Latent Profiles of Fear of Cancer Recurrence in Breast Cancer Patients of Reproductive Age and Associations With Reproductive Concerns.

AIM: To identify distinct profiles of fear of cancer recurrence (FCR) among breast cancer patients of reproductive age, investigate the relationship between these profiles and reproductive concerns and explore potential risk factors encompassing sociodemographic, clinical and reproductive characteristics. DESIGN: A cross-sectional study was conducted from January 2022 to September 2022. METHODS: A convenience sample of 210 reproductive-aged breast cancer patients completed a questionnaire that included a general information section, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the Reproductive Concerns After Cancer Scale (RCAC). Latent profile analysis was conducted using the scores of the 12 items from the FoP-Q-SF as explicit variables, while univariate and multiple logistic regression analyses were employed for statistical analysis. RESULTS: Three latent variables were identified: low FCR-stable group (27.6%), moderate FCR-uneasy group (17.2%) and high FCR-intense group (55.2%). This study found that FCR was predicted by age, education level, cancer stage, chemotherapy and fertility intention. Furthermore, patients with heightened reproductive concerns exhibited a higher likelihood of belonging to the high FCR-intense group. CONCLUSION: These findings indicate that FCR varies among breast cancer patients of reproductive age and demonstrates individual differences. IMPLICATION: Early identification of FCR patterns in patients is crucial for medical professionals, with particular attention given to those in the high-intensity FCR group. Tailored prevention and care strategies should be implemented based on the unique characteristics and influencing factors associated with different potential categories of FCR among patients of childbearing age with breast cancer. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Invasive Aspergillus outbreak in inhalation injury: a case presentation and literature review.

BACKGROUND: Invasive pulmonary aspergillosis often occurs in patients with poor immune function, who abuse steroids or broad-spectrum antibiotics, or who use intravenous drugs. Among the Aspergillus genus of pulmonary infection, Aspergillus fumigatus is the most important pathogen, followed by Aspergillus flavus, Aspergillus niger, and Aspergillus terreus. Inhalation injury complicated by Aspergillus infection has atypical clinical manifestations. Diagnosis is difficult, and it is easy to make mistakes in treatment. Moreover, there are few cases of burn inhalation injury complicated with pulmonary Aspergillus. CASE PRESENTATION: We report a case of severe burns combined with severe inhalation injury, early pulmonary aspergillosis, and severe respiratory failure due to treatment discontinuation. Through analyzing the processes of diagnosis and treatment in the present case and performing a literature review, we explore feasible diagnosis and treatment plans. CONCLUSIONS: Early application of a variety of diagnostic measures can be used to identify Aspergillus infection, and targeted anti-infection treatment is likely to reverse a severe adverse prognosis.

Supporting routine cognitive reactivity assessment during the perinatal period: psychometric testing of the Chinese version of the Leiden Index of Depression Sensitivity.

BACKGROUND: It is critical to find optimal forms to identify perinatal depression (PND) and its vulnerable factors and make them more applicable to depression screening. This study aims to evaluate the reliability and validity of the Chinese version of the Leiden Index of Depression Sensitivity (LEIDS-RR-CV) among perinatal women in China and determine the cut-off values for screening for high-risk depression. METHODS: Women in their third trimester of pregnancy and six weeks postpartum completed the LEIDS-RR-CV and a diagnostic reference standard online. We assessed the LEIDS-RR-CV using classical test theory (CTT) and item response theory (IRT). We also assessed the test performance for cut-off scores using receiver operator characteristic analysis to further screen for high-risk depression at each time point. RESULTS: In total, 396 (third trimester) and 321 (six weeks postpartum) women participated. Cronbach's alpha, two-week test-retest reliability, and marginal reliability for the scale were all greater than 0.8. It showed a five-factor model; the cut-off values were 58 (third trimester) and 60 (six weeks postpartum). The areas under the curve were acceptable (≥ 0.7), and the LEIDS-RR-CV was positively correlated with the total Edinburgh Postnatal Depression Scale (EPDS) score (r = 0.52 and 0.56, p = 0.00), indicating its predictive validity. An IRT analysis further confirmed its discriminative validity. CONCLUSIONS: The LEIDS-RR-CV was found to be reliable, valid, and can be used to quantify cognitive reactivity among perinatal Chinese women and for screening for high-risk depression during this period.

Effect of Antilogous Platelet-Rich Plasma on the Revascularization of Rabbit Prefabricated Flap.

