0.002). Patients in group YM mainly had secondary education, while patients in group E mainly had primary education. There was statistically significant difference in distribution of education level of patients between the two groups (χ²=146.797, P<0.001). (2) The most common causes of injury of patients in the two groups were both flame, but the proportion of patients with flame burn injury in group E was higher. There was statistically significant difference in distribution of cause of injury of patients between the two groups (χ²=25.063, P<0.001). The main locations of injury of patients in groups YM and E were respectively public place and private residence. There was statistically significant difference in location distribution of injury of patients between the two groups (χ²=46.313, P<0.001). The main seasons of injury of patients in groups YM and E were respectively summer and winter. There was statistically significant difference in season distribution of patients between the two groups (χ²=23.143, P<0.001). There was statistically significant difference in distribution of total burn area of patients between the two groups (χ²=25.799, P=0.002). The occurrences of full-thickness burn injury of patients in the two groups were similar (χ²=2.685, P=0.101), while there was statistically significant difference in area of full-thickness burn injury of patients between the two groups (χ²=26.702, P=0.002). There was no statistically significant difference in distribution of wound site of patients between the two groups (χ²=3.954, P=0.785). There were no statistically significant differences in incidence and severity distribution of inhalation injury of patients between the two groups (with χ² values respectively 0.425 and 0.672, P values above 0.05). (3) There was statistically significant difference in distribution of admission time of patients between the two groups (χ²=6.632, P=0.036), but there was no statistically significant difference in proportion of delayed resuscitation of patients between the two groups (χ²=1.261, P=0.261). The proportion of escharectomy or tangential excision and skin grafting of patients in group YM was 72.0% (443/615), which was significantly higher than 35.4% (29/82) of group E (χ²=44.498, P<0.001). The incidence of preinjury systemic disease of patients in group YM was 13.2% (81/615), which was significantly lower than 61.0% (50/82) of group E (χ²=108.337, P<0.001). The risk of preinjury systemic disease of patients in group E was 10.30 times of that of patients in group YM [with 95% confidence interval (CI) of 6.24-17.01, P<0.001]. During hospitalization, 59.8% (49/82) of patients in group E suffered from system complications, which was significantly higher than 36.6% (225/615) of group YM (χ²=16.282, P<0.001). The risk of system complication of patients in group E was 2.57 times of patients in group YM (with 95% CI of 1.61-4.12, P<0.001). The length of hospital stay of patients in group E was significantly shorter than that of group YM (U=36 735, P<0.001). There was statistically significant difference in treatment outcome of patients between the two groups (χ²=106.251, P<0.001). The risk of adverse outcome of patients in group E was 7.52 times of group YM (with 95% CI of 4.40-12.88, χ²=67.709, P<0.001). The proportion of abandoning treatment of patients in group E was significantly higher than that of group YM (χ²=150.670, P<0.001). The risk of abandoning treatment of patients in group E was 15.86 times of that of group YM (with 95% CI of 9.36-26.88, P<0.001). There was no statistically significant difference in distribution of reason of abandoning treatment of patients between the two groups (χ²=4.178, P=0.243). Conclusions There were significant differences in the epidemiological characteristics of patients in groups E and YM. In elderly burn patients, the proportion of rural population was higher and the education level was lower. Flame burn was common and burns mostly occurred in private residences and in winter. The total burn area was slightly lower but the area of full-thickness burn injury was larger. The length of hospital stay was shorter and the proportion of surgical treatment was lower. The incidences of preinjury systemic disease and system complication during hospitalization were higher, and therefore the risks of adverse outcome and abandoning treatment were higher.

Objective To explore main influencing factors of postgraduate entrance examination of medical students in medical universities and to provide guidance for postgraduate entrance examination and employment.Methods Totally 300 2008 and 2009 grade undergraduates of Kunming Medical University were enrolled and divided into postgraduate entrance examination group (n =181)and non postgraduate entrance examination group (n =97).Self-designed questionnaire was used.Intentions of postgraduate entrance examination of two groups and main factors of not taking postgraduate entrance examination were analyzed.Softwares of Excel 2003 and SPSS 17.0 were applied to do constituent ratio analysis and x2 test of gender and residence.Results Among all enrolled students,71.2％ paid attention to the entrance exam and 65.1％ said that they would take part in the entrance exam.There was no significant differences in taking entrance exam between males and females (x2 =3.213,P=0.073).Age (74.1％),family economic situation (71.1％) and current employment status (68.1％) were the main influencing factor of graduate entrance exam.There were significant differences between factors of age and family economic situation and factors of gender and census register (x2 =4.810,P =0.028 and x2 =9.612,P =0.002).There was no significant difference between factors of age and family economic situation and factor of current employment status (x2 =0.279,P =0.597).Conclusions Age,family economical situation and current employment situation are major influencing factors of postgraduate entrance examination for medical students.Postgraduate entrance examination for medical students needs positive guidance and more care from schools,society and family.Medical students should form correct view for employment and postgraduate entrance examination according to their own condition.

Objective To explore the mechanism of cytokines for the scars,and to study the effect of platelet derived growth factor(PDGF)on the biological behavior of fibroblasts in scars.Methods Fibroblasts of scars and normal skins were cultured in vitro.The results were observed and analyzed by light inverted microscopy(LM),and 3-(4,5-dimethyl-thiazol-2-yl)-2,5 ciphenyl tetrazolium bromide (MTT)assay.The effects of PDGF on the biological behaviors of fibroblasts of scars were also determined. Results In vitro study,using LM,FCM and MTT assay,showed that proliferation of fibroblasts were inereased significantly when PDGF was added to the cultures,as compared to the control groups.Conclusions PDGF can increase fibroblast proliferation.These results demonstrate that PDGF is beneficial for wound healing at early stage.

