Microbiology and Immunology is one of core basic curriculums for medical college undergraduates.Combining with characteristics of this course,our teaching comprehension and background calling for curriculum ideological and political education,we consider blending traditional sinology classic"Thirty-Six Stratagems"in teaching of this curriculum.Meanwhile,its practical signif-icance on many aspects will be elucidated.This paper will provide useful reference for blending other sinology classics into ideological and political education of specialized curriculums.

Objective:To introduce a surgical technique of " short distances and multi-segment" buried-guiding suture method and its effects in the surgery of early descent of prosthesis after augmentation mammaplasty.Methods:From August 2019 to January 2022, 15 cases of early descent of prosthesis after augmentation mammaplasty due to axillary approach breast augmentation for micromastia were admitted to the Plastic Surgery Department of Sichuan Provincial People′s Hospital, aged 23-35 years (27.3±3.6) and duration of dislocation from 16 to 35 days (23.8±5.8). There were 12 patients showed unilateral prosthesis drops and 3 patients showed bilateral prosthesis drops. " Short distances and multi-segment" buried-guiding suture method was used to solve the problem, i. e., 2-0 non-absorbable sutures were used to eliminate the lower pole of prosthetic cavity with " short distances and multi-segment" sutures. The distance from the nipple to the midline of the sternum, the distance from the sternotomy to the nipple, the distance from the nipple to the inframammary fold and the distance from the midclavicular point to the inframammary fold were measured bilaterally before and after surgery, and statistical analysis was performed to evaluate the efficacy of the " short distances and multi-segment" buried-guiding suture method for early descent of prosthesis after breast augmentation.Results:All incisions healed by first intention without complications such as hematoma, infection, or scar hyperplasia. 15 patients were followed up for 6-12 months (8.0±1.9). 14 patients were satisfied with the results after surgery, and 1 patient received satisfactory results after secondary surgery. The distance from nipple to inframammary fold was shortened by 0.8-1.4 cm after surgery (1.2±0.2), and the distance from mid-clavicle to inframammary fold was shortened by 1.0-1.6 cm (1.3±0.4), and the differences were statistically significant as compared with the values before surgery ( t=31.17, P<0.05; t=33.78, P<0.05). After surgery, the change in the distance from nipple to sternal was 0.1-0.3 cm (0.16±0.10), and the change in the distance from sternal notch to nipple was 0-0.2 cm (0.12±0.10), and the differences were not statistically significant ( P>0.05). Conclusions:With the advantages of simple operation, little trauma and no additional incision, the " short distance and multi-stage" buried-guiding suture method in the surgery of early descent of prosthesis after augmentation mammaplasty is worthy of clinical application.

Objective To explore the impact of Suzi Jiangqi decoction(SJD)on the inflammatory state of patients with chronic obstructive pulmonary disease(COPD)through the regulation of the mitogen-activated protein kinase(MAPK)signaling pathway.Methods A total of 70 patients with stable COPD,treated from April 2023 to April 2024 at the Department of Traditional Chinese Medicine and Department of Respiratory outpatient clinic of Affiliated Jinhua Hospital,School of Medicine Zhejiang University were selected and randomly divided into observation group and control group,with 35 cases in each group.The control group received tiotropium bromide powder inhalation combined with budesonide/formoterol powder inhalation treatment,while the observation group was given SJD in addition to treatment of control group.After 12 weeks of treatment,the therapeutic effects were evaluated by assessing lung function,airway mucus hypersecretion,levels of interleukin(IL)-17,IL-6,and tumor necrosis factor(TNF)-α,CT quantitative parameters of the lung,as well as the expression levels of IL-17,p38MAPK,nuclear factor kappa-B(NF-κB)and C-X-C motif chemokine ligand 8(CXCL8)mRNA in sputum.Results Following treatment,there was a significant improvement in lung function indicators such as first second expiratory volume/forced vital capacity％,cough score,sputum difficulty score,sputum quality score,and sputum volume score for patients in both groups,with more pronounced improvements observed in observation group(P＜0.05).The levels of serum cytokines IL-17,IL-6 and TNF-αdecreased in both groups after treatment,with observation group showing a more significant reduction(P＜0.05).Additionally,the percentage ratio of low attenuation area to lung area(LAA％),emphysema index of lung CT in observation group significantly decreased after treatment(P＜0.05).Similarly,the expression levels of IL-17,p38MAPK,NF-κB and CXCL8 mRNA in sputum were also significantly reduced after treatment in observation group(P＜0.05).Conclusion SJD may improve lung function and inflammatory status in COPD patients by regulating the MAPK signaling pathway mediated by IL-17,demonstrating a positive therapeutic effect on the treatment of COPD.

