Aortic Dissection Research in China:Analysis of Studies Funded by the National Natural Science Foundation of China

Objective The National Natural Science Foundation of China(NSFC)has made great progress in promoting the development of aortic dissection research in recent years.This study aimed to examine the development and research status of aortic dissection research in China so as to provide references for future research.Methods The NSFC projects data from 2008 to 2019 were collected from the Internet-based Science Information System and other websites utilized as search engines.The publications and citations were retrieved by Google Scholar,and the impact factors were checked by the InCite Journal Citation Reports database.The investigator’s degree and department were identified from the institutional faculty profiles.Results A total of 250 grant funds totaling 124.3 million Yuan and resulting in 747 publications were analyzed.The funds in economically developed and densely populated areas were more than those in underdeveloped and sparsely populated areas.There was no significant difference in the amount of funding per grant between different departments’investigators.However,the funding output ratios of the grants for cardiologists were higher than those for basic science investigators.The amount of funding for clinical researchers and basic scientific researchers in aortic dissection was also similar.Clinical researchers were better in terms of the funding output ratio.Conclusion These results suggest that the medical and scientific research level of aortic dissection in China has been greatly improved.However,there are still some problems that urgently need to be solved,such as the unreasonable regional allocation of medical and scientific research resources,and the slow transition from basic science to clinical practice.

Expression and functional study of cholecystokinin-A receptors on the interstitial Cajal-like cells of the guinea pig common bile duct

BACKGROUND Many studies have shown that interstitial Cajal-like cell(ICLC)abnormalities are closely related to a variety of dynamic gastrointestinal disorders.ICLCs are pacemaker cells for gastrointestinal movement and are involved in the transmission of nerve impulses.AIM To elucidate the expression profile and significance of cholecystokinin-A(CCK-A)receptors in ICLCs in the common bile duct(CBD),as well as the role of CCK in regulating CBD motility through CCK-A receptors on CBD ICLCs.METHODS The levels of tyrosine kinase receptor(c-kit)and CCK-A receptors in CBD tissues and isolated CBD cells were quantified using the double immunofluorescence labeling technique.The CCK-mediated enhancement of the movement of CBD muscle strips through CBD ICLCs was observed by a muscle strip contraction test.RESULTS Immunofluorescence showed co-expression of c-kit and CCK-A receptors in the CBD muscularis layer.Observations of isolated CBD cells showed that c-kit was expressed on the surface of ICLCs,the cell body and synapse were colored and polygonal,and some cells presented protrusions and formed networks adjacent to the CBD while others formed filaments at the synaptic terminals of local cells.CCK-A receptors were also expressed on CBD ICLCs.At concentrations ranging from 10^(-6) mol/L to 10^(-10) mol/L,CCK promoted CBD smooth muscle contractility in a dose-dependent manner.In contrast,after ICLC removal,the contractility mediated by CCK in CBD smooth muscle decreased.CONCLUSION CCK-A receptors are highly expressed on CBD ICLCs,and CCK may regulate CBD motility through the CCK-A receptors on ICLCs.

Stressors and Coping Strategies of Medical Staff in the COVID-19 Pandemic in Wuhan

Exploring whether medical staff perceive stress on the assigned medical tasks,what are the specific sources of stress,what are the tangible sources of support they expected to be helpful,and individual coping with stress to provide more accurate,personal support for psychological crisis.This study uses a cross-sectional descriptive survey adopting convenience sampling among the medical staff who worked for over seven days in the infected areas of one Grade 2A and three Grade 3A hospitals during the COVID-19 pandemic.The assessment includes attitude when receiving tasks,major stressors,factors relieving stress,and personal management of stress.A total of 104(76.8%)valid questionnaires are received.A majority(94.3%)of the medical staff held a positive attitude taking duty for granted but feeling nervous and afraid(81.1%).Contacting the infected(90.6%)and compensation(92.5%)are the main concerns.The major pressure sources are regarding safety for oneself(98.1%),colleagues(92.5%),and family(94.3%),as well as lack of effective treatment(92.5%),inadequate protective equipment(94.3%)and incomplete disinfection(94.3%).The main positive pressure adjustments include strict infection controlling measures(98.4%),maintaining a positive attitude(95.2%),actively attain more information 95.2%,and engage in recreational activities(93.6%),but more than 40%takes negative adjustments to vent their emotions and relieve anxiety,suggesting the importance of early psychological intervention.During the COVID-19 pandemic,the main stressors among medical staff are safety,uncertainty and shortage of resources.Positive coping includes taking effective protective measures and achieving thorough understanding of the virus.

