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Hyperlipidemia is a dyslipidemia caused by dyslipidemia of lipid metabolism， which can be divided into primary and secondary types. The current clinical diagnostic criteria are mainly changes in lipid levels， which are the inducers of high-risk cardiovascular diseases such as atherosclerosis， pancreatitis and coronary heart disease. As a key target in lipid metabolism， peroxisome proliferator-activated receptor α （PPARα） is involved in a variety of metabolic activities， including fatty acid degradation， synthesis， transport， storage， lipoprotein metabolism， etc. Activation of PPARα can maintain the balance of lipid metabolism through a variety of ways， which is an important way to treat hyperlipidemia. At present， chemical drugs such as statins and bettes are mainly used in the clinical treatment of hyperlipidemia. Although they can slow down the disease to a certain extent， there are many adverse reactions and drug resistance. By reviewing the literature in recent years， the author found that the activation of PPARα pathway by traditional Chinese medicine in the treatment of hyperlipidemia has significant effect and small adverse reactions. The lipid-lowering active ingredients include flavonoids， alkaloids， phenols， terpenoids and other compounds. These active components mainly affect the expression of downstream effectors through the activation of PPARα pathway， thereby inhibiting the synthesis of total cholesterol and promoting fatty acid oxidation， and play a role in the treatment of hyperlipidemia. In this paper， we systematically reviewed the structure types and mechanism of active components of traditional Chinese medicine that activate PPARα pathway， so as to provide guidance for the rational development and clinical application of lipid-lowering traditional Chinese medicine new drugs.
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To investigate the clinical efficacy of one-stage repairing the wounds after excision of soft tissue malignant tumor in lower limb with deep inferior epigastric perforator (DIEP) flaps. Methods From Au-gust, 2016 to July, 2018, 11 patients(8 males and 3 females; aged 35-76 years) with the soft tissue defects in the low-er limb underwent immediate reconstructive operations with DIEP flap after their tumor resection. The defects ranged in area from 11 cm×7 cm to 25 cm×10 cm after extended resection, including 5 cases of bone exposure. The DIEP flap area ranged from 11 cm×8 cm to 26 cm×18 cm.Among them, 9 cases were treated with free transplantation and 2 cases with pedicle transplantation.The donor sites were closed directly. The patients’ limb function, tumor recurrence and the healing of surgical incision had been followed-up. Results Eleven flaps survived and the donor sites healed directly. One flap had skin pigmentation due to postoperative vascular crisis, and the other flaps had satisfied texture and appearance. All patients were followed-up from 6 to 30 months. The lower limb movement was normal. All the donor sites had a good healing with no pain and abdominal complications. No tumor recurrence was observed during the followed-up period. Conclusion DIEP flap have many advantages, such as large cutting area, which is suitable for large-area wound repair after extended excision of soft tissue malignant tumor in lower limb. At the same time, the perforator vessel is constant and the caliber are thick, also the donor area is concealed and can be sutured directly.This kind of the technique for reconstruction of lower limb soft tissue defects after malignant tumor resection is well acceptable.
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Objective Based on the principle of evidence-based nursing, we searched, studied and summarized a nursing pathway for patients who after transverse tibial bone transportation, and explored its effect. Methods With A set of targeted nursing intervention program, 17 patients with type 2 diabetic foot patients after transverse tibial bone transportation were nursed. After 2 months, the percentage of ulcer decreased, the visual analogue scale and the temperature of foot dorsum were used to evaluate the nursing effect. Results The average temperature of foot dorsum was (28.49±1.12)℃, the average visual analogue scale was (4.06 ± 1.40). And after 2 months, the average temperature of foot dorsum was (29.97± 1.26)℃, the average visual analogue scale was (1.94±1.92), and the area of ulcer in 15 cases (2 cases could not be counted due to toe amputations in treatment) decreased by 25%~100% , with an average of 59% , compared with that before intervention. Conclusions The implementation of evidence-based nursing can provide effective nursing intervention, relieve the pain of patients, and promote the rehabilitation of diabetic foot ulcers after transverse tibial bone transportation.
