Objective:To investigate the application of transverse closure of longitudinal incisions in repairing pentagonal full-thickness defects of the lower eyelid margin.Methods:A retrospective analysis was performed on clinical data collected from 26 patients with melanocytic nevi at the lower eyelid margin in Department of Dermatology, The Third People′s Hospital of Hangzhou from July 2016 to June 2019. Among the 26 patients, 10 were males, and 16 were females. After lesion resection, all the pentagonal full-thickness defects of the lower eyelid margin were repaired via transverse closure of longitudinal incisions.Results:All the pentagonal defects of the 26 cases were successfully repaired. The longitudinal incisions perpendicular to the eyelid were successfully converted into transverse incisions parallel to the eyelid margin and near the eyelash, and all incisions healed primarily. After surgery, mild congestion of the lower eyelid occurred in 3 patients, and temporary blurred vision in 1. During 1 - 2 years of postoperative follow-up, 26 patients all achieved symmetrical appearance of the skin and soft tissues around the eyes, without obvious postoperative scars or lower eyelid ectropion.Conclusions:Horizontal closure of longitudinal incisions can be used to repair the pentagonal full-thickness defects of the lower eyelid margin, because it can convert the incision closure line perpendicular to the lower eyelid margin into a horizontal transverse incision closure line parallel to the lower eyelid margin, so that the incisions and scars of the lower eyelid can be hided with a satisfactory cosmetic effect.

Objective:To evaluate the value of transrectal ultrasound(TRUS)in diagnosing extramural venous invasion(EMVI) of rectal cancer.Methods:Clinical data of 81 rectal cancer patients were retrospectively analyzed in the People′s Hospital of Inner Mongolia Autonomous Region from January 2015 to December 2021. The extramural vascular sonographic features in these patients were summarized. Based on the postoperative pathology and compared with MRI examination, the efficacy of TRUS for the diagnosis of EMVI in rectal cancer was investigated.Results:①According to the sonographic presentation, extramural vessels of rectal cancer can be divided into the following four types: typeⅠshowed that the mass broke through the muscularis propria of the intestinal wall, and no peripheral vascular shadow was observed; typeⅡshowed that the mass broke through the muscularis propria, surrounded by extraneous vessels with normal diameter, running and blood flow; type Ⅲ showed that the mass broke through the intrinsic muscle layer of the intestinal wall and was surrounded by extramural vessels with abnormally thickened diameters, and blood flow filling defects; type Ⅳ showed a mass that broke through the intrinsic muscular layer, with irregularly dilated vessels outside the peritumoral wall and no blood flow signal in the lumen. ②With type Ⅲ and type Ⅳ as positive signs of EMVI, the diagnosis compliance rate of TRUS was 90.1% (Kappa=0.580, P<0.001), sensitivity was 58.3%, specificity was 95.7%, positive predictive value was 70.0%, negative predictive value was 93.0%, and area under the ROC curve(AUC) was 0.770. The diagnosis compliance rate of MRI was 86.4% (Kappa=0.541, P<0.001), sensitivity was 75.0%, specificity was 88.4%, positive predictive value was 52.9%, negative predictive value was 95.3%, and the AUC was 0.817. The differences in sensitivity and specificity between TRUS and MRI for the diagnosis of rectal cancer EMVI were not statistically significant ( P>0.05), and the differences in the AUC were not statistically significant ( Z=0.447, P=0.655). Conclusions:TRUS is valuable in assessing the extramural vascular status of rectal cancer and is expected to be an effective imaging method for preoperative diagnosis of EMVI.

Increasing understanding of the pathogenesis of rheumatoid arthritis (RA) has remarkably promoted the development of effective therapeutic regimens of RA. Nevertheless, the inadequate response to current therapies in a proportion of patients, the systemic toxicity accompanied by long-term administration or distribution in non-targeted sites and the comprised efficacy caused by undesirable bioavailability, are still unsettled problems lying across the full remission of RA. So far, these existing limitations have inspired comprehensive academic researches on nanomedicines for RA treatment. A variety of versatile nanocarriers with controllable physicochemical properties, tailorable drug release pattern or active targeting ability were fabricated to enhance the drug delivery efficiency in RA treatment. This review aims to provide an up-to-date progress regarding to RA treatment using nanomedicines in the last 5 years and concisely discuss the potential application of several newly emerged therapeutic strategies such as inducing the antigen-specific tolerance, pro-resolving therapy or regulating the immunometabolism for RA treatments.