BACKGROUND We aimed to investigate the effect of the local application of autologous platelet-rich plasma (PRP) on the angiogenesis of the rabbit prefabricated flap. MATERIAL AND METHODS Femoral arteriovenous bundle prefabricated flaps were constructed on both sides of the abdomen of 20 New Zealand white rabbits and were randomly divided into experimental sides and control sides, with 40 sides in total. Autologous PRP was injected around the prefabricated femoral vascular bundle on the experimental side, and the same amount of saline was injected on the control side. After 14 days, stage II surgery was performed to lift the island flap with the implanted femoral vascular bundle at the tip of the preconfigured flap marker line and suture it in situ. Twenty rabbits were divided equally into 4 groups: group A, 7 days after stage I surgery; group B, 14 days after stage I surgery; group C, 7 days after stage II surgery; and group D, 14 days after stage II surgery. The survival of neovascularization and the flaps in the 4 groups were compared by microscopic observation, histology, and immunohistochemistry. RESULTS The density of neovascularization was much higher on the experimental side than on the control side in the 4 groups, and statistically significantly increased with time (P<0.05). Seven days after stage II surgery, flap survival was better on the experimental side than on the control side. CONCLUSIONS PRP effectively promoted the revascularization of a prefabricated flap, and vascular density increased with time.

Structure and Performance Analysis of Signal Acquisition and Doppler Tracking in LEO Augmented GNSS Receiver.

Due to the low signal power, the Global Navigation Satellite System (GNSS) signal is vulnerable to interference and even cannot be captured or tracked in harsh environments. As an alternative, the Low Earth Orbit (LEO) satellite has been widely used in the navigation field due to the advantages of low cost and strong signals. It is becoming a significant component of the new combined navigation system with GNSS. The combination of an LEO Doppler signal and GNSS observables can improve the positioning accuracy and high-precision positioning convergence time of the GNSS receiver. However, the GNSS signal receiving capability cannot be improved from this data fusion level. We propose a novel assisted structure where GNSS signal acquisition and Doppler tracking are assisted by LEO Doppler positioning. The receiver uses the LEO signal to achieve Doppler positioning firstly. Then, the coarse position with the GNSS navigation messages received from LEO, as well as the estimated clock information, is used to assist in the acquisition and tracking of GNSS. In this way, the GNSS receiver's sensitivity can get the benefit from this integrated system. The paper presents the structure of the assisted receiver and analyzes the assisted GNSS signal acquisition and carrier tracking performance in detail. Simulation experiments of this assisted structure are carried out to verify its superiority of acquisition and tracking sensitivity in comparison with standalone GNSS receivers. Theoretical analysis and experimental results show that the proposed acquisition method can achieve 90% detection probability at a carrier-to-noise ratio (C/N0) of 15 dB-Hz, which is about 8 dB higher than the conventional acquisition method without assistance; the proposed tracking method can track weak signals of 5 dB-Hz, which is about 4 dB higher than the conventional method. Therefore, this novel LEO-assisted receiver has significantly improved weak signal acquisition and tracking sensitivity.

A Non-Linear Filtering Algorithm Based on Alpha-Divergence Minimization.

A non-linear filtering algorithm based on the alpha-divergence is proposed, which uses the exponential family distribution to approximate the actual state distribution and the alpha-divergence to measure the approximation degree between the two distributions; thus, it provides more choices for similarity measurement by adjusting the value of α during the updating process of the equation of state and the measurement equation in the non-linear dynamic systems. Firstly, an α -mixed probability density function that satisfies the normalization condition is defined, and the properties of the mean and variance are analyzed when the probability density functions p ( x ) and q ( x ) are one-dimensional normal distributions. Secondly, the sufficient condition of the alpha-divergence taking the minimum value is proven, that is when α ≥ 1 , the natural statistical vector's expectations of the exponential family distribution are equal to the natural statistical vector's expectations of the α -mixed probability state density function. Finally, the conclusion is applied to non-linear filtering, and the non-linear filtering algorithm based on alpha-divergence minimization is proposed, providing more non-linear processing strategies for non-linear filtering. Furthermore, the algorithm's validity is verified by the experimental results, and a better filtering effect is achieved for non-linear filtering by adjusting the value of α .

Decrease in lipid metabolic indexes in infants with neonatal respiratory distress syndrome.