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Objective@#Based on the principle of evidence-based nursing, we searched, studied and summarized a nursing pathway for patients who after transverse tibial bone transportation, and explored its effect.@*Methods@#With A set of targeted nursing intervention program, 17 patients with type 2 diabetic foot patients after transverse tibial bone transportation were nursed. After 2 months, the percentage of ulcer decreased, the visual analogue scale and the temperature of foot dorsum were used to evaluate the nursing effect.@*Results@#The average temperature of foot dorsum was (28.49±1.12) ℃, the average visual analogue scale was (4.06±1.40) . And after 2 months, the average temperature of foot dorsum was (29.97± 1.26)℃, the average visual analogue scale was (1.94±1.92), and the area of ulcer in 15 cases (2 cases could not be counted due to toe amputations in treatment) decreased by 25%~100%, with an average of 59%, compared with that before intervention.@*Conclusions@#The implementation of evidence-based nursing can provide effective nursing intervention, relieve the pain of patients, and promote the rehabilitation of diabetic foot ulcers after transverse tibial bone transportation.
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Objective To explore the method and clinical efficacy of microsurgical reconstructive surgery af-ter malignant tumors radical resection on the surface. Methods From June, 2015 to March, 2017, a total of 32 pa-tients in this group underwent radical resection of malignant tumors. All of them resulted in a large area of soft tissue defect with loss of function.The average defect area was 10.0 cm×12.0 cm.All types of free flap and pedicle flap were selected. Myocutaneous flaps or local flaps were used to repair large areas of soft tissue defect on the basis of micro-surgical techniques to protect the blood supply of the flaps and to reduce the damage to the donor area by evaluating the defect size, surrounding anatomical characteristics, and other factors. Results Thirty-two flaps survived com-pletely. After 4 to 18 months of followed-up, the color of flap was close to that of the surrounding skin. The texture was good. There was no bloated swelling, and the skin protective sensation was restored. There was no obvious scar hyperplasia, no chills, no pain and no other complications in the donor site. Conclusion After the radical mastec-tomy of the body surface, different types of flaps can be selected for the first-stage microsurgery according to the characteristics of the different parts and the tumor excision wounds to obtain a good clinical efficacy.
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Objective@#To understand the status and progress of rapid rehabilitation nursing on orthopedics, to discuss the future direction, in order to grasp the development trend.@*Methods@#PubMed and Wanfang database were searched for the statistical materials. According to the quantity, age, country, subordinates of orthopedics and nursing strategies, all the papers were analyzed.@*Results@#Until February 2017, PubMed and Wanfang collected a total of 60 papers on the rapid rehabilitation nursing of Orthopedics, the number of papers in Chinese occupied the main position, 35 articles accounting for 58.3%.@*Conclusions@#Researchers in this field are focusing on health education, psychological comfort, rehabilitation training and pain control. The mainly research methods include observation, improvement and summary ofclinical nursing, so the conclusions of descriptiveness are more than quantitative conclusions which are from rigorous randomized controlled trials (RCTs).
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Microvascular manual suture technique is invented by doctor Carrel in 1912, it had become a core technique in microsurgery. This vascular anastomosis technique is effective. However, it also has some disadvantages such as time-consuming and labor- consuming. And as a residual foreign body, suture can also cause inflammation. In recent years, vascular couplers have been widely applied in clinic, this method ensuring the quality of anastomosis with faster speed. The four principles on ideal vascular anastomosis, which put forward by Carrel, is the target of improvement on vascular anastomosis tools. In recent years, Ring-coupling using negative pressure, vascular stents, hook stapling anastomat, fibrin glue, P407 and other new technologies have been reported, this paper will focus on the advantages and disadvantages of these technologies.