Objective:To explore the effect of early eschar dermabrasion combined with antimicrobial soft silicone foam dressing (hereinafter referred to as foam dressing) in treating the deep partial-thickness burn wounds in children.Methods:This study was a randomized controlled trial. From June 2021 to December 2022, 78 pediatric patients with deep partial-thickness burns who met the inclusion criteria were admitted to the Department of Burns in Guiyang Steel Plant Employees Hospital. According to the random number table, the pediatric patients were divided into two groups, with 38 cases left in combined treatment group (with 20 males and 18 females, aged 26.00 (16.75, 39.75) months) and 39 cases in foam dressing group (with 21 males and 18 females, aged 19.00 (14.00, 31.00) months) after the exclusion of one dropped-out child in follow-up. The pediatric patients in combined treatment group underwent eschar dermabrasion of the wound within 48 hours after injury, the wound was covered with foam dressing after operation, and the dressing was replaced once every 7 days; for the pediatric patients in foam dressing group, the wound was sterilized within 48 hours after injury and covered with foam dressing, and the dressing was replaced once every 2 to 3 days. After the wound healing, the children in both groups were routinely applied with silicone gel twice a day for 3 weeks before started wearing elastic sleeves for more than 18 hours a day, and continuously for over than 6 months. The degree of pain during dressing change was evaluated using the children's pain behavior inventory FLACC. The adverse reactions during the treatment period, number of dressing changes, and wound healing time were observed and recorded. Six months after wound healing, the Vancouver scar scale (VSS) was used to evaluate the condition of the wound scar.Results:When changing dressing, the FLACC score for pain of pediatric patients in combined treatment group was 3.5 (2.0, 5.0), which was significantly lower than 6.0 (5.0, 8.0) in foam dressing group ( Z=-5.40, P<0.05). During the treatment period, no adverse reactions such as wound edema, fluid accumulation, or peripheral skin rash allergies occurred in any pediatric patient in both groups. The number of dressing changes of pediatric patients in combined treatment group was 3 (3, 4) times, which was significantly less than 8 (7, 10) times in foam dressing group ( Z=-7.58, P<0.05). The wound healing time of pediatric patients in combined treatment group was (19±5) days, which was significantly shorter than (25±6) days in foam dressing group ( t=-4.48, P<0.05). Six months after wound healing, the VSS score for scar of pediatric patients in combined treatment group was 5 (2, 8), which was significantly lower than 7 (5, 10) in foam dressing group ( Z=-3.05, P<0.05). Conclusions:Compared with using foam dressings alone, early eschar dermabrasion combined with foam dressings can reduce the number of dressing changes, alleviate the pain during dressing changes, and shorten the wound healing time in treating children with deep partial-thickness burns, and effectively alleviate scar hyperplasia by combining with anti-scar treatment post burns.

【Objective】 To explore the relationship between the storage time of leukodepleted red blood cells and transfusion adverse reactions by analyzing the occurrence of transfusion adverse reactions of patients after leukodepleted red blood cells transfusion from four hospitals. 【Methods】 By using the electronic medical record management system, the collection and transfusion dates of leukodepleted red blood cells from four hospitals in Enshi Prefecture from 2018 to 2022, as well as the information on transfusion adverse reactions, were retrieved. 【Results】 From 2018 to 2022, a total of 697 61 bags of leukodepleted red blood cells were transfused in four hospitals, resulting in 166 cases of transfusion adverse reactions, among which 93 were allergic reactions, 63 were non hemolytic febrile reactions, and 10 were others, with a total incidence rate of transfusion adverse reactions at 0.24%. The average storage time of leukodepleted red blood cells with and without transfusion adverse reactions was (20.25±6.31) and (19.88±5.50) days, respectively. With a storage time of 7 days as the threshold, the incidence of transfusion adverse reactions was the lowest for a storage time of 15~21 days. The incidence of transfusion adverse reactions of leukodepleted red blood cells in two groups (with storage days ≤21 days and >21 days) was not statistically significant(P>0.05). 【Conclusion】 Allergic reactions were the main type of transfusion adverse reaction caused by leukodepleted red blood cells, and the incidence of transfusion adverse reactions decreased and then increased with the prolongation of the storage time of leukodepleted red blood cells. There was no significant difference in the incidence of transfusion adverse reactions with leukodepleted red blood cells stored for ≤ 21 days and >21 days.

