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2020 Vol. 50, No. 6 Published: 2020-06-25   431 Preparation and physicochemical properties of low immunogenic heterogeneous acellular nerve matrix WANG Jianying, LI Fanghong, LI Huaqiong, WANG Ronghua, WANG Chenfei, ZHAO Allan Zijian DOI: 10.3969/j.issn.2095-9400.2020.06.001 Objective: To prepare low immunogenic xenogeneic decellularized nerve matrix and evaluate its biological properties. Methods: To prepare low immunogenic xenogeneic decellularized nerve matrix by decellularizing the α-1, 3-galactoside transferase gene-knockout (GTKO) pig sciatic nerve with a self-designed combination protocol of hypotonic solution, trypsin, detergent, and nuclease. The decellularization was evaluated by HE, DAPI staining, and the amount of residual DNA. Immunohistochemical staining of type-I collagen, laminin, fibronectin, and Sirius scar staining were used to assess the retention of extracellular matrix components of acellular nerve. A-gal immunofluorescence was used to detect the residual of the heterologous antigen, a-gal. Finally, the three-dimensional (3D) structure and porosity of acellular nerves were analyzed by scanning electron microscopy (SEM). Results: DNA content in the decellularized nerve tissue was 95% lower than that in the natural nerve tissue, and there were few cellular components in the endoneurium, perineurium, and epineurium of acellular nerve. Sirius scar staining and immunohistochemistry showed that the decellularized nerve tissue retained collagen fibers and major extracellular matrix proteins. SEM results showed that the acellular nerve retained its three-dimensional (3D) structure. Cytotoxicity tests showed that the acellular nerve matrix was not cytotoxic. Conclusion: The self-designed decellularization protocol of this study can completely remove the cellular components and heterologous antigens in the nervous tissue, and retain the neural tissue structure more completely. With high similarity to the natural nerves, it has great potential for application as nerve grafts in the future. 2020 Vol. 50 (6): 431-437 [Abstract] ( 787 ) HTML (1 KB)  PDF (1700 KB)  ( 783 ) 438 Changes of miR-34a and GPS2 expression and their effects on JNK pathway protein in acute kidney injury CHEN Weiwei, WANG Dexuan, SHEN Meng, ZHUANG Jieqiu, CAI Hui DOI: 10.3969/j.issn.2095-9400.2020.06.002 Objective: To explore the expression changes of miR-34a and GPS2 and their effects on p-JNK in ischemia-reperfusion and hypoxia/reoxygenation models. Methods: Thirty SD rats were randomly divided into 6 groups (n=5). Serum and kidney tissues were collected from the perfusion control group (0 h, 24 h, 48 h) and the perfusion model group (0 h, 24 h, 48 h). HEK 293T cells were divided into control group (Control, NC inhibitor) and model group (Model, Model+miR-34a inhbitor). RNA and protein were extracted from the cells.The levels of tumor necrosis factor (TNF-α) and transforming growth factor (TGF-β) in serum were measured by ELISA kit. The pathological changes of kidney tissues were compared by hematoxylin-eosin (HE). The mRNA changes of miR-34a and GPS2 were detected by RT-qPCR, and the protein expressions of GPS2 and p-JNK were detected by Western blot. Results: HE results showed that renal tubular injury in the model group had epithelial cell swelling, brush edge disappearance and vacuolation formation, compared with the control group. ELISA results showed that there was no difference in TNF-α and TGF-β levels between the model group and the control group before and after the establishment of the model. TNF-α and TGF-β levels in the model group increased with the perfusion time and significantly higher than the respective control group (P<0.01). Compared with the control group, the damage of renal tubules in the model group had swelling of epithelial cells, disappearance of brush border and formation of vacuoles. The expressions of miR-34a and p-JNK increased in the model group (P<0.05), while GPS2 decreased (P<0.05). Cell PCR and Western blot show that GPS2 increased significantly (P<0.05) and p-JNK decreased significantly (P<0.05) after miR-34a was silenced. Conclusion: miR-34a may indirectly activate JNK pathway through GPS2, and then promotes and aggravates the occurrence of acute kidney injury. 