To summarize the clinical effect of using boosters for orbital autologous fat injection transplantation.

To summarize the clinical effect of using boosters for orbital autologous fat injection transplantation.

Objective To explore the mechanism by which puerarin alleviates the cardiotoxicity induced by doxorubicin in myocardial cells. Methods Cells in the logarithmic growth phase were divided into normal control group,model group,low-(20 mmol·L-1),medium-(40 mmol·L-1) and high-(80 mmol·L-1) dose puerarin groups,and positive control group(captopril,1 mmol·L-1). Except for the normal control group,the other groups were co-incubated with 5 mmol·L-1 doxorubicin. Cell viability was assessed using CCK-8 and lactate dehydrogenase (LDH) assays. ROS levels were detected using a ROS probe. Autophagy flux was detected by transfection with HBAD-mcherry-EGFP-LC3 adenovirus. Western Blot was used to measure the protein expression levels of Beclin-1,LC3,p62,p-AMPKα,and AMPKα. Lysosomal function was assessed using a lysosomal probe. Immunofluorescence was used to detect the relative intensity and co-localization of ASMase and LAMP1. Molecular docking analysis was performed to predict the binding capacity of PUE with ASMase. Differential gene expression was analyzed by gene set enrichment analysis. Results Compared to the normal control group,the model group showed reduced cell viability (P<0.01),increased release levels of LDH and ROS (P<0.05,P<0.01),increased number of autophagosomes (P<0.01),and decreased number of autophagic lysosomes (P<0.05). Beclin-1 protein expression and LC3-II/LC3-I ratio decreased(P<0.01),but p62 protein expression increased(P<0.01). Fluorescence intensity of lysosome decreased(P<0.01),whereas fluorescence intensity of ASMase increased(P<0.01). Immunofluorescence co-localization of ASMase and LAMP1 increased (P<0.01),the ratio of p-AMPKα/AMPKα decreased(P<0.05). Compared to the model group,the high-dose puerarin group showed a rebound in cell viability (P<0.05). The medium-and high-dose puerarin groups showed a decreasing trend in LDH level (P<0.05),and all puerarin groups showed a decreasing trend in ROS level (P<0.01). The number of autophagosomes in high-dose puerarin group reduced (P<0.01). The number of autophagic lysosomes in all puerarin groups increased (P<0.05,P<0.01). The high-dose puerarin group showed increased expression of Beclin-1 (P<0.05) and LC3-II/LC3-I ratio,and decreased p62 expression (P<0.01). All puerarin groups showed increased lysosomal fluorescence intensity (P<0.05,P<0.01). The medium-and high-dose puerarin groups showed a decrease in ASMase fluorescence intensity(P<0.05),a reduction in the immunofluorescence co-localization of ASMase with LAMP1 (P<0.01),and an increase in the p-AMPKα/AMPKα ratio (P<0.01). Molecular docking analysis discovered puerarin showed a binding energy of-8.6 kcal·mol-1 with ASMase. Gene enrichment analysis indicated that the differentially expressed genes in the doxorubicin cardiotoxicity model were related to apoptosis,autophagy,and lysosomal function. Conclusion Puerarin can alleviate doxorubicin-induced cardiotoxicity in myocardial cells and protect myocardial cells by regulating autophagy through AMPK/ASMase,as well as restoring autophagic flux.

OBJECTIVE To evaluate the effect of “Cloud Pharmacy Service System” electronic management platform in medication therapy management （MTM） of chronic airway diseases. METHODS MTM module setting of “Cloud Pharmaceutical Service System” was introduced. Totally 371 patients with chronic airway disease admitted to our hospital from January 2021 to March 2022 were selected for MTM based on the “Cloud Pharmacy Service System”. The standardization of inhalation device mastery and compliance of patients before and after intervention were compared with self-made inhalation device evaluation scale and Morisky medication adherence scale-8 （MMAS-8）. The satisfaction of patients with pharmacist after intervention was investigated. RESULTS “Cloud Pharmaceutical Service System” is mainly divided into 4 modules， such as medication therapy review， pharmacist intervention， personal medication record and the medication-related action plan， other functions. Among 371 patients， there were 237 outpatients （142 cases of asthma， 95 cases of chronic obstructive pulmonary disease） and 134 inpatients （19 cases of asthma and 115 cases of chronic obstructive pulmonary disease）. The score of the patients using inhalation device increased from 74.76±24.71 before intervention to 99.45±2.12 after intervention （P＜0.05）. MMAS-8 score increased from 7.14± 1.15 before intervention to 7.88±0.44 after intervention （P＜0.05）. The degree of patients’ satisfaction with pharmacists reached 100% after intervention. CONCLUSIONS “Cloud Pharmacy Service System” is helpful to improve the effects of pharmaceutical service for patients with chronic airway disease by providing whole-process， online， visual and immediate MTM.

Objective:To analyze the failure causes and repair methods of conjoint fascial sheath (CFS) suspension in ptosis correction.Methods:From 2021 September to September 2022, 13 cases (5 males and 8 females, aged from 19 to 49 years with an average of 25 years) were collected, and there were 18 eyes of CFS suspension in the Department of Burn and Plastic Surgery Center, the 940th Hospital of the Joint Logistic Support Force of PLA with a failed ptosis surgeries, including levator palpebrae superioris muscle shortening, CFS suspension, and frontalis muscle suspension.Results:Among the 13 patients (18 eyes), the failure causes included a result of the unfamiliar anatomy of CFS, unstable suture fixation, dysplasia of CFS, and improper suture site, CFS suspension failed to correct ptosis. After following-up for 6 to 30 months after reconstructive surgery, 14 eyes were corrected satisfactorily, 2 eyes were relieved of ptosis, and 2 eyes had ptosis recured six months after restorative surgery and a frontalis muscle suspension was used in the recured cases with a satisfactory outcome.Conclusions:According to the patient′s eye condition, mastering the indications, be familiar with the local anatomy and accurate surgical procedures are the key to success.

