ObjectiveTo determine the optimal combination of the effective monomer components "quercetin-kaempferol-abietic acid-boswellic acid" in Fujin Shengjisan for promoting diabetic ulcer （DU） wound healing through uniform design， thereby achieving the modern application of the ancient formula. MethodsFollowing the principle of "uniform design-pharmacodynamic experiment-mathematical modeling and model verification"， the U₁₄（14⁵） uniform design table was adopted.The four monomer components of Chinese medicine were considered as the independent variables， and the proliferation rate of human umbilical vein endothelial cells （HUVECs） induced by glucose was used as the pharmacodynamic indicator. A mathematical model was constructed using DPS software to correlate the effective monomer components with the pharmacodynamic indicator. The results of uniform design were verified through CCK-8 assay， cell scratch healing， tube formation， Western blot， and Real-time PCR. ResultsAmong the 14 compatibility groups， compared with the high-glucose model group， compound compatibility group 6 showed the strongest proliferation effect and statistical significance （P<0.05）. Four quadratic polynomial regression equations （Y₁-Y₄） were obtained through DPS modeling. Considering the model's fit， stability， and practical application， equations Y₁-Y₃ were selected for the follow-up verification. To ensure experiment reproducibility， group 6 was used for validation. Group 6 and equations Y₁-Y₃ were renamed as compound prescription ① to compound prescription④， respectively， to represent the modern application of the ancient FJSJ Powder through compatibility of monomer components. Verification experiments showed that in the CCK-8， scratch healing， and tube formation assays， the cell viability， wound healing rate， and tube formation number of HUVECs stimulated with 50 mmol·L^-1 glucose were significantly reduced compared with the blank group. Moreover， the expression levels of angiogenesis-related cytokines， vascular endothelial growth factor （VEGF） and fibroblast growth factor 2 （FGF2）， and CD31 secretion were significantly down-regulated. However， after intervention with compound prescriptions ① to ④， compound prescriptions ① and ③ significantly improved the biological functions of HUVECs induced by 50 mmol·L^-1 glucose. Further analysis of the regression coefficients of compound prescriptions ① and ③， and the relative dose ratios of each monomer component， indicated that abietic acid， quercetin， and boswellic acid promoted angiogenesis of HUVECs in the high glucose environment， with a major effect （positive partial correlation coefficients， all > 0.9）. Abietic acid and boswellic acid， as well as kaempferol and boswellic acid， promoted angiogenesis in HUVECs through interaction （positive partial correlation coefficients）. ConclusionCompound prescriptions ① and ③ are the optimal combinations. They can reverse the inhibitory effects of high glucose， stimulate the proliferation， migration， and tube formation abilities of HUVECs in a high glucose environment， and promote the expression of vascular endothelial growth factorA（VEGFA）， FGF2， and CD31， thereby promoting angiogenesis and facilitating DU wound healing. This finding not only confirms the good reproducibility and feasibility of compound prescriptions ① and ③ but also provides new insights and methods for the rational construction of mathematical models to further study the compatibility theory of Chinese medicine.

Purpose/Significance To analyze the satisfaction,service effectiveness and willingness to participate in telemedicine services from the perspective of medical staff,and to identify the existing problems.Method/Process The research group conducts an e-lectronic questionnaire survey for medical institutions across the country,and collects a total of 1 524 valid questionnaires.Based on questionnaire survey data,logistic regression models are constructed to analyze the key factors that affect the evaluation and attitude of medical staff.Result/Conclusion The overall satisfaction and service effectiveness of medical staff to telemedicine services are at a high level,and their willingness to participate is strong.It is necessary to improve the telemedicine service system and promote the experience of medical staff by strengthening infrastructure construction,optimizing service process,and perfecting incentive mechanisms.