2020 Vol. 50 (6): 438-443 [Abstract] ( 676 ) HTML (1 KB)  PDF (1568 KB)  ( 763 ) 444 Apelin-13 rescues bupivacaine-induced cardiac arrest in rats by activating ERK1/2 pathway WANG Shi, HE Yuting, CHEN Zhengjie, LIN Tingting, WANG Quanguang, LIN Li’na DOI: 10.3969/j.issn.2095-9400.2020.06.003 Objective: To explore the role and mechanism of Apelin-13 in bupivacaine-induced cardiac arrest in rats. Methods: Thirty-five male SD rats were randomly divided into three groups: sham operation group (Sham group, n=5), bupivacaine+saline group (A group, n=15), bupivacaine+Apelin (B group, n=15). Rat femoral artery and vein open, intravenous bolus of bupivacaine 30 mg·kg-1 was injected to cause cardiac arrest. B group was immediately given 150 μg of Apelin-13, and A group was injected intravenously with the same amount of normal saline. Cardiac arrest was recorded as zero and cardiopulmonary resuscitation (CPR) was started until ROSC (return of spontaneous circulation) or the end of a 40 min period. The survivors were sacrificed 120 minutes after ROSC observation, and myocardial tissue was retained. The rate of the recovery, the rate of survival, the time from initiation of bupivacaine to cardiac arrest (T0), the time from the start of CPR to the first spontaneous heartbeat (Ts), and the time from the start of CPR to ROSC (Tr) and hemodynamics were recorded. The expression of APJ, ERK1/2 and p-ERK1/2 protein in myocardial tissue was detected by Western blot and the concentration of Apelin-13 in myocardial tissue by ELISA. Results: The results showed that compared with the Sham group, the expression of Apelin-13, APJ, p-ERK1/2 protein were signally down-regulated (P<0.05) in the A group. Compared with the A group, the recovery rate and the survival rate were increased, Tr shortened, he modynamics improved significantly after ROSC and the expressions of Apelin-13, APJ, p-ERK1/2 protein were signally up-regulated (P<0.05) in the B group. Conclusion: Apelin-13 can rescue bupivacaine-induced cardiac arrest in rats, and the mechanism may be related to activation of ERK1/2 pathway protein phosphorylation. 2020 Vol. 50 (6): 444-448 [Abstract] ( 634 ) HTML (1 KB)  PDF (1508 KB)  ( 644 ) 449 The protective effect of vitamin B12 on nerve cells damaged by oxidative stress YE Luxia, XU Lifei, XUE Yujie, TONG Heyan, HE Yifang, LI Xiaokun DOI: 10.3969/j.issn.2095-9400.2020.06.004 Objective: To explore the protective effect of Vitamin B12 pretreatment on PC12 cell injury induced by hydrogen peroxide and of its influence on autophagy and apoptotic protein expression. Methods: PC12 cells were divided as the control group (Control) with RPMI 1640 culturethe injury group (H2O2) with RPMI 1640 culture plus 200 μmol/L hydrogen peroxide stimulation and the Vitamin B12 protection group (H2O2+Vit B12) with RPMI 1640 culture plus 200 μmol/L vitamin B12 and 200 μmol/L hydrogen peroxide stimulation. Cell growth was examined 24 h later, and apoptosis and autophagy-related protein expression were detected by Western blot. Results: Compared with the Control group, the cell survival rate, the level of cell DNA replication, the expression level of Bcl-2 and P62 protein, the expression level of Bax, ATG-5 and LC3 protein, and the activation number of LC3 in cytoplasm increased significantly in the injury group (all P<0.05). Compared with the injury group, the cell survival rate and the level of cell DNA replication in the vitamin B12 protected group increased, the expression level of Bcl-2 and P62 protein increased, the expression level of Bax, ATG-5 and LC3 protein significantly decreased, and the activation number of LC3 in the cytoplasm decreased (all P<0.05). Conclusion: Vitamin B12 can inhibit oxidative stress-induced apoptosis by regulating autophagy. 2020 Vol. 50 (6): 449-453 [Abstract] ( 1034 ) HTML (1 KB)  PDF (2074 KB)  ( 804 ) 454 Differences of immune cell composition between colorectal cancer and normal colorectal tissue WU Linfeng, SUN Yongji, YE Lele, SHEN Xian, XUE Xiangyang, SHEN Shurong DOI: 10.3969/j.issn.2095-9400.2020.06.005 Objective: To investigate the infiltrated immune cells in colorectal cancer patients and normal people, and to provide new ideas and directions for cancer related research. Methods: Gene expression profiles of 51 normal people and 333 colorectal cancer (CRC) patients from GEO database were analyzed, and CIBERSORT was used to transform the gene expression profile data into the infiltration ratio of 22 kinds of immune cells, and the distribution of these immune cells in both groupd of patients was compared. Results: The composition of intestinal infiltrated immune cells was significantly different between CRC patients and healthy people. The infiltration of T cells and B cells in tumor tissue was less than that in healthy people, while the infiltration of macrophages, neutrophils, mast cells and dendritic cells in tumor tissue was more than that in healthy people. Conclusion: There are great differences in the infiltration of immune cells in colorectal tissues between CRC patients and healthy people. These different immune cells may play an important role in the development of cancer. 