Incomplete pulmonary function and insufficient production of pulmonary surfactant in premature infants may affect alveolar relaxation, inducing neonatal respiratory distress syndrome (NRDS). The present study was a retrospective comparison of lipid metabolism indexes and clinic information between NRDS and non-NRDS infants. Data on general information, pregnancy, clinical symptoms, family history as well as plasma biochemical and lipid metabolic indexes were retrospectively collected and statistically analyzed from 79 patients with NRDS and 44 non-NRDS infants. Infants in the NRDS group showed lower body weight (2,055 vs. 3,225 g) and gestation age (33.39 vs. 38.53 weeks) than those in the non-NRDS group (P<0.05). Baseline information was corrected by the inverse probability of treatment weighting (IPTW) analysis. The weighted adjusted median age was the same in both groups and there was no significant difference between two groups in birth weight. The IPTW analysis revealed that the levels of plasma triglyceride (TG), total cholesterol, low-density lipoprotein, free triiodothyronine, free thyroxine, glucose, calcium (Ca2+) and phosphorus in the NRDS infants were significantly lower compared with those in the non-NRDS infants. Additionally, NRDS infants had significantly higher incidence rates of pneumonia, sepsis, brain injury infection, preterm birth, patent foramen ovale, patent ductus arteriosus and premature rupture of membranes compared with the non-NRDS infants (P<0.05). Multivariate logistic analysis showed that TG and Ca2+ were risk factors associated with NRDS (P<0.05). Infants with NRDS have significantly lower levels of plasma lipid indexes. The results of the present study provide data to guide the clinical management of NRDS.

Polymorphism of fucosyltransferase 3 gene is associated with inflammatory bowel disease: a systematic review.

Background: Inflammatory bowel disease (IBD) is a condition with an unclear genetic basis. Fucosyltransferase 3 (FUT3) could potentially be linked to IBD susceptibility. Objective: To investigate the association between FUT3 gene polymorphisms and IBD. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist and Population, Intervention, Comparison, Outcomes, and Study (PICOS) guidelines, case-control studies published until April 30, 2020 was searched. Two independent reviewers conducted screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Meta-analysis, sensitivity analysis, and Egger tests were performed using RevMan and Stata12.0. Results: The review included 5 articles and 12 case-control studies involving 1712 IBD patients and 1903 controls. The meta-analysis revealed the following combined odds ratios [95% confidence intervals]: rs3745635 genotype (GA+AA vs GG) 0.84 (0.72-0.97), (GG+GA vs AA) 1.93 (1.23-3.05), (GG vs AA) 2.38 (1.52-3.74), (A vs G) 0.84 (0.73-0.96); rs3894326 genotype (TA+AA vs TT) 1.03 (0.87-1.23), (TT+TA vs AA) 1.19 (0.56-2.51), (TT vs AA) 1.19 (0.56-2.51), (A vs T) 1.02 (0.86-1.20); rs28362459 genotype (TG+GG vs TT) 0.98 (0.85-1.12), (TT+TG vs GG) 1.20 (0.90-1.61), (TT vs GG) 1.21 (0.90-1.62), (G vs T) 0.96 (0.86-1.07). Sensitivity analysis indicated the stability of the results, and Egger analysis showed no significant publication bias. Conclusions: The rs3745635 gene polymorphism may be associated with IBD susceptibility, whereas the rs3894326 and rs28362459 gene polymorphisms may not be associated with IBD.

A Case Report of Heterotopic Ossification Caused by High-Voltage Electric Injury.

This case report described the diagnosis and treatment of a patient with ectopic bone injury due to high-pressure electric shock. A 24-year-old male patient suffered from burns that covered 50% of TBSA, including on limbs and torso, after coming into contact with 10-kV high-voltage electricity. A repeated Meek micrografting technique (MEEK) was applied for wound healing; skin grafts were cut into micrografts and expanded at a ratio of 1:4 to cover large areas after burn trauma. After the injury, right elbow redness, fever, pains, and joint movement disorder were reported by the patient, which might be attributed to excessive exercises and acute scarring. However, these symptoms were not treated immediately. Six months after the injury, his right elbow joint showed 90° locking and a restricted 5° movement capacity. X-ray examination revealed a new bone formation at the inner tibia shin. In addition, 3D CT showed the formation of right tibia, the ruler bone, and the skull of the humming bridge. Under general anesthesia, the right elbow joint was released, the medial collateral ligament was repaired, and the hinge external fixator was fixed. A large number of hyperplastic bone masses were found at the right elbow joint during surgery, specifically in the foot bone hawk's beak nest. No complications after surgery were observed. X-ray examination in February showed disappearance of the bone bridge and normal relationship of the right elbow joint. This case study revealed that electric shock injury could lead to ectopic bone formation, and much attention should be paid on any changes that indicate aseptic inflammation, such as redness, swelling, fever, and pain during the treatment process. Finally, identification of the scar constriction phase could indicate surgical treatment in order to promote the limb rehabilitation process.