Objective:To evaluate the risk factors for prognosis of primary intussusception treated by enema reduction in children.Methods:A retrospective analysis of 519 patients with primary intussusception in Anhui Provincial Children′s Hospital from January 2017 to December 2020 was performed. Among the 519 patients, there were 346 males and 173 females. The median age was 15 months, with a range of 3 to 69 months, some basic information was collected. Patients were divided into bad prognosis group ( n=71) and good prognosis group ( n=448) according to prognosis.Propensity score matching (PSM) was conducted to reduce confounding bias between the groups. Conditional logistic regression were used to analysis the risk factors of primary intussusception treated by enema reduction. Results:There were 71 cases of poor prognosis among 519 primary intussusception patients, incidence was 13.7%.Before PSM, there was significant difference in 6 covariates, including gender, age, duration of symptoms, bloody stool, diarrhoea and fever between two group ( P<0.05). There was no significant difference in abdominal pain and vomit between two group ( P>0.05). With propensity score matching, 69 pairs of patients were sucessfully matched. After PSM, distribution of the above covariates reached equilibrium between two groups ( P>0.05). There were statistically significant differences in enema reduction, mass location, seroperitoneum, lactic acid and overweight/obese between the two groups ( P<0.05). Conditional logistic regression analysis confirmed that enema reduction( OR=3.478, 95% CI: 1.150-10.517, P=0.027), mass location ( OR=6.596, 95% CI: 1.669-26.056, P=0.007), lactic acid( OR=1.012, 95% CI: 1.003-1.021, P=0.010), overweight/obese ( OR=6.085, 95% CI: 1.650-22.436, P=0.007) were independent factors for predicting prognosis of primary intussusception treated by enema reduction. Conclusions:AER, mass located left hemicolon, elevated lactic acid and overweight/obese were independent risk factors for poor prognosis of primary intussusception treated by enema reduction.

Objective:To summarize the experience of unilateral fan-shaped pedicle flap in repairing facial soft-tissue defects.Methods:From September 2015 to September 2018, 20 patients with facial skin and soft-tissue defects were admitted to the 940th Hospital of the Joint Logistic Support Force of the PLA, including 12 males and eight females, aged between five and 40 years old, with an average age of 25 years. On the side of the facial defect, a unilateral fan-pedicled subcutaneous pedicle flap, parallel with the skin lines, was designed to repair the defect in a rotation-advancement way.Results:All the 20 cases survived, and the incision healed in the first stage. All the patients were followed up for three months to 1 year. The facial organs showed no displacement. The scar of the incision was not obvious, and the patients were satisfied with the appearance, which achieved the cosmetic repair effect.Conclusions:To repair the soft-tissue defect around the facial organs, the unilateral fan-shaped pedicle flap is a good choice. It provides a simple and easy method. The damage is slight, the flap blood supply is stable, and the outcome is satisfactory.

Objective:To summarize the experience of unilateral fan-shaped pedicle flap in repairing facial soft-tissue defects.Methods:From September 2015 to September 2018, 20 patients with facial skin and soft-tissue defects were admitted to the 940th Hospital of the Joint Logistic Support Force of the PLA, including 12 males and eight females, aged between five and 40 years old, with an average age of 25 years. On the side of the facial defect, a unilateral fan-pedicled subcutaneous pedicle flap, parallel with the skin lines, was designed to repair the defect in a rotation-advancement way.Results:All the 20 cases survived, and the incision healed in the first stage. All the patients were followed up for three months to 1 year. The facial organs showed no displacement. The scar of the incision was not obvious, and the patients were satisfied with the appearance, which achieved the cosmetic repair effect.Conclusions:To repair the soft-tissue defect around the facial organs, the unilateral fan-shaped pedicle flap is a good choice. It provides a simple and easy method. The damage is slight, the flap blood supply is stable, and the outcome is satisfactory.