OBJECTIVE To evaluate the safety of epinephrine hydrochloride injection(EHI) given by nebulized inhalation in guinea pigs with the off-label drug use. METHODS The actual dose of inhalation administration was determined by establishing a nebulized administration drug concentration assay. The systemic allergic reactions and respiratory toxicity of EHI after nebulized inhalation were evaluated by guinea pigs using the allergy test protocol with the combination of frequency and dose of epinephrine hydrochloride administration and allergy test. Thirty-two guinea pigs were randomly divided into 4 groups according to body weight: negative control group(equal volume of saline), positive control group(sensitizing dose: 20 mg·kg-1 ovalbumin), low dose group(sensitizing dose: 15.5 μg·kg-1 EHI) and high dose group(sensitizing dose: 31 μg·kg-1 EHI). The excitation dose of each group was two times the sensitization dose, at the time of excitation, the symptoms of allergic reaction were observed. After excitation, blood and alveolar lavage fluid were collected, whole blood was collected for hematological testing and isolated serum and alveolar lavage fluid were used for IgE testing. Bronchial and lung tissues were taken for histological testing and immunohistochemistry after dissection. RESULTS Using a nebulizer device to administer EHI to guinea pigs at a clinically equivalent dose at 3.95 min of administration. The guinea pigs in all groups showed normal weight gain during sensitization administration. At the time of excitation, the guinea pigs in the positive control group showed strong positive allergic reactions, while the guinea pigs in the negative control group, low dose group and high dose group showed no significant allergic reactions. Compared with the negative control group, eosinophils in the blood of the positive control guinea pigs were significantly higher(P<0.05) and the IgE content in the serum and alveolar lavage fluid was significantly increased(P<0.05 or P<0.01). Histopathological results showed that inflammatory cells infiltrated in the lung tissue of the positive control guinea pigs after excitation, and a large number of erythrocytes and exudate appeared in the alveoli. The immunohistochemical indiacated that the inflammatory symptoms in the lung tissues of the positive guinea pigs were associated with an increase in B lymphocytes. The hematological indexes, serum IgE content, immunohistochemical and histological examination results of guinea pigs in the low and high dose groups were not significantly different from those of the negative control group. CONCLUSION No allergic reaction and no respiratory toxicity occurred in guinea pigs given EHI by nebulization, and the administration of EHI by nebulized inhalation off-label drug use is safe and feasible.

【Objective】 To learn the production efficient of platelet components among prefecture-level blood stations in China, to provide supporting data for those blood stations to optimize the production mode of platelet components and continuously improve production efficiency and supply capacity. 【Methods】 The data from 2017 to 2020 was obtained from 24 prefecture-level blood stations who were the members of the practice comparison network for blood institutes in China. The collection units of apheresis platelets, the number of dual-collections of apheresis platelets and plasma, the average apheresis units of one platelet apheresis procedure, the discarded rate of apheresis platelets, the amount of expired apheresis platelets and the amount of apheresis platelets issued were collected. For concentrated platelets, the prepared amount of platelet concentrates and the amount of expired platelet concentrates were collected; both the quantity of qualified and issued concentrated platelets were submitted for statistical analysis.The total output and efficiency of platelet components were calculated based on the collected data. 【Results】 The average annual growth rate of apheresis platelets collection in 24 prefecture-level blood stations was 12.23%, accounting for 99.80% of the total platelet output; the average collection unit of one platelets apheresis procedure was 1.75; from 2019 to 2020, only 5 blood stations performed dual-collection of platelet and plasma during one apheresis procedure; the discarded rate of apheresis platelets was 0.28%, of which 0.007% was due to expiration. A total of 1 621.2 therapeutic units of concentrated platelets were prepared, and 13.03% of them was discarded due to the expiration. The production efficiency of platelet components was 97.56%, of which the production efficiency of apheresis platelets was 97.61% and the production efficiency of concentrated platelets was 74.43%. 【Conclusion】 There are large regional differences in the supply capacity of platelet components in prefecture-level blood stations. Apheresis platelets are the main resource of platelet components product, and the collection capacity is increasing over the years with the characteristics of high production efficiency and low expiration scrapping rate. However, the preparation of concentrated platelets are still limited with relatively low production and high expiration discarded rate.

Objective:To investigate the clinical application and effect of orbicularis oculi muscle shaping in lower blepharoplasty.Methods:A retrospective analysis was performed on the clinical data of 32 cases of flabby blepharoplasty patients admitted to the Orthopedic Surgery Clinic of Sichuan people＇s Hospital from October 2018 to September 2019. At the same time of transcutaneous blepharoplasty, 32 patients were treated with orbicularis oculi muscle shaping to remove the relaxed orbicularis oculi muscle, to reconstruct the annular strength and shape of the orbicularis oculi muscle, to strengthen the supporting structure of the lower eyelid, to reset the relationship between the external canthus orbicularis muscle and the skin, and then to reconstruct the soft tissue filling degree of the lower eyelid margin. The safety, efficacy and stability of the operation were evaluated by Barton grading, postoperative complications and scoring before and after operation and satisfactory analysis based on patients＇ satisfaction scale after operation.Results:All the patients were free of postoperative infection and healed at stage I. There were 2 cases of ecchymosis, 3 cases of ocular foreign body sensation, and no cases of infection, lower eyelid retraction, lower eyelid ectropion, or retrobulbous hematoma. The mean Barton score of all patients before surgery was 1.88±0.49, and the mean Barton score after surgery was 0.53±0.51. The t-test showed that the difference was statistically significant ( t=15.75, P<0.05), and the postoperative lacrimal groove deformity was improved. According to the score of satisfaction scale, 7 people were basically satisfied (21.88%) and 25 people were very satisfied (78.12%). Conclusions:Forming in the orbicularis oculi muscle relaxation eyelid bag type of prosthesis, in addition to the part of the orbicularis oculi muscle relaxation, deformation, and widely shed canthus outside skin and orbicularis connection, make the next eyelid edge to reproduce the full shape, obviously the bulging under the eyelid relaxation, the shape of the degree of repair, lateral canthus wrinkles tail department have also improven, restoring the full eyelid platform. The operation has strong pertinence, simple procedures, less complications and better long-term effect.

