Developing and implementing biosafety standards for pathogenic microbiology laboratories is essential to achieving scientific, efficient, and standardized management and operation. This article analyzes the current standardization construction in biosafety in pathogenic microbiology laboratories domestically and internationally. It proposes a framework for the biosafety standard system of pathogenic microbiology laboratories, which mainly includes four parts: basic standards, management standards, technical standards, and industry applications. It provides a reference for the standardization work of pathogenic microbiology laboratories and helps to standardize the biosafety industry in China.

Objective:To explore the clinical efficacy of posterior femoral muscle flaps combined with posterior femoral cutaneous nerve nutrient vessel flap and closed lavage in the treatment of stage Ⅳ ischial tuberosity pressure ulcers.Methods:This study was a retrospective observational study. From March 2021 to March 2022, 15 patients with stage Ⅳ ischial tuberosity pressure ulcers who met the inclusion criteria were admitted to Dezhou Dongcheng Hospital, including 11 males and 4 females, aged 31 to 72 years. The pressure ulcer wound size ranged from 6.0 cm×4.5 cm to 10.0 cm×6.0 cm, with cavity diameters of 10-14 cm. Five cases were complicated with ischial tuberosity bone infection. After clearing the lesion, the biceps femoris long head muscle flap with an area of 10.0 cm×4.0 cm-18.0 cm×5.0 cm and the semitendinosus muscle flap with an area of 8.0 cm×4.0 cm-15.0 cm×5.0 cm combined with the posterior femoral cutaneous nerve nutrient vessel flap with an area of 6.5 cm×5.5 cm-10.5 cm×6.5 cm was transplanted to repair the pressure ulcer wound. The flap donor area was directly sutured, and the closed lavage with tubes inserted into the wound cavity was performed for 2-3 weeks. The postoperative survival of the muscle flaps and skin flaps, the wound healing of the donor and recipient areas were observed. The recurrence of pressure ulcers, the appearance and texture of flaps, and scar conditions of the donor and recipient areas were followed up.Results:All the muscle flaps and skin flaps in the 15 patients successfully survived after surgery. Two patients experienced incisional dehiscence at one week after surgery due to improper turning over, during which the incision in the recipient area was pressed on, and the wounds healed after dressing changes of 3 to 4 weeks; the wounds in the donor and recipient areas healed well in the other patients. All patients received follow-up after surgery. During the follow-up period of 6 to 12 months, none of the patients experienced pressure ulcer recurrence, and the texture, color, and thickness of the skin flaps closely resembled those of the surrounding skin at the recipient site, with only linear scar left in the donor and recipient areas.Conclusions:When using the posterior femoral muscle flaps combined with the posterior femoral cutaneous nerve nutrient vessel flap and closed lavage to treat stage Ⅳ ischial tuberosity pressure ulcers, the tissue flap can be used to fully fill in the dead space of the pressure ulcers. After treatment, the wound heals well, the appearance of the donor and recipient areas is better, and the pressure ulcers are less prone to reoccur.

Objective:To develop and evaluate the efficacy and safety of a three-dimensional (3D) digestive endoscope for gastric endoscopic submucosal dissection (ESD) through animal experiments.Methods:Two Dutch pigs were utilized from the Zhengzhou University Animal Experiment Center for the study. ESD procedures were performed by two senior endoscopists, one using 3D glasses and the other utilizing a 3D high-definition head display. The success of ESD was assessed based on predefined criteria, including completion of surgical steps, complete detachment of the presumptive lesion, and effective bleeding control during and after the surgery. The number of successful procedures and incidences of perforation were recorded. The stereoscopic experience of the endoscopists, including both the primary endoscopist and the assistant, was also evaluated. Furthermore, the assessment encompassed any reported symptoms of eye discomfort, such as eye fatigue, ocular pain, and blurred vision. Additionally, the confidence level of the endoscopists in the mechanical aspects of the operation, as well as encountered issues during the endoscopic procedures, were documented.Results:Two ESD were successful and no perforation occurred. Feedback from endoscopists suggested that 3D digestive endoscopy offered clear images with enhanced three-dimensionality during surgery, clear sense of distance and layering, allowing for a precise judgment of bleeding points, which surpassed 2D capabilities. No eye discomfort was experienced by endoscopists or assistants during or after the procedures. While endoscopists exhibited high confidence in 3D digestive endoscopy, they noted issues with image blurring when the camera was positioned less than 10 mm from the gastrointestinal tract wall.Conclusion:Preliminary results show that 3D digestive endoscopes can provide excellent stereo imaging, improved positioning accuracy, and safety during live animal stomach ESD procedures, without significantly increasing endoscopists' eye discomfort. Nevertheless, efforts are needed to address image blurring concerns when the camera is close to the gastrointestinal tract wall.