2020 Vol. 50 (6): 454-460 [Abstract] ( 834 ) HTML (1 KB)  PDF (1563 KB)  ( 1123 ) 461 Study on the relationship between myopia progression and accommodative functions in children CHEN Yunyun, DING Chenglu, BAO Jinhua, LI Xue, HUANG Yingying, CHEN Hao DOI: 10.3969/j.issn.2095-9400.2020.06.006 Objective: To study the changes of accommodative parameters in myopic children during their myopia progression and analyze their roles in myopia progression. Methods: Totally 21 myopic children with mean age of (11.1±1.5) years old were enrolled in this study. Distance accommodative facility and dynamic accommodative stimulus-response curve (ASRC) of right eyes were measured upon enrollment and at 2-year follow-up. Results: Myopia of 21 children significantly progressed (-1.55±0.58) D in 2 years (t=12.24, P<0.01). There were no statistical differences in distance accommodative facility and ASRC related parameters between baseline and 2-year visit (all P>0.05). Accommodative lag was statistically significant only when accommodative stimulus was 4 D (t=-2.018, P=0.048) and there were no statistical differences under other accommodation stimuli (all P>0.05). Multilinear regression analysis found myopia progression was only positively correlated with age (R2=0.186, P=0.029), but not related to accommodative parameters at baseline. Conclusion: During myopia progression in children, accommodative function remains relatively stable. Myopia progression is not related to accommodative parameters, but affected by age. The younger the child, the faster myopia progresses. 2020 Vol. 50 (6): 461-464,470 [Abstract] ( 596 ) HTML (1 KB)  PDF (1452 KB)  ( 1035 ) 465 Study on miRNA expression and target genes in serum of patients with polycystic ovary syndrome and insulin resistance and the intervention of metformin WANG Chenye, DING Caifei DOI: 10.3969/j.issn.2095-9400.2020.06.007 Objective: To study the effect of metformin on the serum gene expression profiles in polycystic ovary syndrome (PCOS) patients with insulin resistance (IR). Methods: Six PCOS-IR patients were selected for the metformin treatment group and six healthy women of childbearing age as the control group. Gene chip and RT-PCR were used to study the changes of serum miRNA expression in clinically diagnosed PCOS-IR patients and the changes of serum miRNA expression after metformin intervention. For miRNAs with differential expression after screening and validation, bioinformatics method was used before gene ontology and KEGG pathway databases were used for function and pathway analysis. Results: The results of cluster analysis showed that there were differences between the untreated PCOS-IR group and the healthy control group as well as before and after metformin treatment in PCOS-IR patients. RT-PCR validated that there were 10 differentially expressed miRNAs in the untreated PCOS-IR group compared to the healthy control group, and 8 differentially expressed miRNAs before and after metformin treatment in PCOS-IR patients. GO analysis showed that the differentially expressed genes were related to transcription regulation, signal transduction, transmembrane transport, cell proliferation, cell apoptosis, cell metabolism, cell adhesion, protein phosphorylation, protein transport, multicellular biological development, coagulation function, nerve conduction, etc. KEGG analysis showed that the differentially expressed miRNAs were significantly involved in the following pathways: EGFR tyrosine kinase inhibitor resistance, Rap1 signaling pathway, Wnt signaling pathway, prostate cancer pathway, mTOR signaling pathway, cAMP signaling pathway, phosphatidylinositol signaling system, MAPK signaling pathway. With this method to narrow the search scope, 878 genes were obtained and related to insulin resistance and metformin therapy in PCOS patients. Conclusion: Some miRNAs were suggested to be involved in the pathogenesis of insulin resistance in PCOS patients and the treatment process of metformin. 