Objective To investigate whether or not the infusion of anti-SARS-CoV-2 antibody-positive stock plasma inducing the antibody-dependent enhancement(ADE)effect in the patients with COVID-19 complicating liver dysfunction.Methods The clinical data of 26 patients with COVID-19 complicating liver dysfunction infused with SARS-CoV-2 antibody-positive stock plasma in this hospital from December 15,2022 to January 20,2023 were analyzed retrospectively.The changes of peripheral blood mononuclear cells(MONO)count and cytokines IL-2,IL-4,IL-6,IL-10,TNF-α and IFN-γ levels were compared and analyzed before and after plasma infusion.Thirty-seven patients with COVID-19 without plasma infusion during the same period served as the control group.The situation such as peripheral blood MONO count,cytokines lev-els,throat swab SARS-CoV-2 nucleic acid test,pulmonary infection lesion absorption on 5 d of treatment were compared between the two groups.Results The proportions of peripheral blood MONO count increase in the observation group and control group were 69.23％and 59.56％respectively,the proportions of cytokines in-crease were 66.67％vs.76.92％for IL-2,22.22％vs.46.15％for IL-4,33.33％vs.38.46％for IL-6,33.33％vs.30.27％for IL-10,33.33％vs.46.15％for TNF-α and 44.44％vs.61.54％for IFN-γ,the throat swab SARS-CoV-2 nucleic acid detection negative ratio was 46.67％vs.59.09％.The proportion of the pa-tients with lesion absorption beginning was 87.50％vs.84.85％,and the differences were not statistically sig-nificant(P＞0.05).Conclusion Infusion of stock plasma containing anti-SARS-CoV-2 polyclonal antibodies in the patients with COVID-19 complicating liver dysfunction does not induce significant ADE.

Objective:To explore the effect of preliminary application of a surgical microscope with a measuring system in measurement of the outer diameter of blood vessels in the super-microsurgical model of chicken wing.Methods:From November 2022 to January 2023, 12 chicken wing models were established by having the main blood vessels of chicken wings dissected and separated. Outer diameter of blood vessels were measured by the surgical microscope with an installed measuring system and a digital vernier calliper. Results of the 2 measuring methods and measuring time were compared. SPSS 26.0 was used for statistical analysis of the data. The comparison between the 2 measuring methods with continuity data consistent with the homogeneity of normal distribution variance was performed by paired t test, and expressed by Mean ± SD. The difference between the 2 measuring methods was statistically significant ( P<0.05). Results:Results measured by the microscope with a measuring system and a digital vernier calliper were 1.29 mm± 0.08 mm and 1.28 mm± 0.07 mm for chicken wing brachial artery, 1.11 mm± 0.11 mm and 1.09 mm ± 0.11 mm for radial artery, 0.98 mm± 0.09 mm and 0.99 mm± 0.12 mm for ulnar artery, 0.63 mm ± 0.06 mm and 0.64 mm± 0.07 mm for dorsal metacarpal artery, and 0.39 mm± 0.06 mm and 0.40 mm± 0.09 mm for palmar artery, respectively. No significant difference was found between the 2 measuring methods ( P>0.05). The time of measurement for the 2 measuring methods was 5.90 s± 1.12 s and 8.86 s± 1.74 s, respectively. The time for the microscope with a measuring system was less, with statistically significant difference ( P<0.05). Conclusion:It is accurate, convenient and intuitive to use a surgical microscope installed with a measuring system to measure the outer diameter of tinny vessels. It is worth to popularise and apply the surgical microscope equipped with a measuring system in super-microsurgery.

The nasal tip defect has a significant influence on one’s facial appearance, and reconstruction of this defect is challenging. In February 2021, a 44-year-old man with a soft tissue defect of the nasal tip after biting was diagnosed and treated in Xuzhou Renci Hospital. The nasal tip was reconstructed with a free preauricular flap based on the superficial temporal artery, which was anastomosed with the terminal branches of the facial artery by super microsurgical technique. After the operation, the skin flap survived with infection prevention, anticoagulation, and antispasmodic treatment. After three months of follow-up, the incision scar was un-noticeable, and the patient was satisfied with the appearance of the reconstructed nasal tip.