Abstract: Objective To analyze the epidemic characteristics and influencing factors of school influenza-like cases in 2011-2022 in Nanchang, so as to provide reference for the prevention and control of school influenza outbreaks. 　　　Methods The epidemiological relevant data of school influenza-like cases from 2011 to 2022 in Nanchang and the pathogen test results of respiratory tract samples were collected for epidemiological and etiology analysis. Results　From 2011 to 2022, a total of 142 influenza-like cases were reported in schools in Nanchang, with a cumulative morbidity of 2 880 cases and a morbidity rate of 1.89%. A total of 1 263 samples were collected, with an overall positive influenza nucleic acid detection rate of 58.91%. The highest proportion of outbreaks occurred in 2017-2019, while the lowest incidence was in 2011-2013. Outbreaks mainly occurred from November to March of the following year (accounting for 79.58%), presenting obvious seasonal characteristics. The distribution was mainly in primary schools, accounting for 70.42% (100/142) of all outbreaks. From 2011 to 2022, all types of influenza viruses were tested, and more than 2 types of influenza viruses were prevalent each year. The dominant strains alternated between influenza A H1N1, influenza A H3N2 and Victoria lineages of type B influenza viruses. From 2011 to 2019, the influenza epidemic in schools in Nanchang showed a continuous upward trend. During COVID-19 in 2020-2022, Nanchang adopted a variety of non-drug prevention and control measures for COVID-19, and both the number of influenza epidemics in various schools and the number of influenza virus nucleic acid positive cases decreased. The average number of classes involved in the epidemic was (3±2), and the average duration of the epidemic was (8±4) days. 　Conclusions The outbreaks of influenza-like illness in Nanchang schools is highly prevalent in winter and spring, , with urban primary schools being the high incidence locations. Non-drug prevention and control measures for COVID-19 have an impact on the epidemic trend of influenza, so the continuous monitoring of the school influenza virus activities and improving the timeliness of the report will be conducive to the rapid control of the epidemic.

Adaptation, Physiological ; Adenosine Monophosphate ; administration & dosage ; analogs & derivatives ; pharmacology ; therapeutic use ; Administration, Intranasal ; Alanine ; administration & dosage ; analogs & derivatives ; pharmacology ; therapeutic use ; Animals ; Betacoronavirus ; genetics ; physiology ; Chlorocebus aethiops ; Coronavirus Infections ; drug therapy ; virology ; Disease Models, Animal ; Female ; Host Specificity ; genetics ; Lung ; pathology ; virology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mutation, Missense ; Nasal Mucosa ; virology ; Pandemics ; Pneumonia, Viral ; drug therapy ; virology ; RNA, Viral ; administration & dosage ; genetics ; Turbinates ; virology ; Vero Cells ; Viral Load ; Virus Replication

Extended nursing plays an important role in promoting construction of Healthy China and improving level of medical and health services. In order to explore development trend of extended nursing in China, in this article concerning extended nursing, the concept, status quo of providers and needs of application objects were reviewed; modes, effect evaluation tools and quality control situation were summarized, so as to provide ideas for further research.