2020 Vol. 50 (6): 465-470 [Abstract] ( 642 ) HTML (1 KB)  PDF (1601 KB)  ( 635 ) 471 Pregnancy outcomes of patients in two endometrial preparation protocols after endometrial polypectomy: a comparative study XU Jialing, SU Weijue, CHEN Yufeng, FU Yanghua, XI Haitao, ZHAO Junzhao DOI: 10.3969/j.issn.2095-9400.2020.06.008 Objective: To investigate the potential of gonadotropin-releasing hormone agonist down-regulated hormone replacement therapy (GnRH-a+HRT) and hormone replacement therapy (HRT) for patients after endometrial polypectomy. Methods: This study analyzed 109 patients with endometrial polypectomy in three months who underwent frozen-thawed blastocyst transfer within three months after endometrial polypectomy at Reproductive Center of the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from July 2018 to July 2019. The basic conditions of the patients, blastocyst transfer outcomes and pregnancy outcomes between two groups were compared. Results: A total of 56 patients were enrolled in the HRT group and one of them canceled the transplant and 53 patients were enrolled in the GnRH-a+HRT group. There was no significant differences between the two groups of patients in their basic conditions. Though the HRT group had lower rate of the specific infertility factor than the GnRH-a+HRT group, there was no statistically difference. No difference was found in the conditons of endometrial and blastocysts transplants between the two gruops. Compared to the HRT group, the positive rate of HCG, the rate of clinical pregnancy, the rate of embroy implantation was higher in GnRH-a+HRT group but no significant difference were found. There were no difference between the groups in the early abortion rate and multiple pregnancy. Conclusion: Both GnRH-a+HRT and HRT could achieve great pregnancy outcomes and each has its own advantages and disadvantages. For patients with endometriosis, adenomyosis, intramural myomas, polycystic ovary syndrome or hydrosalpinxs, it is suggested that the GnRH-a+HRT be considered the first choice. 2020 Vol. 50 (6): 471-474 [Abstract] ( 716 ) HTML (1 KB)  PDF (1391 KB)  ( 734 ) 475 Diagnosis of benign and malignant breast lesions based on DCE-MRI by using radiomics and deep learning with different networks ZHOU Jiejie, ZHANG Yang, SU Minying, HE Xiaxia, XU Ni’na, YE Shuxin, LI Jiance, WANG Ouchen, WANG Meihao DOI: 10.3969/j.issn.2095-9400.2020.06.009 Objective: To evaluate and compare the performance of radiomics and deep learning in the diagnosis of benign and malignant breast lesions based on DCE-MRI. Methods: A total of 152 patients receiving breast MRI for diagnosis were analyzed, including 93 patients with malignant cancers, and 59 patients with benign lesions. Three DCE parametric maps corresponding to early wash-in signal enhancement (SE), maximum signal enhancement, and wash-out slope were generated. Radiomics analysis based on texture and intensity histogram, and deep learning using 5 networks (ResNet50, VGG16, VGG19, Xception, InceptionV3), were performed for differential diagnosis. Results: The accuracy of radiomics was 80%; the smallest bounding box obtained higher diagnostic accuracy than that with tumor only and 1.2 times box which was not significant (both P>0.05), and also higher than 1.5 times box and 2.0 times box (both P<0.01); the accuracy of ResNet50 (93%), Xception (94%), InceptionV3 (93%) was significantly higher than VGG16 (80%), VGG19 (79%) (both P<0.01). Conclusion: CNN achieved better diagnostic performance in the diagnosis of benign and malignant breast lesions. The smaller bounding box containing the tumor with small amount of per-tumor tissue had the higher diagnostic accuracy than that with the tumor only and than larger bounding box. 2020 Vol. 50 (6): 475-479 [Abstract] ( 902 ) HTML (1 KB)  PDF (1645 KB)  ( 791 ) 480 The effect of Lianhuaqingwen on acute pulmonary embolism in rabbits CHEN Zhili, CHEN Yuxi, QIU Xianke DOI: 10.3969/j.issn.2095-9400.2020.06.010 Objective: To investigate the effect of Lianhuaqingwen (LHQW) on reducing inflammatory cytokines in a rabbit model of acute pulmonary embolism (APE). Methods: Rabbits were randomly divided into sham operation group, model group and LHQW group, with 10 rabbits in each group. In the model group and the LHQW group autologous blood clots were repeatedly injected into the main pulmonary artery of the rabbits to establish the APE model. After the model was established, the LHQW group was intragastrically administered with LHQW 0.42 g/kg; the sham operation group and the model group were intragastrically administered with an equal amount of 0.9% NaCl solution. The changes in arterial blood gas, hemodynamics and inflammatory factors at different time points were compared among the three groups. Results: Compared with the model group, PaO2 was significantly higher at 1 and 8 hours post LHQW treatment (P<0.05). Compared with the model group, the MPAP in the LHQW group was significantly reduced at 1, 2, 4, and 8 hours after treatment (P<0.05); compared with the model group, the MAP in the LHQW group was significantly increased at 1, 2, 4, and 8 hours after treatment (P<0.05). The levels of cTnI, NT-proBNP, TNF-α, IL-6 and IL-1β in the LHQW group were significantly lower than those in the model group at 1, 2, 4 and 8 hours after treatment (P<0.05). HE staining showed that the accumulation of neutrophils in the pulmonary embolism tissue of the LHQW group was significantly lower than that of the model group (274.6±96.0 vs. 111.5±38.1, P=0.003). Conclusion: LHQW is helpful in reducing the level of systemic inflammation and myocardial injury while improving arterial blood gas and hemodynamics in APE rabbits. It has therapeutic effect on APE to a certain extent. 