The nasal tip defect has a significant influence on one’s facial appearance, and reconstruction of this defect is challenging. In February 2021, a 44-year-old man with a soft tissue defect of the nasal tip after biting was diagnosed and treated in Xuzhou Renci Hospital. The nasal tip was reconstructed with a free preauricular flap based on the superficial temporal artery, which was anastomosed with the terminal branches of the facial artery by super microsurgical technique. After the operation, the skin flap survived with infection prevention, anticoagulation, and antispasmodic treatment. After three months of follow-up, the incision scar was un-noticeable, and the patient was satisfied with the appearance of the reconstructed nasal tip.

Objective:To explore the clinical effects of fractional carbon dioxide laser combined with autologous fat injection in the treatment of hypertrophic scar after burn.Methods:From April 2018 to April 2019, 12 patients with hypertrophic scar after burn who met the inclusion criteria were admitted to the Department of Plastic Surgery and Burns of Xuzhou Renci Hospital, and were included in this prospective randomized controlled clinical study. There were 7 males and 5 females with age of (32±11) years and scar area of (612±195) cm 2. One scar was selected from each patient and divided into two equal area scars, and they were divided into combined treatment group and laser alone group with 12 scars in each group according to the random number table. The scar in laser alone group was only treated with fractional carbon dioxide laser, while the scar in combined treatment group was injected with autologous granular fat and then treated with fractional carbon dioxide laser. Scars in the two groups were treated once every 2 months, totally 3 times. Before the first treatment and 6 months after the last treatment, the scars in the two groups were evaluated by modified Vancouver Scar Scale (mVSS), hematoxylin-eosin staining and color Doppler ultrasound. Six months after the last treatment, the curative effect of scars in the two groups was evaluated, and the effective number of scar treatment was calculated. The adverse reactions during the whole treatment were recorded. Data were statistically analyzed with independent sample t test, paired sample t test, and McNemar exact probability method test. Results:Six months after the last treatment, the mVSS score of scars in combined treatment group was (4.5±0.4) points, which was significantly lower than (7.8±0.6) points in laser alone group ( t=10.000, P<0.01). Six months after the last treatment, the mVSS scores of scars in combined treatment group and laser alone group were significantly lower than those before the first treatment ((13.5±0.7) and (13.8±0.6) points, t=8.805, 9.010, P<0.01). The effective number of scar treatment in combined treatment group was significantly more than that in laser alone group ( P<0.05). There was no scar aggravation, infection, or other adverse reactions during the treatment of scars in both groups. Before the first treatment, the scars in both groups had large collagen, disordered arrangement, proliferation of capillaries, infiltration of some inflammatory cells, and disappearance of skin appendages. Six months after the last treatment, the scar collagen in both groups was sparse and orderly arranged, and the vascular density was reduced. The improvement of scars in combined treatment group was more obvious than that of laser alone group. Six months after the last treatment, the scar thickness in combined treatment group was significantly smaller than that in laser alone group ( t=2.657, P<0.05). Before the first treatment, the blood flow of scars in both groups was abundant; 6 months after the last treatment, the blood flow of scars in combined treatment group was significantly less than that in laser alone group. Conclusions:Fractional carbon dioxide laser combined with autologous fat injection in the treatment of hypertrophic scar after burn can significantly reduce the pain and itching symptoms of scar, and improve the thickness, texture, and congestion of scar. The combined treatment has synergistic effect and less adverse reactions, providing a more effective treatment for patients with hypertrophic scar.

