Objective:To investigate the feasibility and effectiveness of incision subcutaneous porous catheter combined with ropivacaine analgesia in enhanced recovery after laparoscopic gastrointestinal surgery.Methods:The clinical data of 140 patients underwent gastrointestinal surgery from August 2021 to April 2022 in Shanghai Fourth People′s Hospital, School of Medicine, Tongji University were retrospectively analyzed. Among them, 70 patients were given routine postoperative analgesia (control group), and 70 patients were given incision subcutaneous porous catheter combined with ropivacaine analgesia on the basis of routine postoperative analgesia (observation group). The visual analogue score (VAS) 4, 24, 32, 48, 56 and 72 h after operation was evaluated; and the complications of subcutaneous catheterization, incision infection, postoperative nausea vomiting, neurological symptoms, time to extubation, patient satisfaction degree, recovery time of intestinal function and hospital stay were recorded.Results:The VAS 4, 24, 32, 48, 56 and 72 h after operation in observation group was significantly lower than that in control group: 1.000 (- 0.250, 2.250) scores vs. 1.000 (- 1.000, 3.000) scores, 2.000 (1.000, 3.000) scores vs. 4.000 (2.000, 6.000) scores, 1.000 (0.000, 2.000) scores vs. 3.000 (1.000, 5.000) scores, 2.000 (1.000, 3.000) scores vs. 3.000 (1.750, 4.250) scores, (1.100 ± 0.934) scores vs. (2.085 ± 0.943) scores and (0.985 ± 0.842) scores vs. (1.814 ± 0.921) scores, and there was statistical difference ( P<0.05 or <0.01). The recovery time of intestinal function and hospital stay in observation group were significantly shorter than that that in control group: (1.743 ± 0.557) d vs. (2.200 ± 0.714) d and (8.043 ± 1.160) d vs. (8.757 ± 1.221) d, and there were statistical difference ( P<0.01); there were no statistical differences in the rate of incision infection, incidence of postoperative nausea vomiting, time to extubation and patient dissatisfaction rate between two groups ( P>0.05); there were no the complications of subcutaneous catheterization and neurological symptoms in two groups. Conclusions:The incision subcutaneous porous catheter combined with ropivacaine analgesia after laparoscopic gastrointestinal surgery is a safe, effective and feasible method. Multimodal analgesia under enhanced recovery after surgery can increase the postoperative recovery after gastrointestinal operations and shorten the postoperative hospital stay.