2020 Vol. 50 (6): 480-484 [Abstract] ( 745 ) HTML (1 KB)  PDF (1610 KB)  ( 643 ) 485 The effect of narrative therapy on psychological intervention of patients with COPD in the end stage HU Danhong, MA Ping, XIANG Fei, WANG Mifang, ZHANG Chunmei DOI: 10.3969/j.issn.2095-9400.2020.06.011 Objective: To explore the effect of narrative therapy on improving the mental state of patients with chronic obstructive pulmonary disease (COPD) at the end of the period and its influence on the attitude towards death. Methods: From January 2018 to June 2019, 112 patients with COPD in the Second Affiliated Hospital of Wenzhou Medical University were selected. Due to 6 patients lost to follow-up, there were 52 patients in the control group and 54 patients in the experimental group. The control group was given routine psychological care, while the patients in the experimental group was treated by narrative therapy to give psychological intervention. SDS, SAS, POMS and EORTC QLQ-C30 were conducted on patients and their death fear was assessed by the death fear scale. Results: There was no significant difference between the two groups (P>0.05). Compared with the general nursing of the control group, narrative therapy can significantly improve depression and anxiety degree (control group vs. experimental group, SAS score: 30.31±4.29 vs. 22.12±3.28; SDS score: 33.35±2.64 vs. 24.23±3.98). The difference between the two groups was statistically significant (P<0.05). Narrative therapy can significantly improve patients’ mood (P<0.05). The intervention of therapy could significantly improve the natural acceptance score and reduced fear of death and acceptance of escape (P<0.05), thus significantly improving the life quality of patients (P<0.05). Conclusion: Narrative psychological intervention can effectively reduce the level of anxiety and depression in patients with COPD at the end of the period, alleviate the pessimistic mood of patients and fear of death, and therefore improve the life quality of patients. 2020 Vol. 50 (6): 485-488,492 [Abstract] ( 694 ) HTML (1 KB)  PDF (1432 KB)  ( 944 ) 489 The effect of modified prone position ventilation on pressure injury in ARDS patients ZHENG Xiaoqian, LI Aidan, CHEN Wangfeng, LIN Xiaowen, ZHANG Xiaolong DOI: 10.3969/j.issn.2095-9400.2020.06.012 Objective: To investigate the effect of modified prone position ventilation on pressure injury of ARDS patients. Methods: During January 2015 to January 2019, 68 patients required prone position ventilation in the Department of Anesthesia and Critical Care were included in our study. The patients were randomly divided into the control group (n=33) and the intervention group (n=35). Patients in the control group received ventilation in 0° continuous prone position for 16 hours. In the intervention group, 35 patients were placed in 30° left lateral prone position and 30° right lateral prone position alternately, and each position was maintained for 2 hours with the head of bed elevated 30°. After 16 hours, the patients were changed to supine position. The incidence of pressure injury in different locations and stages were compared between two groups. Results: We found 47 pressure injuries that occurred in 14 patients in the control group including 26 injuries in stage 1 and 21 in stage 2. Importantly, total 15 pressure injuries were found in intervention group including 10 injuries in stage 1 and 5 in stage 2. The incidence of pressure injury was 42.42% in the control group while 17.14% in intervention group. There were statistical differences in the incidence of pressure injury in different locations and stages between the two groups (P<0.05). Conclusion: The results suggest that the modified prone position ventilation could reduce the incidence of pressure injury. 