Objective:Lung ultrasound (LUS) has been used in the diagnosis of neonatal respiratory distress syndrome(RDS) successfully, but there have been no multicenter prospective studies to verify its reliability or determine how to grade RDS with LUS findings.This study aimed to discuss the necessity and feasibility of using LUS findings to determine RDS grades through a multicenter prospective study.Methods:Every researcher participated in the National Neonatal Lung Ultrasound Training Course and receiving 3-6 months of lung ultrasound system training at the National Neonatal Lung Ultrasound Training Center.Patients between June 2018 and May 2020 who met the RDS ultrasound diagnostic criteria and had full available clinical data were included in this study.The LUS examination was completed immediately after the patients were admitted to the hospital.Some of them also underwent chest X-ray examination.Arterial blood gas analysis was completed immediately before or after the LUS ultrasound examination.RDS grading was performed according to the LUS findings and whether the patient had serious complications.Results:A total of 275 qualifying cases were included in this study, which included 220 premature infants and 55 full-term infants, and the primary RDS occurred in 117 cases (42.5%), and secondary RDS occurred in 158 cases (57.5%). LUS manifestations of RDS patients can be divided into three categories: (1)A ground-glass opacity sign: which could be found among 50 infants when they were admitted to the hospital (that was, at their first LUS examination). Twenty-eight of these infants were considered to have wet lungs and were not sent for special management on admission, but LUS showed typical snowflake-like lung consolidation within 0.5 to 4 hours.Twenty-two of them were given mechanical ventilation with exogenous pulmonary surfactant; Eighteen cases were controlled within 6-12 hours, but the lung lesions became more severe in the other 4 infants (due to severe intrauterine infection). (2)Snowflake-like lung consolidations: the first LUS on admission showed typical snowflake-like lung consolidation involving areas ranging from 1-2 intercostal spaces to 12 lung divisions in 204 cases.Thirty-eight infants among them the lung consolidation only had involvement of 1-2 intercostal spaces at the time of admission; Fifteen of them received invasive respiratory support and recovered within 4-12 hours.Twelve patients received noninvasive respiratory support; Seven of them recovered, while five cases developed severe lung illness.The remaining 11 patients who were not given any form of ventilator support developed severe conditions within 1-4 hours.Thirty of them showed snowflake signs involving 12 lung regions at admission.The remaining 136 patients had lung consolidation degree between the two degree above condition.(3)Snowflake-like sign with complications: Twenty-one patients had severe complications such as pneumothorax, pulmonary hemorrhage or/and persistent pulmonary hypertension of the newborn or large area atelectasis, etc, although snowflake lung consolidation did not involve all lung regions.Conclusion:(1) LUS is reliable and accurate for diagnosing RDS.RDS has the same characteristics on ultrasound for both preterm and full-term infants, both primary and secondary RDS.(2) To facilitate the management of RDS, it is necessary to classify RDS according to the ultrasound findings and the presence of severe complications.(3) Based on the results of this study, it is recommended that RDS can be divided into mild, moderate and severe degrees.The exact standards for grading are as follows: Mild RDS: the early stage of RDS, in which lung consolidation shows as a ground-glass opacity sign on ultrasound; Moderate RDS: lung consolidation shows a snowflake sign on ultrasound, not all of the lung fields are involved; Severe RDS meets one or more of the following criteria: lung consolidation shows as a snowflake sign on ultrasound and all lung regions are involved, or regardless of its degree and extent, lung consolidation has caused serious complications, such as pulmonary hemorrhage, pneumothorax, persistent pulmonary hypertension of the newborn, or/and a large area of pulmonary atelectasis.

Objective:To explore the effects of fractional carbon dioxide laser combined with autologous fat injection in the treatment of hypertrophic scar after burn.Methods:From April 2018 to April 2019, 12 patients with hypertrophic scar after burn who met the inclusion criteria were admitted to the Department of Plastic Surgery and Burns of Xuzhou Renci Hospital, and were included in this prospective parallel controlled clinical study. There were 7 males and 5 females with an age of (32±11) years old and scar area of (412±295) cm 2. One scar was selected from each patient and divided into two equal area scars, and they were divided into combined treatment group and laser alone group with 12 scars in each group according to the ramdom number table.The scar in laser alone group was only treated with fractiona carbon dioxide laser, while the scar in combined treatment group was injected with autologous granular fat and then treated with fractional carbon dioxide laser. Scars in the two groups were treated once every 2 months, a total of 3 times. Before the first treatment and 6 months after the last treatment, the scars in the two groups were evaluated by modified Vancouver Scar Assessment Scale (mVSS), hematoxylin-eosin staining and color Doppler ultrasound. Six months after the last treatment, the curative effect of scars in the two groups was evaluated. The adverse reactions during the whole treatment were recorded. Data were statistically analyzed with independent sample t test, paired sample t test, and McNemar exact probability method test. Results:Six months after the last treatment, the mVSS score of scars in combined treatment group was (4.5±0.4) points, which was significantly lower than (7.8 ±0.6) points in laser alone group ( t=10.000, P<0.01). Six months after the last treatment, the mVSS scores of scars in combined treatment group and laser alone group were significantly lower than those before the first treatment [(13.5±0.7) and (13.8±0.6) points, t=8.805, 9.010, P<0.01]. The effective number of scar treatment in combined treatment group was significantly more than that in laser alone group ( P<0.05). There was no scar aggravation, infection, or other adverse reactions during the treatment of scars in both groups. Before the first treatment, the scars in both groups had large collagen, disordered arrangement, proliferation of capillaries, infiltration of some inflammatory cells, and disappearance of skin appendages. Six months after the last treatment, the scar collagen in both groups was sparse and orderly arranged, and the vascular density was reduced. The improvement of scars in combined treatment group was more obvious than that of laser alone group. Six months after the last treatment, the scar thickness in combined treatment group was significantly smaller than that in laser alone group ( t=2.657, P<0.05). Before the first treatment, the blood flow of scars in both groups was abundant; 6 months of the last treatment, the blood flow of scars in combined treatment group was significantly less than that in laser alone group. Conclusions:Fractional carbon dioxide laser combined with autologous fat injection in the treatment of hypertrophic scar after burn can significantly reduce the pain and itching symptoms of scar, and improve the thickness, texture, and congestion of scar. The combined treatment has synergistic effect and less adverse reactions, which provides a more effective treatment for patients with hypertrophic scar.

