A case report of extremely severe 93% total body surface area burns in a 5-year-old boy.

BACKGROUND: Large surface area burns with concurrent severe burn sepsis are a rare phenomenon, particularly when the wounds are closed in a short timeframe. CASE REPORT: This study describes a 5-year-old patient with 93% total body surface area (TBSA) burns and severe burn sepsis, who was managed through the use of a 54-day brickwork-mixed graft of self-allogeneic skin operation. The mechanisms of skin healing, in this case, are also discussed. CONCLUSIONS: The brickwork-mixed graft of self-allogeneic skin may be an effective treatment option for patients with large surface area burns and severe burn sepsis. Further research is required to establish the generalizability of these findings. Early wound management and anti-infection measures are crucial in treating severe burns, and the clinical outcomes of the patient and the impact of the chosen treatment method on the patient's recovery and prognosis should be assessed.

Changes of wound area and inflammatory factors in diabetic foot patients after comprehensive nursing of traditional Chinese medicine.

OBJECTIVE: The aim of this study is to analyze the application effect of traditional Chinese medicine (TCM) comprehensive nursing in diabetic foot patients. PATIENTS AND METHODS: 230 patients with diabetic foot admitted to Third people's Hospital of Haikou from January 2019 to April 2022 were classified as two groups, which consisted of a control group (n = 95) and an experimental group (n = 135). The control group took routine nursing intervention, while the experimental group took TCM comprehensive nursing intervention. The effect of intervention was compared by inflammatory factors (B-FGF, EGF, VEGF, and PDGF), wound area, self-rated anxiety scale (SAS), and self-rated depression scale (SDS). RESULTS: After nursing, the levels of B-FGF, EGF, VEGF, and PDGF were higher in the experimental group (all p < 0.05). The total effective rate of diabetic foot recovery in the experimental group was 94.87% (74/78), higher than 87.67% (64/73) in the control group (p = 0.026). After nursing, the scores of SAS and SDS in the experimental group were lower than those in the control group (all p < 0.05). CONCLUSIONS: The application of TCM comprehensive nursing in diabetic foot patients can greatly change the levels of B-FGF, EGF, VEGF, and PDGF in wound tissue, promote the healing of ulcer surface, improve patients' anxiety and depression, and enhance the quality of life of patients.

[The preliminary study of Neuroform EZ stent in the treatment of severe intracranial atherosclerotic stenosis].

Objective: To evaluate the safety and clinical efficacy of Neuroform EZ stent in the treatment of severe intracranial atherosclerotic stenosis (ICAS). Methods: A total of 36 patients with severe ICAS receiving Neuroform EZ stent angioplasty were retrospectively analyzed at Beijing Anzhen Hospital from July 2018 to January 2020. Digital subtraction angiography (DSA) before endovascular intervention confirmed the diagnosis. Follow-up information was reviewed by neurologists at 30 days and 6 months after the procedure. The primary endpoints were transient ischemic attack (TIA), ischemic or hemorrhagic stroke and death caused by any reason within 30 days. Results: The overall technical success rate was 100%. The median stenosis rate was reduced from 93.6%±4.5% to 18.8%±11.2% (t=37.36,P<0.001).Primary endpoint event was not reported. During follow-up, one patient developed TIA and no death or ischemic stroke was observed. No in-stent restenosis at six months occurred. Conclusion: Neuroform EZ stent is safe and effective in patients with severe ICAS. However, perspective studies need to be operated for further validation via long-term follow-up.

[Long-term mesh-related complications after total pelvic reconstruction surgery with tension-free transvaginal mesh].

Objective: To investigate the long-term mesh-related complications and treatment outcome of total pelvic reconstruction surgery with tension-free transvaginal mesh (PROSIMATM pelvic floor repair system). Methods: From July 2010 to June 2012, 48 patients with severe pelvic organ prolapse(POP)who underwent PROSIMATM were enrolled and treated in Peking Union Medical College Hospital. 29 patients (60.4%) were followed up periodically for at least 3 years to observe the occurrence of long-term mesh-related complications, and the clinical characteristics, classification of complications and treatment outcome of these cases were summarized. Results: The 29 cases with an average age of (65.1±5.2) years were followed up for an average of (71.6±21.2) months. The last follow-up was 36-105 months after treatment. The long-term success rate of the treatment was 79.3% (n=23). There were 18 cases of mesh exposure (18/48, 37.5%), of which 10 cases (55.6%) were new and persistent. 4 cases (4/18) had symptoms; the rest were found by pelvic examination. Ten patients (10/18) were positive for vaginal swab culture. As for treatment outcome, one case suffered from mesh erosion into the bladder. 4 patients (6.9%) complained of postoperative pain. Twenty-nine patients were divided into the exposure group (n=18) and the non-exposure group (n=11) according to mesh exposure occurrence. There was a significant difference in the proportion of positive swab culture results between the two groups (P=0.019), but no significant difference in the incidence of postoperative pain (P=0.566). Conclusion: The incidence of long-term mesh exposure in PROSIMATM is not low, and most of patients with which had no symptoms.