Objective:To investigate the role of coupler perfusion in transrectal ultrasound in the diagnosis of preoperative T staging of rectal cancer.Methods:A retrospective analysis of the preoperative clinical data of 132 patients with rectal cancer in the People′s Hospital of Inner Mongolia Autonomous Region from June 2015 to November 2020. According to whether or not the patients agreed to coupler perfusion before ultrasound examination, they were divided into 2 groups, namely the perfusion group 69 cases and the non-perfusion group of 63 cases, with postoperative pathology as the gold standard, and compared with magnetic resonance imaging(MRI) to evaluate the accuracy of the 2 groups and MRI in the T staging of rectal cancer.Results:The total coincidence rates of the coupling agent perfusion group, non-perfusion group and MRI group for the diagnosis of rectal cancer T staging were 89.9%, 76.2% and 87.9%, respectively, and the difference among the three methods was statistically significant (χ 2=6.096, P=0.047). The diagnostic sensitivity of the coupling agent perfusion group for T1 stage was 96.0%, which was higher than 61.5% of the non-perfusion group and 92.3% of the MRI ( P=0.010). The specificity of the perfusion group for the diagnosis of T2 stage was 95.7%, higher than the non-perfusion group and MRI ( P=0.037), the positive predictive value of the perfusion group for T2 stage was 90.9%, which was higher than the non-perfusion group and MRI ( P=0.035). The diagnostic accuracy of the perfusion group for T2 stage was 94.2%, higher than the non-perfusion group and MRI (χ 2=7.070, P=0.029). There were no statistically significant differences in diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy among the perfusion group and the non-perfusion group and the MRI for T3 and T4 (all P>0.05). Conclusions:Coupled-agent perfusion makes it convenient and fast for intracavity ultrasound to diagnose T staging of rectal cancer, and the diagnostic efficiency is comparable to MRI. In particular, it can be used as a highly reliable imaging method for T1 and T2 rectal cancer.

Objective:To understand the status quo of self-stigma of diabetic patients in college students and analyze its influencing factors.Methods:This study was a cross-sectional study, and the convenient sampling was conducted online and offline from July 2017 to June 2020. College students with diabetes who were treated in outpatient or inpatient Departments of Endocrinology and Metabolism in 5 Class Ⅲ Grade A hospitals were selected as the research objects, and similar patients who followed 2 diabetes public accounts were selected as online supplements. General information questionnaire and China-Self Stigma Scale (C-SSS) were used for questionnaire surveys. Data were statistically processed by t-test, analysis of variance and multiple linear regression analysis. A total of 200 questionnaires were distributed, and 189 valid questionnaires were recovered, with an effective recovery rate of 94.50%. The self-stigma of 80.42% of college students with diabetes mellitus was at a medium-to-high level. The total average score of C-SSS was (2.34±0.49) , of which the mean scores of cognitive dimension, emotional dimension and behavioral dimension were respectively (2.33±0.50) , (2.41±0.57) and (2.19±0.64) . The results of univariate analysis showed that there were statistically significant differences in the stigma scores of diabetic patients with different genders, family locations, parental physical conditions, diabetes types, family history, diabetes complications and insulin treatment or not ( P<0.05) . The results of multiple linear regression analysis showed that gender and type of diabetes were factors affecting the self-stigma level of college students with diabetes mellitus ( P<0.05) . Conclusions:The level of self-stigma in college students with diabetes mellitus is generally high. Hospitals, schools and families should strengthen cooperation and pay attention to these with high level of self-stigma. Meanwhile, early prevention and control should be targeted through dynamic tracking, psychological counseling and other interventions.

Salinity is the most important factor for the growth of crops. It is an effective method to alleviate the toxic effect caused by salt stress using saline-alkali-tolerant and growth-promoting bacteria in agriculture. Seven salt-tolerant bacteria were screened from saline-alkali soil, and the abilities of EPS production, alkalinity reduction and IAA production of the selected strains were investigated. A dominant strain DB01 was evaluated. The abilities of EPS production, alkalinity reduction and IAA production of strain DB01 were 0.21 g/g, 8.7% and 8.97 mg/L, respectively. The isolate was identified as Halomonas aquamarina by partial sequencing analysis of its 16S rRNA genes, and had the ability to inhibit the growth of Fusarium oxysporum f. sp., Alternaria solani, Phytophthora sojae and Rhizoctonia cerealis. It also could promote root length and germination rate of wheat seedlings under salt stress. Halomonas aquamarina can provide theoretical basis for the development of soil microbial resources and the application in saline-alkali soil improvement.
Alkalies ; metabolism ; Bacteria ; drug effects ; genetics ; Halomonas ; genetics ; Plant Roots ; microbiology ; RNA, Ribosomal, 16S ; genetics ; Salt Tolerance ; genetics ; Seedlings ; growth & development ; microbiology ; Soil ; chemistry ; Soil Microbiology ; Triticum ; microbiology

Objective:To evaluate performance of O-Z-O flaps in repair of adjacent facial skin defects.Methods:A retrospective analysis was conducted. A total of 60 patients with adjacent facial skin defects receiving O-Z-O flap repair were collected from the Third People′ s Hospital of Hangzhou from 2015 to 2018, including 50 with pigmented nevus, 4 with seborrheic keratosis, 3 with verruca vulgaris, 2 with basal cell carcinoma and 1 with squamous cell carcinoma. Among the 60 patients, 14 were males and 46 were females, with the age being 18 - 75 years. According to the condition of skin lesions, in situ resection was performed, and the optimal incision was designed; the "flap bridge", that is, the normal tissue between adjacent defects, was severed; according to the skin tension line and wrinkle line, residual ends of the two flap bridges were interlaced with each other, sutured and fixed interruptedly, and the wounds were repaired. Results:The skin defects could be completely covered by O-Z-O flaps in the 60 patients. All the patients received primary healing of incisions without scar hyperplasia after operation.Conclusions:The O-Z-O flap has advantages of flexible design and small incisions, and can be used for tension-reducing suture after excision of adjacent skin lesions. It is a good choice for repair of adjacent facial skin defects with satisfactory clinical effect.