Objective: To investigate the clinical outcome of microfat injection on facial hypertrophic scar treatment. Methods: A total of 22 patients had facial hypertrophic scar were treated with microfat injection. The microfat was injected into the scar three times for each case, with an interval of 2 months. The severity of scar was evaluated preoperatively and 1-month postoperatively, using modified Vancouver scar score, to evaluate the efficacy. Results: Postoperative infection occurred in 1 case, and no further microfat injection was performed on him/her. All the other 21 cases have relieved cicatricial hyperemia, with the scar softening and flattening. The symptom of itching and pain were alleviated as well. The overall effective rate was 95.45%. The score of modified Vancouver scar scale was reduced from 12.82±2.15 preoperatively, to 7.05±1.76 6 months after the treatment (P<0.05). Conclusions The microfat injection can effectively improve the color and texture of the facial hypertrophic scar, and reduce the symptoms of itching and pain. It is a new choice for the treatment for hypertrophic scar.

AIM To observe the clinical role for Supplemented Xijiao Powder (Bubali cornu,Coptidis Rhizoma,Cimicifugae Rhizoma,etc.) in management of hepatitis B virus (HBV) associated acute-on-chronic liver failure.METHOD Seventy-five patients,including the ones receiving internal medicine treatment,were divided into control group and experimental group.The experimental group received conventional treatment and additionally took Supplemented Xijiao Powder for one month.The clinical symptoms and signs were observed.Levels of ALT,AST,TBIL,ALB,CHE,PTA were measured,and the incidence of liver failure was evaluated.RESULTS Supplemented Xijiao Powder could improve symptoms,signs and the level of PTA.The incidence of liver failure tended to reduce.The comparison of other indexes had no marked difference.CONCLUSION Supplemented Xijiao Powder has a certain therapeutic effect on HBV associated prioracute-on-chronic liver failure.Its mechanism may be related to blocking the occurrence of liver failure.

BACKGROUNDThe mutation frequencies of three common deafness genes (MT-RNR1 m.1555A>G, GJB2, and SLC26A4) among patients with nonsyndromic sensorineural hearing loss (NSHL) were different in previous studies. Inconsistent selection criteria for recruiting patients could have led to differences in estimating the frequencies of genetic mutations thus resulting in different mutation frequencies among these studies. The aim of this study was to reveal the differences in the mutation spectrums of the three common genes between familial and sporadic Chinese Han patients.

METHODSTotally, 301 familial probands and 703 sporadic patients with NSHL were enrolled in this study. Three genes, MT-RNR1 m.1555A>G, GJB2, and SLC26A4, were screened for mutation in our study cohort. A χ(2) test was performed to compare the mutation frequencies between the two groups.

RESULTSThe study showed that the disease-causing mutation frequencies of MT-RNR1 m.1555A>G, GJB2, and SLC26A4 were 12.29%, 14.62%, and 18.27% in familial probands and 3.56%, 18.63%, and 18.92% in sporadic patients, respectively. The mutation frequency of MT-RNR1 m.1555A>G in familial probands was significantly higher than in sporadic patients (χ(2) test, P = 0.000), while there were no significant differences in the mutation frequencies of GJB2 and SLC26A4 between the familial and sporadic groups (χ(2) test, P > 0.05).

CONCLUSIONSIt is necessary to reveal the differences in gene mutation frequencies between patients of different sources or characteristics by comparative studies in order to avoid selection bias. The mutations of GJB2, SLC26A4, and MT-RNR1 m.1555A>G are the most important etiological factors in Chinese Han patients, among which SLC26A4 might be the most frequent.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; Connexin 26 ; Connexins ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Genetic Testing ; Hearing Loss, Sensorineural ; genetics ; Humans ; Infant ; Male ; Membrane Transport Proteins ; genetics ; Middle Aged ; Mutation ; genetics ; Young Adult