[The influence of JNK inhibitor on hemodynamics after ischemia/reperfusion injury to the heart in rats].

OBJECTIVE: To investigate the effect and mechanism of JNK mitogen-activated protein kinases (JNK MAPKs) inhibitor SP 600125 on hemodynamics after ischemia/reperfusion (I/R) injury to heart in anesthetized rats. METHODS: Thirty-six healthy adult Sprague-Dawley (SD) rats were randomly divided into six groups (each n=6): sham operation (SO) group, I/R group, three JNK inhibitor groups (model groups) and ligustrazine hydrochloride (LH) group. In the SO group, a silk suture was passed underneath a main branch of the left coronary artery without tying. In the rest groups, the left coronary artery was occluded lasting for 30 minutes followed by reperfusion for 180 minutes. In the model groups, SP 600125 was intravenously administered 5 minutes before the end of the ischemia period, and continued during reperfusion period with a total dose of 4.7, 14.4 and 47.9 mg/kg respectively. Control animals received normal saline or LH 30 mg/kg in the same manner. The changes in hemodynamics, including heart rate (HR), mean blood pressure (MBP), maximal change rate of intraventricular pressure rise/down (+/-dp/dt max),left ventricular systolic pressure (LVSP), LVDP' [LVDP'=LVSP-left ventricular diastolic pressure (LVDP)], left ventricular end-diastolic pressure (LVEDP), were determined during I/R. RESULTS: There was no statistical difference in hemodynamics among the groups before occluding. The values of HR, MAP, +/-dp/dt max, LVSP, LVDP' in I/R group were significantly lower than those in SO group, and LVEDP was significantly higher. Compared with I/R group, +/-dp/dt max, LVSP, LVDP' in model groups and LH group were significantly higher (P<0.05 or P<0.01). There was no significant change in HR, MBP and LVEDP after the administration of JNK inhibitor or LH. CONCLUSION: Both JNK inhibitor and LH ameliorate cardiac systolic and diastolic dysfunction induced by I/R, without influence on MBP and HR in anesthetized rats.

Inactivation of Staphylococcus aureus in water by pulsed spark discharge.

A pulsed spark plasma discharge system was developed and tested as an energy efficient water sterilization method. A 5 log10 reduction on Staphylococcus aureus concentration of 108 CFU/ml was obtained. Complete inactivation was achieved for concentration of 106 CFU/ml. Of the various factors generated by an underwater spark discharge, ultraviolet radiation plays a major role. The inactivation was completely suppressed by the addition of 30 mg/L of a soluble sunscreen, Benzophenone-9. Results obtained using the pulsed spark plasma discharge showed that this system has several advantages, such as high energy efficiency, absence of harmful by-products and portability, over the conventional sterilization methods.

Platelet generation in vivo and in vitro.

Platelet (PLT) transfusion, which is the primary cell therapy for thrombocytopenia, has been a source of concern in recent years due to its limitations of donor-dependent supply and soaring costs. In vitro platelet generation on an industrial scale is a possible solution requiring exploration. The technology of platelet generation ex vivo has been widely studied across the world, though the mechanisms of physiological thrombopoiesis and platelet biology function in vivo still remain elusive today. Various culture systems have been studied, most of which proved quite inefficient in generating functional platelets ex vivo, so there is still a long way to reach our ultimate goal of generating a fully functional platelet in vitro on an industrial scale. This review integrates the latest research into physiological platelet biogenesis and ex vivo-platelet/megakaryocyte (MK) generation protocols with a focus on the ability to generate PLT/MK in large quantities, summarizes current culture systems based on induced human pluripotent stem cells and adipose-derived stem cells, and discusses significant challenges that must be overcome for these approaches to be perfected.

Platelet-rich plasma reduces skin flap inflammatory cells infiltration and improves survival rates through induction of angiogenesis: An experiment in rabbits.