Objective:To scientifically measure and morphologically evaluate the anatomical shape of the skin in the first web space based on cadavers, and to guide the design of flap in this area.Methods:Sixteen human cadavers fixed with 10% formaldehyde without injury or deformity on the hand were selected in the Department of Hand Surgery, the Third Hospital of Suqian. According to the characteristics of the first web area, marker points were selected for measurement and morphological observation. Morphological characteristics of the first web with thumb radial abduction(r) or palmar abduction(p) were measured and compared. The t-test was used for statistical analysis. P<0.05 was considered statistically significant. According to the results of measurement, standardised shapes and parameters of the skin were obtained for flap repair of defect of the first web. Results:When the thumb was in palmar abduction, the maximum distance [a(p)] of the first web of female(F) and male(M) was 5.78/8.42 cm(F/M), and the skin [S(p)] was 17.09/23.63 cm 2(F/M), both were significantly greater than the distance [a(r)] at 4.86/6.28 cm and the area of skin area [S(r)] at 14.39/20.15 cm 2 when thumb was in the radial abduction position( P<0.05). There was no significant difference in the length of [b(r)] and [b(p)] alone the long axis of flap between palmar and radial abductions(7.54/9.38 cm and 7.34/9.74 cm, respectively) of the thumb( P>0.05). It was found that the area of first web was not shaped as a symmetrical spindle, but an irregular quadrilateral inclined to the index finger. Conclusion:Design and measurement of a flap for the first web space should take the maximum palmar abduction of a thumb as a reference. The asymmetric quadrilateral flap design is more in line with the anatomical and characteristics in the region.

Objective:To explore the effect of hyperbaric oxygen (HBO) on the blood-brain barrier via the silent information regulator 1 (SIRT1)/Forkhead box O1(FoxO1) signaling pathway after cerebral ischemia and reperfusion using a rat model.Methods:Forty Wistar rats were randomly assigned into sham, cerebral ischemia-reperfusion (CIR), CIR+ HBO and CIR+ HBO+ EX527 groups, each of 10. The cerebral ischemia-reperfusion model was established in all groups except the sham group by right middle cerebral artery occlusion using the modified thread-occlusion method. The sham group was not ligated. Both the CIR+ HBO and CIR+ HBO+ EX527 groups were given HBO 1, 9, 21, 45 and 69 hours after the reperfusion. The CIR+ HBO+ EX527 group was additionally injected with 5mg/kg of EX527(a SIRT1inhibitor) peritoneally 4, 12, 24, 48 and 72 hours after the reperfusion. Then 2% Evens blue (EB) was injected into the tail vein an hour before the rats were sacrificed. The content of EB and the expression of SIRT1, FoxO1, ZO-1, Occludin, Claudin-5 mRNA and their proteins were determined using spectrophotometry, reverse transcription-polymerase chain reactions and Western blotting.Results:The average EB content of the hippocampal brain tissue from the CIR, CIR+ HBO and CIR+ HBO+ EX527 rats was significantly greater than the Sham group′s average 72h after reperfusion. The average expression of SIRT1, FoxO1, ZO-1, Occludin and Claudin-5 mRNA and their proteins was significantly lower, with the CIR + HBO + EX 527 group′s average significantly lower than that of the CIR+ HBO group.Conclusions:HBO can increase the expression of tight junction protein via the SIRT1/FoxO1 pathway. It helps to protect the blood-brain barrier in CIR injury situations.