Objective:To evaluate the effects of Preventing Jaundice and Antibacterial Biological Medical Gel in prevention of hyperbilirubinemia and umbilical infection in newborn.Methods:A total of 600 healthy neonates in a tertiary hospital were selected. Participants were randomly divided into the control group ( n=300) and the observation group ( n=300). The control group was given routine nursing guidance while the observation group was treated with Preventing Jaundice and Antibacterial Biological Medical Gel. The differences in the number of times of the fetus feces in 3 days after birth, the first fetal feces, yellow discharge time of the fetus feces, the incidence of hyperbilirubinemia, the incidence of neonatal phototherapy and the incidence of umbilical infection between the two groups were compared. Results:The number of times of the fetus feces in 3 days after birth and the first fetal feces and yellow discharge time of the fetus feces of the observation group were (8.12±1.36) times, (7.39±3.71) hours, (26.05±3.98) hours, respectively. The control group were (5.31±1.02) times, (13.04±5.26) hours, (28.65±3.54) hours, respectively. The difference between the two groups was significant ( Z value was -6.133, -6.483, t value was -19.011, P<0.05). The incidence of hyperbilirubinemia, being in neonatal intensive care unit, the incidence of blue light irradiation and the incidence of umbilical infection of the observation group was 0.67%(2/300), 0, 1.00%(3/300) and 0, respectively. The control group was 3.33%(10/300), 2.00%(6/300), 5.00%(15/300) and 3.33%(10/300), respectively. the difference between the two groups was significant ( χ2 value was 4.209-8.247, P<0.01). Conclusions:Preventing Jaundice and Antibacterial Biological Medical Gel could help control the incidence of hyperbilirubinemia and reduce the umbilical infection. It is worth clinical spreading.

Objective:To investigate the clinical effect of using chimeric perforator flap with muscle flap in repairing deep dead space of refractory wound.Methods:From February 2015 to February 2019, 22 cases of refractory wounds with deep dead space were admitted to the Burn and Plastic Surgery Center of the 940th Hospital of the Joint Logistic Support Force of the PLA, including 17 males and 5 females, aged from 17 to 72 years old, with an average age of 36.4 years old. 6 cases were located in the plantar, 6 in the calf and ankle joints, 5 in the perineum, 2 in the elbow, 2 in the back and 1 in the orbit. Defect area ranged from 5 cm×4 cm to 16 cm×11 cm. Dead space ranged from 3 cm×2 cm to 10 cm×4 cm. 14 cases were repaired with free transplantation of anterolateral femoral chimeric perforator flap, 5 cases with anterolateral femoral chimeric perforator flap, 1 case with peroneal artery chimeric perforator flap, 1 case with superficial peroneal artery chimeric perforator flap, and 1 case with posterior tibial artery chimeric perforator flap.Results:In the 22 cases of this group, the flap area ranged from 6 cm×5 cm to 17 cm×12 cm, and the muscle flap area ranged from 3 cm×2 cm to 10 cm×4 cm. One case of refractory wound repaired by superficial peroneal artery perforator chimeric flap was poorly healed in the margin of the flap, which was healed by skin grafting in the second stage after dressing change. One case of refractory wound repaired by anterolateral femoral chimeric perforator flap presented subcutaneous sinus after surgery. The wound was healed after dressing change and debridement. All the other 20 cases survived well. The patients were followed up for 3-18 months, and the appearance and function of the wound were recovered satisfactorily.Conclusions:In the chimeric perforator flap with muscle flap, the muscle flap filled up the dead space and the flap covered the wound on body surface at the same time, which is one of the good methods to repair the refractory wound with deep dead space.