Objective:To explore an optimal surgical approach for different types of labia minora hypertrophy and to design a better personalized surgical treatment plan for patients.Methods:From October 2017 to October 2020, 71 patients with labia minora hypertrophy were treated in the plastic surgery department of Sichuan Provincial People＇s Hospital, aged 18-38 years, with an average of 26 years. According to the type and degree of hypertrophy, the appropriate surgical method was selected. The wound healing and complications were observed after operation, and the shape of labia minora was followed up.Results:Among the 71 patients, 1 patient had postoperative hematoma and no flap necrosis after active treatment. 1 patient had poor healing of distal labia minora incision and improved after dressing change. The other patients had good blood supply of labia minora, no necrosis, no postoperative infection, hematoma and other complications. The patients were followed up for 1-6 months. The appearance of labia minora was natural, bilateral symmetry, and the incision scar was hidden. The improvement was significant compared with that before operation. The patients were satisfied with the shape and function.Conclusions:According to the degree of hypertrophy of the labia minora, the specific shape and the psychological expectation of patients, we can choose the appropriate operation method, which can achieve the aesthetic standard of symmetry and beautiful shape of the labia minora, and meet the normal physiological function and aesthetic requirements of patients.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Objective:To discuss the application of free double-layered auriclar composite tissue flap (auriclar cartilage and the skin) in repairing the full-thickness nasal alar defects.Methods:The clinical data of the patients with unilateral full-thickness nasal alar defects who were admitted to the Department of Plastic Surgery of Sichuan Provincial People’s Hospital from June 2016 to December 2019 were analyzed. The free double-layered auricular composite grafts were harvested from the unilateral nasal cavity as the nasal lining and covered with pedicled skin flap. The survival of free double-layered auricular composite grafts and pedicled skin flap as well as the appearance of the reconstructed nasal alar were observed.Results:A total of 12 patients with unilateral full-thickness alar defect were included, including 4 females and 8 males, aged from 6 to 53 years old, with an average of 35.3 years old. The areas of the defects were 0.7 cm × 1.0 cm-2.0 cm × 2.6 cm, and the areas of double-layered auricular composite grafts(skin) were 0.8 cm × 1.0 cm-2.1 cm × 2.7 cm. All the 12 patients healed primarily. No necrosis or infection occurred in the double auricle composite tissue flap and pedicled skin flap. After the completion of the whole treatment, the reconstructed nasal alar with similar shape and function to the normal nasal alar was obtained. After the last operation, the patients were followed up for 3 months to 32 months, with an average of 15 months.Conclusions:The free double-layered auricular composite grafts breaks the area limitation of free transplantation of full-layer auricle composite tissue flap. The combined grafting with pedicled flap shortens the treatment duration with skin flap alone, and it is easier to obtain vivid nasal alar.

Objective:To discuss the application of free double-layered auriclar composite tissue flap (auriclar cartilage and the skin) in repairing the full-thickness nasal alar defects.Methods:The clinical data of the patients with unilateral full-thickness nasal alar defects who were admitted to the Department of Plastic Surgery of Sichuan Provincial People’s Hospital from June 2016 to December 2019 were analyzed. The free double-layered auricular composite grafts were harvested from the unilateral nasal cavity as the nasal lining and covered with pedicled skin flap. The survival of free double-layered auricular composite grafts and pedicled skin flap as well as the appearance of the reconstructed nasal alar were observed.Results:A total of 12 patients with unilateral full-thickness alar defect were included, including 4 females and 8 males, aged from 6 to 53 years old, with an average of 35.3 years old. The areas of the defects were 0.7 cm × 1.0 cm-2.0 cm × 2.6 cm, and the areas of double-layered auricular composite grafts(skin) were 0.8 cm × 1.0 cm-2.1 cm × 2.7 cm. All the 12 patients healed primarily. No necrosis or infection occurred in the double auricle composite tissue flap and pedicled skin flap. After the completion of the whole treatment, the reconstructed nasal alar with similar shape and function to the normal nasal alar was obtained. After the last operation, the patients were followed up for 3 months to 32 months, with an average of 15 months.Conclusions:The free double-layered auricular composite grafts breaks the area limitation of free transplantation of full-layer auricle composite tissue flap. The combined grafting with pedicled flap shortens the treatment duration with skin flap alone, and it is easier to obtain vivid nasal alar.