Objective:To analyze the clinical effect of extracorporeal membrane oxygenation (ECMO) in the treatment of burn patients with acute respiratory distress syndrome (ARDS).Methods:The retrospective observational study and the systematic review were applied. From March 2014 to July 2020, five burn patients with ARDS received ECMO treatment in the First Affiliated Hospital of Army Medical University (the Third Military Medical University). All the five patients were male, aged from 40 to 62 years. The average total burn surface area was 58.8% total body surface area (TBSA) and four cases had severe inhalation injury. Patient's ECMO starting time, duration and mode, and whether successfully weaned or the cause of death, and others. were recorded. Furthermore, the changes of oxygenation and infection before, during, and after utilizing ECMO were analyzed. PubMed and Web of Science from the establishment of each database to August 2021 were searched using "Extracorporeal Membrane Oxygenation", "ECMO", "burn", "inhalation" as the search terms and "Title/Abstract" as the field to retrieve the clinical articles that meet the selection criteria . Basic information were extracted from the articles, including sample size, gender, age, total burn area, inhalation injury, the indication of ECMO, the start and lasting time of ECMO, ECMO mode, rate of successful weaning, complications of ECMO, mortality, the combined application of continuous renal replacement therapy (CRRT). Results:Five patients started venovenous ECMO on an average of 10.2 days after injury and lasted an average of 180.4 hours. Three out of 5 patients were weaned successfully with one patient survived. Four patients died of multiple organ dysfunction syndrome (MODS) and septic shock. Compared with those before ECMO treatment, the arterial oxygen partial pressure (PaO 2) and oxygen saturation in arterial blood (SaO 2) of three successfully weaned patients obviously increased during and after ECMO treatment. The fraction of inspired oxygen (FiO 2) decreased below 50% and PaO 2/FiO 2 ratio increased above 200 mmHg (1 mmHg=0.133 kPa) during and after ECMO. Furthermore, lactic acid and respiratory rate decreased, basically. Compared with those before ECMO, PaO 2 and SaO 2 in the other two patients during ECMO, who failed to be weaned, continuously decreased while lactic acid increased. Before and during ECMO, the PaO 2/FiO 2 ratios of unsuccessfullg weaned cases were less than 200 mmHg, and partial pressure of carbon dioxide in arterial blood (PaCO 2) were more than 40 mmHg. Compared with those before ECMO, there were no significant changes in body temperature during and after ECMO, which were less than 38 ℃. Compared with those before ECMO, the leucocyte number (the index without this in unsuccessfully weaned cases was omitted, the same as below) in four patients showed a significant decrease during ECMO, but rose after removal of ECMO. The proportion of neutrophils in three patients were slightly higher during ECMO than before ECMO, and did not change significantly after removal of ECMO. Compared with those before ECMO, platelet counts in three patients were significantly reduced during ECMO, and all five patients during ECMO were below normal levels. Compared with those before ECMO, the procalcitonin levels in four deaths were significantly increased during ECMO. Catheter culture of microorganism was performed in three successfully weaned patients, all of which were negative. A total of 13 literature were included, ranging from 1990 to 2019. The sample size in 6 studies was less than 10, and the sample size in 4 studies was between 10 and 20, and only 2 literatures had a sample size larger than 50. ECMO was applied in 295 burn patients with overall mortality of 48.8% (144/295), including 157 adults and 138 children. The most common indication of ECMO was severe ARDS. Among 157 adult burn patients (95 males and 65 females), 36 cases had inhalation injury. The average burn area was 27%-37%TBSA in 5 reported studies and was more than 50%TBSA in 2 reported studies. The most common mode was venovenous ECMO. ECMO treatment began 26.5 hours to 7.4 days after injury and lasted from 90 hours to 18 days, and the rate of successful weaning ranged from 50% to 100%. The most common complications were bleeding and infection. The mortality was 52.9% (83/157). MODS and sepsis were the leading causes of death. Among 138 pediatric burn patients (77 boys and 61 girls), 29 patients had inhalation injury. The average burn area was 17%-50.2%TBSA in 3 studies. ECMO treatment lasted from 165.2 hours to 324.4 hours. Bleeding was the most common complication. The mortality was 44.2% (61/138). Conclusions:ECMO is an effective strategy for the salvage treatment of burns complicated with ARDS. Furthermore, the prevention and treatment of bleeding, infection and organ dysfunction should be emphasized during the use of ECMO. More importantly, evidence-based guidelines for burns are urgently needed to further improve the clinical effect of ECMO.

with the increasing prevalence of myopia in Chinese children, there are more methods for its prevention and control.Orthokeratology is one of the most appealing techniques for myopia correction.In recent years, an increasing number of hospitals have applied this technology, and its acceptance among patients is increasing.The safety of the orthokeratology have drawn increasing attention, especially in relation to orthokeratology-associated infectious keratitis.Acanthamoeba keratitis (AK) is one of the most worrying diseases.The onset of AK is slow, and its early clinical manifestation is particularly atypical, which often leads to incorrectly diagnosis, so as to mistreatment or delay of medical therapy, and subsequently irreversible impairment of visual function.Therefore, it is very important to reinforce the knowledge of its early symptoms in order to improve the early diagnosis level, and manage the associated risk factors.Early diagnosis and promper treatment can contribute to good visual outcomes.

2019 novel coronavirus (2019-nCoV) is one of the beta coronaviruses and was identified as the pathogen of the severe "coronavirus disease 2019 (COVID-19)" in 2019. China has formally included the 2019-nCoV in the statutory notification and control system for infectious diseases according to the Law of the People's Republic of China on the Prevention and Treatment of Infectious Diseases. Currently, the national defending actions on the 2019-nCoV in China is in a critical period. Burn Department is also confronted with risk of infection by the 2019-nCoV. According to the guidelines on the diagnosis and treatment of COVID-19 (6^th trial edition), the latest relative literature at home and abroad, the features of the COVID-19, recommendations for the COVID-19 prevention and control issued by the National Health Commission of China, and management experience of diagnosis and treatment in the related disciplines, we put forward recommendations for the medical practices of burn treatment during the outbreak of the COVID-19 in outpatient and emergency treatment, inpatient treatment, operation and ward management, etc. We hope these recommendations could benefit the professionals of the same occupation as us and related hospital managers, improve the treatment of burn during the outbreak of the COVID-19, and avoid or reduce the risk of infection of medical staff .