Effective therapy options for pneumoconiosis are lacking. Traditional Chinese medicine (TCM) presents a favorable prospect in the treatment of pneumoconiosis. A pilot study on TCM syndrome differentiation can evaluate the clinical efficacy and safety of TCM and lay a foundation for further clinical research. A double-blind, randomized, and placebo-controlled trial was conducted for 24 weeks, in which 96 patients with pneumoconiosis were randomly divided into the control and treatment groups. Symptomatic treatment was conducted for the two groups. The treatment group was treated with TCM syndrome differentiation, and the control group was treated with placebo. The primary outcomes were the six-minute walking distance (6MWD) and the St. George Respiratory Questionnaire (SGRQ) score. The secondary outcomes were the modified British Medical Research Council Dyspnea Scale (mMRC), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), and pulmonary function. Only 83 patients from the 96 patients with pneumoconiosis finished the study. For the primary outcome, compared with the control groups, the treatment group showed a significantly increased 6MWD (407.90 m vs. 499.51 m; 95% confidence interval (CI) 47.25 to 135.97; P < 0.001) and improved SGRQ total score (44.48 vs. 25.67; 95% CI -27.87 to -9.74; P < 0.001). The treatment group also significantly improved compared with the control group on mMRC score (1.4 vs. 0.74; 95% CI -1.08 to -0.23; P =0.003), CAT score (18.40 vs. 14.65; 95% CI -7.07 to -0.43; P =0.027), and the total symptom score (7.90 vs. 5.14; 95% CI -4.40 to -1.12; P < 0.001). No serious adverse events occurred. This study showed that TCM syndrome differentiation and treatment had a favorable impact on the exercise endurance and quality of life of patients with pneumoconiosis.
Humans ; Medicine, Chinese Traditional/methods* ; Quality of Life ; Pilot Projects ; Drugs, Chinese Herbal/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Pneumoconiosis/drug therapy* ; Double-Blind Method ; Treatment Outcome ; Syndrome

Objective:To investigate the clinical effect of the relaying perforator flap for repairing the donor site of the anterolateral thigh flap.Methods:From March 2019 to June 2020, 28 consecutive patients who underwent anterolateral thigh free flap reconstruction for limb soft tissue defects were retrospectively reviewed. A relaying perforator flap was selected from one of the four areas adjacent to the donor site of the anterolateral thigh flap for covering the donor site of the anterolateral thigh flap. The secondary donor site was closed directly. The followed-up contents included the appearance and texture of the flaps. The postoperative followed-up was performed through outpatient visits, telephone, and WeChat interviews.Results:A total of 28 patients were included, with an average age of 37.3 (ranging from 15 to 65). The relaying perforator flap was selected from the anteromedial thigh region ( n=13), the proximal anterolateral thigh region( n=6), the distal anterolateral thigh region ( n=5), and the ilioinguinal region ( n=4). The size of the anterolateral thigh flap ranged from 12.0 cm×10.0 cm to 20.0 cm×13.0 cm, and the size of the relaying perforator flap ranged from 6.0 cm×5.0 cm to 11.0 cm×7.5 cm. The followed-up time ranged from 1 to 6 months (mean 4.8 months). The color, texture, and contour of the flaps were good. Only one linear scar is left in the donor site. Two cases with small necrosis (1.0 cm×2.0 cm and 1.5 cm×1.5 cm, respectively) were found in the distal edge of relaying perforator flaps. Conclusions:The relaying perforator flap is considered as an optimized and reliable method for repairing the donor site of an anterolateral thigh flap and should be recommended.

Objective:Objective The inhibitory effect of Niuhuang Qinggan Capsule on 2019-nCoV virus was studied to provide experimental evidence for drug screening and treatment of 2019-nCoV acute respiratory disease.Methods:The 2019-nCoV virus GS048 strain was isolated and cultured by Vero-E6 cells. The solution of Niuhuang Qinggan capsule was incubated with virus in vitro to determine the change of virus titer. The effect of Niuhuang Qinggan capsule on the proliferation of 2019-nCoV virus was determined by cell culture medium method.Results:It was found that the concentration of 274.3 μg/ml was not toxic to the cells when the concentration of drugs was lower. When the drug was incubated with virus, the titer of virus decreased from 10 4.4TCID 50/ml to 10 2.8TCID 50/ml. In vitro 2019-nCoV virus culture experiment showed that the addition of the drugs reduced the cytopathy, and the logarithmic value of virus titer decreased by 40% -50%. Conclusion:In this study, in vitro inhibition experiments suggest that Niuhuang Qinggan capsule has the potential to inhibit the proliferation of 2019-nCoV. It can be used as a candidate drug to further verify the therapeutic effect of the 2019-nCoV acute respiratory disease.

