Objective:To explore the effects of intense pulsed light and carbon dioxide fractional laser sequential treatment of early hypertrophic scar after deep burn.Methods:A retrospective cohort study was used. The patients with early hypertrophic scar after deep burn who were admitted to the First People’s Hospital of Zhengzhou from May 2019 to January 2021 and met the inclusion criteria were selected as the study subjects. All patients began to receive sequential laser treatment 4-8 weeks after complete healing of wounds. The treatment method was selected according to the Vancouver scar scale (VSS) score before each treatment. If the blood vessel distribution ≥ 2 points and the thickness<2 points, they were treated with intense pulsed light. If the blood vessel distribution ≥2 points and the thickness ≥ 2 points, they were treated with intense pulsed light combined with carbon dioxide laser. If the blood vessel distribution <2 points and the thickness ≥ 2 points, they were treated with carbon dioxide laser. If the blood vessel distribution < 2 points and the thickness < 2 points, the treatment was ended. Intense pulsed light therapy was performed once a month, and carbon dioxide laser therapy was performed once every 3 months. Before and after treatment, patients were evaluated with VSS, observer scar assessment scale (OSAS) and patient scar assessment scale (PSAS), while higher scores indicated more severe scars. The number of intense pulsed light and carbon dioxide laser treatment during the treatment period, the time of scar formation and the occurrence of complications at the end of the treatment were recorded. SPSS 22.0 software was used for statistical analysis. Measurement data were expressed as Mean±SD, and paired sample t-test was used to compare patients before and after treatment. Results:A total of 28 patients were included, including 16 males and 12 females, aged 12-54 years. After the sequential treatment, the VSS scores of color, thickness, vascular distribution, softness and total score were significantly lower than those before the treatment ( t=15.00, 11.90, 15.59, 9.46, 39.24, P<0.001); OSAS scores of vascular distribution, color, thickness, roughness, softness, surface area, overall evaluation and total score were significantly lower than those before treatment ( t=14.89, 10.82, 9.54, 7.23, 16.97, 8.60, 16.42, 25.08, P<0.001); PSAS scores of pain, itching, color, hardness, thickness, irregularity, overall evaluation and total score were significantly lower than those before treatment ( t=26.40, 24.53, 16.54, 12.18, 12.25, 21.04, 22.00, 29.38, P<0.001). During the treatment, the patients were treated with intense pulsed light for (4.00±1.22) times (2-6 times), carbon dioxide laser for (2.54±1.00) times (0-5 times). At the end of the treatment, the scar formation time was (13.82±2.98) months (8-20 months). Complications occurred in 5 cases during treatment and follow-up, including 4 cases of skin blisters and 1 case of infection. No immediate skin lesions, pigmentation, depigmentation, scar aggravation and other adverse reactions occurred. Conclusion:The combination of sequential therapy of intense pulsed light and carbon dioxide laser can significantly improve the appearance and texture of early hypertrophic scar after deep burn, which has good safety.