BACKGROUND: This study was conducted to evaluate the effects of platelet-rich plasma (PRP) on flap survival in an experimental rabbit model. METHODS: Symmetrical rectangular dorsal cutaneous flaps (8 × 2 cm) were elevated in 15 rabbits. The rabbits were randomly divided into a 3-day group (n = 5), a 7-day group (n = 5), and a 14-day group (n = 5). Either side of the dorsum was selected for injection of PRP into the flap basal surface, while the other side received an equal volume of saline as a control. The flaps were immediately sutured back, after which the flap survival was measured and histology specimens were collected at 3, 7, and 14 days. RESULTS: Platelet-rich plasma significantly improved flap survival rates of the PRP side flaps relative to the control in the 3-day (74.4% ± 4.7% vs 65.8% ± 6.8%; p < 0.05), 7-day (72.4% ± 7.5% vs 58.5% ± 7.0%; p < 0.05), and 14-day (74.5% ± 5.0% vs 65.0% ± 5.4%; p < 0.05) groups. Histological analysis revealed significantly fewer inflammatory cells and an increased blood vessel density in the platelet-rich plasma side flap vs the blank control side flap. CONCLUSION: Platelet-rich plasma (PRP) promotes the survival of random rabbit flaps and, therefore, represents a promising treatment to prevent skin flap necrosis in reconstructive and plastic surgery.

[Advance in the research of platelet-rich plasma in burn treatment].

Platelet-rich plasma (PRP) is the plasma derived from the repeatedly centrifuged whole blood, and it contains high concentration of platelets. The growth factors and concentrated platelets in PRP play important roles in proliferation, division, and differentiation of cells, and wound repair. In the past, PRP was used in the treatment of bone fracture, bone defect, soft tissue injury, and refractory wound. In recent years, it had been used in burn treatment, but it provoked some disputes. This article reviews the advance in the research of PRP in burn treatment and discusses the problems in its clinical application.

[Improving myocardial mechanics parameters of severe burn rabbits with oral fluid resuscitation].

OBJECTIVE: To investigate the protective effect of oral fluid resuscitation on cardiac function in severe burn rabbits. METHODS: One hundred and fifty rabbits were randomly divided into normal control group (NC group, n = 6, without treatment), burn group (B group, n = 42, without fluid therapy), immediate oral fluid resuscitation group (C group, n = 42), delayed oral fluid resuscitation group (D group, n = 30) and delayed and rapid oral fluid resuscitation group (E group, n = 30). The rabbits in B, C, D, E groups were subjected to 40% TBSA full-thickness burn, then were treated with fluid therapy immediately after burn (C group), at 6 hour after burn (D, E groups). The myocardial mechanics parameters including mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), LV +/- dp/dt max were observed at 2, 6, 8, 12, 24, 36 and 48 post burn hour (PBH). Urine output was also examined. RESULTS: The level of LVSP, LV +/- dp/dt max in B roup were significantly lower than those in NC group. The level of LVSP, LV +/- dp/dt max in the C and E group were singnificantly increased during 24 hour after burn. The level of LV + dp/dt max and LV-dp/dt max in C group peaked at 8 PBH (892 +/- 116 kPa/s) and at 6PBH (724 +/- 149 kPa/s) respectively. The levels of LV +/- dp/dt max, LVSP in D group at each time point were similar to B group (P > 0.05). Both the levels of LV +/- dp/dt max in E group peaked at 8 PBH. The level of LVEDP was no obvious difference between B and other groups at each time point (P > 0.05). The changes of MAP and urine output on 24 PBH in each group were similar to above indices. CONCLUSION: Effective oral fluid therapy in severe burn rabbits during 24 hours after burn can ameliorate myocardial mechanics parameters. The amount of fluid resuscitation can be estimated according to relevant formula for delayed fluid resuscitation in burn rabbits.

[The protective effect of high density lipoprotein on the lung function of rats with severe burns].