BACKGROUND: The locking plates are often used for internal fixation of closed tibial fractures. The use of a locking plate as an external fixator is still controversial, particularly for closed fractures. The purpose of this study is to evaluate the results of external fixation using the femoral less invasive stabilization system (LISS) plate in proximal metaphyseal fractures of the tibia. METHODS: We prospectively evaluated 35 patients (26 males and 9 females) with a mean age of 42 years (range, 21 to 62 years) who presented with fresh tibial proximal metaphyseal fractures. According to the AO Foundation and Orthopaedic Trauma Association (AO/OTA) classification, the fractures were identified as type 41-A2 in 18 cases and type 41-A3 in 17 cases, including 25 closed fractures and 10 open fractures. The femoral LISS plate was used to fix these fractures, which was placed on the anteromedial aspect of the tibia as an external fixator. The mean follow-up period was 18 months (range, 13 to 22 months). RESULTS: All fractures healed in a mean time of 14 weeks (range, 10 to 20 weeks). There was no case of nonunion, deep infection, and loosening of screws and plates. One month after the appearance of cortical bridging on biplanar radiographs, the locking plate was removed within 3 minutes in the clinic without any difficulty. According to the Hospital for Special Surgery (HSS) knee scoring system and American Orthopaedic Foot & Ankle Society (AOFAS) ankle scoring system, the mean HSS score was 91 (range, 85 to 100) and 98 (range, 93 to 100), and the mean AOFAS score was 94 (range, 90 to 100) and 98 (range, 95 to 100) at 4 weeks postoperatively and final follow-up, respectively. CONCLUSIONS: For proximal metaphyseal fracture of the tibia, external fixation using the femoral LISS plate is a safe and reliable technique with minimal complications and excellent outcomes. Its advantages include ease of performing the surgery, use of a less invasive technique, and convenience of plate removal after fracture healing.
Adult ; *Bone Plates ; External Fixators ; Female ; Fracture Fixation/*instrumentation/methods ; Humans ; Male ; Middle Aged ; Prospective Studies ; Tibial Fractures/radiography/*surgery ; Young Adult

OBJECTIVETo investigate the application of microsurgical technique in the replantation of amputated ear.

METHODS7 cases of amputated ears were analyzed from June 2009 to April 2015 in our department. We used microsurgical technique to anastomose about five vessels and nerves. The blood supply of auricle was restored within three to six hours. All subjects underwent treatments including anti-freezing, anti-spasm and anti-infection treatment after the emergency surgery.

RESULTS7 amputated ears were all survived after replantation. The patients were followed up for one month to six months ( average for 28 months). The appearances of survived ears body were fully recovered without any significant atrophy or pigmentation. The sensory function of ears recovered to normal after 1 year.

CONCLUSIONSThe application of microsurgical technique in the replantation of amputated ear can expect the high success rate of ear replantation. However, skilled and high-quality anastomosis technique of small vascular are required.

Amputation, Traumatic ; surgery ; Anastomosis, Surgical ; methods ; Ear Deformities, Acquired ; surgery ; Ear, External ; blood supply ; innervation ; Graft Survival ; Humans ; Microsurgery ; methods ; Replantation ; methods

Objective To study the effect of the uncertain deflection of the Delta4 phantom (ScandiDos AB,Sweden) in setting up on the Gamma index passing rate during the VMAT plan verification.Methods Two patients with head and neck cancer,two with lung cancers and one with pelvic cancer receiving VMAT radiotherapy were randomly chosen.By means of Eclipse8.6 TPS the treatment plans elaborated for the five patients were picked up to make the verification plans and Delta4 was used to perform dose verification On VARIAN Clinac Ⅸ.The Delta4 phantom was precisely set up first,and then it was deflected in a given angle towards the horizontal direction in relation to the center of the linear accelerator isocenter to perform the dose verification for 11 times successively.To figure out the relationship between the deflection angle of the Delta4 phantom and the Gamma index passing rate.Results As the Delta4 phantom was deflected by 0.0°,0.2°,0.4°,0.6°,0.8°,1.0°,1.2°,1.4°,1.6°,1.8° and 2.0° in sequence,the measured Gamma index passing rates presented a slight decline,but all greater than 90％ (DD 3％,DTA 3 mm).Conclusions In the VMAT plan verification,the Gamma index passing rate of Delta4 has no dependence on the uncertain deflection of the Delta4 phantom provided that the uncertain deflection of the Delta4 phantom is no greater than 2°,but the passing rates of DD and DTA vary significantly with the uncertain deflection of the Delta4 phantom.