Objective:To explore the effects of intense pulsed light and carbon dioxide fractional laser sequential treatment of early hypertrophic scar after deep burn.Methods:A retrospective cohort study was used. The patients with early hypertrophic scar after deep burn who were admitted to the First People’s Hospital of Zhengzhou from May 2019 to January 2021 and met the inclusion criteria were selected as the study subjects. All patients began to receive sequential laser treatment 4-8 weeks after complete healing of wounds. The treatment method was selected according to the Vancouver scar scale (VSS) score before each treatment. If the blood vessel distribution ≥ 2 points and the thickness<2 points, they were treated with intense pulsed light. If the blood vessel distribution ≥2 points and the thickness ≥ 2 points, they were treated with intense pulsed light combined with carbon dioxide laser. If the blood vessel distribution <2 points and the thickness ≥ 2 points, they were treated with carbon dioxide laser. If the blood vessel distribution < 2 points and the thickness < 2 points, the treatment was ended. Intense pulsed light therapy was performed once a month, and carbon dioxide laser therapy was performed once every 3 months. Before and after treatment, patients were evaluated with VSS, observer scar assessment scale (OSAS) and patient scar assessment scale (PSAS), while higher scores indicated more severe scars. The number of intense pulsed light and carbon dioxide laser treatment during the treatment period, the time of scar formation and the occurrence of complications at the end of the treatment were recorded. SPSS 22.0 software was used for statistical analysis. Measurement data were expressed as Mean±SD, and paired sample t-test was used to compare patients before and after treatment. Results:A total of 28 patients were included, including 16 males and 12 females, aged 12-54 years. After the sequential treatment, the VSS scores of color, thickness, vascular distribution, softness and total score were significantly lower than those before the treatment ( t=15.00, 11.90, 15.59, 9.46, 39.24, P<0.001); OSAS scores of vascular distribution, color, thickness, roughness, softness, surface area, overall evaluation and total score were significantly lower than those before treatment ( t=14.89, 10.82, 9.54, 7.23, 16.97, 8.60, 16.42, 25.08, P<0.001); PSAS scores of pain, itching, color, hardness, thickness, irregularity, overall evaluation and total score were significantly lower than those before treatment ( t=26.40, 24.53, 16.54, 12.18, 12.25, 21.04, 22.00, 29.38, P<0.001). During the treatment, the patients were treated with intense pulsed light for (4.00±1.22) times (2-6 times), carbon dioxide laser for (2.54±1.00) times (0-5 times). At the end of the treatment, the scar formation time was (13.82±2.98) months (8-20 months). Complications occurred in 5 cases during treatment and follow-up, including 4 cases of skin blisters and 1 case of infection. No immediate skin lesions, pigmentation, depigmentation, scar aggravation and other adverse reactions occurred. Conclusion:The combination of sequential therapy of intense pulsed light and carbon dioxide laser can significantly improve the appearance and texture of early hypertrophic scar after deep burn, which has good safety.

Objective:To explore the effects of fast-track surgery (FTS) combined with acupuncture at Neiguan acupoint on stress indicators and recovery quality in patients during anesthesia of craniocerebral surgery.Methods:According to block randomization method, 120 patients with craniocerebral trauma meeting inclusion criteria in the hospital were divided into three groups between January 2018 and December 2020, 40 in each group. The control group was given routine awakening intervention, intervention 1 group was given routine awakening intervention and acupuncture at Neiguan acupoint, and intervention 2 group was given FTS and treatment of intervention 1 group. At 10 min after entering the room, immediately after tracheal intubation and immediately after extubation, level of serum cortisol (COR) was detected by electrochemical luminescence apparatus. The level of serum dopamine was detected by ELISA. The blood pressure and heart rates were recorded. The recovery quality during anesthesia was compared, including recovery time, recovery time of spontaneous breathing, extubation time and recovery time of orientation. The cognitive function of patients was evaluated by Neurobehavioral Cognitive Status Examination (NSCE). The incidence of intestinal paralysis, nausea and vomiting, and hospitalization time were observed and recorded during treatment.Results:Immediately after tracheal intubation and extubation, systolic blood pressure in intervention 2 group, intervention 1 group and control group were significantly decreased ( F=12.03, 13.96), levels of serum COR ( F=91.40, 53.76), and dopamine ( F=29.72, 69.39) were significantly decreased ( P<0.01). The recovery time of orientation during anesthesia [(39.09±3.12)min vs. (41.57±3.54)min, (43.84±3.28)min, F=34.65] in intervention 2 group was significantly shorter than that of the intervention 1 group and control group ( P<0.01), and hospitalization time [(9.36±1.78)d vs. (10.92±1.81)d, (12.10±1.95)d, F=1.44] was significantly shorter than that of the intervention 1 group and control group ( P<0.05). Conclusion:The FTS combined with acupuncture at Neiguan acupoint can reduce stress level during anesthesia, improve recovery quality and relieve postoperative cognitive dysfunction in patients undergoing craniocerebral surgery.