2020 Vol. 50 (6): 489-492 [Abstract] ( 657 ) HTML (1 KB)  PDF (1424 KB)  ( 734 ) 493 Factors affecting penile erectile dysfunction in male patients with obstructive sleep apnea syndrome LI Guoping, JIANG Na, JIN Xiaosheng DOI: 10.3969/j.issn.2095-9400.2020.06.013 Objective: To investigate the factors that cause penile erectile dysfunction (ED) in male patients with obstructive sleep apnea syndrome (OSAS) and its possible mechanism. Methods: As measured by polysomnography (PSG) and simultaneous nocturnal penile erection (NPT), of 90 male OSAS patients 48 patients were with ED (ED group) and 42 patients without ED (OSAS group). The concentrations of serum testosterone (TT), prolactin (PRL), estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), nitric oxide (no) and nitric oxide synthetase (NOS) were measured in the next morning. Results: Compared between the two groups, there was significant difference in BMI (P<0.05), but not in sex hormone levels (P>0.05). However, the levels of NO and NOS in the ED group were significantly lower than those in the OSAS group (P<0.05), and logistic regression analysis showed that obesity, TT and NO were the main factors affecting erectile dysfunction in male OSAS (all P<0.05). Obesity was a risk factor, while TT and NO were protective factors. Conclusion: The occurrence of ED in male OSAS patients may be related to obesity, TT and NO. It was speculated that the level of NO in OSAS patients may play a key role in maintaining their erectile function. 2020 Vol. 50 (6): 493-496 [Abstract] ( 718 ) HTML (1 KB)  PDF (1403 KB)  ( 725 ) 497 Effect of health care exercise on the incidence of musculoskeletal diseases in ultrasound physicians LYU Mingshun, ZHANG Zihong, CHEN Bin, ZHENG Xiaojuan DOI: 10.3969/j.issn.2095-9400.2020.06.014 Objective: To explore whether health care exercise can prevent the occurrence of musculoskeletal diseases in ultrasound physicians. Methods: Forty-two physicians who had just engaged in ultrasound work in September 2014 were selected as the subjects of the survey, excluding those with hypertension, hyperlipidemia, arrhythmia, sleep disorders, musculoskeletal diseases or other musculoskeletal diseases. Forty-two doctors were randomly numbered and divided into experimental group and control group. They were followed up for 5 years. Among them, 21 doctors in the experimental group insisted on strengthening exercises for different muscle groups more than three times a week, while 21 doctors in the control group did not. Relevant physical examination data were collected at the end of each year, and the incidence of musculoskeletal diseases in the two groups was compared by chi-square test. Results: The prevalence of musculoskeletal diseases was 9.5% in the experimental group and 71.4% in the control group (χ2=16.701, P<0.001), which had significant difference. Conclusion: Ultrasound doctors can effectively prevent the occurrence of musculoskeletal diseases by carrying out targeted muscle group exercises in their spare time. 2020 Vol. 50 (6): 497-499 [Abstract] ( 605 ) HTML (1 KB)  PDF (1432 KB)  ( 693 ) 500 Postoperative clinical classification and nursing strategies for the arterialized venous flap transplantation Zhao Bin, Luo Xiaobin, Rao Shiming, Wu Zhipeng, Li Zhijie, Yan Hede DOI: 10.3969/j.issn.2095-9400.2020.06.015 Objective: To classify different clinical manifestations after arterialized venous flap transplantation in order to take targeted nursing interventions for the improvement of flap survival. Methods: All the cases reconstructed with free arterialized venous flaps in the Second Affiliated Hospital of Wenzhou Medical University from June 2010 to March 2019 were collected. A systematic analysis was carried out in terms of the color and tension of the flaps, the degree of swelling, the formation of blisters and the congestion status. Nursing interventions were adopted individually according to different clinical features. The survival of the flaps was taken as the main evaluation parameter. Results: A total of 64 cases including 68 arterialized venous flaps were included. According to their postoperative features, they were divided into three types: the normal physiological flap type (NPF type, 25 cases, 27 flaps), the blister formation type (BF type, 18 cases, 18 flaps), and the congestion swelling type (CS type, 21 cases, 23 flaps). Among them, all the NPF type survived uneventfully; only one partial flap loss occurred in the BF type and two partial and one total flap loss were encountered in the CS type after active conservative management. Conclusion: The clinical manifestations of arterial venous flaps are quite different. It is essential to strengthen postoperative observation and nursing interventions according to different clinical types. 2020 Vol. 50 (6): 500-505 [Abstract] ( 615 ) HTML (1 KB)  PDF (1767 KB)  ( 1153 )

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