[Effect of the pessary treatment on anxiety disorder in patients with symptomatic pelvic organ prolapse].

Objective: To evaluate the effect of the pessary treatment on general anxiety disorder in patients with symptomatic pelvic organ prolapse (POP). Methods: Between December 2018 and January 2020, 213 patients who received the pessary treatment for symptomatic POP in the Peking Union Medical College Hospital (PUMCH) were enrolled in this prospective observational study. Accepting the pessary successfully means that the patient keeping the pessary for 2 weeks were satisfied with it and willing to use it afterwards, or means that the patient having changed a new pessary and keeping it for 2 weeks were satisfied with it and willing to use it afterwards. The questionnaire General Anxiety Disorder-7 (GAD-7) was used to assess the anxiety state of POP patients, including 163 patients who accepted the pessary treatment successfully and 50 patients who failed, before and after the pessary treatment. A score of 10 or more was considered as the moderate or severe anxiety and defined as the anxiety disorder. Patients who accepted the pessary treatment successfully were followed up for 3 months. Results: Before the treatment, the prevalence of anxiety disorders was 20.9% (34 out of 163) for those patients accepting the pessary and that was 20.0% (10 out of 50) for those patients who failed in keeping the pessary, the difference of which were not statistically significant (P=0.896). The difference of demographic data and clinical characteristics between the anxiety disorder group and the non-anxiety disorder group were not statistically significant (P>0.05). After 3 months of the pessary treatment for those patients using the pessary treatment, the prevalence of anxiety disorders dropped to 3.7% (6/163) from 20.9% (P<0.001). The GAD-7 score of patients with anxiety disorders decreased from a median of 16.0 (12.5, 21.0) before the treatment to 1.0 (0, 4.0) after the treatment, and the difference was statistically significant (P<0.001). Conclusion: Around 20% POP patients receiving pessary treatment had the moderate or severe general anxiety disorder. After 3 months of using the pessary treatment, the prevalence of anxiety disorders in POP patients had dropped significantly.

[Verification of skin paste electrodes used in wireless polysomnography].

OBJECTIVE: To explore an electrode suitable for wireless portable sleep monitoring equipment and analyze the result of the signals of electrooculogram (EOG) and electroencephalography (EEG) collected by this kind of flexible electrodes. METHODS: The flexible electrodes were prepared by microelectromechanical systems (MEMS) technology. This kind of electrodes consisted parylene, chromium, and gold. Parylene, the flexible substrate of this kind of flexible electrodes, was of biocompatibility. Between parylene and gold there was an adhesion layer of chromium, which connected parylene and gold tightly. Then the flexible electrodes were stuck to medical adhesive tape. The electrodes were designed and made into a grid to make sure that the medical adhesive tape could tape on the skin tightly, so that the contact impedance between the electrodes and the skin would be reduced. Then the alternating current impedance of the electrode were tested by the CHI660E electrochemical workstation after the electrode was achieved. To make sure that this kind of electrodes could be used in EOG monitoring, the electrodes were connected to a wireless signal acquisition suite containing special biological signal acquisition and digital processing chip to gather different sites around the eyes and the electrical signals of different directions of the eye movements, then analyzed the signal-to-noise ratio of the EOG. At the end, the Philips A6 polysomnography was used to compare the noise amplitude of the EEG signals collected by the flexible electrode and the gold cup electrode. RESULTS: The electrodes stuck to the skin tightly, and these electrodes could collect signals that we wanted while the experiment was performed. The alternating current impedance of the flexible electrode was between 4 kΩ and 13 kΩ while with the frequency of alternating current under 100 Hz, most EEG signal frequencies were at this range. The EOG signals collected by the flexible electrodes were in line with the clinical requirements. The noise amplitude of EEG signals collected by the flexible electrodes was lower than that of the electrical signals collected by the gold cup electrodes. CONCLUSION: The flexible electrode could be taken into consideration as an alternative electrode for monitoring EOG and EEG signals, and the wireless portable sleep monitoring devices are to be further developed in the future.

Analysis of circulating long non-coding RNA UCA1 as potential biomarkers for diagnosis and prognosis of osteosarcoma.

OBJECTIVE: The aim of this investigation was to examine the potential usefulness of long non-coding RNA UCA1 (UCA1) as a biomarker for diagnosis and prognosis in osteosarcoma. PATIENTS AND METHODS: The expression level of UCA1 was determined using TaqMan real-time PCR in human osteosarcoma tissues and patients' sera. Next, we investigated to clarify the relationship of UCA1 with clinicopathological features. The receiver operating characteristic (ROC) curve was performed to estimate the diagnostic value of UCA1. Finally, the prognosis of patients with osteosarcoma was assessed by Kaplan-Meier method and Cox proportional hazards model. RESULTS: We observed that UCA1 was significantly increased in osteosarcoma tissue compared with normal bone tissue (p<0.001) and the serum expression of UCA1 was significantly higher in patients with osteosarcoma than that in healthy controls (p<0.01). Up-regulation of UCA1 was correlated with clinical stage (p=0.001) and metastasis (p=0.007). Furthermore, serum UCA1 levels were observed to be robust in differentiating osteosarcoma patients from control subjects [area under the curve (AUC) = 0.831; 95% confidence interval (CI)= 0.746 to 0.916]. Kaplan-Meier analysis showed that that high UCA1 expression level was associated with poorer overall survival (p<0.001) and disease-free survival (p<0.001). Finally, Cox regression analyses showed that UCA1 expression might be an independent prognostic parameter to predict poor prognosis. CONCLUSIONS: Our study firstly showed that UCA1 could be a specific and noninvasive candidate biomarker for the diagnosis and prognosis of UCA1.