Objective:To evaluate clinical efficacy of pedicled fat flaps in the repair of facial defects after skin tumor resection.Methods:Clinical data were collected from 39 patients with facial tumors in Department of Dermatology, The Third People′s Hospital of Hangzhou, and analyzed retrospectively. There were 20 males and 19 females, aged 55 ± 7.3 years (range, 42 - 80 years) , including 15 with basal cell carcinoma, 10 with squamous cell carcinoma, 5 with keratoacanthoma and 9 with solar keratosis. Postoperative skin defects varied from 1.5 cm × 3.0 cm to 8.0 cm × 4.5 cm in size. All patients received skin defect repair with pedicled fat flaps after tumor resection. Twenty-four hours after the surgery, survival condition of the flaps was observed. These patients were followed up at 1, 3 months after the surgery and every 3 months thereafter, and the shape and texture of the flaps and their matching degree with surrounding tissues were evaluated.Results:Twenty-four hours after surgery, the flaps survived well without infection in the 39 patients. Partial necrosis was observed at the distal end of the flaps in 2 cases, whose skin defects were on the lower eyelid, with the ratio of the flap length to pedicle width being greater than 3∶1, and wounds were healed after treatment in both of the 2 cases. One month after surgery, bloated appearance was observed in 3 cases, of which 2 had defects of the upper lip and 1 had defects of the cheek, and the ratios of flap length to pedicle width were less than 2∶1, 2∶1 - 3∶1, and greater than 3∶1 respectively. All patients were followed up for 1 - 12 months, with an average of 7 months. The color and texture of the flaps were good, and favorable function and shape were achieved in both the donor and recipient sites.Conclusion:The pedicled fat flap is markedly effective for the repair of facial skin defects, with high survival rate of flaps, high safety and reliability, and less damage to the donor site.

OBJECTIVE: To compare the accuracy of five warfarin-dosing algorithms and warfarin stable dose model (2.5 mg/day) for Shandong population. METHODS: One hundred and twenty five patients who achieved stable warfarin dose were enrolled. Clinical and genetic data were used to evaluate the value of each algorithm by calculating the percentage of patients whose predicted warfarin dose was within 20% of the actual stable therapeutic dose and mean absolute error (MAE). RESULTS: The frequency of patients with CYP2C9*1/*1, CYP2C9*1/*3 and CYP2C9*1/*2 genotype was 92.00%, 7.20%, 0.80%, respectively. That of VKORC1-1639 AA, AG and GG genotype was 82.40%, 15.20%, 2.40%, respectively. CYP4F2*1/*1, *1/*3, *3/*3 genotype was 50.40%, 39.20%, 10.40%, respectively. With the same genotypes for other loci, patients who carried at least one VKORC1-16398G mutant allele had increased warfarin stable daily dose compared with VKORC1-1639AA. Compared with CYP4F2*1/*1, those carrying at least one CYP4F2*3 mutant allele had warfarin stable daily dose increased by 5.9%-13.00%. The percentage of ideal prediction calculated from IWPC model (59.20%), Huang model (57.60%) and Ohno model (52.80%) were higher than others. The MAE were 0.35 (95%CI: 0.11-0.49), 0.15 (95%CI: 0.10-0.32), 0.39 (95%CI: 0.12-0.51), respectively. CONCLUSION The polymorphisms of CYP2C9, VKORC1 and CYP4F2 genes can influence the stable dose of warfarin in Shandong population. IWPC algorithm is suitable for guiding the use of warfarin in this population.
Anticoagulants ; administration & dosage ; Aryl Hydrocarbon Hydroxylases ; Cytochrome P-450 CYP2C9 ; genetics ; Cytochrome P450 Family 4 ; genetics ; Dose-Response Relationship, Drug ; Genotype ; Humans ; Models, Theoretical ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; administration & dosage

Objective To explore the effects of skin care team in the clinical management of pressure ulcer.Methods The skin care team was established by choosing a nurse from each ward, and was trained the knowledge about pressure ulcer. The pressure ulcer outcome was compared before and after establishing the skin care team, and the nurse's perception and assessment score were also compared.Results Before implementing skin care team management program, the cure rate of pressure ulcers was 95.59% (412/431), but after implementing skin care team, it was 98.26%(564/574) with statistical significance (χ2 =6.322,P<0.05). Pressure ulcer knowledge score for team member examination improved from (92.77±5.24) to (94.40±4.80), and the difference was statistically significant (t=3.413,P<0.05).Conclusions The establishment of skin care team can improve the pressure ulcer nursing ability, effectively reduce the pressure ulcer, and improve the nursing quality of patients with pressure ulcer.