Objective:To prepare a drug release system of drug-loaded cross-linked decellularized corneal stromal lenticules and evaluate its drug release characteristics in vitro. Methods:Lenticules were obtained during femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery in Chongqing Aier Ophthalmology Hospital.Decellularized corneal stromal lenticules were prepared using high concentration sodium chloride (NaCl) combining nuclease.The decellularized corneal stromal lenticules were randomly divided into normal group, 0.5% levofloxacin group, 3% levofloxacin group and 5% levofloxacin group, with 4 lenticules in each group.The lenticules did not receive any treatment in the normal group, and drug-loading those were soaked in different doses of levofloxacin solution for three hours according to grouping.In the crosslinking test, 12 decellularized corneal stromal lenticules were randomly divided into non-crosslinking group, 0.01 mmol 1-(3-dimethylamino) propylimine (EDC) group, 0.05 mmol EDC group and 0.25 mmol EDC group.The lenticules for cross-linking were soaked in different contents of mixed solution of EDC with N-hydroxysuccinyl (NHS) for four hours respectively according to grouping, and then in 3% levofloxacin solution for three hours.Only 3% levofloxacin solution soaking was carried in the non-crosslinking group.High performance liquid chromatography (HPLC) was employed to detect the drug release concentration of the lenticules, and spectral scanning method was performed to measure light transittance of the lenticules.The surface ultrastructure of the decellularized lenticules among different cross-linking groups was examined and compared with scanning electron microscope.The use of the human corneal lenticules was approved by an Ethics Committee of Chongqing Aier Ophthalmology Hospital (No.2019012). Written informed consent was obtained from each patient before surgery.Results:The release concentrations of decellularized corneal stroma lenticules were significantly different at 1 day, 7, 14, and 21 days among 0.5%, 3%, and 5% levofloxacin group ( P<0.05) or also among the 0.01 mmol EDC, 0.05 mmol EDC, and 0.25 mmol EDC cross-linked groups ( P<0.01). The drug release concentrations in 0.05 mmol EDC group were the highest at various time points, and the release time of the three cross-linked groups lasted until 21 days after release concentrations of decellularized corneal stroma lenticules.The drug release concentrations in cross-linked groups and non-crosslinking group were gradually declined with the prolong of drug-loading time, showing a significant difference at different time points ( P<0.05). The transmittance of the lenticules was (88.68±1.19)% and (91.55±1.16)% in the non-crosslinking group and normal group, respectively, with no significant difference ( P>0.05). The average transmittance of the lenticules was significantly reduced in the drug-loaded groups compared with the normal group ( P<0.05). The smaller collagen fiber voids and closely arranged collagen fibers were displayed in the cross-linking groups under the scanning electron microscope with the best effect in the 0.25 mmol EDC group. Conclusions:EDC/NHS cross-linking can improve the drug-loading effect of decellularized corneal stromal lenticules probably by lessening collagen fiber voids.The drug-loaded cross-linked decellularized corneal stromal lenticules have a good drug release effect in vitro.

Objective To compare the agreement of central vault measurements between anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in the eyes with posterior chamber phakic intraocular lens implantation and analyze the association sculus to sculus (STS) diameter and white-to-white (WTW) diameter of cornea with central vault.Methods A cross-sectional study was carried out.Medical records of 150 phakic eyes of 75 myopic patients who underwent implantable collamer lens (ICL) surgery for the correction of myopia were collected in Chongqing Aier Eye Hospital from December 2017 to March 2018.The postoperative central vault were measured with AS-OCT and UBM.Intraclass correlation coefficient (ICC) and Bland-Altman plot were used to evaluate the repeatability and agreement of the measurements between two devices.The affecting factors of central vault measurements were assessed.Results Mean central vault in the 150 phakic eyes after ICL surgery was (0.73±0.25)mm by AS-OCT and (0.76-±0.31)mm by UBM,respectively with the ICC of 0.91 for the measurements of AS-OCT and UBM.Bland-Altman analysis showed that the 95％ limits of agreement of central vault measurements were-0.38-0.31 mm between the two devices.Five values were beyond the 95％ consistency interval,and the maximum absolute value of the difference was is 0.31 mm,which was beyond the clinical acceptable range,showing an non-interchangeable difference in the central vault measurements between the devices in ICL implanted eyes.WTW was a affecting factor for vault with a regression equation of Y=0.145 3X-0.960 1 (t =2.272,P＜0.05).Horizontal and vertical STS were the indirect affecting factors for vault by the association with WTW with the regression equation of Y=0.524 1X+5.362 4 and Y=0.613 4X+4.658 3,respectively.Conclusions Central vault measured by UBM is higher that than AS-OCT after ICL surgery,and the measurements are uninterchangeable between the two devices.Accurate measurement of STS distance is essential for the selection of appropriate lens before operation.