Cross-sectional study of traumatic stress disorder in frontline nurses 6 mo after the outbreak of the COVID-19 in Wuhan

BACKGROUND Frontline nurses in Wuhan directly fighting severe acute respiratory syndrome coronavirus-2 diseases are at a high risk of infection and are extremely susceptible to psychological stress,especially due to the global coronavirus disease 2019(COVID-19)pandemic.The psychological after-effects of this public health emergency on frontline nurses will last for years.AIM To assess factors influencing post-traumatic stress disorder(PTSD)among frontline nurses in Wuhan 6 mo after the COVID-19 pandemic began.METHODS A total of 757 frontline nurses from five hospitals in Wuhan,China,participated in an online survey from July 27 to August 13,2020.This cross-sectional online study used a demographic information questionnaire,the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders,the Connor-Davidson Resilience Scale,and the Patient Health Questionnaire-4.The chisquare test and logistic regression were used to analyze the association of demographics,COVID-19-related variables,and PTSD.Logistic regression was also conducted to investigate which variables were associated with PTSD outcomes.RESULTS A total of 13.5%,24.3%,and 21.4%of the frontline nurses showed symptoms of PTSD,depression,and anxiety,respectively.The multivariate logistic regression analysis showed that the following factors were strongly associated with PTSD:Having a relative,friend,or colleague who died of COVID-19;experiencing stigma;or having psychological assistance needs,depressive symptoms or anxiety.Showing resilience and receiving praise after the COVID-19 outbreak were protective factors.CONCLUSION Frontline nurses still experienced PTSD(13.5%)six months after the COVID-19 outbreak began.Peer support,social support,official recognition,reward mechanisms,exercise,better sleep,and timely provision of information(such as vaccine research progress)by the government via social media,and adequate protective supplies could mitigate the level of PTSD among nurses responding to COVID-19.Stigmatization,depression,and anxiety might be associated with a greater risk of PTSD among nurses.

Inhibition of Bcl-6 Expression Ameliorates Asthmatic Characteristics in Mice

Objective The function of Bcl-6 in T follicular helper(Tfh)cell maturation is indispensable,and Tfh cells play a pivotal role in asthma.This study investigated the impact of Bcl-6 on asthmatic traits.Methods The microscopic pathological alterations,airway resistance(AR),and lung compliance(LC)were determined in asthmatic mice and Bcl-6 interference mice.The surface molecular markers of Tfh cells and the Bcl-6 mRNA and protein expression were determined by flow cytometry,RT-qPCR,and Western blotting,respectively.The relationships between the Tfh cell ratio and the IgE and IgG1 concentrations in peripheral blood mononuclear cells(PBMCs)and bronchoalveolar lavage fluid(BALF)were determined.Results Asthmatic inflammatory changes were observed in the lung tissue and were attenuated by Bcl-6 siRNA and dexamethasone(DXM).Asthmatic mice exhibited an increased AR and a decreased LC,while Bcl-6 siRNA or DXM mitigated these changes.The percentages of Tfh cells and eosinophils were significantly increased in the asthmatic mice,and they significantly decreased after Bcl-6 inhibition or DXM treatment.RT-qPCR and Western blotting analyses revealed that the Bcl-6 expression level in PBMCs was significantly higher in asthmatic mice,and it decreased following Bcl-6 inhibition or DXM treatment.The IgE expression in the serum and BALF and the B cell expression in PBMCs exhibited a similar trend.In asthmatic mice,the ratio of Tfh cells in the peripheral blood showed a strong positive correlation with the IgE levels in the serum and BALF,but not with the IgG1 levels.Conclusion The amelioration of airway inflammation and airway hyper-responsiveness is achieved through Bcl-6 suppression,which effectively hinders Tfh cell differentiation,ultimately resulting in a concurrent reduction in IgE production.