Objective:To investigate the clinical effect of using chimeric perforator flap with muscle flap in repairing deep dead space of refractory wound.Methods:From February 2015 to February 2019, 22 cases of refractory wounds with deep dead space were admitted to the Burn and Plastic Surgery Center of the 940th Hospital of the Joint Logistic Support Force of the PLA, including 17 males and 5 females, aged from 17 to 72 years old, with an average age of 36.4 years old. 6 cases were located in the plantar, 6 in the calf and ankle joints, 5 in the perineum, 2 in the elbow, 2 in the back and 1 in the orbit. Defect area ranged from 5 cm×4 cm to 16 cm×11 cm. Dead space ranged from 3 cm×2 cm to 10 cm×4 cm. 14 cases were repaired with free transplantation of anterolateral femoral chimeric perforator flap, 5 cases with anterolateral femoral chimeric perforator flap, 1 case with peroneal artery chimeric perforator flap, 1 case with superficial peroneal artery chimeric perforator flap, and 1 case with posterior tibial artery chimeric perforator flap.Results:In the 22 cases of this group, the flap area ranged from 6 cm×5 cm to 17 cm×12 cm, and the muscle flap area ranged from 3 cm×2 cm to 10 cm×4 cm. One case of refractory wound repaired by superficial peroneal artery perforator chimeric flap was poorly healed in the margin of the flap, which was healed by skin grafting in the second stage after dressing change. One case of refractory wound repaired by anterolateral femoral chimeric perforator flap presented subcutaneous sinus after surgery. The wound was healed after dressing change and debridement. All the other 20 cases survived well. The patients were followed up for 3-18 months, and the appearance and function of the wound were recovered satisfactorily.Conclusions:In the chimeric perforator flap with muscle flap, the muscle flap filled up the dead space and the flap covered the wound on body surface at the same time, which is one of the good methods to repair the refractory wound with deep dead space.

Objective To explore the influence of interleukin-2 receptor antagonists(IL-2Ra) on the morbidity and prognosis of new onset diabetes after transplantation(NODAT)in liver transplant recipients. Methods Pre-and post-operative clinical data of 879 nondiabetic patients who underwent a liver transplantation between April 2001 and December 2016 were retrospectively studied. All the enrolled patients were divided into IL-2Ra and non-IL-2Ra groups according to the use of IL-2Ra. Transient-NODAT(T-NODAT)and Persistent-NODAT(P-NODAT)were defined according to whether NODAT would be existed continuously. The impacts of IL-2Ra on the cumulative incidence as well as the risk of NODAT and T-NODAT were analyzed through comparison between patients who used IL-2Ra or not. And influence of IL-2Ra on the long-term survival of NODAT patients was further analyzed. Results Among 879 patients,177(32.24%)from the IL-2Ra group(n=549)developed NODAT and 29.38%(n=52)of the NODAT reversed,while 131(39.70%)from the non-IL-2Ra group(n=330)developed NODAT and 26.72%(n=35)of the NODAT reversed. After adjusting for 18 possible confounding factors,the IL-2Ra group had significantly decreased cumulative incidence of NODAT over the non-IL-2Ra group(adjusted P=0.028). COX regression analyses showed that IL-2Ra was a protective factor against NODAT development(HR 0.774;95% CI 0.616-0.973; P=0.028), while the use of IL-2Ra and the reverse of NODAT did not significantly related. In addition, long-term survival of the NODAT patients were far better in the IL-2Ra group(adjusted P=0.001). Conclusion IL-2Ra significantly reduces the risk of NODAT in liver transplant recipients and is beneficial to the long-term survival of NODAT patients.

Objective To investigate the perception of Mandarin's tones by children with speech development disorders so as to provide a theoretical basis for clinical rehabilitation.Methods Thirty children with speech development disorders (DPDs) aged 4 to 6 were matched with 30 healthy counterparts as a control group.Both groups underwent the tone perception experiment,which included tone identification and discrimination tasks.The speech stimuli were 11 computer-simulated voices expressing a continuum of sounds from Mandarin speech ranging from /bá/ to /bà/.The two groups were compared in their ability to identify and differentiate the tones.Results Both groups showed typicalS-shaped identification curves in a category pattern.The category boundaries of the control group were between stimulus steps 6 and 7,significantly different from those of the experimental group where the boundary fell between stimulus steps 5 and 6.On the distinguishing curve,both groups presented obvious peak values.The stimulus steps of the peaks and the crossing points of the identification curves were consistent.In addition,the average ahsolnte value (b1) of the identification curve and the peaks' degree of steepness (DP) of the DPD group's distinguishing curve were significantly lower than those of the control group.At the same time,the average boundary width (Wcb) was significantly higher than that of the control group.Conclusion Children with speech development disorders perceive Mandarin tones with categories different from those of normal children.They may have difficulty in perceiving tones,which might be an important factor leading to pronunciation errors.