Objective To investigate the relationship between serum vitamin A deficiency (vitam in A deficiency, VAD) and infectious diseases in children.MethodsAdopt the method of random sampling, sample of Cixi City prevention center with a total of 5000 children under the age of 6, according to the age groups were divided into 6 groups, the detection of vitamin A in children refers to the blood, separation of serum collected in dark conditions, with strict quality control, detection of serum vitamin A by fluorescence method (vitamin A the concentration of VA.).ResultsIn the two weeks, the incidence of VA in children with fever and acute respiratory infection (ARI) increased.ConclusionOur children's serum VA content is low, the lack of the high rate of children regardless of individuals or groups are prone to acute infection, VAD is the cause of children prone to acute infectious diseases is one of the important reasons.To strengthen health education, improve parents' feeding knowledge, proper oral Cod Liver Oil drops and reasonable feeding, is conducive to the healthy growth of children.

Objective To understand the successive dynamic change of population structure of Oncomelania hupensis during a one-year period,so as to provide the evidence for snail control. Methods A river beach and a ditch infested with O. hupensis snails were selected and longitudinally investigated in the midmonth during one year. The snail survey indices included the sur-vival status,gender,number of whorls,length and width of shell,and gonad development status(measured by the color depth of gonad and the length ratio of gonad to liver),and the monthly snail eggs in the soil were collected and counted simultaneous-ly. In addition,the temperature and humidity of the soil and the daily data of air temperature and precipitation were measured or collected during the study period(every month). Results Both survival rate of snails and live snail density at the two environ-ments were positively correlated with the temperatures of air and soil. With a slight bimodal distribution ,the snail survival rate peaked from May to June,and in September. The living snail densities got the highest level in July and September in the river beach,and from April to May in the ditch. The regression equations of snail length(L)and width(W)were Lbeach = 2.355 +1.678W(F=2989.43,P<0.01)and Lditch=0.478+2.091W(F=2.989.43,P<0.01),respectively. The snails were the ones with 4.07-11.81 mm in the length(8.98 ± 0.92)mm in the river beach,and the snails were the ones with 3.63-9.92 mm in the length(7.03 ± 0.82)mm in the ditch. The main snails were the ones with five to eight whorls of shell in the river beach and four to seven whorls of shell in the ditch. The proportions of snails with less than or equal to five whorls(in the river beach)and four (in the ditch)were the highest in May and September,about 20％. The ratios of male and female snails were 1.66 in the river beach and 1.22 in the ditch,respectively. The gonad development status of male and female snails was basically synchronous and had a bimodal abundance period-from April to May and September to October. The numbers of snail eggs in the soil among months were significantly different,reaching the highest in June in the river beach(100.8/0.1 m2),and May in the ditch(82.5/0.1 m2). Conclusion The principal periods of breeding and alternation of generations of snails are April-May and September-October every year,which should also be the optimal time for mollusciciding in schistosomiasis susceptible zones.

Objective To evaluate the necessity and feasibility by using two different PCR-based techniques for prenatal diagnosis of thalassemia. Methods 509 specimens for prenatal diagnosis of thalassemia were detected respectively by single tube multiplex PCR(STMP),reverse dot blot(RDB)or probe melting curve assay(PMCA)for commonα-thalassemia orβ-thalassemia mutations in double-blind tests. Samples with different detection results were confirmed with DNA sequencing analysis. Prenatal diagnosis of thalassemia results were verified or followed up after birth. Results In detectingα-thalassemia andβ-thalassemia,there was one case in STMP + RDB and another case PMCA indicating differentiating results. The detection sensitivity of STMP + RDB was higher than that of PMCA,and its difference can be used as an indication for maternal blood contamination. Conclusion The two PCR methods with different principles were necessary and feasible for the prenatal diagnosis of thalassemia. The two methods were complementary to each other ,which can ensure the reliability of the prenatal diagnosis results and reduce the defects of single technique. It is worthy to be popularized in clinical application.

Genotype ; Humans ; beta-Thalassemia