OBJECTIVE: To explore the protective effect of high density lipoprotein on the lung function of rats with severe burns. METHODS: One hundred and thirty-five Wistar rats were employed in the study and were randomly divided into control (n = 15, without injury), burn (n = 60, with 30% TBSA full-thickness burn on the back) and experimental [(n = 60, with the injection of HDL (80 mg/kg) via the caudal vein immediately after burns)] groups. The rats in the latter two groups were resuscitated with intraperitoneal isotonic saline (50 ml/kg) 30 minutes after burns. The serum content of ICAM-1 and TNF-alpha as well as the blood content of PCO2 and PO2 of the rats in burn and experimental groups were determined at 12, 24, 48 and 72 post-burn hours (PBH) and in control group. The pathological changes in the lung tissue of the rats in all groups were observed under light microscope and electronic microscope at 48 PBH. RESULTS: PCO2 and the contents of ICAM-1 and TNF-alpha in burn group were significantly higher, but the PO2 was lower than those in control group at each time-point (P < 0.05 or P < 0.01). There were no obvious differences in the above indices between the experimental and control groups (P > 0.05), but the ICAM-1 and TNF-alpha levels in experimental group were markedly decreased than those in burn group at each time-point (P < 0.05 or P < 0.01). The ICAM-1 and TNF-alpha contents in burn group at 48 PBH were (3.42 +/- 0.25) microg/L and (4. 04 +/- 0.28) ng/L, respectively, which were markedly higher than those in experimental group [(2.24 +/- 0.14) microg/L, (3.35 +/- 0.22) ng/L, P < 0.05 or P < 0.01]. Dilation of capillaries, congestion and inflammatory infiltration in the pulmonary capillaries, and loosening of conjunction between pulmonary capillary vascular endothelial cells and endothelial swelling were observed in burn group at 48 PBH. Compared with the burn group, the injury was markedly alleviated in the experiment group, and the pulmonary capillary endothelial cells showed tighter junction. CONCLUSION: HDL exhibits a protective effect on the lung function of rats with severe burns via reducing the expression of ICAM-1 and TNF-alpha.

[Genioplasty with morselized autologous bone graft].

OBJECTIVE: To investigate a new method of genioplasty for treatment of a prominent mandibular angle with mandibular malformation. METHODS: According to the different types of the mandible, the prominent mandibular angle was grinded with the masseter muscle kept intact. Autologous micromorselized bone of the grinded mandibular angle was collected and implanted into the chin for augmentation mentoplasty, and the chin was fixed with gypsum after operation. RESULTS: Fifteen patients receiving the surgery were followed up for 6 -12 months, and satisfactory effects were achieved in 12 patients. One patient requested modification of the shape of the chin 10 days after the operation, and another two sustained chin distortion due to external forces and underwent subsequent shape adjustment of the chin. CONCLUSION: The procedure described avoids graft rejection and causes less complications for genioplasty with easy moulding and satisfactory outcome.

[Expression of alpha-melanocyte-stimulating hormone in human split-thickness skin graft].

OBJECTIVE: To investigate the expression of alpha-melanocyte-stimulating hormone (alpha-MSH) in human split-thickness skin autograft and the role of alpha-MSH in hyperpigmented process of the grafted skin. METHODS: Immunohistochemical technique was used to detect the expression and distribution of alpha-MSH in the split-thickness grafted skin and normal skin separately. RESULTS: The expression of alpha-MSH in most of the split-thickness grafted skin was much stronger than the control skin. The positive ratio of alpha-MSH expression was 61.1% in the split-thickness grafted skin, 11.1% in the normal skin of the donor area and 16.7% in the normal skin around the recipient area. The expression of alpha-MSH in the split-thickness grafted skin was significant high, compared with the normal skins (P < 0.01). The expression of alpha-MSH in the normal skin of the donor area was no statistic remarkably differences compared to the normal skin around the recipient area. CONCLUSION: The results indicate that the expression of alpha-MSH may markedly increase in the split-thickness grafted skin and correlate with its pigmentation after the skin graft. Overexpression of alpha-MSH may play an important role in hyperpigmented process of the skin graft.

[The application of tourniquet in burn patients during tangential excision on the extremities].

OBJECTIVE: To investigate the application of tourniquet in burn patients during tangential excision on the extremities. METHODS: Seventy - nine burn patients who were arranged to receive tangential excision and skin grafting on the extremities were randomly divided into A and B groups. The patients in A group (n = 41) underwent the operation with the tourniquet applied continuously throughout the operation, while those in B group (n = 38), only with tourniquet applied during tangential excision. The amounts of blood loss and blood transfusion, the operation time and the take rate of grafted skin and the incidence of complications were investigated and recorded. RESULTS: The amounts of blood loss and blood transfusion during operation in A group were 42% and 50% less than those in B group, respectively (P < 0.001). Moreover, the operation time on the upper and lower extremities in A group was much shorter (for 41% and 37%, respectively) than those in B group (P < 0.001). In addition, there was no difference of the take rate of skin graft and the incidence of subcutaneous hematoma between the two groups (P > 0.05). CONCLUSION: Continuous tourniquet application during tangential excision on the extremities in burn patients was proved to be effective in reducing operational blood loss, blood transfusion and in shortening operation time.