OBJECTIVETo study the effects of astaxanthin on renal fibrosis and apoptosis induced by partial unilateral ureteral obstruction (UUO) in rats.

METHODSNinety-six male adult SD rats were randomized into 6 equal groups, namely the blank control group, sham-operated group, UUO group, and astaxanthin group at high, medium, and low doses. Left ureteral ligation was performed in UUO and astaxanthin groups, and two days before the operation, the rats in astaxanthin groups were lavaged with 25, 50, or 100 mg/kg astaxanthin daily for 14 days, while the same volume of saline was given to rats in UUO group and sham-operated group. Renal pathological in the rats was observed with HE staining, and the expression levels of TGF-β1, SGK1, and CTGF in the left kidney were detected immunohistochemically; the expression level of Bcl-2 and Bax were detected using Bcl-2 and Bax detection kits.

RESULTSCompared to UUO group, high- and medium-dose astaxanthin groups showed obviously ameliorated renal pathologies and reduced expressions of TGF-β1, SGK1, and CTGF in the left kidney with lessened renal cell apoptosis.

CONCLUSIONAstaxanthin can reduce UUO-induced renal fibrosis and renal cell apoptosis, demonstrating the renoprotective effect of astaxanthin against renal fibrosis.

Animals ; Apoptosis ; drug effects ; Connective Tissue Growth Factor ; metabolism ; Fibrosis ; Immediate-Early Proteins ; metabolism ; Kidney ; drug effects ; metabolism ; pathology ; Kidney Diseases ; metabolism ; pathology ; Male ; Protein-Serine-Threonine Kinases ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism ; Ureteral Obstruction ; metabolism ; pathology ; Xanthophylls ; pharmacology ; bcl-2-Associated X Protein ; metabolism

Objective To investigate the feasibility of setting mAs in liver enhanced CT scan according to plain scan noise with fixed mA CT scanner,in order to reduce the radiation dose.Methods One hundred continuous patients underwent liver enhanced CT scan (group A) prospectively.Two hundred and fifty mAs was used in plain and enhanced CT scans.Noises of plain and venous phase CT images were measured,and the image quality was evaluated.The equation between mAs of enhanced scan and noise of plain scan image was derived.Another 100 continuous patients underwent liver enhanced CT scan (group B).Enhanced scan mAs was calculated from noise on plain scan by using the equation above.Noises on venous phase images were measured and the image quality was measured.Based on body mass index (BMI),patients in groups A and B were divided into three subgroups respectively:BMI ＜ 18.5 kg/m2,18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2 and BMI ≥ 25.0 kg/m2.Image quality score was compared with nonparametric rank sum test,CT dose index (CTDI) and effective dose (ED) were measured and compared between each subgroup with 2 independent samples t or t' test.Results The equation between enhanced scan mAs (mAsX) and plain scan noise (SDp) was as follows:mAsX =mAs1 × [(0.989 × SDp + 1.06) /SDx]2,mAs1 =250 mAs,SDx =13.In patients with BMI ＜ 18.5 kg/m2,ED of group A [(6.86 ±0.38) mSv,n =12] was significantly higher than group B [(2.66 ±0.46) mSv,n =10)] (t =18.52,P ＜0.01).In patients with 18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2,ED of group A [(7.08 ± 0.91) mSy,n =66] was significantly higher than group B [(4.50 ± 1.41) mSv,n =73] (t' =10.57,P ＜ 0.01).In patients with BMI ≥25.0 kg/m2,there was no significant difference between EDs of group A (7.54 ± 0.62 mSv,n =22) and group B [(8.19 ±3.16) mSv,n =17] (t' =0.89,P =0.39).Image quality of 5 patients in group A and none in group B did not meet the diagnostic requirement.Conclusion Setting mAs of enhanced scan according to plain scan noise could reduce the radiation dose with maintainence of image quality.