Objective:To investigate the clinical effect of the relaying perforator flap for repairing the donor site of the anterolateral thigh flap.Methods:From March 2019 to June 2020, 28 consecutive patients who underwent anterolateral thigh free flap reconstruction for limb soft tissue defects were retrospectively reviewed. A relaying perforator flap was selected from one of the four areas adjacent to the donor site of the anterolateral thigh flap for covering the donor site of the anterolateral thigh flap. The secondary donor site was closed directly. The followed-up contents included the appearance and texture of the flaps. The postoperative followed-up was performed through outpatient visits, telephone, and WeChat interviews.Results:A total of 28 patients were included, with an average age of 37.3 (ranging from 15 to 65). The relaying perforator flap was selected from the anteromedial thigh region ( n=13), the proximal anterolateral thigh region( n=6), the distal anterolateral thigh region ( n=5), and the ilioinguinal region ( n=4). The size of the anterolateral thigh flap ranged from 12.0 cm×10.0 cm to 20.0 cm×13.0 cm, and the size of the relaying perforator flap ranged from 6.0 cm×5.0 cm to 11.0 cm×7.5 cm. The followed-up time ranged from 1 to 6 months (mean 4.8 months). The color, texture, and contour of the flaps were good. Only one linear scar is left in the donor site. Two cases with small necrosis (1.0 cm×2.0 cm and 1.5 cm×1.5 cm, respectively) were found in the distal edge of relaying perforator flaps. Conclusions:The relaying perforator flap is considered as an optimized and reliable method for repairing the donor site of an anterolateral thigh flap and should be recommended.

Objective:To evaluate the clinical effect of the modified transfer of the proximal interphalangeal joint (PIPJ) from the second toe in the treatment of a finger PIPJ defect.Methods:A total of 13 patients with finger PIPJ defects caused by traumatic injury were enrolled from May, 2017 to March, 2020. All the PIPJ defects had primary traumatic repairs. The causes of injury: 5 patients were caused by strangulation, 4 by chainsaw, 2 by strangulation and 2 by crushing. Of which, 7 patients had index finger injury, 3 middle fingers and 3 ring fingers. The operations were carried out 3-7 months after the first stage of treatment. The grafting of the PIPJ of the second toe with modified vascular anastomosis were performed. The ipsilateral second toe was taken in 10 patients, and the contralateral second toe in 3 patients. The grafted joints all carried observation skin islands, with an area of 1.0 cm×1.5 cm-1.0 cm×2.0 cm. All the secondary bone defects in the donor site of the toe were reconstructed with iliac bone grafts, and the length of the iliac bone strips was 4.0-6.0 cm. At the same time, the island flap on the fibular side of the great toe was removed and repaired at the donor site, with an area of 1.1 cm×1.6 cm - 1.1 cm×2.1 cm. Early postoperative rehabilitation was performed. The patients were followed-up through outpatient visits, telephone and WeChat interviews.Results:All the 13 finger PIPJ and donor site island flaps survived. Bone healing were observed in all patients with the healing time in 8-12(average 10) weeks. Three patients with severe adhesion of joint and tendon were treated with secondary release. All the patients were followed-up for 10 - 18 months without degeneration of PIPJ. Active range of motion of PIPJ ranged: 45°-90° in flexion and 0°-10° in extension, the average motion activity was 66.3°. Seven patients were in excellent, 4 in good and 2 in fair, according to the function assessment proposed by the Society of Hand Surgery of Chinese Medical Association. The appearance on donor site was good and the walking was normal in the longterm follow-up. Only one linear scar was left in the ilioinguinal donor site without obvious discomfort.Conclusion:It was possible to use the modified transfer of the PIPJ from the second toe in the treatment of a finger PIPJ defect. An iliac bone graft and an island flap of the first toe transfer can preserve the appearance and function of the toes.