In order to improve the teaching quality of medical microbiology, teachers constructed the syllabus from six levels according to Bloom's taxonomy, including memory, understanding, application, analysis, evaluation and innovation, teaching objectives, teaching methods and lesson preparation. The aim is to stimulate students' enthusiasm for learning and to promote students' ability of deep learning and innovation.

Objective:To examine 2019 novel coronavirus (2019-nCoV) RNA in clinical specimens of COVID-19 patients in Anhui province, and provide evidence for laboratory diagnosis of COVID-19 and risk assessment of clinical specimens.Methods:ORF1ab gene and N gene of 2019-nCoV were detected by real-time fluorescence RT-PCR in 466 clinical specimens of 197 COVID-19 cases. Chi-square test was used to analyze the differences in positive rates of specimens with clinical classification and time of onset.Results:The positive rates of 2019-nCoV in throat swab, sputum, serum, blood sample were 88.83%, 94.67%, 6.78% and 5.08%. The positive rate for 2019-nCoV RNA in throat swabs and sputum differed significantly ( χ2=8.994, P=0.003) in common cases during 7 days after illness onset. Conclusions:The positive rate of RNA in sputum was higher than throat swabs. 2019-nCoV RNA was detected in serum and blood specimens of COVID-19 cases. There was a risk of serum and blood specimens for transmission of COVID-19.

Objective:To analyze the epidemiological and etiological characteristics of a dengue fever outbreak in Hunan province in 2018.Methods:Real-time PCR assay was performed for the laboratory diagnosis of 8 suspected dengue fever cases. Etiological surveillance was performed in 186 suspected dengue fever cases and fever cases who had close contacts with dengue fever patients. C6/36 cells was used for the virus isolation from acute phase serum. By sequencing the full length of E genes of 15 dengue virus strains, phylogenetic analysis was performed based on the sequences obtained, including reference sequences from the NCBI GenBank database, the serotypes and gene subtypes of the virus were analyzed to trace the possible source of transmission. An emergency monitoring of vector density and a retrospective survey of sero-epidemiology in healthy population were conducted in the epidemic area.Results:In the serum samples of 8 suspected patients, 6 were dengue virus RNA positive, and 4 were NS1 antigen positive. In 186 suspected patients, 96 were dengue virus nucleic acid, NS1 antigen or antibody positive in etiological test. A total of 64 dengue virus strains were isolated. The phylogenetic analysis showed that all the dengue virus strains belonged to type 2, which might be from Guangdong or Zhejiang provinces. The Bretub index was up to 65, indicating an extremely high risk of transmission. The positive rate of the dengue virus IgG antibody was 0.53%(2/377) in retrospective survey of 377 healthy people.Conclusion:The field epidemiologic and the molecular genetics analyses showed the outbreak of dengue fever in Hunan in 2018 was caused by imported cases and dengue virus 2.

Objective:To explore the therapeutic effect of ultra pulse carbon dioxide fractional laser combined with intense pulsed light for early treatment of scar after deep Ⅱ degree burns.Methods:48 patients with scar after deep Ⅱ burns were admitted to the First People′s Hospital of Zhengzhou from January 2017 to November 2018. Patients accepted the first treatment of intense pulsed light 2-4 weeks after complete healing of wounds, and then followed per 4 weeks, totally for 3 times. Then patients accepted ultra pulse carbon dioxide fractional laser 4 weeks after the 3 intense pulsed light treatments, and then followed per 3 months, totally for 3 times. Before the first treatment, 1 month after 3 treatments of intense pulsed light and 3 months after 3 treatments of ultra pulse carbon dioxide fractional laser, the curative effect was assessed by Vancouver scar scale (VSS), Observer scar assessment scale (OSAS) and Patient scar assessment scale (PSAS).Results:The VSS, OSAS and PSAS scores after 3 treatments of intense pulsed light were all significantly lower than those before the first treatment( P<0.05). The VSS, OSAS and PSAS scores after 3 treatments of ultra pulse carbon dioxide fractional laser were all significantly lower than those before the first treatment and 3 treatments of intense pulsed light ( P<0.05). Conclusions:Ultra pulse carbon dioxide fractional laser combined with intense pulsed light has definitely clinical effect on early treatment of patients with scar after deep Ⅱ degree burns with significant application value.