Valsartan Inhibits Angiotensin Ⅱ-induced Proliferation of Vascular Smooth Muscle Cells via Regulating the Expression of Mitofusin 2

Angiotensin Ⅱ (ANGⅡ) plays an important role in the pathogenesis of atherosclerosis by inducing proliferation of vascular smooth muscle cells (VSMCs).In our study,we observed the effects of valsartan on proliferation of cultured VSMCs treated with or without ANGⅡ by cell counting and methyl thiazolyl tetrazolium (MTT) assay,and detected the expression of mitofusin 2 (Mfn2),a newly discovered cell proliferation inhibitor and a related cell proliferation signaling pathway pro-tein by Western blotting.ANGⅡ at a concentration of 10-6 mol/L significantly stimulated VSMCs proliferation,down-regulated the expression of Mfn2 and upregulated the expression of Raf and ERK1/2.Valsartan inhibited such effects of ANGⅡ at concentrations of 10-5 and 10-6 mol/L,but not at 10-7 mol/L.Valsartan had no significant effect on the proliferation of untreated VSMCs.These results suggest that valsartan inhibits ANGⅡ-induced proliferation of VSMCs in vitro via Mfn2-Ras-Raf-ERK/MAPK signaling pathway.

Role of Wnt/β-Catenin Pathway in the Arterial Medial Calcification and Its Effect on the OPG/RANKL System

In this study,the hypothesis that Wnt/β-catenin pathway is involved in the arterial calcification by regulating the osteoprotegerin(OPG)/receptor activator of NF-κB ligand(RANKL)system was tested.Theβ-catenin expression was measured in the warfarin-induced calcified arteries and the osteoblast-like cells differentiating from smooth muscle cells(SMCs)by immunohistochemistry and Western blotting.The Wnt/β-catenin pathway was activated or inhibited by lithium chloride(LiCl)or dickkopf 1(DKK1)in vitro and in vivo.Then the calcification level was determined by von Kossa staining,Ca^2+content assay,and alkaline phosphatase(ALP)activity assay.The expression levels of osteocalcin,OPG and RANKL were detected by Western blotting or real-time PCR.The results showed that in calcified arteries and OBL cells,the activation of Wnt/β-catenin pathway significantly enhanced the calcification as evidenced by increased von Kossa stains,Ca^2+contcnts,ALP activities,and osteocalcin expression levels(P<0.05),and it promoted the RANKL expression(P<0.05),but slightly affected the OPG expression.These results indicated that the activation of Wnt/β-catenin pathway worsens the arterial calcification,probably by promoting the RANKL expression.

The Role of Endolymphatic Hydrops in Patients with Pantonal Idiopathic Sudden Sensorineural Hearing Loss:A Cause or Secondary Reaction

The purpose of this study was to investigate the presence of endolymphatic hydrops(EH)in both affected and unaffected ears of patients with pantonal unilateral idiopathic sudden sensorineural hearing loss(ISSNHL)using three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(3D-FLAIR MRI)and further evaluate the significance of EH in this disorder.Twenty-seven ISSHL patients were enrolled in this study.3D-FLAIR MRI was performed 24 h after intratympanic injection of gadolinium-diethylenetriaminepentaacetic acid(Gd-DPTA).The incidences of EH in the affected ears and contralateral unaffected ears were compared and the correlations of EH with vertigo or prognosis were analyzed using the Chi-square test.The results showed that the incidence of EH was 68.0%(17/25)in the affected ears and 34.8%(8/23)in the unaffected ears.There was a statistically significant difference between affected ears and unaffected ears in regard to the incidence of EH(P<0.05).There were no significant correlations of EH with vertigo(P=1.000)or with prognosis(P=0.359)in the affected ears.In conclusion,there is EH in the inner ear of patients with pantonal ISSNHL;EH is not related to vertigo,a concomitant symptom of ISSNHL,and the prognosis of this condition.The presence of EH may be a secondary reaction following the impairment of the inner ears with pantonal ISSNHL.