BACKGROUND: Nerve growth factor is secreted and synthetized by a variety of cells, such as inflammatory calls and repairing calls, its biological effects are diverse and closely related to the process of wound repair, but its mechanism is not yet clear.OBJECTIVE: To observe the influence of nerve growth factor on the biological characteristics of scar fibroblasts.METHODS: Eight clinical surgical resection specimens, including 5 face and neck hyperplastic scar or keloid specimens, did not receive any treatment; three were prepuce specimens following circumcision (normal tissue). By use of tissue block method, the scar and normal skin fibroblasts were cultured, followed by digestion passage. The scar tissue and normal tissue flbroblasts at 3-6passages in the logarithmic phase were seeded in 96-well plate and divided into the experimental group (scar flbroblest group) and the control group (normal skin fibroblasts group), with two parallel holes in each group were added with 3,33, 0.33 mg/L nerve growth factor, 50 μL. Inverted microscope was used to observe fibroblast morphology. At 24, 48, 72 hours after culture, the absorbanca value was measured using MTT. Fibroblast DNA content and cell apoptosis were determined by flow cytometry.RESULTS AND CONCLUSION: The fibroblasts were adherent cells, the scar and normal skin tissues were shown to cell free out of tissue block and gradual expansion at 4-6 days after incubation. Compared with normal skin fibroblasts, the pathological scar fibroblasts became larger, irregular shape and arrangement. MTT results showed that nerve growth factor could promote the normal and hypertrophic scar fibroblasts growth, which becomes more apparent. Flow cytometry results showed that by adding nerve growth factor, the percentage of scar fibroblasts at proliferating S-G_2-M phase was higher than that in the control;group; with a Iower level of apoptosis. It is indicated that nerve growth factor plays an obviously promoting role on normal and scar skin fibroblasts growth and proliferation, especially on the scar skin.

Objective To explore the role in the localization of vascular puncture points with dynamic contrast-enhanced magnetic resonance angiography (DCE-MRA) before transjugular intrahepatic portosystemic shunt (TIPS). Methods MRA images of 46 patients with portal hypertension were measured. The patients were then punctured according to the measurement Results The supero-inferior distant from the puncture point of hepatic vein to plane of right branch of portal vein (AA') was (22.63±10.21)mm, the anteroposterior distant from the puncture point of hepatic vein to plane of right branch of portal (A'A'') was (13.93±1.07)mm, the angle of sag was (31.64±9.23)°. The distant from puncture point of hepatic vein (AS) and right branch (BS) were (23.51±2.12)mm and (38.51±5.36)mm. The angle of cor was (33.57±8.93)°. Forty-five patients were successful punctured, and the time of puncture decreased. Conclusion The location of portal vein puncture point during TIPS are changeable, therefore individualized location of positioning is needed. DCE-MRA is a valuable non-invasive method of localization, playing an important role in localization of vascular puncture points of TIPS.

Objective To evaluate the clinical application of selective renal artery embolization (SRAE) for the treatment of kidney diseases. Methods Seventy-four cases of renal carcinomas, 11 cases of renal angiomyolipomas (RAML) and 72 cases of traumatic renal haemorrhages were first demonstrated by renal arteriography under Seldinger technique to ensure a site, range and neighbouring relation of lesions and then followed by percutaneous catheterized selective renal arterial embolization with embolic agents. Results The edema around the carcinomas and abscesses became obvious, and bleeding were reduced, which were convenient for operation after SRAE for the preoperative adjuvant treatment of renal carcinomas. The clinical symptoms were improved obviously in 9 eases with advanced renal carcinoma after palliative treatment. The tumour volumes of 11 RAML were decreased evidently by 15 %-65 % with the average of 42 %. The bleeding in 68 cases of traumatic renal haemorrhage were ceased completely in 1-4 days after embolism, 2 cases with serious renal fragmented injury and huge perirenal hematoma combined with shock received successful operation after SRAE, 2 cases bleeding again after SRAE were cured by the second SRAE. No severe complications occurred after embolization in all the patients. Conclusions As a minimal invasive technique,selective renal artery embolization is a safe, effective method with less complications and an adjuvant pre-op-erative therapy for renal carcinoma or a palliative treatment for advanced carcinoma and an effective treatment for RAML and traumatic renal haemorrhage.

Objective To evaluate the efficacy of X-ray guided choledochoscopy via T tube tunnel and interventional treatment of residual bile duct stones.Methods Cholangiography was performed in patients suspected of residual bile duct stone with choledochoscopy via the remaining T tube tunnel,and data of 45 patients who received endoscopically treatment for the residual bile duct stones and bile duct stricture were analyzed.Results Seven patients' with adhesive bile duct stenosis were resolved by repeat rinse and dilation,but the procedure failed in 2 cases of bile duct stricture caused by scar;seven cases of common bile duct stone combined with gradeHand Ⅲ multiple hepatic cholelith were removed within 1.5 h:six cases of hepatic bile duct narrowing with multiple cholelith were taken out in 1.0 hour;six cases of grade Ⅱ and Ⅲ multiple massive choledocholith were removed with lithotrity for over 2.0 h:six cases of grade Ⅱ-Ⅳ cholelith were eliminated within 1.5 h:six cases of hepatobiliary stone were removed successfully in 30 min.Stones in 3 cases of multiple stones with intrahepatie bile duct stenosis were not taken out due to bile duct stricture;stones in 2 cases of gradeⅡand Ⅲ multiple choledocholith were not removed for T tube tunnel bleeding.Conclusion X-ray guided choledochoscopy is convenient and effective to remove residue cholelith.