Objective:To explore the therapeutic effect of ultra pulse carbon dioxide fractional laser combined with intense pulsed light for early treatment of scar after deep Ⅱ degree burns.Methods:48 patients with scar after deep Ⅱ burns were admitted to the First People′s Hospital of Zhengzhou from January 2017 to November 2018. Patients accepted the first treatment of intense pulsed light 2-4 weeks after complete healing of wounds, and then followed per 4 weeks, totally for 3 times. Then patients accepted ultra pulse carbon dioxide fractional laser 4 weeks after the 3 intense pulsed light treatments, and then followed per 3 months, totally for 3 times. Before the first treatment, 1 month after 3 treatments of intense pulsed light and 3 months after 3 treatments of ultra pulse carbon dioxide fractional laser, the curative effect was assessed by Vancouver scar scale (VSS), Observer scar assessment scale (OSAS) and Patient scar assessment scale (PSAS).Results:The VSS, OSAS and PSAS scores after 3 treatments of intense pulsed light were all significantly lower than those before the first treatment( P<0.05). The VSS, OSAS and PSAS scores after 3 treatments of ultra pulse carbon dioxide fractional laser were all significantly lower than those before the first treatment and 3 treatments of intense pulsed light ( P<0.05). Conclusions:Ultra pulse carbon dioxide fractional laser combined with intense pulsed light has definitely clinical effect on early treatment of patients with scar after deep Ⅱ degree burns with significant application value.

This article reports the clinical data, diagnosis and treatment plan and prognosis of 3 patients with breast cancer under 20 years old. The clinical pathological features, treatment and prognosis were discussed in the literature, and compared with the biological characteristics of young (under 35 years old) breast cancer patients, providing a reference for the clinical individualized treatment of the disease.

Objective: To explore the bacteriological characteristics and bacterial resistance of children with purulent meningitis in the Shenmu Hospital, and to provide evidence for the rational use of antibiotics. Methods: We retrospectively analyzed the clinical data and bacterial culture results of 43 children with purulent meningitis in our hospital from June 2009 to March 2017. Results: There were 21 types of bacteria culture and drug susceptibility test: Gram-positive bacteria in 16 cases(76.19%), Gram negative bacilli in 5 cases(23.81%), including 8 staph infections, gambogic/lira micrococcus in 4 cases, excrement enterococcus in 1 case, streptococcus pneumoniae in 2 cases, produce mononuclear listeria in 1 case.All the Gram-negative bacilli were Escherichia coli.In cerebrospinal fluid culture, Gram-positive bacteria were significantly higher than Gram-negative bacteria, and the difference was statistically significant(χ²=7.813, P=0.005). There was no statistically significant difference in the number of Gram-positive cases between cerebrospinal fluid and blood culture pathogens(χ²=0.075, P=0.78). Gram positive coccus was generally resistant to penicillin, erythromycin and clindamycin, generation 1 cephalosporin antibiotic, including pneumococcal resistance rate was 100.0%, coagulase negative staphylococcus resistance rate was 87.5%, E.coli was resistant to ampicillin and levofloxacin. Conclusion In the pediatric treatment of our hospital, coagulase negative staphylococcus aureus and vine/Lila micrococcus is the important pathogenic bacteria that causes the children purulent meningitis, Escherichia coli is the only pathogenic bacteria of the Gram-negative bacterial meningitis.Vancomycin and linezolide are sensitive to cocci, and Escherichia coli is sensitive to antibiotics in the second and third generation of cephalosporins.