Change of the peripheral blood immune pattern and its correlation with prognosis in patients with liver cancer treated by sorafenib

Objective:To study the change of the peripheral blood immune pattern and its correlation with prognosis in patients with liver cancer after treated by sorafenib.Methods:Patients with advanced liver cancer admitted in our hospital were enrolled and treated with sorafenib.After two months of the treatment,their peripheral blood was collected.The immune cell subset and cytokines level were determined by flow cytometry and luminex technology.According to the reaction expressed by patients towards sorafenib,patients were divided into the response group and the no response group.The changes of the peripheral blood immune pattern and its correlation with prognosis of patients in the two groups were compared.Results:Before and after treatment of sorafenib,there was no significant difference in the ratios of T cells,NK cells and their subtypes in peripheral blood of patients between the two groups;while after treatment the ratio of B cells and regulatory B cells(Breg) of patients in the response group was significant higher than that of the no response group(P<0.05),and the prognosis conditions of patients with decreased ratio of Breg cells were better than other patients after undergoing chemotherapy.The levels of plasma cytokines IL-6,IL-10,IL-12,IL17,FIL-3L,IFN- γ,TNF-α,MCP-1 and VEGF showed no significant differences.Conclusions:After treatment of sorafenib,the prognosis conditions of patients of advanced liver cancer with a reduced Breg ratio are better than patients with an unaltered or increased Breg ratio.The ratio of Breg in peripheral blood may be considered as early biological indicator for the prediction of the curative effects of sorafenib.

Video-assisted Thoracoscopic Surgery for the Treatment of Mediastinal Lymph Node Tuberculous Abscesses

The mediastinal lymph node tuberculous abscesses（MLNTAs） are secondary to mediastinal tuberculous lymphadenitis. Surgical excision is often required when cold abscesses form. This study was aimed to examine video-assisted thoracoscopic surgery（VATS） for the treatment of MLNTA. Clinical data of 16 MLNTA patients who were treated in our hospital between December 1, 2013 and December 1, 2015 were retrospectively analyzed. All of the patients underwent the radical debridement and drainage of abscesses, and intrathoracic lesions were removed by VATS. They were also administered the intensified anti-tuberculosis treatment（ATT）, and engaged in normal physical activity and follow-up for 3 to 6 months. The results showed that VATS was successfully attempted in all of the 16 MLNTA patients and they all had good recovery. Two patients developed complications after surgery, with one patient developing recurrent laryngeal nerve injury, and the other reporting poor wound healing. It was concluded that VATS is easy to perform, and safe, and has high rates of success and relatively few side-effects when used to treat MLNTA.

Perioperative immunotherapy for esophageal squamous cell carcinoma:Now and future

Esophageal cancer(EC)ranks among the most prevalent malignant tumors affecting the digestive tract.Esophageal squamous cell carcinoma(ESCC)stands as the prevailing pathological subtype,encompassing approximately 90%of all EC patients.In clinical stage II-IVA locally advanced ESCC cases,the primary approach to treatment involves a combination of neoadjuvant therapy and surgical resection.Despite concerted efforts,the long-term outcomes for ESCC patients remain unsatisfactory,with dismal prognoses.However,recent years have witnessed remarkable strides in immunotherapy,particularly in the secondand first-line treatment of advanced or metastatic ESCC,with the development of monoclonal antibodies that inhibit programmed death 1 or programmed death ligand 1 demonstrating encouraging responses and perioperative clinical benefits for various malignancies,including ESCC.This comprehensive review aims to present the current landscape of perioperative immunotherapy for resectable ESCC,focusing specifically on the role of immune checkpoint inhibitors during the perioperative period.Additionally,the review will explore promising biomarkers and offer insights into future prospects.