ObjectiveTo determine the prevalence of ticks parasitic on domestic animals in Yiwu City of Zhejiang Province. MethodsWe monitored， identified and analyzed ticks parasitic on domestic animals in Yiwu in 2021. ResultsA total of 452 domestic animals were monitored， of which 306 were infected with ticks， suggesting a prevalence of 67.70%. A total of 2，603 ticks were captured， and the tick index was determined to be 5.76. The ticks were identified to belong to one family， four genera， and 10 species. Haemaphysalis longicornis was the dominant tick （59.16%）， followed by Rhipicephalus haemaphysaloides （26.32%） and Rhipicephalus microplus （6.45%）. Prevalence of ticks， tick index， and number of tick species were listed for domestic animals as follows： goats （74.37%， 7.45， 7 species）， yellow cattle （62.50%， 4.14，6 species）， and dogs （54.62%， 2.59， 8 species）. Moreover， goat was the main domestic animal infected with more than two tick species （25.99%）； H.longicornis （91.26%） was the species with most repated infections. The dominant species of ticks were H.longicornis （65.15%） and R.haemaphysaloides （29.42%） in goats， R.microplus （67.67%） and R.haemaphysaloides （20.69%） in yellow cattle， and H.longicornis （57.14%） and Haemaphysalis porcupines （21.10%） in dogs. However， seasonal fluctuation in tick index differed among goats， yellow cattle and dogs. The fluctuation in tick index in goats and dogs was consistent with that of H.longicornis， with a major peak in March and the minor peaks in September and October. The fluctuation in tick index in yellow cattle was consistent with that of R.microplus， with two peaks in April and August-September. In addition， larval ticks， nymphal ticks and adult ticks were caught in this study， among which nymphal ticks were most common. We found that single domestic animals were infected with ticks of the same species and different stages， which was more common in goats and those animals infected with H.longicornis. ConclusionTicks parasitic on domestic animals are common in Yiwu. Multiple species of ticks have been identified， with H.longicornis as the dominant species. It warrants further monitoring and countermeasures.

OBJECTIVE To improve the utilization rate of intravenous infusion in inpatients and enhance the level of rational drug use. METHODS PDCA cycle method was used to formulate and implement countermeasures from the aspects of institution， system， person and management. The utilization rate of intravenous infusion and the average daily number of bags （bottles） per bed for intravenous infusion were used as indicators to evaluate the implementation effect of PDCA. RESULTS The utilization rate of intravenous infusion decreased from （92.58±0.11）% 3 months before PDCA cycle to （89.72±0.62）% 3 months after PDCA cycle， and the average daily number of bags （bottles） per bed from intravenous infusion decreased from 5.20±0.09 to 4.64±0.24 （P＜ 0.05）. The utilization rate of intravenous infusion decreased from 92.55% 6 months before PDCA cycle to 89.98% 6 months after PDCA cycle （P＜0.05）； but average daily number of bags （bottles） per bed for intravenous infusion decreased from 5.36±0.26 6 months before PDCA cycle to 4.97±0.39 6 months after PDCA cycle， without statistical significance （P＞0.05）. CONCLUSIONS PDCA cycle method can effectively reduce the utilization rate and average daily number of bags （bottles） per bed for intravenous infusion in the inpatients and improve the level of rational drug use.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective:To explore the importance of managing retro-orbicularis oculi fat (ROOF) in double-fold eyelid operation for patients with swollen upper-eyelid.Methods:From January 2018 to December 2020, 76 cases of swollen upper-eyelid were treated with double-fold eyelid operation by PARK method. In operation, an oval shape ROOF was removed from the outside-to the inside, and then appropriate lateral intraorbital fat was also removed. If fleshy orbicularis oculi muscle and anterior tarsus fat affected appearance of double-fold eyelid, both of them might be removed properly.Results:All patients were followed up from seven days to two years, two cases presented with shallowed double-fold eyelid, 5 cases of lacrimal gland prolapse had good lacrimal gland reduction and no recurrence; 4 cases of ptosis had normal corneal exposure and natural appearance after correction; the swollen upper-eyelid was obviously improved in 74 cases, and restoration stage was short, the apperaence and radian of doule-fold eyelid were beautiful, local scar was slight, satisfactory operative effect was achieved.Conclusions:In double-fold eyelid operation by PARK method for patients with swollen upper-eyelid, an ideal effect would be achieved, if transconjunctival route and fleshy orbicularis oculi muscle are appropriately removed in turn according to the reasons to give rise to swollen upper-eyelid.

Radiotherapy following breast conserving surgery is a standard treatment in early stage breast cancer, and tumor bed delineation is a very important part of radiotherapy. Traditionally, operative record, preoperative ultrasound, postoperative scar, clips and other conventional methods were used to contour tumor bed in clinical, but they still have many limitations. In recent years, there were some progress in tumor bed delineation of the new style of lumpectomy cavity filling, preoperative/postoperative MRI images with CT images and other new methods. It is expected to solve the lack of postoperative tumor bed delineation consensus and standard in the future.