[A brief introduction to the disease-syndrome names in bamboo slips of Qin Dynasty].

There are plenty of names of disease-syndrome from the four kinds of unearthed Qin bamboo slips, namely Fangmatan, Shuihudi, Zhoujiatai, and Liye. Altogether, these names number to 85. According to statistics, nomenclature of 34 disease-syndromes are derived from the location of the lesion, 8 from symptoms, 1 from etiology, 12 from location of lesion plus symptom, 3 from location plus etiology, and 25 are for special diseases. Through comparison of these names, with those from oracle bones and Han bamboo slips, Prescriptions for Hundred Kinds of Disease, it is summarized that, as time passes, nomenclature simply named by the location of the lesion was gradually reduced, and named by etiology and special diseases gradually increased. To some extent, it reflects the historical process of knowledge of the disease gradually deepened in ancient times.

Mechanical thrombectomy with Solitaire stent for acute internal carotid artery occlusion without atherosclerotic stenosis: dissection or cardiogenic thromboembolism.

BACKGROUND: In acute ischemic stroke patients, internal carotid artery occlusion with middle cerebral artery (ICA/MCA) occlusion in succession predicts a poor outcome after systemic thrombolysis. It is not known whether this occlusion subtype of the anterior circulation is due to dissections or cardiogenic thromboembolism. We aimed to find useful evidence to judge the condition with accuracy and establish reasonable treatment protocols. PATIENTS AND METHODS: This retrospective study included 7 consecutive patients with acute ICA/MCA occlusion in succession who had undergone mechanical thrombectomy with a Solitaire stent retrieval between January 2012 and June 2013. Then we also reviewed the current literature. RESULTS: The patients had a mean age of 56 years and a mean baseline National Institutes of Health Stroke Scale (NIHSS) score of 20. The procedure resulted in thrombolysis in cerebral ischemia (TICI) scores of 2a or better in all patients, but complete recanalization of the ICA occlusion segment was achieved in only 2 patients. Stenting was not performed in all patients. At 90 days, 1 patient was dead and 4 of the 7 patients had favorable functional outcomes (modified Rankin score (mRS) ≥ 2). We identified 9 studies with 85 patients with nonatherosclerotic acute ICA occlusion who underwent mechanical thrombectomy with Solitaire stent. The mean age was 65 years with a mean baseline National Institute Health Stroke Scale (NIHSS) score of 16 and mean time to treatment of 242 minutes. The mean time of the procedures ranged from 40-160 minutes in 9 studies. Successful recanalization was achieved in 69.4% of the patients and mortality was 16.5%. Favorable outcome (mRS ≤ 2) occurred in 42.4% of patients. Few studies stated whether complete recanalization was achieved in patients with ICA occlusion. CONCLUSIONS: Our results and the literature review suggest that mechanical thrombectomy in acute stroke due to ICA/MCA occlusion is feasible and safe, with high rates of recanalization and favorable functional outcomes. More patients with ICA/MCA occlusion in succession could obtain favorable functional outcomes with accurate judgment of the lesion location and appropriate treatment protocols. However, there is no consensus on how to judge the correct location of the ICA dissected portion and whether stenting is appropriate.

[Observation on the efficacy and experimental study of compound suanzaoren ansen capsules in insomnia].

374 patients suffering from insomnia were divided into three groups by random: 202 cases in group I were treated with compound Suanzaoren Ansen capsules (SAC); 85 cases in group II were treated with Zhusha Ansen pills (ZAP) as control; 87 cases in group III were treated with Methaqualone (Hyminal) also as control. The therapeutic results were as follows: Groups I, II and III showed significant effective rates of 49.50%, 18.82% and 32.18% respectively; moderate effective rates of 34.65%, 48.24% and 49.43% respectively; and total rates of effectiveness of 84.15, 67.06% and 81.61% respectively. The authors found significant statistical difference between group I and II (P less than 0.005) and of no statistical difference between group I and III (P greater than 0.05). The results showed that the effects of compound SAC were better than ZAP, and similar to that of methaqualone. EEG analysis carried out while sleeping confirmed the effects mentioned above. Low toxicity (LD50 10.7 g/kg) of compound SAC was found through animal experimentations. No towards reactions were revealed in clinical trials except nausea in 3 cases. Heart rate and blood pressure changed lightly in a few cases.