Silencing of long non-coding RNA CCHE1 inhibits the ovarian cancer SKOV3 cell invasion and migration and inactivates the p38-MAPK signaling pathway

Ovarian cancer(OC)is a major cause of cancer-related deaths among gynaecologicalmalignancies.Emerging studies suggest that the long non-coding RNA(lncRNA)may be the potential biomarker for the diagnosis and prognosis of the cancer.The current study was carried out to investigate the role of lncRNA CCHE1 silencing in OC cell invasion and migration.Expression of lncRNA CCHE1 in normal ovarian cell Hose and OC cell lines HO 8910,A2780 and SKOV3 was detected.LncRNA were transfected with siRNA,and then the proliferation of cells was detected by using MTT assay.Cell invasion and migration was measured by using Transwell assay and scratch test,respectively.The protein levels of E-cadherin,N-cadherin,ERK,p38-MAPK and the phosphorylation of ERK and p38-MAPK in cells after siRNA transfection were detected by using Western blot analysis.Consequently,lncRNA CCHE1 expression was highly expressed in OC cell lines,especially in SKOV3 cells.siRNA1,siRNA2 and siRNA3 all decreased.lncRNA CCHE1 expression in SKOV3 cells and siRNA2 showed the best silencing efficacy.Silencing of lncRNA CCHE1 decreased proliferation,invasion and migration,and reduced the protein levels of N-cadherin,ERK,p38-MAPK and the phosphorylation of ERK and p38-MAPK,while reducing the protein level of E-cadherin in SKOV3 cells.Collectively,our study proved that the silencing of lncRNA CCHE1 could inhibit SKOV3 cell invasion and migration via inactivating the p38-MAPK signaling pathway.

Induction of Differentiation of Mesenchymal Stem Cells into Retinal Pigment Epithelial Cells for Retinal Regeneration by Using Ciliary Neurotrophic Factor in Diabetic Rats

Diabetic retinopathy(DR)is a common cause of blindness all over the world.Bone marrow mesenchymal stem cells(BMSCs)have been considered as a promising strategy for retinal regeneration in the treatment of DR.However,the poor viability and low levels of BMSCs engraftment limit the therapeutic potential of BMSCs.The present study aimed to examine the direct induction of BMSCs differentiation into the cell types related to retinal regeneration by using soluble cytokine ciliary neurotrophic factor(CNTF).We observed remarkably increased expression of cellular retinaldehyde-binding protein(CRALBP)and retinoid isomerohydrolase(RPE65)in BMSCs treated with CNTF in vitro,indicating the directional differentiation of BMSCs into the retinal pigment epithelium(RPE)cells,which are crucial for retinal healing.In vivo,the diabetic rat model was established by use of streptozotocin(STZ),and animals treated with BMSCs+CNTF exhibited better viability and higher delivery efficiency of the transplanted cells than those treated with BMSCs injection alone.Similar to the in-vitro result,treatment with BMSCs and CNTF combined led to the differentiation of BMSCs into beneficial cells(RPE cells),and accelerated retinal healing characterized by the activation of rod photoreceptor cells and phagocytosis function of RPE cells.In conclusion,CNTF contributes to the differentiation of BMSCs into RPE cells,which may help overcome the current stem cell therapy limitations in the field of retinal regeneration.

Artificial intelligence-assisted endoscopic detection of esophageal neoplasia in early stage:The next step?

Esophageal cancer(EC)is a common malignant tumor of the digestive tract and originates from the epithelium of the esophageal mucosa.It has been confirmed that early EC lesions can be cured by endoscopic therapy,and the curative effect is equivalent to that of surgical operation.Upper gastrointestinal endoscopy is still the gold standard for EC diagnosis.The accuracy of endoscopic examination results largely depends on the professional level of the examiner.Artificial intelligence(AI)has been applied in the screening of early EC and has shown advantages;notably,it is more accurate than less-experienced endoscopists.This paper reviews the application of AI in the field of endoscopic detection of early EC,including squamous cell carcinoma and adenocarcinoma,and describes the relevant progress.Although up to now most of the studies evaluating the clinical application of AI in early EC endoscopic detection are focused on still images,AIassisted real-time detection based on live-stream video may be the next step.

Monitoring and Analysis of Chinese Chronic Myeloid Leukemia Patients Who Have Stopped Tyrosine Kinase Inhibitor Therapy

Discontinuation of tyrosine kinase inhibitor(TKI)therapy after achieving a persistent deep molecular response(DMR)is an urgently needed treatment goal for chronic myeloid leukemia(CML)patients and has been included in the National Comprehensive Cancer Network(NCCN)guidelines(version 2.2017)for CML.Indeed,various studies have confirmed the feasibility of discontinuing TKI therapy.In this study,we analyzed data from 45 CML patients who had discontinued TKI therapy.Univariate analysis was performed to predict factors that were potentially related to treatment-free remission(TFR)and identify the differences between early relapse and late relapse.Out of the 45 patients,20 exhibited molecular relapse after a median follow-up of 18 months(range,1-54 months),and the estimated TFR at 24 months was 40%.The univariate analysis revealed that a high Sokal score and interruptions or dose reductions during TKI treatment were the only baseline factors associated with poor outcomes.Our results indicate that TKI discontinuation could be successfully put into practice in China.

Effect of Occupational Extremely Low-Frequency Electromagnetic Field Exposure on the Thyroid Gland of Workers:A Prospective Study

Objective:The aim of this study was to investigate the biological effects of occupational extremely low-frequency electromagnetic field(ELF-EMF)exposure on the thyroid gland.Methods:We conducted a prospective analysis of 85 workers(exposure group)exposed to an ELF-EMF(100μT,10-100 Hz)produced by the electromagnetic aircraft launch system and followed up on thyroid function indices,immunological indices,and color Doppler images for 3 years.Additionally,116 healthy volunteers were randomly selected as controls(control group),the thyroid function of whom was compared to the exposure group.Results:No significant difference was observed in thyroid function between the exposure and control groups.During the follow-up of the exposure group,the serum free triiodothyronine(FT3)level was found to slowly decrease and free thyroxine(FT4)level slowly increase with increasing exposure time.However,no significant difference was found in thyroid-stimulating hormone(TSH)over the three years,and no significant difference was observed in the FT3,FT4 and TSH levels between different exposure subgroups.Furthermore,no significant changes were observed in thyroid autoantibody levels and ultrasound images between subgroups or over time.Conclusion:Long-term exposure to ELF-EMF may promote thyroid secretion of T4 and inhibit deiodination of T4 to T3.ELF-EMF has no significant effect on thyroid immune function and morphology.

Dose-response relationship between risk factors and incidence of COVID-19 in 325 hospitalized patients:A multicenter retrospective cohort study

BACKGROUND The epidemiological and clinical characteristics of coronavirus disease 2019(COVID-19)patients have been widely reported,but the assessment of doseresponse relationships and risk factors for mortality and severe cases and clinical outcomes remain unclear.AIM To determine the dose-response relationship between risk factors and incidence of COVID-19.METHODS In this retrospective,multicenter cohort study,we included patients with confirmed COVID-19 infection who had been discharged or had died by February 6,2020.We used multivariable logistic regression and Cox proportional hazard models to determine the dose-response relationship between risk factors and incidence of COVID-19.RESULTS It clarified that increasing risk of in-hospital death were associated with older age(HR:1.04,95%CI:1.01-1.09),higher lactate dehydrogenase[HR:1.04,95%confidence interval(CI):1.01-1.10],C-reactive protein(HR:1.10,95%CI:1.01-1.23),and procalcitonin(natural log-transformed HR:1.88,95%CI:1.22-2.88),and D-dimer greater than 1μg/m L at admission(natural log transformed HR:1.63,95%CI:1.03-2.58)by multivariable regression.D-dimer and procalcitonin were logarithmically correlated with COVID-19 mortality risk,while there was a linear dose-response correlation between age,lactate dehydrogenase,D-dimer and procalcitonin,independent of established risk factors.CONCLUSION Higher lactate dehydrogenase,D-dimer,and procalcitonin levels were independently associated with a dose-response increased risk of COVID-19 mortality.

Effect of prostaglandin E1 combined with Xuebijing on the inflammatory response process and target organ function in patients with sepsis

Objective: To explore the effect of prostaglandin E1 combined with Xuebijing on the inflammatory response process and target organ function in patients with sepsis. Methods: A total of 78 patients with sepsis who were treated in our hospital between February 2014 and July 2017 were divided into control group (n=39) and study group (n=39) by random number table method. Control group received Xuebijing therapy on the basis of routine treatment, and study group received prostaglandin E1 combined with Xuebijing therapy on the basis of routine treatment. The differences in serum levels of inflammatory mediators and target organ function indexes were compared between the two groups before treatment (T0), after 1 week of treatment (T1) and after 2 weeks of treatment (T2). Results: At T0, there was no statistically significant difference in the serum levels of inflammatory mediators, myocardial enzyme spectrum indexes as well as liver and kidney function indexes between the two groups. At T1 and T2, serum inflammatory mediators IL-6, IL-10, PCT and CRP levels of study group were lower than those of control group;serum myocardial enzyme spectrum indexes CK-MB, hs-cTnT and LDH contents were lower than those of control group;serum liver and kidney function indexes BUN, Cr, TBIL and TBA contents were lower than those of control group. Conclusion: prostaglandin E1 combined with Xuebijing can effectively reduce the systemic inflammatory response and actively protect the liver and kidney function of patients with sepsis.

One-stage limb Pelnac®reconstruction after removal of skin cancer:safety,efficacy,and aesthetic outcomes

Objective To assesse the outcomes of one-stage limb reconstruction after removal of skin cancers defect.Methods This prospective study was conducted from September 2017 to January 2020 and included 15 patients.All patients underwent extensive tumor resection and one-stage Pelnac®reconstruction of large skin defects,and regular postoperative follow-up was scheduled.At the 6-month follow-up,tumor recurrence and scar quality was assessed using the Vancouver Scar Scale(VSS).None of the patients exhibited infection,wound necrosis,hematoma,seroma,or recurrence.Results All the skin grafts were well accepted by the patients.Nine patients reported normal or near-normal sensory function,while six reported slight sensory loss.No cases of significant functional loss were observed.We enrolled 10 men and 5 women with a mean age of 63.9 years(range:46-78 years).The mean follow-up duration was 20.6 months(range:12-36 months).The skin tumors were located on the feet(n=4),forearms(n=3),and legs(n=8).The malignant tumors included malignant melanomas(13.3%),basal cell carcinomas(33.3%),and squamous cell carcinomas(53.3%).The mean operative time was 40.7 min.Two patients underwent radiotherapy.The average length of hospital stay was 2.6 days.The mean skin defect area was 33.2 cm^(2)(range:16.6-51.6 cm^(2)).The patient satisfaction score(regarding the aesthetic appearance of the grafted area)was 79.7/100,and the VSS score was 3.8.Conclusion Pelnac®dermal templates facilitate efficient and reliable reconstruction of skin defects after skin cancer resection.

Influence of polymyxin intravenous drip combined with aerosol inhalation on the inflammatory response process in patients with Acinetobacter baumannii infectious VAP

Objective: To explore the influence of polymyxin intravenous drip combined with aerosol inhalation on the inflammatory response process in patients with Acinetobacter baumannii infectious VAP. Methods: A total of 60 patients with Acinetobacter baumannii infectious VAP who received hospitalization in the hospital between January 2014 and January 2017 were collected and divided into control group and observation group by random number table, 30 cases in each group. Control group of patients received conventional therapy, observation group of patients received conventional therapy + polymyxin intravenous drip combined with aerosol inhalation, and the therapy lasted for 2 weeks. The differences in serum levels of acute phase proteins, oxidative stress indexes and inflammatory response indexes were compared between the two groups before and after treatment. Results: Before treatment, the differences in serum levels of acute phase proteins, oxidative stress indexes and inflammatory response indexes were not statistically significant between the two groups of patients. After 2 weeks of treatment, serum acute phase protein PA level of observation group was higher than that of control group while CRP and CER levels were lower than those of control group;serum oxidative stress indexes MDA and LHP levels were lower than those of control group while SOD level was higher than that of control group;serum inflammatory response indexes IL-1, IL-6, IL-8 and TNF-α levels were lower than those of control group. Conclusion: Polymyxin intravenous drip combined with aerosol inhalation can inhibit the systemic inflammatory response process and promote the disease recovery in patients with Acinetobacter baumannii infectious VAP.